Coronary heart disease is just as serious a problem for women as it is for men, yet historically women have been significantly underrepresented in research studies related to the disease and treatment options, including cardiac surgery. Cardiac surgery is a proven therapy for the management of coronary heart disease in women. Research addressing the physical, psychosocial, and emotional issues women face during the preoperative, postoperative, and recovery phases of surgery is limited. Nurses play a pivotal role in the education and management of women undergoing cardiac surgery and need to be aware of unique issues related to the experience. This article reviews the literature pertaining to women's issues during the perioperative and recovery phases of cardiac surgery.
1. The determination of urinary sugar and acetone by ward nursing service personnel is often inaccurate. In 12 per cent of the tests reported in this study the level of inaccuracy could lead to significant errors in management.2. Lack of familiarity with the test procedures and personal bias were two major factors associated with these inaccuracies. Both may be reduced by better training and supervision.3. Limitations in the test procedures are also a major factor. These cannot be eliminated completely but the twodrop Clinitest method for urine sugar offers several advantages and should be used in preference to the five-drop method. DIABETES J7: 281-85, May, 1968. Routine testing of urine for sugar and acetone in patients with diabetes mellitus is employed almost universally. The results of the tests are used mainly in the evaluation of adequacy of the control of carbohydrate defect. In addition, the results often determine the doses of Regular Insulin employed in acute periods of loss of control. The commercial preparations available to perform these tests are reasonably reliable and give good reproducibility when performed correctly. Nevertheless, a number of pitfalls exist in their performance and interpretation. 1 Our experience indicated that mistakes of considerable magnitude were common in routine testing on our wards. We could find no studies of the reliability of these methods as carried out by hospital ward personnel. Accordingly, two tests were evaluated as performed by personnel assigned to test diabetic urines on the medical wards of a large private hospital affiliated with a medical school. METHODSThe test materials employed were Clinitest for sugar and Acetest for acetone. All urine used in these studies was obtained from one healthy subject during water diuresis on the days that the test sets were prepared. Two drops of toluene were added as a preservative to each ioo ml. of urine. Before use the urine was screened with glucose oxidase paper, Clinitest and Acetest, to assure that no detectable sugar or acetone was present. Glucose was added in weighed amounts to exact volumes to obtain solutions of known concentration. Acetone was added, drop by drop, with careful testing between additions until the desired colors were obtained on the test tablet. All urines were then tested with Clinitest and Acetest by three experienced technicians who had no knowledge of the concentration of the added components, and the samples were used only after they concurred in results.In the first study five urine samples containing various concentrations of glucose and acetone were used. The sugar concentrations were 5 per cent, 2 per cent, 1 per cent, 0.5 per cent, and none. Acetone was added to duplicate the large, moderate and small concentrations shown on the color chart supplied by the manufacturer. No acetone was added to one urine and reduced glutathione was added to the other to give an immediate purple color, fading within fifteen seconds (hence a false positive). The amounts of sugar and acetone added to ea...
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