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Nursing Clinics of North America

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https://www.readbyqxmd.com/read/28779829/geriatric-syndromes-meeting-a-growing-challenge
#1
EDITORIAL
Jennifer Kim, Sally Miller
No abstract text is available yet for this article.
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779828/clinical-and-community-strategies-to-prevent-falls-and-fall-related-injuries-among-community-dwelling-older-adults
#2
REVIEW
Ruth E Taylor-Piliae, Rachel Peterson, Martha Jane Mohler
Falls in older adults are the result of several risk factors across biological and behavioral aspects of the person, along with environmental factors. Falls can trigger a downward spiral in activities of daily living, independence, and overall health outcomes. Clinicians who care for older adults should screen them annually for falls. A multifactorial comprehensive clinical fall assessment coupled with tailored interventions can result in a dramatic public health impact, while improving older adult quality of life...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779827/impaired-mobility-and-functional-decline-in-older-adults-evidence-to-facilitate-a-practice-change
#3
REVIEW
Deanna Gray-Miceli
The Centers for Medicare and Medicaid services report nearly 55% of Medicare beneficiaries older than 85 experience impaired mobility and nearly 28% (n = 671,833) of these individuals have difficulty getting help. Impaired mobility is a precursor to disability, which has notable clinical significance and importance to older adults. Using case exemplars of older adults who have experienced a "serious" fall, along with evidence-based research, the physical, psychosocial, emotional, and clinical consequences are discussed, along with assessment parameters and interventions for maximizing function and early mobility...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779826/polypharmacy-and-medication-management-in-older-adults
#4
REVIEW
Jennifer Kim, Abby Luck Parish
Polypharmacy in older adults is a global problem that has recently worsened. Approximately 30% of adults aged 65 years and older in developed countries take 5 or more medications. Although prescribed and over-the-counter medications may improve a wide range of health problems, they also may cause or contribute to harm, especially in older adults. Polypharmacy in older adults is associated with worsening of geriatric syndromes and adverse drug events. Given the risks and burdens of polypharmacy and potentially inappropriate medications, nurses must use patient-centered approaches and nonpharmacologic strategies to treat common symptoms and to optimize patient function and quality of life...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779825/geriatric-urinary-incontinence
#5
REVIEW
Jessica A R Searcy
Urinary incontinence (UI) is an international problem, affecting a high percentage of geriatric women. Nurses caring for geriatric women of all ages should be aware of the problem of UI and familiarize themselves with the potential treatment options for these patients. This article focuses on the prevalence, burden, clinical application, and management recommendations for the different types of UI.
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779824/nutritional-problems-affecting-older-adults
#6
REVIEW
Neva L Crogan
Nutritional problems, such as malnutrition, dehydration, and electrolyte imbalance, are multifaceted and complex issues for older adults. This article describes these potential nutritional problems and then discusses evidence-based assessment strategies and treatment modalities that target these problems. Micronutrient deficiency is explored and evidence-based supplementation discussed. Many factors contribute to weight loss and malnutrition in older adults. These factors are classified as social, psychological, and/or biological...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779823/gastrointestinal-disturbances-in-the-elderly
#7
REVIEW
Natalie R Baker, Kala K Blakely
Gastrointestinal (GI) age-related changes create alterations in the body's ability to digest, absorb, and excrete nutrients, medications, and alcohol and disrupts GI immunity responses. All older adults exhibit some degree of swallowing difficulty, also known as senescent swallowing. The effects of chronic disease and sustained use of alcohol, tobacco, and medications often exacerbate age-related GI dysfunction. Older adults often have nonspecific complaints, warranting a thorough health history and physical examination, including prescription and over-the-counter medications...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779822/impairments-in-skin-integrity
#8
REVIEW
Rose W Murphree
Altered skin integrity increases the chance of infection, impaired mobility, and decreased function and may result in the loss of limb or, sometimes, life. Skin is affected by both intrinsic and extrinsic factors. Intrinsic factors can include altered nutritional status, vascular disease issues, and diabetes. Extrinsic factors include falls, accidents, pressure, immobility, and surgical procedures. Ensuring skin integrity in the elderly requires a team approach and includes the individual, caregivers, and clinicians...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779821/impaired-sleep-a-multifaceted-geriatric-syndrome
#9
REVIEW
Grace E Dean, Carleara Weiss, Jonna L Morris, Eileen R Chasens
Impaired sleep increases in prevalence in older adults, with multiple possible causes that can interact with each other and can lead to poor health outcomes. This article describes normal changes in sleep with aging, sleep disorders that increase in prevalence in older adults, medications and sleep, and medical conditions and psychosocial conditions associated with impaired sleep. In addition, a brief assessment that nurses could use to assess for impaired sleep and nonpharmacologic interventions to improve sleep are discussed...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779820/pain-assessment-in-older-adults
#10
REVIEW
Ann L Horgas
Pain is a common experience for many older adults. Significant efforts have been undertaken to address and improve the assessment of pain in older adults over the past 2 decades. There have been many empirical studies and several expert panel statements to guide health care providers in the best practices for assessing pain in this population. This article provides a conceptual model that summarizes causes and consequences of pain and highlights the relationship between acute and persistent pain. Recommendations for pain assessment tools, including those developed for use in cognitively impaired elders, are presented...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779819/cognitive-issues-decline-delirium-depression-dementia
#11
REVIEW
Melodee Harris
Cognitive decline in older persons can be pathologic or occur as a part of the normal aging process. Delirium, depression, and dementia are geriatric syndromes and neurocognitive disorders that are the result of cognitive decline associated with pathology. This overview is a brief guide on cognitive decline and how to identify, manage, and treat associated neurocognitive disorders, including delirium, depression, and dementia.
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28779818/understanding-frailty-a-nurse-s-guide
#12
REVIEW
Cathy A Maxwell, Jinjiao Wang
Frailty is a public health crisis for an aging society. As a concept and condition, frailty is poorly understood and underrecognized in clinical settings. Nurses play an important role as frontline providers who care for aging adults. The aim of this article is to raise awareness among nurses about frailty and to discuss the recognition and management of this prevailing condition. The authors present conceptual definitions and models of frailty, a brief discussion of the underlying biological mechanisms and evidence-based interventions for frailty identification, and approaches to delay and decrease the burden of frailty...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478883/current-issues-in-fluid-and-electrolyte-management
#13
EDITORIAL
Joshua Squiers
No abstract text is available yet for this article.
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478882/i-sing-the-body-electric-where-it-all-begins
#14
EDITORIAL
Stephen D Krau
No abstract text is available yet for this article.
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478881/abdominal-compartment-syndrome-as-a-complication-of-fluid-resuscitation
#15
REVIEW
Bradley R Harrell, Sarah Miller
Fluid resuscitation is a primary concern of nurse clinicians. Excessive resuscitation with crystalloids places patients at particular risk for many subsequent complications that carry associated increases in mortality and morbidity. Intra-abdominal hypertension and abdominal compartment syndrome are deadly complications of third spacing and capillary leak that occur secondary to excessive fluid resuscitation. Careful consideration is necessary when achieving fluid balance in acutely ill patients, including reducing the use of crystalloids, implementing damage control resuscitation, and establishing measurable resuscitation endpoints...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478880/neurologic-intensive-care-unit-electrolyte-management
#16
REVIEW
Craig Hutto, Mindy French
Dysnatremia is a common finding in the intensive care unit (ICU) and may be a predictor for mortality and poor clinical outcomes. Depending on the time of onset (ie, on admission vs later in the ICU stay), the incidence of dysnatremias in critically ill patients ranges from 6.9% to 15%, respectively. The symptoms of sodium derangement and their effect on brain physiology make early recognition and correction paramount in the neurologic ICU. Hyponatremia in brain injured patients can lead to life-threatening conditions such as seizures and may worsen cerebral edema and contribute to alterations in intracranial pressure...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478879/tumor-lysis-syndrome-a-unique-solute-disturbance
#17
REVIEW
Penelope Z Strauss, Shannan K Hamlin, Johnny Dang
Tumor lysis syndrome (TLS) is a life-threatening disorder that is an oncologic emergency. Risk factors for TLS are well-known, but the current literature shows case descriptions of unexpected acute TLS. Solid tumors and untreated hematologic tumors can lyse under various circumstances in children and adults. International guidelines and recommendations, including the early involvement of the critical care team, have been put forward to help clinicians properly manage the syndrome. Advanced practice nurses may be in the position of triaging and initiating treatment of patients with TLS, and need a thorough understanding of the syndrome and its treatment...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478878/fluid-management-in-lung-transplant-patients
#18
REVIEW
Benjamin Stuart Schultze
Overall, there is a lack of randomized controlled trials examining the correlation between fluid volume delivery and outcomes in postoperative lung transplant patients. However, using thoracic surgery patients as a guide, the evidence suggests that hypervolemia correlates with pulmonary edema and should be avoided in lung transplant patients. However, it is recognized that patients with hemodynamic instability may require volume for attenuation of this situation, but it can likely be mitigated with the use of inotropic medication to maintain adequate perfusion and avoid the development of edema...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478877/microvascular-fluid-resuscitation-in-circulatory-shock
#19
REVIEW
Shannan K Hamlin, Penelope Z Strauss, Hsin-Mei Chen, LaDonna Christy
The microcirculation is responsible for blood flow regulation and red blood cell distribution throughout individual organs. Patients with circulatory shock have acute failure of the cardiovascular system in which there is insufficient delivery of oxygen to meet metabolic tissue requirements. All subtypes of shock pathophysiology have a hypovolemic component. Fluid resuscitation guided by systemic hemodynamic end points is a common intervention. Evidence shows that microcirculatory shock persists even after optimization of macrocirculatory hemodynamics...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28478876/metabolic-and-electrolyte-abnormalities-related-to-use-of-bowel-in-urologic-reconstruction
#20
REVIEW
Amanda N Squiers, Karleena Twitchell
Many urologic reconstructive techniques involve the use of autologous bowel for urinary diversion and bladder augmentation. The resection of bowel and its reimplantation into the urinary system often comes with a variety of metabolic and electrolyte derangements, depending on the type of bowel used and the quantity of urine it is exposed to in its final anatomic position. Clinicians should be aware of these potential complications due to the serious consequences that may result from uncorrected electrolyte disturbances...
June 2017: Nursing Clinics of North America
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