Nursing research
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The purpose of this study was to describe the physiological responses of premature infants to an acute tissue-damaging stimulus and to determine how severity of illness and behavioral state influenced these responses. The physiological responses (heart rate, oxygen saturation, and intracranial pressure) of a convenience sample of 124 premature infants between 32 and 34 weeks gestational age were described during four phases of a routine heel stick procedure. Analysis of the results showed a significant multivariate main effect of phase on the group of physiological responses. Behavioral state was found to influence the physiological responses, but severity of illness did not.
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Comparative Study Clinical Trial Controlled Clinical Trial
Rewarming cardiac surgery patients: radiant heat versus forced warm air.
This study compared time required to rewarm, incidence of shivering, and nurses' preferences in hypothermic postoperative cardiac surgery patients treated with a forced air warmer (Bair Hugger) or a noninfrared radiant heater (Thermal Ceiling). Data were collected on 38 subjects and 6 nonsubjects treated with warm blankets. ⋯ The warm air subjects had significantly higher skin temperatures, lower incidence of shivering, and less severe afterdrop, suggesting that rewarming in these patients resulted from heat gained from the environment. Nurses preferred the forced air warmer to the noninfrared radiant heater.
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Randomized Controlled Trial Clinical Trial
Coping with unplanned childhood hospitalization: effects of informational interventions on mothers and children.
Two types of information, separately and in combination, were evaluated for their effects on the process and outcomes of maternal and child coping with unplanned childhood hospitalization. One hundred eight mothers of hospitalized children, 2 to 5 years old, were randomly assigned to one of four study groups. Child behavioral information and parental role information had positive effects on maternal state anxiety as well as on parental support and participation in their children's care during hospitalization. Ten to 14 days following hospitalization, positive main effects were shown for child behavioral and parental role information on mothers' state anxiety levels and for child behavioral information on children's negative behaviors.
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Comparative Study
Multidimensional predictors of success or failure with early weaning from mechanical ventilation after cardiac surgery.
The purpose of this study was to determine the contributions of pulmonary mechanics, gas exchange, and hemodynamic function to prediction of success or failure with early weaning from mechanical ventilation after cardiac surgery. More than 40 physiologic measurements were determined on 162 patients at two time points in the early postoperative period: during full-support mechanical ventilation and during a trial of spontaneous ventilation. Discriminant analysis was used to analyze the differences between the success group (n = 134) and the failure group (n = 28) and to predict group membership of individual cases. ⋯ The discriminant function contained variables from all three dimensions of weaning criteria, with dimensions of hemodynamic function and pulmonary mechanics having greater import. The predictor set had a sensitivity of .98, specificity of .71, positive predictive value of .94, and negative predictive value of .87. Routine bedside measurements had a predictive performance equal or superior to variables previously studied.
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This paper reports further findings from an ongoing clinical study designed to evaluate the extent to which pH values of aspirates from feeding tubes can be used to differentiate between gastric and intestinal tube placement and gastric and respiratory tube placement. The sample consisted of 405 aspirates from small-bore nasogastric tubes and 389 aspirates from nasointestinal tubes, which were obtained from 605 subjects ranging in age from 18 to 94 years. Data were collected at the time of initial placement and again, when possible, after feedings were initiated. ⋯ Gastric placement was successfully distinguished from intestinal placement of the feeding tubes on the basis of pH-meter readings (p < .0001). Approximately 85% of the 405 pH-meter readings from gastric fluid were between 0 and 6.0, while over 87% of the 389 pH-meter measurements performed on intestinal aspirates were greater than 6.0. Four aspirates from feeding tubes inadvertently placed in the respiratory tract (two in the pleural space and two in the tracheobronchial tree) were tested with a pH-meter, all had pH values greater than 6.5.