Dietary essential fatty acids in cystic fibrosis.

Analyses of serum lipids of children with cystic fibrosis (CF) have indicated a deficiency in essential fatty acids (EFA). In view of a report that intravenous administration of soybean oil emulsions normalized sweat sodium values in CF children, we studied the effects of orally administered essential fatty acids (as corn oil) for one year. Some improvement was noted in all patients, but no one consistent factor predominated. However, arachidonic acid, which was found only in trace amounts or was absent in sera of all children with CF before the clinical trial, was increased significantly in the sera after the oral administration of EFA for one year. Other findings included a significant decrease in sweat sodium and T3 in most patients.

Success in NCLEX-RN: identifying predictors and optimal timing for intervention.

This ex post facto study was designed to identify predictors of success in the NCLEX-RN and determine the optimal point in time for identifying students at risk. The convenience sample consisted of 407 graduates of an integrated, upper division, baccalaureate nursing program, 1984-1987. Prematriculation (total lower division GPA, science GPA, type of lower division College, age, and sex), junior year (three Nursing theory course grades) and pre graduation variables (three senior year nursing theory course grades and Mosby ASSESSTEST) were analyzed for predictive value. Nursing theory courses at the junior and senior year and the Mosby ASSESSTEST strongly correlated (p less than .0001) with NCLEX performance. Discriminant analysis enabled successful classification of 62% of the sample at prematriculation, 81% at the end of the junior year, and 86% at the end of the senior year. The study indicates that students at high risk can be identified at the end of the junior year so that enrichment and support programs can be introduced at that time.

Update: new guidelines for the treatment of infants with sickle cell disease. Agency for Health Care Policy and Research.

These clinical practice guidelines set forth a comprehensive program for identifying, diagnosing, and treating newborns and infants with sickle cell disease and recommend education and counseling strategies for their parents. Sickle cell disease comprises a group of genetic disorders characterized by the production of hemoglobin S, anemia, and acute and chronic tissue damage secondary to the blockage of blood flow by abnormally shaped red cells. Sickle cell anemia is the most common form of the disease, and it affects approximately 1 in 375 African-American infants. Although in the United States sickle cell disease is most commonly found in persons of African ancestry, it also affects other populations. The panel recommends screening of all newborns for sickle cell disease, since targeting specific groups will miss some infected infants. Samples of dried blood on filter paper or liquid blood samples should be used for hemoglobinopathy screening. Hemoglobin electrophoresis, isoelectric focusing, and high performance liquid chromatography are acceptable, reliable, and accurate testing methods. Infants identified on initial screening must be retested to establish a definitive diagnosis. Affected infants must be given twice-daily oral penicillin beginning at 2 months of age to reduce pneumococcal, conjugated Haemophilus influenzae, and hepatitis B vaccines. Infants with sickle cell disease require the same well-child care as infants without the disease. Education and nondirective genetic counseling should be offered to all parents of infants with sickle cell disease. The guidelines stress the need for a comprehensive and fully integrated approach to reduce morbidity and mortality from sickle cell disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Pediatric rehabilitation: from concepts to practice.

The field of pediatric rehabilitation nursing is a relatively new one in which professionals have raised many pertinent questions. A theoretical basis and an organizing framework are needed in this specialty field in order to assure that we are providing comprehensive and holistic care.

The guidelines for immunizations have changed ... again!

Once again, the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (1994) issued new guidelines for immunizations. Pediatric nurses should be aware of these new recommendations, summarized in this article.

Infectious diseases and the immunizations of today and tomorrow.

For decades, health care providers have administered immunizations for common childhood infections. These have been given at predicted times according to an agreed-upon schedule. However, in the past decade, common immunizations have been changed, the number of immunizations has increased, and the schedule for administration of vaccines officially changes every January. In addition, as science continues to grow, new vaccines are being developed faster than ever before.

The multiple faces of immune deficiency in children.

Immune deficiency in children comes in many different forms. This article differentiates these forms from a physiologic perspective and identifies implications for the pediatric nurse.

Understanding hearing loss in children.

At some point in their career, nurses will care for a child with a hearing loss. Understanding how to work best with these children necessitates an in-depth knowledge of how the hearing loss impacts both the child and family. Each component is interrelated. Knowing, for example, that the child has a profound sensorineural hearing loss tells the nurse much about the child's potential prognosis for improvement, use of amplification, communication style, and parental and family stress. While many variables impact on these basic features, they set the foundation for a deeper understanding and the formation of a stronger, trusting bond between the nurse and patient. As in all professional fields, issues related to deafness continue to change. There are new and improved forms of amplification as well as various effective communication methodologies. Most importantly, there is a change in attitude. The deaf do not view themselves as disabled. Instead they have a sense of pride in sharing a culture and a common language. Through this understanding, respect for one another can be achieved.

Nursing perceptions of using physical restraints on hospitalized children.

PURPOSE: To describe the perceptions of pediatric nurses about restraint use in children. METHOD: A descriptive survey using a questionnaire collected data from nurses working in four types of pediatric facilities. Nurses were asked to rate reasons for using restraints and alternatives to restraints on a Likert Scale. Analysis of variance analyzed the nurses' responses according to type of institution and age of the child. An open-ended question asked nurses to list reasons for using restraints. RESULTS: Responses were collected from 60 nurses. There were significant differences in responses according to age of the child and according to the type of hospital. There were no interaction effects. The perceived need for restraints was highest between 1 and 6 years of age. Reasons for using restraints differed among types of facility. CONCLUSIONS: Restraint policies may need to vary according to the type of institution. Intervention and outcome studies are needed regarding the use of physical restraints in children.

Institutional policies on the use of physical restraints on children.

Within health care institutions, nursing policies often serve as the gold standard for nursing practice. Policies regarding the use of physical restraints on children are typically not based on any scientific evidence. This article analyzed multiple hospital policies and makes recommendations to better assess whether or not restraints are needed, suggests a list of least to most restrictive devices, identifies interventions for the child in restraints, and offers alternatives to the use of restraints.

Beyond hospital walls: educating pediatric nurses for the next millennium.

As pediatric units in acute care hospitals close, as lengths of stay shorten, and as increasing numbers of procedures are completed on an outpatient basis, faculty must find different learning experiences for their prelicensure students. Some programs have discontinued pediatric rotations, others are seeking clinical experiences in community settings. These community experiences hopefully produce a more well-rounded, globally thinking nurse to practice in the 21st century, yet they also raise a number of concerns.

Sex and sexuality for the adolescent with a chronic condition.

Sexuality and sexual identity are developmental milestones that occur throughout the life span with sexual maturation usually occurring during adolescence. Parents and health care providers must prepare children with chronic conditions for this important component of adulthood to which they are entitled.

Jewish women and nursing: an overview of early history.

This paper seeks to fill a gap in nursing historiography by presenting an overview of the historical presence of Jewish women in nursing. The topic is viewed within the context of women's history and of nursing history. The authors identify several illustrious Jewish women whose contributions to nursing have earned them a place in the annals of the profession. It is hoped that this article will inspire studies about Jewish women in nursing today.