Outcomes in non-surgical management for bowel dysfunction.

This retrospective review considers clinical outcomes of patients following non-surgical management of bowel dysfunction (faecal incontinence and constipation), within a tertiary centre's pelvic floor unit. Between November 2010 and January 2013, 443 patients were entered into a database and the results of their treatment were recorded. To capture the treatment modalities that patients received they were grouped into three categories: defaecatory techniques and/or pelvic floor exercises; dietary advice and/or medication recommendations; rectal irrigation or the use of anal plugs. Patients received a median number of three sessions with a specialist nurse or physiotherapist. After completing a programme of therapy, 81% of patients had an improved St Mark's incontinence score and 75% of patients had an improved Thompson's functional constipation score. Subjective symptom improvement was reported in 78% of patients. The majority of these patients were discharged in 2011 and 2012 and have not required follow-up, suggesting that non-surgical management is effective on a medium-term basis.

Hypnosis for pain management in the older adult.

Pain is a physical, emotional and psychologic phenomenon that is often ignored in older adults causing depression and poor quality of life. Older adults report the use of complementary and alternative medicine in some form with 80% of these users reporting improvement in their health conditions. Although physical pain in the older adult is usually managed with pharmacologic interventions, methods that may reduce the use of prescription drugs may decrease adverse effects that can compromise the physiologic state of the older adult. Hypnosis has continued to gain acceptance within mainstream medicine as an appropriate treatment and can be integrated safely with conventional medicine as an effective treatment for a variety of conditions in the older adult. It is an intervention that can be used for relaxation and pain control, especially when conventional pharmacologic regimens have failed. The purpose of this article is to review the concepts related to pain in older adults; the use of complementary and alternative medicine in the older adult; hypnosis and the older adult (i.e., background, definition, benefits, research, mechanism of action, hypnotizability, and the process); and the implications of using hypnosis for pain management in the older adult.

Bone metabolism and disease--K/DOQI impact on nurses and dietitians.

Earlier monitoring and treatment of elevated phosphorus and PTH prior to initiation of dialysis may prevent the development of bone disease. We can no longer be complacent or content with patients having a calcium-phosphorus product of 70 or phosphorus of 6.0. When we strive for the recommended optimal levels and goals and work toward these new goals we will improve our patient outcomes. We must be vigilant and have an increased intensity of focus on bone metabolism as part of the total patient care. The entire team serves to provide ongoing education and encouragement throughout the continuum of care with the CKD client.

Restless legs syndrome: a case study.

Restless legs syndrome (RLS) is a sensory motor neurological movement disorder affecting 12 million Americans. Few healthcare providers know of the existence of this syndrome. Often underdiagnosed and unrecognized because of comorbid conditions, RLS is a lifelong condition with worsening symptoms. For the healthcare provider, RLS may present with confusing symptoms. With no cure, treatment is often unsuccessful in alleviating the discomfort associated with the syndrome. Although RLS is a common, potentially disabling condition, neuroscience nurses may provide interventions to assist in the successful management of the syndrome.

How a specialist nurse helps patients undergoing deep brain stimulation.

Deep brain stimulation is becoming the most frequently used neurosurgical treatment for patients with complex Parkinson's disease. This paper reports on the creation of a clinical nurse specialist role in a Scottish hospital's movement disorder team to support patients going through this treatment and their families, working with the neuroscience nurses and multidisciplinary team.

Caring in forensic nursing. Expanding the holistic model.

Nurses have practiced forensic nursing for many years without formal recognition of the domain as a discipline for specialized study. Forensic nursing expands the traditional concept of holism to include the medical-legal aspects of potential or actual client problems. The American Nurses Association (ANA) and the International Association of Forensic Nurses (IAFN) recently have designated forensic nursing as a unique specialty. Recognition of forensic nursing as a specialty area of practice within nursing mandates that the specialty define and explicate its major conceptual base. A concept germane to the practice of forensic nursing is that of caring. Caring as a central concept to the role of this specialty is discussed, and the implications for its inclusion in a curriculum preparing forensic nurses are explored.

The use of glutamine and its implications for the WOC nurse.

Glutamine is the most abundant free amino acid in the body. It is synthesized and stored in skeletal muscle and released in significant amounts during times of stress. Glutamine is primarily used by rapidly replicating cells such as enterocytes, lymphocytes, macrophages, and fibroblasts. The role of glutamine supplementation in certain disease states has been extensively studied during the past decade, with use of both animals and human subjects. This article will review glutamine supplementation and its implications for WOC nursing practice.

Bowel preparation for rectal and colonic investigation.

BACKGROUND: Nurses need to have a clear understanding of the reasons for effective bowel preparation for patients undergoing imaging of the rectum and colon. CONCLUSION: Depending on the specific investigation, a variety of effective oral and rectal preparations are available. One of the most important deciding factors in choosing which should be used is patient tolerance.

The role of the gastroenterology nurse in colorectal cancer screening.

This article provides an overview of the incidence of colorectal cancer in the United States and describes personal and familial factors that increase a person's risk for developing colorectal cancer. Recommendations for each classification of patient risk group are outlined. An in depth review of screening justification for colorectal cancer is presented as well as the American Cancer Society's recommendations for screening. Descriptions of and recommended frequency for fecal occult blood tests, flexible sigmoidoscopy, double contrast barium enema, and colonoscopy are explained as well as the advantages and disadvantages of each test. The role and fundamental responsibilities of the nurse endoscopist are presented based on the author's personal experience. Factors that influence patient compliance are also described, including the role of the gastroenterology nurse in facilitating colorectal cancer screening.

Electrical stimulation of the overactive bladder.

Bladder overactivity is a significant health-care problem. Electrical stimulation has been shown to be a safe and effective treatment option. Careful patient selection may improve results obtained with this technique. Further studies are required to determine optimal treatment parameters.

Centering: reducing rape trauma syndrome anxiety during a gynecologic examination.

1. Individuals often delay seeking routine gynecologic care or have difficulty completing gynecologic examinations due to the effects of trauma. 2. Advance practice nurses (APN) are challenged to participate with clients to reduce their anxiety, thereby decreasing the health risks associated with avoiding routine gynecologic care. 3. "Centering" is a holistic, noninvasive modality to reduce anxiety associated with rape trauma syndrome.