Prolonged QT Interval in Patients Receiving Psychotropic Medications.

INTRODUCTION: Prolonged QT interval (PQTI) is a cardiac condition widely documented in the mental health literature and linked to psychotropic medication use. Medications notable for contributing to the condition are antipsychotics, antidepressants, and some mood stabilizers. Although additional medication classes and other contributing risk factors are often present, the prudent mental health provider benefits from having a basic understanding of this condition and how to prevent and manage it with safe prescribing practices. AIMS: This guide seeks to provide mental health prescribers with a basic understanding of the risk factors, pathophysiology, identification, and management of PQTI. METHOD: Relevant literature and practice guidelines were reviewed and summarized with a focus on practical interventions for the psychiatric mental health nurse practitioner (PMHNP). RESULTS: One of the primary contributing factors to PQTI development and complications is polypharmacy. Patients with co-occurring medical, mental health, and/or substance use disorders may receive medications from multiple providers. Anticancer drugs, antiarrhythmic medications, and even a number of common antibiotics can increase the QT interval, making it a challenge for even the most experienced mental health provider to monitor medication interactions and side effects that contribute to PQTI. Having a sound knowledge base of these factors can guide safe PMHNP practice. CONCLUSIONS: Decision-making trees grounded in evidence-based research were developed in order to direct thorough assessment and safe treatment of patients requiring psychotropic medications.

Assessing adults with leukemia.

Patient history, physical findings, and laboratory and diagnostic tests can assist in efficient and effective assessments of adults with leukemia who are undergoing conventional chemotherapy and follow-up monitoring. A systematic approach can enhance assessment and improve early detection of common problems that impact complications, care, and cost.

Year 2000 Oncology Nursing Society Research Priorities Survey.

PURPOSE/OBJECTIVES: To determine the Oncology Nursing Society's (ONS's) research priorities for 2001-2005 for oncology nursing across the entire scope of cancer care, including prevention, detection, treatment, and palliative care. DESIGN: A cross-sectional, mailed survey. SAMPLE: Stratified by the general member group (i.e., a random sample of 1,850 ONS members) and researcher group (i.e., census of 150 ONS researchers). 788 responded for an overall response rate of 39%. MAIN RESARCH VARIABLES: 113 topics that were identified from the 1994 ONS Research Priority Survey questionnaire and earlier ONS Research Priority Surveys, with the addition of 20 new items to existing questionnaire categories and one new category area: health services research. FINDINGS: Top 20 research priorities were distributed across six of eight questionnaire categories, and the number of top 20 priorities within categories differs. Compared to the 1994 survey, 9 topics were common to both top 20 lists; 8 were new to the top 20, and 11 dropped out of the top 20. When the researcher group and adjusted total sample group top 20 priority ratings were compared, nine topics were common to both groups. CONCLUSIONS: Examining research priorities affords different perspectives to guide practice, education, research, management, and administration. IMPLICATIONS FOR NURSING: ONS Research Priority Survey results provide an important foundation for developing future research across the entire scope of oncology nursing.

Chemotherapy-induced nausea and vomiting.

Nausea and vomiting (N&V) is among the most distressing side effects of chemotherapy, despite the development of more efficacious antiemetic agents. As many as 60% of patients who receive cancer chemotherapy experience some degree of N&V. However, the actual incidence is difficult to determine with accuracy because of the variety of drugs, doses, and health conditions of the patients who receive cancer treatments. This article examines the state of the science related to chemotherapy-induced nausea and vomiting and reviews both pharmacologic and behavioral strategies that have demonstrated efficacy in managing these distressing symptoms.

Advanced practice nursing: reflections on the past, issues for the future.

PURPOSE/OBJECTIVES: To provide a comprehensive historical review of advanced practice nursing, describe the development of the professional role of oncology advanced practice nurses (APNs), and document the current status of major issues. DATA SOURCES: Published articles, research findings, position papers and statements, conference proceedings, books, newsletters, newspaper articles, executive summaries, standards and guidelines, and personal communications. DATA SYNTHESIS: The oncology APN role has evolved over the past 100 years in response to the healthcare needs of society and available educational opportunities. Trends in health care and education continue to influence the expansion of the professional APN role. CONCLUSIONS: Oncology APNs are prepared to practice in a variety of roles, providing expert clinical, educational, emotional, and supportive care to patients with cancer. Several major professional issues have been identified and addressed. Oncology APNs must document the influence of expert nursing care on patient outcomes and organizational efficiency.