Journal of intravenous nursing : the official publication of the Intravenous Nurses Society
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Review
The immune system and intravenous administration of immune globulin. Part I, The immune system.
Interest in the immune response has greatly increased, mostly because of the discovery of the AIDS virus. An understanding of the basic function of the normal human immune system is vital knowledge for today's nurse. Part 1 of this article describes normal immune response as well as abnormal immune system function, and correlates this information with the clinical picture of the patient.
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Controlling patients' pain is no longer a luxury in health care. Studies have shown that pain can cause physical harm. A better understanding of the pain pathway has enabled health care professionals to control pain more effectively. ⋯ Fewer side effects and decreased narcotic use are among the advantages demonstrated with PCA and intraspinal infusions. Side effects can be minimized and complications reduced when nursing can intervene during narcotic infusions. The role of the intravenous nurse is expanding into the area of pain management as educator and clinical practitioner.
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Incorrect technique in subclavian catheter removal may result in fatal air emboli. This article discusses the pathophysiologic development and consequence of air emboli and outlines preventive nursing measures and emergency treatment.
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Chronic moderate-to-severe pain is a common problem that directly impacts on the quality of life of the patient with a malignant neoplasm. It is estimated that pain is a major symptom in 70% of cancer patients. Continuous subcutaneous infusion of opioids has proved to be an efficacious and safe method to control the chronic pain of the home-bound and hospitalized patient. ⋯ The subcutaneous route offers economic as well as physiologic advantages. The primary disadvantage to the system is volume limitations. Competent nursing management of the subcutaneous infusion helps to maximize the effectiveness of the opioid, thereby improving the patient's quality of life.
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Home pain management is a complex and challenging therapy for the home infusion nurse. A thorough knowledge of pain assessment, therapeutic approaches, and pharmacology of narcotics; management of side effects; and a recognition of individual variations in response are necessary for successful pain control. ⋯ A retrospective chart review of 20 patients cared for by Deaconess Home Health Care Corporation in Boston, Massachusetts, illustrates the wide variation in individual narcotic requirements necessary to achieve pain control. Three case studies are also included to provide further comparison.