The American journal of nursing
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Dysphagia, the impairment of any part of the swallowing process, increases the risk of aspiration. Dysphagia and aspiration are associated with the development of aspiration pneumonia. ⋯ This article discusses best practices for assessment and prevention of aspiration among older adults who are being hand-fed or fed by tube. To view an accompanying online video, go to http://links.lww.com/A226.
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Older adults are especially vulnerable to malnutrition, which often goes undetected and increases the risks of illness and death. The Joint Commission has required U. S. hospitals to provide nutrition screening to all patients within 24 hours of admission, but that doesn't cover patients in other settings, nor is there a standardized assessment tool for finding malnutrition in older adults. ⋯ It consists of 18 questions and can be completed in about 15 minutes. A short form, containing the first six questions, can be used for screening. For a free online video demonstrating the use of this tool, go to http://links.lww.com/A221.
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In order to determine whether opioid-naive patients at risk for respiratory depression are better monitored with either capnography or pulse oximetry and respiratory-rate assessment, the authors conducted a randomized, prospective trial. In 54 opioid-naive postoperative orthopedic patients at one hospital, capnography resulted in greater detection of respiratory depression, and the authors conclude that capnography may be more appropriate for use with postsurgical high-risk patients taking opioids on the general care nursing unit. Capnography's sensitivity in the detection of pauses in breathing in the sedated patient may have the added advantage of indicating those patients who may be at risk for obstructive sleep apnea. Further research is needed to confirm these results.
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The generation of electric power is one important source of pollutants such as mercury, sulfur dioxide, nitrogen oxides, and fine particulate matter that can affect the respiratory, cardiovascular, and central nervous systems and cause pregnancy complications. But protecting people from environmental health hazards has become increasingly complex. Air pollutants are often invisible and travel many miles virtually undetected. Nurses can play a critical role in preventive strategies, as well as in the national debate on energy production and dependence on fossil fuels.