Clinical excellence for nurse practitioners : the international journal of NPACE
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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.
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Clin Excell Nurse Pract · Sep 1999
Appendectomy in pregnancy and postpartum: analysis of data from a large private hospital.
Little research is found in the nursing literature regarding appendicitis in the pregnant patient. Appendicitis in pregnancy is associated with: perforation of the appendix, peritonitis, and increased fetal and maternal mortality and morbidity. Preterm labor and early delivery may further complicate the pregnancy. ⋯ Deliveries numbered more than 66,000 during the 10 years. A total of 42 cases of appendicitis during pregnancy and the 2 weeks following delivery was identified. The characteristics of the population as well as considerations for practice are discussed.
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Babesiosis is an intraerythrocytic parasitic infection caused by protozoa of the genus Babesia and transmitted by the Ixodes dammini tick, which also transmits Lyme disease. Babesiosis is emerging as an illness of public health significance in the United States. ⋯ However, overall mortality rates for symptomatic cases are less than 10%. This article presents a case report on a white male in his 70s diagnosed with human Babesiosis and emphasizes the need for early detection and prompt interventions to minimize the sequelae related to this tick-borne disease.
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Clin Excell Nurse Pract · Mar 1999
Implementing a nurse information system in a nurse-managed primary care practice: a process in progress.
As part of a larger project, a nurse-managed primary care clinic (Valencia Pediatric and Family Practice) sought to implement a nursing information system for the purposes of (1) patient record keeping, (2) capturing advanced practice nursing interventions and outcomes and transforming them into standardized language, (3) project data management, and (4) evaluating advanced practice nursing care thereby improving and standardizing quality of care. This article represents the background information for selection of a data management system and early experiences of implementation.