Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing
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Review Case Reports
Surviving sudden loss: when life, death, and technology collide.
Patients who survive sudden cardiac arrest are at risk for anxiety, depression, and other psychosocial difficulties. By exploring the impact of surviving sudden cardiac arrest as it relates to the expectations and emotions of patients and their families, nurses can promote realistic and readily usable processes for facilitation of healthy grieving, adaptive coping, and reinvestment in life.
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The objective of this research was to examine the routine postoperative management of patients who have undergone carotid endarterectomy and compare the intensive care unit (ICU) with the ward high-dependency unit (HDU) in terms of the number, type, severity, or management of postoperative clinical events within a 48-hour time frame. Two of the vascular surgeons routinely admitted patients to the ICU, and 1 vascular surgeon routinely admitted patients to the ward HDU. This research determines whether there was a difference in outcomes between the 2 groups with the intention of changing the practice of the 2 vascular surgeons who routinely admitted their patients to the ICU. ⋯ There was no significant difference in the number of patients with bradycardia in either group of patients. Chi-square analysis revealed a chi 2 value of 1.4 and a P value of.23 during the first 24 hours postoperatively. We believe that careful selection of patients to the ward HDU is safe and cost-effective.
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Heparin-induced thrombocytopenia is a rare but complex adverse drug reaction that can produce devastating results. Treatment and clinical management of the patient requires close observation and education of the pathophysiology occurring at the cellular level. Documented cases of heparin-induced thrombocytopenia have been reported in the literature for years. This case presentation details a multiple trauma patient in whom heparin-induced thrombocytopenia developed and the effect this syndrome had on her treatment and eventual recovery.
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The majority of vascular patients are elderly and present a unique set of problems after an operation. Age plays a major role in their recovery, but the greatest challenge is their preexisting medical problems. The changes that occur with aging in the following body systems will be discussed: cardiac, pulmonary, renal, gastrointestinal, genitourinary, and central nervous system. Special concerns related to pain management, risk of delirium, and wound healing present continuing nursing challenges that require close observation after surgery.