RESUMEN
A common cause of emergency department visits, asthma is on the rise. Find out how to keep patients breathing easy.
Asunto(s)
Asma/enfermería , Cuidados Críticos/métodos , Evaluación en Enfermería , Asma/epidemiología , Asma/fisiopatología , Asma/terapia , Servicio de Urgencia en Hospital , HumanosRESUMEN
Review three major technological advances in cardiac care: brachytherapy for coronary artery disease, amiodarone for cardiac arrest, and transmyocardial revascularization.
Asunto(s)
Amiodarona/uso terapéutico , Antiarrítmicos/uso terapéutico , Braquiterapia/métodos , Cardiopatías/terapia , Revascularización Miocárdica/métodos , Humanos , Terapia por Láser/métodos , Guías de Práctica Clínica como Asunto , Resultado del TratamientoRESUMEN
Learn how to take a team approach to managing your patient's asthma. Strategies focus on preventing acute attacks, relieving acute attacks when they occur, and preventing complications.
Asunto(s)
Asma/terapia , Enfermedad Aguda , Adulto , Algoritmos , Antiasmáticos/uso terapéutico , Antiinflamatorios/uso terapéutico , Asma/diagnóstico , Asma/etiología , Broncodilatadores/uso terapéutico , Niño , Árboles de Decisión , Tratamiento de Urgencia/métodos , Tratamiento de Urgencia/enfermería , Femenino , Humanos , Rol de la Enfermera , Evaluación en Enfermería/métodos , Educación del Paciente como Asunto , Selección de Paciente , Ápice del Flujo Espiratorio , Recurrencia , Factores de Riesgo , AutocuidadoAsunto(s)
Asma/diagnóstico , Asma/terapia , Tratamiento de Urgencia/métodos , Tratamiento de Urgencia/enfermería , Enfermedad Aguda , Adulto , Algoritmos , Asma/epidemiología , Asma/etiología , Niño , Árboles de Decisión , Femenino , Humanos , Evaluación en Enfermería , Grupo de Atención al PacienteRESUMEN
BACKGROUND: Cardiac catheterization is a common procedure that involves the introduction of a small sheath (5F-8F) into the femoral artery for insertion of other diagnostic catheters. After cardiac catheterization, local compression of the femoral artery is required to prevent bleeding and to achieve hemostasis. Traditional methods of achieving hemostasis require significant time and close supervision by medical personnel and can contribute to patients' discomfort. VasoSeal is a recently developed device that delivers absorbable collagen into the supra-arterial space to promote hemostasis. OBJECTIVES: To compare outcomes between patients receiving a collagen plug and patients in whom a traditional method of achieving hemostasis was used after diagnostic cardiac catheterization. METHODS: An outcomes tracking tool was used to analyze the medical records of 95 patients in whom a traditional method was used (traditional group) and 81 patients in whom VasoSeal was used (device group) to achieve hemostasis. Complications at the femoral access site, patients' satisfaction, and times to hemostasis, ambulation, and discharge were compared. RESULTS: Hematomas of 6-cm diameter occurred in 5.3% of the traditional group; no complications occurred in the device group. The device group also achieved hemostasis faster and had earlier ambulation (P < .001). Patients in the device group were discharged a mean of 5 hours sooner than patients in the traditional group (P < .05). No significant differences were found in patients' satisfaction. CONCLUSIONS: VasoSeal is a safe and effective method of achieving hemostasis after cardiac catheterization that can hasten time to hemostasis, ambulation, and discharge.
Asunto(s)
Cateterismo Cardíaco , Arteria Femoral , Técnicas Hemostáticas/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Colágeno/administración & dosificación , Equipos y Suministros , Femenino , Hematoma/etiología , Técnicas Hemostáticas/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , PresiónRESUMEN
Accurate recognition of signs and symptoms and prompt diagnosis of myocardial infarction are essential for preserving myocardial function and saving lives. However, measurements of cardiac enzymes such as creatine kinase, lactate dehydrogenase, and their isoenzymes do not always provide accurate clinical diagnosis, particularly in patients with other concomitant diseases. Recently, alternative biomarkers of cardiac disease have been described: creatine kinase mass, cardiac troponins, and myoglobin. All cardiac biomarkers have some clinical usefulness in diagnosing acute coronary syndrome and acute myocardial infarction. Indications for use vary for each biomarker, and each has advantages and disadvantages and can be used at various times. However, the following must be considered: (1) Serial testing is essential with any biomarker. (2) None of the current biomarkers can be used to detect myocardial ischemia. (3) The decision of which biomarker to use should be based on the capabilities of the healthcare facility and the signs and symptoms of the patient.
Asunto(s)
Biomarcadores/sangre , Creatina Quinasa/sangre , L-Lactato Deshidrogenasa/sangre , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/enzimología , Mioglobina/sangre , Troponina/sangre , Humanos , Isoenzimas , Isquemia Miocárdica/sangre , Selección de Paciente , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Social support expected, discrepancies in support (differences between support expected and received), and self-esteem were used to predict emotional (tension and depression) and functional outcomes (recreation, housework, and social life) in a sample of women who had coronary artery bypass surgery (N = 86). Women were interviewed before hospital discharge (T1) and 1 (T2) and 3 (T3) months later. Higher self-esteem was associated with lower depression and tension (T3) and less disruption in social interaction (T2 and T3) and recreation (T3). Results suggest that social support may influence outcomes through enhancement of self-esteem. Directions for further study are given.