ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Cardiac glycosides were used as early as the first century A.D. The most commonly prescribed compound of this family is digoxin, because of its relatively short half-life. Intravenous digoxin has high utility 1) for instances in which digitalization must be rapidly accomplished; 2) when oral digitalization is not feasible; and/or 3) as augmentation therapy to other medication protocols. Myocardial uptake of I. V. digoxin is rapid and extensive; yet, serum half-life is approximately 34 hours, the same as in oral administration. Intravenous digoxin can be administered in divided doses every 4 to 8 hours, the 24-hour dose not to exceed 1.0 mg for a 155-pound, or 70.0-kg patient. Awareness of risk factors along with state-of-the-art technology can improve ongoing monitoring of the patient receiving I. V. digoxin.

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Chemotherapy administered by continuous infusion has been shown to be more effective and less toxic than bolus therapy in many instances. Because of advances in infusion-pump and access-device technology, most patients receive their chemotherapy as outpatients. Careful patient selection and comprehensive patient teaching are essential to ensure the success of continuous infusion chemotherapy delivery.

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Ifosfamide and mesna as a chemotherapeutic and protective combination has increased oncologists' choice of agents in the treatment of various forms of cancer today. Additional responsibility is placed on both patient and caregiver when high doses of these drugs are administered in an outpatient setting. Of utmost importance is the education of the patient and the caregiver in their immediate responsibilities, as well as required procedures after the course of the drug has been completed. In this article, areas of concern to the patient and caregiver are described in detail. Initial therapy and any subsequent side effects are managed on an outpatient basis except in rare circumstances.

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Total parenteral nutrition (TPN) is most commonly delivered into a large vein through a central venous catheter (CVC). Because complications associated with CVCs may be life threatening or costly to the patient and the medical facility, proper care and maintenance of a CVC is essential. A 12-month retrospective study was conducted by a nutritional support team to evaluate cost effectiveness of CVC care in patients receiving TPN. Certain factors, such as catheter type and location, duration of usage, number of catheters, physician who placed the catheter, and complications were recorded for each patient receiving TPN. All CVCs used for TPN were maintained by a member of the nutritional support team.A total of 434 CVCs were placed in 277 patients who required TPN (average, 1.6 catheters/patient; range, 1–10 catheters/patient). Specific catheter-related data, and occurrences of complications were recorded on a flow sheet designed specifically for patients requiring TPN. Major complications (those which potentially increased mortality and morbidity) and minor complications (those that did not prolong hospitalization) were distinguished and the average cost of these complications was determined based on actual patient charges. Major complications occurred in 5% of the catheters placed, including: pneumothorax, thoracic duct fluid leak, artery laceration, malposition, failed attempts, and catheter-related sepsis. Catheter-related sepsis occurred in only 0.5% of patients, compared with a reported incidence of 5%, and cost an average $20200. Thus, complications of CVC may be reduced when maintenance is provided by a skilled clinician or specific-team, decreasing the cost, as well as improving the quality of care.

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Comfort in the post-thoracotomy patient is frequently a major care issue. It is particularly relevant for nurses practicing in smaller institutions where physician staff are not “in house” and easily accessible. A retrospective chart audit was used to compare pain therapy in two groups of patients undergoing thoracic surgery. Group 1 patients received traditional pain control therapy primarily by the intravenous route. Group 2 patients received intercostal bupivacaine with epinephrine via the CADD-Plus Ambulatory Infusion Pump Model 5400 (Pharmacia Deltec, Inc., St. Paul, Minn). Narcotic and analgesic medication requirements, length of stay, patient perception of comfort, and nursing interventions for pain management were evaluated. The use of the CADD-Plus infusion pump was found to have a positive outcome on the recovery of post-thoracotomy patients in this institution. They had a decreased length of stay, a decreased perceived level of pain, and used less nursing time for pain control than patients treated with more traditional methods of pain control.

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Peter A. Tomasulo, MD, is the recently appointed chief operating officer of blood services at the American Red Cross. His blood center management career spans 16 years, beginning in Milwaukee, Wis in 1976. In 1988, he became medical director for the South Florida Blood Service in Miami, Fla. Tomasulo is board-certified in internal medicine and hematology, and is certified in blood banking by the American Board of Pathology.

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0896-5846    

出版商:OVID    

年代:1992

数据来源: OVID