Immunotherapy: concepts and nursing implications.

Concepts of immunlogy and the human immune system are essential for an understanding of the rationale of immunotherapy. Immunotherapy is presently being investigated as adjunct therapy for patients with cancer. It is therefore essential for the professional nurse to become cognizant of the various modalities and possible complications of immunotherapy in order that the nursing implications may be incorporated into clinical practice.     

Hypertension: medical and nursing implications.

Hypertension is a major public health problem affecting 20 to 30 million people in the United States, many of whom are undetected, untreated, or inadequately treated. Because hypertension often is asymptomatic for decades, it must be systematically sought out in apparently well persons if the condition is to be treated in its earliest stages and complications prevented. With the recent advent of effective antihypertensive medications treatment is available, once the patient has been diagnosed. Physicians and nurses have a major responsibility to direct the patient into treatment and to assure the effectiveness of his follow-up care. Noncompliance is a direct challenge to everyone seeing the patient. The patient must be motivated to accept and continue therapy through education and, most important, by the establishment of a good interpersonal relationship with the nurse and/or the physician.     

Breast feeding

Breast feeding is becoming more popular among all socioeconomic classes. By providing instruction and care of the mother and infant, the physician can greatly enhance the chances for success. Although breast feeding is a natural function, the proper technique needs to be learned. There are relatively few contraindications. The infant requires vitamin K at the first opportunity and supplementation with vitamin D and fluoride as necessary. Recommended daily dietary allowances are increased for nursing mothers. The physician must understand the effects of different contraceptive methods on lactation.     

Breast feeding and society

Britain has the lowest breastfeeding rate of all countries in Europe; it is no longer the cultural norm in our society. Breastfeeding rates are affected by public attitude. This state of affairs is partly because of society's views on breastfeeding mothers, even though breastfeeding is known to be the optimum method of infant feeding for the baby, family and society. Common themes in the literature and websites are the economic advantages of breastfeeding, the public health benefits and the social construct of breastfeeding. Paediatric nurses have an important role in supporting breastfeeding mothers so that they are able to continue breastfeeding.     

Breast feeding: success or failure

Awareness of the important role of breast feeding in child health and the reproductive cycle, which is well documented elsewhere, necessitates an examination of the changing practice of breast feeding. This paper reviews these changing practices both in Western and developing societies, examines the problems which lead to lactation failure, and looks at factors related to success in breast feeding.
In the light of the need for practical help for successful breast feeding, the present system of support both in hospital and at home is then discussed. An alternative system of structured home support for post-natal women, which has been shown to increase the success rate of breast feeding, is outlined. The way in which this system acts is discussed and the implications for both mothers and health staff are considered.     

Masochism: implications for psychiatric nursing.

Psychiatric nurses often encounter patients who seem to be victims of negative circumstances and are unable to reverse these situations. This article explores the phenomenon of masochism as an outcome of the fear of separation or abandonment. A unified theory is presented, and a case is used to demonstrate the theory.     

Coronary atherectomy: overview and implications for nursing.

Coronary atherectomy, a new invasive procedure for the treatment of atherosclerotic heart disease, consists of the excision and removal of atherosclerotic tissue from coronary artery walls. This article provides current information on atherectomy, including its potential advantages over percutaneous transluminal coronary angioplasty (PTCA). Indications, limitations, medical research, and implications for nursing research are described. A case study is presented.     

Alternative and complementary healing: implications for nursing.

The current interest in alternative and complementary therapies is examined within the social context of technology, economics, and philosophical beliefs of a culture that is moving from the Industrial Age into the Information Age. A philosophical shift toward ecology, religion, and spirituality coincides with a shrinking global perspective resulting in increased accessibility to healing ideologies from other cultures. The community of alternative and complementary healers is responding to these social conditions by offering healing modalities congruent with public interests. Responses of the health care industry are discussed as are the similarities of alternative and complementary healing to nursing practice. Implications for nursing research, practice, and education are suggested.     

Breast feeding and infant nutrition

Breast feeding is a management problem requiring knowledge of the physiology of lactation, maternal and infant nutritional requirements, and specifics such as drugs which enter the milk. The job of the physician is to allay anxiety; this helps establish the let-down reflex and increases milk production. "Caking," mastitis and even abscesses are not indications for weaning. Rest, warm compresses and frequent nursing are indicated. Breast-fed infants have less tendency to obesity than those who are bottle-fed. Early solid foods in the diet are not needed.     

Durable power of attorney: nursing implications.

Written, witnessed advance directives such as Durable Powers of Attorney and Living Wills communicate patients' care preferences. The critical care nurse must be knowledgeable about these legal documents to be able to effectively uphold the specific care requests. The authors define advance directives and outline the role of the nurse in execution of these directives.     

Outcomes assessment: implications for nursing education.

In response to public criticisms about the outcomes of higher education, colleges and universities have implemented comprehensive assessment programs. In nursing education, outcomes assessment has become a criteria for accreditation. Yet, currently no guidelines exist describing "best practices" in nursing education outcomes assessment. Experts in educational assessment provide helpful guidelines for nurse educators as they establish comprehensive assessment plans. The authors provide a review of the literature in the field of assessment and offer strategies for developing successful assessment programs in nursing education.