Osteoporosis: Diagnosis and management updates.

ABSTRACT: Osteoporosis, a common chronic bone disease, results in reduced bone mineral density and heightened fracture risk, particularly vertebral fractures. This article provides an overview of the condition's diagnosis and management updates.

Preventing transfusion-associated circulatory overload in acute care settings.

ABSTRACT: Transfusion-associated circulatory overload (TACO) is a potentially life-threatening complication that can occur with the transfusion of any blood component, and accounts for up to 24% of transfusion-associated patient fatalities. This article discusses how to develop evidence-based continuing education and guideline recommendations that will increase nursing staff awareness of TACO and guide nurses in prevention and prompt intervention.

CE: Type 2 Diabetes: A Pharmacologic Update.

Of the more than 30 million Americans who have diabetes mellitus, as many as 95% have type 2 diabetes. While interventions for type 2 diabetes include modifying diet and exercise, pharmacologic therapy is a mainstay in diabetes treatment. In recent years, with the addition of new medications and medication classifications, pharmacologic therapy for type 2 diabetes has changed dramatically. Nurses need to understand the many pharmacologic agents and combination therapies now in use. This article includes established as well as more recently introduced type 2 diabetes medications, as well as nursing implications regarding patient education and the monitoring of patients for adverse effects.

Therapeutic hypothermia after cardiac arrest.

Recent evidence supports the use of therapeutic hypothermia after cardiac arrest. This article reviews recent published studies and describes the pathophysiology of hypothermia. Nurses need to understand the physiology of hypothermia to provide care for patients receiving therapeutic hypothermia. A suggested protocol is included to help manage the care of these patients.

Decompressive hemicraniectomy with duraplasty: a treatment for large-volume ischemic stroke.

Increased intracranial pressure (ICP) is a cause of death and disability in neurological patients. Patients experiencing malignant stroke of the middle cerebral artery (MCA) have a high mortality related to cerebral edema, increased ICP, and subsequent cerebral herniation. Decompressive hemicraniectomy with duraplasty is a surgical option for those experiencing large volume MCA stroke. When decompressive hemicraniectomy with duraplasty is performed, functional outcomes improve if the MCA stroke candidate is younger, the onset of increased ICP occurred less than 24 hours before surgery, and surgery is performed before clinical signs of herniation syndrome occur. The level of care required for these patients makes nursing care challenging.

The PFA-100: analysis and interpretation of a platelet function measurement.

The PFA-100 is a laboratory test designed to measure platelet function. Adequate platelet function depends upon the platelet's ability to adhere to the site of endothelial injury, activate surface receptors to attract other platelets and aggregate or clump together to form a platelet plug. This process is necessary to stop bleeding but may be harmful if it causes occlusion of a vessel. Platelet altering medication therapy is widely used in the prevention and treatment of coronary artery disease, peripheral arterial occlusive disease, and cerebrovascular ischemia. The PFA-100 provides the clinician with valuable information about platelet function. This information is helpful in determining the therapeutic effectiveness of antiplatelet medications, assisting in evaluating risk of bleeding and identifying primary platelet dysfunction.

Evidence-based practice for the use of N-acetylcysteine.

The use of N-acetylcysteine has increased in the prevention of radiographic contrast induced nephrotoxicity. Many nurses need to be aware of the proper administration and action of this prophylactic agent. This article discusses the research behind the use of N-acetylcysteine and the protocol for administration to prevent radiographic contrast-induced nephrotoxicity.

The coronary artery bypass experience: gender differences.

OBJECTIVE: The primary purpose of this study was to examine differences between women and men on physical, social and psychological domains of health quality of life before, 1 month after, and 3 months after coronary artery bypass surgery. DESIGN: A prospective, longitudinal design was used. SETTING: The study was conducted at a Midwestern, 500-bed community hospital with an ongoing cardiothoracic surgical program. PARTICIPANTS: Forty pairs of women and men matched on age within 5 years and body surface area within 0.1m 2. INSTRUMENTS: The physical, social and psychological domains of health quality of life were assessed using the following instruments: Ferrans and Powers Quality of Life Index, Specific Activity Scale, Symptom Scale, Profile of Mood States, Overall Health Rating Index, and Personal Resource Questionnaire. RESULTS: Both women and men improved on physical and psychological measures following coronary artery bypass surgery. Compared with men, women reported more shortness of breath and depression and lower ratings of activity, vigor, and overall health. Measures of social support yielded little information. CONCLUSIONS: Despite matching for age and body surface area, women did not have as favorable an outcome after surgery as men. Continued research needs to further examine the interaction of physical outcomes and depression in women after coronary artery bypass surgery.