ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Nurse practitioners (NPs) have an unprecedented opportunity to become key primary health care providers, yet barriers to Independent practice still exist. The purpose of this research was to explore and describe the practice of NPs from their perspective. Open-ended, interactive Interviews were conducted with 23 NPs. Data analysis using the grounded theory method revealed that NPs attempt to establish their roles from a marginalized position and are often subjected to psychological and structural discounting. To combat discounting, the NPs in this research worked to negotiate the symbolic space required for their acceptance as valued health care providers. They used techniques of cultivating, bargaining, confronting, and disengaging. All of these techniques promote NP role definition by generating and preserving role boundaries, thereby moving NPs toward the symbolic space necessary for them to become part of the national consciousness. This research contributes to clarification of the NP role and the building of a formal theory of advanced nursing practice.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This article reviews the existing literature about acute bronchitis, a condition commonly diagnosed but poorly defined. The little epidemiologic research that has been done has failed to identify a microbiologic etiology approximately 60% to 85% of the time. The majority of cases appear to be caused by viruses, but 25% of adults with nonspecific lower respiratory symptoms may actually have pertussis.Mycoplasma pneumoniaeand Chlamydia pneumoniae probably play minor roles. Although clinicians frequently prescribe antibiotics to patients they have diagnosed with acute bronchitis, there is little evidence in support. General treatment studies have failed to demonstrate benefit, and the natural history of even potentially curable pathogens is not altered by antimicrobial therapy. Some recent studies suggest that albuterol may be the best treatment choice for acute bronchitis; it can successfully ameliorate symptoms, and does not pose the same public health risk as inappropriate antibiotics do. Erythromycin may occasionally be indicated for patients in frequent contact with small infants not yet immunized against pertussis, but careful surveillance of the child is probably more effective than treating the contagious adult.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Pediatric cardiovascular problems, although not common, have the potential to have significant associated morbidity and mortality if they go unrecognized. This article focuses on pediatric assessment techniques required to perform a comprehensive cardiovascular evaluation on an infant or an older child in the primary care setting. Specific key physical assessment parameters to be evaluated and a general developmental approach to the assessment of children are suggested. Auscultation of the pediatric heart is a main focus, including strategies in approaching children, a guide for organizing the ausculatory process, and differences between adult and pediatric heart sounds. Assessment of peripheral pulses, blood pressure, skin and mucous membrane color, and capillary refill are emphasized as an important aspect of comprehensive evaluation of the child's peripheral circulation. Criteria for referral are provided in terms of which children should be referred, who the referral should be made to, and the time frame in which the referral should be made.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID