RESUMO
Myofascial pelvic pain is a common, nonarticular musculoskeletal disorder characterized by the presence of myofascial trigger points in the lower abdominal wall and/or pelvic floor muscles. Myofascial pelvic pain is involved in an estimated 22% to 94% of cases of chronic pelvic pain, which is one of the most common gynecologic conditions in the United States. Myofascial pelvic pain may exist independently or in conjunction with disorders such as vaginismus, dysmenorrhea, and endometriosis and is frequently a causative factor in sexual pain or dyspareunia. This article reviews the pathophysiology, assessment, and treatment options for myofascial pelvic pain, with a particular focus on trigger point injections. Increased recognition and treatment of this commonly overlooked diagnosis has the potential to improve care and outcomes for many patients suffering from chronic pelvic pain.
Assuntos
Dor Crônica , Endometriose , Síndromes da Dor Miofascial , Dor Crônica/etiologia , Dor Crônica/terapia , Dismenorreia/etiologia , Dismenorreia/terapia , Feminino , Humanos , Síndromes da Dor Miofascial/complicações , Síndromes da Dor Miofascial/diagnóstico , Síndromes da Dor Miofascial/terapia , Dor Pélvica/etiologia , Dor Pélvica/terapiaRESUMO
Vitamin K is important in the clotting cascade, and vitamin K prophylaxis is important in preventing vitamin K deficiency bleeding (VKDB) in newborns. Breastfed newborns have been found to be particularly vulnerable to VKDB. Although oral vitamin K is available, there is no version for newborns approved by the U.S. Food and Drug Administration (FDA), and if a dose is missed, the risk of VKDB may more than double. Therefore, an injection is recommended by the American Academy of Pediatrics to prevent VKDB in newborns. Nurses often administer the newborn vitamin K injection, and they play a key role in educating parents and helping them make informed decisions about vitamin K prophylaxis for their newborns.
Assuntos
Antifibrinolíticos/uso terapêutico , Quimioprevenção/enfermagem , Pais/educação , Sangramento por Deficiência de Vitamina K/prevenção & controle , Vitamina K/administração & dosagem , Feminino , Humanos , Recém-Nascido , Sangramento por Deficiência de Vitamina K/enfermagemRESUMO
Advances in health care science and delivery, coupled with patient need for access to care, have driven expanded practice in midwifery for decades. The process for development and implementation of expanded practices for midwives and midwifery practices is described. Important components include assessment of need, identifying stakeholders and supporters, development of a program proposal, obtaining privileges, developing training programs, and conducting ongoing quality management and program evaluation. Examples of expanded practice in midwifery are presented.
