The American journal of nursing
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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.
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Delirium is common in older adults who have dementia, but too often nurses confuse the symptoms of delirium with those of dementia and it goes unrecognized and untreated. Delirium can signal a serious underlying condition such as infection or dehydration and can increase the risk of falling and the length of hospitalization. This article presents an algorithm meant to guide nurses in the assessment and treatment of delirium superimposed on dementia. For a free online video demonstrating the use of this algorithm, go to http://links.lww.com/A211 [corrected].