Nurse practitioner forum
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Nurse practitioner forum · Mar 2000
Review Case ReportsDiscontinuing treatment in children with chronic, critical illnesses.
Decisions about optimal treatment for critically ill children are qualitatively different from those related to adults. Technological advances over the past several decades have resulted in myriad treatment options that leave many children chronically, critically ill. These children are often technology dependent. ⋯ In this article, relevant factors about the care of children older than neonates are described: standards, decision makers, age of the child, and pain management. A case study is used as a mechanism to explore these issues. Dimensions of futility, discontinuing aggressive treatment, and a consideration of benefits and burdens are integrated throughout the discussion to inform nurse practitioner practice.
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Neuropathic pain refers to syndromes that may be related to peripheral or central neural structure compression, infiltration, or damage. Cancer-related neuropathic pain results from compression or infiltration of nerves by the tumor, nerve trauma from operative procedures, or neuropathic pain related to cancer treatment. ⋯ Intractable neuropathic pain may require the use of intraspinal delivery or anesthetic and neurosurgical procedures. The nurse practitioner plays an important role in the assessment and "trial and error" management of cancer-related neuropathic pain.
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Nurse practitioner forum · Jun 1998
ReviewNew criteria for the detection, diagnosis, and classification of diabetes mellitus.
The diagnosis and classification of diabetes mellitus have been reviewed and revised for the first time since 1979. A precedent-setting recommendation by the American Diabetes Association for routine screening of adults is an effort to identify the estimated 8 million people in the United States with undiagnosed diabetes. Stricter diagnostic criteria will identify more accurately those who are at risk for diabetic complications. Classification and nomenclature have been revised to describe the cause rather than the treatment of diabetes.
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The author reviews the healthy newborn examination pointing out normal findings and some of the normal variants and abnormal conditions. Only common conditions that are encountered in everyday practice are discussed in this document. It is essential that the nurse practitioner have knowledge of physiology and behavior of the newborn as well as exceptional communication skills to speak with the parents.