RESUMEN
Metabolic abnormalities such as diabetes, obesity and dyslipidaemia are found in much higher rates in people with a diagnosis of schizophrenia when compared with the general population. This review discusses the most prevalent metabolic abnormalities associated with schizophrenia, their frequency and implications for mental health nurses (MHN). This review illuminates the need for MHN to acquire added awareness, knowledge and practical strategies in managing people at high risk of developing metabolic abnormalities associated with MetS. By doing this, it contributes to the literature by highlighting practical strategies for MHN in assessment and ongoing monitoring of metabolic abnormalities in clinical practice. This review highlights the need for MHN to be vigilant in monitoring a person's physical state on commencement and throughout treatment with antipsychotics. There is a need for an early detection monitoring system for people who are potentially at risk of developing metabolic abnormalities. The literature review aimed to investigate metabolic abnormalities associated with metabolic syndrome (MetS) in people diagnosed with schizophrenia; they are almost twice as likely to have metabolic risk factors and die approximately 20 years younger than the general population. MetS has become an issue of growing concern in mental health nursing. A comprehensive literature review was conducted utilizing various databases to address the reviews aim. Databases such as CINAHL Plus with full text (via EBSCO), MEDLINE(R) (OVID), PsycINFO and the COCHRANE library were accessed. The main metabolic abnormalities that emerged were: diabetes, obesity and dyslipidaemia. Antipsychotic medication also plays a vital role in a person's susceptibility to the development of MetS. It is critical that MHN has access to training and education in managing people at high risk of developing metabolic abnormalities associated with MetS. This review contributes to the literature by highlighting practical strategies for MHN in assessment and ongoing monitoring of metabolic abnormalities in clinical practice.
Asunto(s)
Comorbilidad , Síndrome Metabólico , Enfermería Psiquiátrica/métodos , Esquizofrenia , Humanos , Síndrome Metabólico/epidemiología , Esquizofrenia/epidemiologíaAsunto(s)
Hospitales , Ruido/efectos adversos , Estrés Psicológico/etiología , Anciano , Femenino , Humanos , MasculinoRESUMEN
During a four-year period there were 77 episodes and 15 recurrences of peritonitis in 30 children treated with continuous ambulatory peritoneal dialysis for periods of one to 39 months (mean, 15.3 months). The incidence was one episode per 6.0 patient-months. Organisms cultured included Staphylococcus epidermidis (17 episodes), Staphylococcus aureus (15 episodes), and fungi (four episodes). Special culture techniques were needed to ensure a high yield of positive cultures. Peritonitis was usually treated with intraperitoneal administration of cefazolin sodium, and 61% of the episodes were treated at home. There was one death, from Candida peritonitis, and catheters were removed in 11 children because of resistant or recurrent peritonitis (eight cases) or fungal peritonitis (three cases). Peritonitis rates were highest in children who had difficulty performing bag changes aseptically but who could not be transferred to hemodialysis and in hospitalized patients.
Asunto(s)
Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Diálisis Peritoneal/efectos adversos , Peritonitis/etiología , Adolescente , Adulto , Anfotericina B/uso terapéutico , Antibacterianos/uso terapéutico , Cefazolina/uso terapéutico , Niño , Preescolar , Quimioterapia Combinada , Femenino , Flucitosina/uso terapéutico , Humanos , Lactante , Masculino , Peritonitis/tratamiento farmacológico , Peritonitis/microbiología , Recurrencia , Tobramicina/uso terapéuticoRESUMEN
The clinical and biochemical effects of continuous ambulatory peritoneal dialysis in 20 children and of hemodialysis in 16 children were compared over a 2 1/2-year period. Statistically significant differences between the treatment groups included higher hematocrit, higher serum carbon dioxide and cholesterol levels, large intake of calories and protein, and lower systolic blood pressure and rates of transfusion in the patients receiving continuous ambulatory peritoneal dialysis. These patients had more complications than the patients receiving hemodialysis, but hospitalization rates in the two groups were similar. The cost of continuous ambulatory peritoneal dialysis was +19,600 per patient-year; the cost of hemodialysis was +54,300 per patient-year; the cost of hemodialysis was +54,300 per patient-year. There were four treatment failures with continuous ambulatory peritoneal dialysis and one with hemodialysis. Patients treated with both forms of dialysis preferred continuous ambulatory peritoneal dialysis. We conclude that continuous ambulatory peritoneal dialysis is an important alternative to hemodialysis in children.
Asunto(s)
Diálisis Peritoneal Ambulatoria Continua , Diálisis Peritoneal , Diálisis Renal , Presión Sanguínea , Dióxido de Carbono/sangre , Niño , Colesterol/sangre , Femenino , Crecimiento , Hematócrito , Unidades de Hemodiálisis en Hospital , Humanos , Masculino , Fenómenos Fisiológicos de la Nutrición , Evaluación de Procesos y Resultados en Atención de Salud , Aceptación de la Atención de Salud , Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Diálisis Peritoneal Ambulatoria Continua/economía , Diálisis Renal/efectos adversos , Diálisis Renal/economía , Factores de Tiempo , Uremia/mortalidad , Uremia/terapiaRESUMEN
Nurses in this ambulatory care center recognized a need for a systematic, planned approach to health education, and developed a health education model. The nurses on the committee serve as inhouse consultants to help other nurses develop, implement, and evaluate health education programs.