Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Aug 2005
ReviewPatient-controlled modalities for acute postoperative pain management.
Although numerous clinical practice guidelines for pain management have been published throughout the last 12 years, inadequate pain relief remains a significant health care issue. Several patient-controlled analgesia (PCA) modalities are currently available for the treatment of acute postoperative pain, including intravenous (IV) PCA, epidural (PCEA), and oral PCA. ⋯ Consequently, noninvasive PCA systems are under development to circumvent many of these limitations, including the fentanyl hydrochloride patient-controlled transdermal system (PCTS); (IONSYS Ortho-McNeil Pharmaceutical, Raritan, NJ) and a number of patient-controlled intranasal analgesia (PCINA) delivery systems. The objective of this article is to review the PCA modalities currently in use and to discuss those in development for the treatment of acute postoperative pain.
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Domestic abuse is a devastating social, legal, and health care problem of enormous proportions. Routine and multiple screenings by skilled health care providers, when conducted face-to-face, markedly increase the identification of physical, psychological, and sexual abuse. Patients are not the only ones who can benefit from domestic violence screening and intervention. This article describes the subtle signs of domestic abuse that might be observed in a colleague, explains how to initiate a conversation with a colleague, and suggests appropriate ways to offer support.
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J. Perianesth. Nurs. · Aug 2005
Nurses' diagnoses and treatment decisions regarding care of the agitated child.
Postoperative agitation has many potential etiologies and remains a significant clinical issue in the pediatric PACU setting. Caring for the agitated child requires a thorough assessment and calls for targeted interventions. This observational study evaluated nurses' diagnoses and treatment decisions regarding care of the agitated child. ⋯ Physiologic abnormalities were identified as the source for agitation in only 3 cases, but went unrecognized for an extended period in 2 children. Results of this study underscore the complexity of assessment and treatment decisions when caring for agitated children. A decision algorithm based on this study is described as a potential aid toward differentiation of agitation and appropriate intervention.
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Postdischarge nausea and vomiting (PDNV) is a serious threat to the recovery of ambulatory surgical patients. Pharmacological interventions available before discharge are not readily available to the patient after discharge; therefore, the activities that patients perform to manage new-onset PDNV may affect their surgical recovery. Assembled from a comprehensive study of PDNV, this paper describes the self-care activities that ambulatory patients use to manage new-onset nausea and vomiting after discharge. The findings have implications for patient education and future research.