ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Behavioral flow sheets are tools that can be used outside the domain of mental health. For the knowledgeable health care provider in any setting, they render a cost-effective, noninvasive mechanism for diagnosis and management of a variety of patient problems of organic as well as behavioral natures. Though there exists an assortment of standardized formats, flow-sheet design can be tailored to address the unique circumstances of each patient. They provide an avenue for actively involving patients and families in problem assessment as well as in the planning and evaluation of treatment regimens. In addition, flow sheets provide a feedback mechanism that can enhance patient/family self-esteem and increase the likelihood of adherence to treatment recommendations. There is both an art and a science to their design and use, but the skills Involved are readily acquired by any interested practitioner. The conscientious professional will become acquainted with the potential pitfalls and thus avoid irresponsible or unethical application. The authors provide guidelines for developing and Implementing flow sheets and Illustrate their value through the sharing of several clinical vignettes.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Over the past few years, the lay and medical press Increasingly have focused on attention-deficit/hyperactivity disorder (ADHD) as a widespread and common disorder of school-age children and adults. ADHD's cause remains unknown, but current research supports a neurobiological foundation. An ADHD diagnosis should focus on the three main components of the disorder: Impulsivity, hyperactivity, and Inattention. There are no specific tests, but the diagnosis is based on history, Interview, physical examination, and developmental and psychological evaluation. Management should include a balanced treatment plan of pharmacologic methods combined with behavioral/psychological therapy and environmental manipulation. Current drug therapy supports the careful and closely monitored use of stimulants like methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and pemollne (Cylert). Additionally, patients and their families are encouraged to seek Individual, group, family, and marital therapy. Special adaptations for schools, homes, and workplaces are now also available. The NP's role In ADHD treatment is that of evaluator, coordinator, and monitoring clinician. Treatment goals are established with the patient and family; the NP assists in the completion of these goals through teaching, monitoring, and referring to community services when appropriate. While this multimodal treatment and management Is complex, it supports the ADHD patient and his family.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Diabetic patients typically have a low compliance rate to intervention and lifestyle change. Although diabetes has been stud-led for years, the disease remains a leading cause of death In the United States and approaches a prevalence of 40% in certain ethnic populations. The mortality rate for NIDDM is two to three times higher than the average healthy person, primarily due to cardiovascular complications. More than 10 million people in the United States alone are diagnosed with diabetes. Clearly, with health care resources dwindling, improved treatment outcomes are needed. The physiologic mechanism involved in the development of the preliminary phase of Type II diabetes or syndrome X is particularly amenable to primary and secondary prevention as well as health promotion activities. NPs provide an alternative delivery of care based on health-promotion and disease-prevention principles. NPs working in a primary care delivery model with patients at risk for diabetes have the opportunity to bring about measurable outcome differences.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Recent trends in the American lifestyle, such as a high-fat diet and Inactivity, have promoted the emergence of a metabolic disorder titled syndrome X. Although originally linked to non-Insulin-dependent diabetes mellitus (NIDDM) and characterized by insulin resistance, syndrome X is now better described as a cascade of disorders encompassing not only NIDDM, but also hypertension, atherosclerosis, centrally distributed obesity, and dyslipidemia. Further pathology has been linked to syndrome X, such as polycystic ovary disease, microvascular angina, and the presence of acanthosis nigricans. Recognition and appropriate management of syndrome X will prevent deleterious patient outcomes that might occur without continuity of care in treating associated disorders. Pharmacological management of syndrome X includes the use of insulin-sparing antihyperglycemic agents and/or combination therapy and avoidance of several frequently prescribed medications. Clinicians need to Initiate renewed efforts to provide lifestyle counseling to promote ideal body weight, since Interpretation of research data concerning syndrome X reinforces that serious health consequences will result from obesity and Inactivity.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Hantavirus pulmonary syndrome (HPS) is a viral Infection from a new strain of Hantavirus. TheHantaviruswas first discovered In North America in 1993 after an outbreak of fatal illness on a Navajo Indian reservation In New Mexico. Since then, 122 cases of HPS (with a high mortality rate of more than 50%) have been reported in 23 states, with the highest prevalence In the Four Corners area. The reservoir forHantavirusis small rodents, mostly field mice, vole, and chipmunks. It is transmitted through Inhalation of airborne virus from dry rodent excreta and saliva.A North American strain ofHantavirus, named sin nombre virus (SNV), primarily affects the lungs, causing rapid accumulation of fluids and leading to non-cardiogenic pulmonary edema, pleural effusion, and acute respiratory distress syndrome (ARDS). In the prodromal stage, HPS presents with flu-like symptoms, nausea, vomiting, and gastrointestinal pain and is often mistaken on the first visit for other infectious diseases or gastroenteritis. In the second acute stage, rapid respiratory deterioration begins; HPS is often misdiagnosed for pneumonia, idlopathic ARDS, and pulmonary edema. HPS treatment with an experimental antiviral Intravenous drug, ribavirin, Is under investigation. Practitioners must possess thorough clinical knowledge on the diagnoses, pathology, treatment, and course of the disease to reduce the mortality and morbidity rate of this rare but serious infection. A case report based on a recent HPS death In New York State on Long Island In April 1995 is presented.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

While it is generally recognized that NPs offer affordable, quality health care, few studies have measured outcomes of clients who seek primary care services from NPs. This pilot study describes the outcomes of children with otitis media who received care from NPs employed in an academic nursing center. Outcome measurements included issues related to timing, level of analysis, and attribution. Parents of 27 children participated in a telephone survey consisting of seven questions relating to the care their children received from NPs and their recovery path. Although every respondent reported having a positive visit at the nursing center, concerns for NPs surfaced during the process of measuring outcomes. This study emphasizes the need for measuring outcomes in nursing clinics and demonstrates one way to measure client outcomes, revealing both general health care and specific nursing practice implications.

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1996

数据来源: OVID