Clinical excellence for nurse practitioners : the international journal of NPACE
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Clin Excell Nurse Pract · Nov 1999
ReviewAmyotrophic lateral sclerosis: a team approach to primary care.
Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes degeneration of motor neurons and results in death. The most frequent presenting symptom of patients with ALS is muscle weakness. The role of the nurse practitioner (NP) in the diagnosis and management of ALS is multifaceted. ⋯ The role of the NP is important in providing symptomatic relief for the patient, and essential in providing education and psychosocial support for the patient and family caregivers. This article reviews the pathophysiology, assessment, management, and recent advances in research related to ALS. The challenging role of the NP in improving the quality of life of patients with ALS and their families is discussed.
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Clin Excell Nurse Pract · Nov 1999
ReviewThe use of bupropion hydrochloride for smoking cessation therapy.
All healthcare providers have an obligation to promote smoking cessation to their patients who smoke. While patients are advised to stop smoking, the use of specific smoking cessation strategies is rarely addressed by primary care providers. This article discusses smoking cessation for two specifically vulnerable groups: women and African-Americans. ⋯ Relapses in smoking cessation are due to nicotine craving and the attempt to alleviate symptoms of nicotine withdrawal. Bupropion hydrochloride, an oral antidepressant, is believed to work by elimination of nicotine cravings and to decrease the physiologic and psychologic symptoms associated with nicotine withdrawal. Patients who have not been successful in smoking cessation may benefit from bupropion hydrochloride therapy in conjunction with counseling and behavior modification.
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Clin Excell Nurse Pract · Nov 1999
Relationship of the menstrual cycle to postoperative incidence of emesis after laparoscopic cholecystectomy.
Despite advances in anesthetic practice and surgical techniques, the overall incidence of postoperative vomiting (POV) ranges from 20% to 30% during the first 24 hours after surgery. Studies specifically examining the relationship between POV and the menstrual cycle demonstrate equivocal findings. The purpose of this study was to examine the relationship between the incidence of POV and the phase of the menstrual cycle, age, body mass index, history of POV, duration of anesthesia, and use of droperidol among 79 women undergoing laparoscopic cholecystectomy. ⋯ Chi square analysis indicated that women in the menstruating group were more likely to experience POV (chi 2 = 20.87, P < .01). Among those receiving droperidol (n = 43; 54%), analysis revealed that those in the menstruating group experienced POV at a significantly higher rate (chi 2 = 9.15, P < .05). A reduction of POV may be accomplished by scheduling elective surgery to avoid the correlating menstrual cycle peaks.