The Nursing clinics of North America
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Cardiac injuries due to blunt trauma are common and contribute to the overall mortality of the trauma victim. Such injuries may be difficult to detect, and the clinician must maintain a high degree of suspicion for their presence. Clinical findings are nonspecific, but the nurse should focus on assessing the adequacy of cardiac output and tissue perfusion. ⋯ Intravascular volume replacement is an important aspect of the resuscitation. Injuries such as aortic transection or ventricular rupture lead to exsanguination and the need for rapid infusion of large volumes of blood. On the other hand, cardiac function may be severely depressed with myocardial contusion and septal or valvular rupture; volume replacement must proceed cautiously.
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The care patients with spinal cord or head injury receive in the acute phase of their injury is critical to outcome. The basics of trauma care are of primary importance to the patient with central nervous system trauma. ⋯ Proper immobilization of the neck is a priority concomitant to establishing an airway in the SCI patient, while control of ICP is a challenge in the head-injured patient. Paramedics, nurses, and physicians who are aware of these important factors in caring for the neurotrauma patient will ensure the patient every chance of functional recovery.
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Nurs. Clin. North Am. · Jun 1986
ReviewAlterations in communication. Biopsychosocial aspects of aphasia, dysarthria, and right hemisphere syndromes in the stroke patient.
Aphasia, dysarthria, and right hemisphere syndromes will be discussed from several vantage points which are important in facilitating the nurse's role in the work of the speech pathologist. General guidelines for determining whether a patient exhibits a communicative disorder and is in need of further diagnosis and treatment will be delineated. Communication suggestions for family and staff and a checklist of deficit areas will be offered. Additionally, a description of possible psychological reactions to the disorder and their effect on the patient and his social network will be provided.
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The aforementioned social trends affecting women, including women in poverty, women in the labor force, and elderly women, are all ultimately related to problems of access to health care. In almost every age group, women use more health and medical services. Women are hospitalized more often, although their stays in hospitals tend to be shorter. ⋯ As the field of women's health expands and receives more emphasis, the data reflecting the experiences of large groups of women will have to be collected and analyzed ever more carefully. Information collected should include physiologic, psychosocial, and economic factors that together affect the health status of women. These data may then be used to guide health policy decision making, as well as provide a basis for health promotion and disease prevention interventions with individual clients.
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Nurs. Clin. North Am. · Jun 1985
Implications of the new hospice legislation and the accompanying regulations.
Recent government intervention into hospice care resulted from legislation designed to provide payment for care for Medicare recipients. The new regulations are reviewed, financial ramifications are investigated, and the possible implications of this reimbursement system are addressed.