Pain of moderate to severe intensity continues to be an important problem for many hospitalized patients.Nurses spend more time with patients than any other health professional group and have a key role to play in the management of patients' pain. This paper reports the findings from a series of focus group interviews which were undertaken to explore nurses' perceptions regarding pain and the administration of narcotic analgesia.Themes identified from participants' comments related to (1) the pivotal role of nurses in pain management; (2) nursing assessment and pain management decisions (3) individual factors influencing nurses' pain management decisions and (4) the influence of others on nurses' pain management decisions.These findings have implications for further research and the development of innovative educational strategies.
NEONATAL VASCULAR THROMBOSIS is rare; however, it is emerging as a more frequent problem in tertiary neonatal care.1Both the incidence and severity of thromboembolic events are increasing in children, with newborns being the largest group affected.2A 1995 Canadian study estimated that the incidence of clinically diagnosed cases of neonatal thrombosis was 2.4 per 1,000 admissions.3A two-year study published in Germany in 1997 reported 5.1 per 100,000 births.4The first study reported that thrombotic disease diagnosed in neonates is most commonly associated with the presence of an indwelling intravascular catheter. The second study reported that most venous thromboses were diagnosed in the second week of life in premature or mature infants in the upper venous system and were directly associated with indwelling central catheters. Although spontaneous thrombosis does occur, it is usually confined to the renal veins.3
My name is Roberta Clark and I have subscribed to your journal for many years as well as published in it. I was recently reading an article in the March/April 2007 issue entitled “Potassium and Sodium Homeostasis in the Neonate,” and have a few questions. On page 127, Table 1 lists the common therapies for hyperkalemia, and the first question I have is what reference(s) did the author use to extrapolate that data? The formula for the insulin glucose infusion is very vague. It states that one should start insulin 0.2 unit/kg/hour with glucose 0.5 gm/kg/hour, and I am uncertain as to what this actually means. First of all, how does one calculate gm/kg/hour on a glucose infusion when the formula doesn’t give a specific concentration of glucose, or is this variable? Then I am curious about whether this is a supplemental infusion or included in the total glucose load for the patient. I retrieved articles number 4 & 12, as referenced in the section “Treatment of K+ Imbalance,” and found no information dealing with a specific gm/kg/hour rate of glucose infusion to be used with the initiaition of insulin for hyperkalemia.
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