Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing
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Peripheral percutaneous transluminal angioplasty with endovascular stent is a procedure to improve the symptoms of claudication caused by peripheral vascular disease. There is evidence to show that upward of 30% of patients seek further intervention for recurring symptoms in 1 year. ⋯ The Synergy Model is useful to develop a relationship between the patient and the nurse that promotes a lifestyle change. The outlined patient who underwent peripheral percutaneous transluminal angioplasty and the nurse characteristics within the Synergy Model lend themselves to frame a short, intense hospital stay inclusive of thorough, patient-centered teaching.
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Effort thrombosis or Paget-Schroetter syndrome most often affects young, active adults who are engaged in sports activities or whose professions require repetitive arm movements causing trauma to the axillary-subclavian vein and precipitating deep vein thrombosis. The presence of unilateral edema in the upper extremity is often thought to be attributable to trauma from an exercise regimen rather than acute deep vein thrombosis or compression of the subclavian vein by extrinsic anatomic structures. Because this syndrome occurs in young, active adults it has the potential for considerable long-term morbidity if it remains undetected or inadequately treated. ⋯ The purpose of this article is to increase the awareness of the prevalence, clinical significance, and importance of early detection of effort thrombosis of the axillary-subclavian vein, also known as Paget Schroetter syndrome, to educate health care providers regarding the limitations of some diagnostic tools, and to introduce new methods of treatment that offer better long-term results. The prevalence, differential diagnosis, diagnostic modalities, and medical and surgical interventions that have been successfully used to treat Paget-Schroetter syndrome are discussed, and evidence is provided to support the selections. The results of patients who were identified and treated within the last 2 years at the University of Southern California Center for Vascular Care are reviewed.
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Lower limb atherosclerotic disease (LLAD) is a worldwide health problem. Approximately 100,000 Finns have LLAD. Currently, a large number of health-related quality of life (HRQoL) studies are available, but we still have scant comprehensive information of HRQoL of patients with LLAD. ⋯ The HRQoL of middle-aged men was significantly poorer than that of controls. Male sex, retirement, asymptomatic walking distance, other atherosclerotic disease, lack of exercise, and feeling incapable of performing daily activities are important causes of impaired HRQoL. Health care professionals should pay extra attention to the development of rehabilitation programs aimed at preventing patients with LLAD from experiencing a myriad of problems.
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Review Case Reports
Non-heart-beating organ donation: Issues and ethics for the critical care nurse.
Non-heart-beating organ donation is an important topic that continues to be misunderstood by many health care professionals. As organ transplantation has become an accepted mode of treatment for end-stage organ failure, the need for organs has increased. ⋯ The author will review the history of organ donation, focusing on the process of non-heart-beating organ donation. A patient case study is presented to facilitate understanding of the critical care nursing role essential to the success of this process that can provide a positive outcome for families involved in very tragic situations.
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Neuropathic pain is the focus of current clinical research, clinical identification, and treatment. It is unique from nociceptive pain and requires evaluation of the relevance and utility of common pain measures created for other painful conditions. This study evaluated the psychometric properties of a modified Brief Pain Inventory (BPI) for patients with painful diabetic peripheral neuropathy (BPI-DPN). ⋯ Worst Pain and Interference ratings were significantly associated with hospital use and outpatient visits because of DPN. These results replicate, in a pure peripheral neuropathic pain condition, the BPI psychometric characteristics documented in populations with nociceptive or mixed pain conditions. The BPI-DPN is a promising instrument in the evaluation of painful DPN.