ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Adherence with prescribed therapies is a key factor in maintaining health in persons with chronic illnesses. The purpose of this descriptive study (which is one segment of a larger study being conducted to develop decision rules for early detection of infection or rejection in posttransplant patients) is to explore facilitators and barriers to adherence with home monitoring. Use of latent analysis revealed that the facilitators to adherence were health promotion, commitment to research, and following advice. Barriers to adherence were poor health status, laziness, and time conflict. Health professionals can use this information to plan strategies to promote adherence to home monitoring.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Lung transplantation is a growing surgical option for patients with end-stage lung and pulmonary vascular diseases. After completing an extensive evaluation and meeting the selection criteria, patients are listed for either single or bilateral–sequential lung transplantation. Immediate postoperative management requires detailed attention to fluid management, monitoring for infection, reperfusion injury, pulmonary hygiene, and pain management. Length of stay depends on the patient’s condition before transplant and postoperative complications. Discharge from the hospital can be as early as 7 days after transplantation. Newer immunosuppressive medications offer more options for treating and preventing rejection. Advanced practice nurses, such as coordinators, case managers, nurse practitioners, and clinical nurse specialists, are uniquely positioned to play key roles in coordinating the care of transplant patients across settings and both before and after the transplant procedure. The perioperative needs of lung transplant patients and the impact of this complex procedure on the recipients’ and family’s quality of life merit further investigation by clinicians and researchers.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Breathing pattern retraining, in the form of pursed-lip breathing, has been used as one method in pulmonary rehabilitation to help alleviate the symptoms of dyspnea endured by people who suffer from airflow obstruction secondary to chronic obstructive pulmonary disease (COPD). Other techniques such as biofeedback also have been successfully used. This article describes the altered breathing patterns used by patients with COPD at rest and during physical activity. The literature is reviewed regarding techniques of breathing pattern retraining that have been developed to improve the capacity of persons with COPD to perform activities of daily living, a primarily rehabilitative outcome.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Weight loss in patients with chronic obstructive pulmonary disease has a negative effect on the clinical course of the patient. Causes of weight loss in this population are known to include the effects of an energy imbalance, increased cytokines, hypoxia, and glucocorticoid use. This article delineates mechanisms included in these processes and highlights specific deleterious aspects of each. In addition, the effects of the following therapies are discussed in light of recent research findings: nutrition support, anabolic steroids, recombinant human growth hormone, and polyunsaturated fatty acids. This review summarizes the current state of knowledge in this area.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Dyspnea is a multidimensional, subjective perception of breathing difficulty commonly seen in patients who are critically or terminally ill. Understanding the mechanisms and assessment of dyspnea will help nurses in advanced practice roles to successfully manage these patients. Major mechanisms of dyspnea include stimulation of the chemoreceptors, stimulation of chest wall and intrapulmonary receptors, and increased sense of effort (also termed increased respiratory motor command). The causes of dyspnea are multifactorial, including numerous clinical conditions and aggravating situations that promote dyspnea. Assessment of dyspnea includes an accurate history of timing, precipitating factors, associated symptoms, alleviating factors, intensity and quality of the symptom. Measurement tools for dyspnea include both unidimensional and multidimensional tools, as well as tools that measure changes in the perception of dyspnea. Most tools have been tested for reliability and validity on healthy subjects or on patients with chronic obstructive pulmonary disease and, therefore, should be used with caution in critically or terminally ill patients.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Airway pressure release ventilation (APRV) is a relatively new mode of ventilation, that only became commercially available in the United States in the mid-1990s. Airway pressure release ventilation produces tidal ventilation using a method that differs from any other mode. It uses a release of airway pressure from an elevated baseline to simulate expiration. The elevated baseline facilitates oxygenation, and the timed releases aid in carbon dioxide removal.Advantages of APRV include lower airway pressures, lower minute ventilation, minimal adverse effects on cardio-circulatory function, ability to spontaneously breathe throughout the entire ventilatory cycle, decreased sedation use, and near elimination of neuromuscular blockade. Airway pressure release ventilation is consistent with lung protection strategies that strive to limit lung injury associated with mechanical ventilation. Future research will probably support the use of APRV as the primary mode of choice for patients with acute lung injury.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The literature clearly establishes the problems and difficulties of loss of speech among mechanically ventilated patients in the intensive care unit. Critical care nurses typically receive little or no training in the interpretation of nonvocal communication or in the assessment and application of augmentative communication methods. This article presents an integrative review of the research and related literature on communication with adult patients in critical care settings. Clinical issues and technological advancements in assistive and augmentative communication applicable to critical care are discussed and a new research agenda is proposed.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Chest radiographs remain one of the oldest, noninvasive methods for identifying chest diseases. This tool is relatively inexpensive, low risk, and important for the advanced practice nurse to use in making an initial differential diagnosis. Timely intervention depends on the advanced practice nurse’s ability to recognize the radiographic abnormalities commonly associated with acute pulmonary disease. When linked with the history, presenting signs and symptoms, and a thorough physical assessment, the chest radiograph is key to appropriate diagnosis and management. This article reviews the basic radiographic lung densities, describes a systematic approach to ensure thorough chest radiographic interpretation, and presents characteristic chest radiographs found in the acute care setting. Selected examples of diffuse lung diseases, localized alveolar opacities, pleural effusions, and hyperlucency of the lungs will also be presented.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Pulmonary injuries resulting from blunt chest trauma remain a common clinical entity for critical care and emergency nurses. In this article, the epidemiology and mechanism of injury most often observed in patients with blunt chest trauma are reviewed. Selected pulmonary injuries are discussed in terms of mechanism of injuries, assessment and diagnostic modalities, standard therapies, and cutting-edge therapies used today with a focus on pulmonary contusion. Many advances and experimental therapies currently used in the management of the patient with severe lung injuries are discussed. A case study is presented highlighting a complicated case of a blunt chest injury resulting in severe pulmonary contusion.

ISSN:1079-0713    

出版商:OVID    

年代:2001

数据来源: OVID