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51.
NANCY JEANNE CONLEY BA BSN ELLEN OLSHANSKY RNC DNSc 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》1987,16(5):321-328
Approximately 11,550 women with epilepsy give birth annually, yet maternity nurses receive little information on how to care for these patients. Children of epileptic mothers are born with an increased incidence of birth defects, and have a higher perinatal mortality rate. Complications such as bleeding during pregnancy, and interventions such as cesarean births and labor inductions are more common among epileptic women, and seizures tend to increase during pregnancy in more than one-third of epileptic women. Informed nursing care is essential to ensure the best possible outcome of these pregnancies. 相似文献
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KAREN ROETMAN MD LEILA WELBORN MD RAAFAT HANNALLAH MD ROBERT FINK MD JANET NORDEN MSN & REGINA O'DONNELL BA 《Paediatric anaesthesia》1997,7(5):391-397
This study compared recovery characteristics and postoperative ventilatory function when halothane, fentanyl or combination of halothane and fentanyl in addition to N2O were used for intraoperative anaesthesia in term infants undergoing hernia repair as outpatients. Sixty-six full term ASA PS I infants ages 1–12 months were studied. All received inhalation induction with N2O, O2 and halothane, followed by intravenous atropine and atracurium, tracheal intubation, and controlled ventilation. For anaesthesia maintenance, patients were randomized into one of three groups. Group I received 70% N2O, 30% O2 and halothane. Group II received 70% N2O, 30% O2, halothane and 2 μg·kg?1 fentanyl. Group III received 70% N2O, 30% O2 and 10 μg·kg?1 fentanyl. Awakening times were similar in all three groups, however, Group I patients had significantly shorter recovery and discharge times than those of Group II and III. None of the patients experienced postoperative apnoea or periodic breathing. One patient in Group III experienced two brief episodes of bradycardia not associated with apnoea or arterial desaturation (Spo 2 >90% for greater than 30 s). Decreased Spo 2 occurred less frequently in Group I (5.9%) compared to Group II (22.7%) and Group III (19.0%) patients, however, the group differences were not significant. Transcutaneous CO2 (TcCO2) values were not statistically different among the three groups. Pain scores were initially lower in Groups II and III, but at 120 min the differences were not significant. Postoperative apnoea was not observed in this study. Spo 2 <90% and TcCO2 >9 kPa (70 mmHg) was more common in infants receiving 2 and 10 μg·kg?1 fentanyl than in infants receiving halothane and nitrous oxide anaesthesia. Infants <3 months old did not have a higher incidence of Spo 2 <90% or significantly higher TcCO2 values when compared to infants >3 months old. Fentanyl in doses used in this study did not prolong awakening time but did prolong recovery and discharge times in outpatient infants. 相似文献
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Nigel Wynne RGN/Dip BSc Stuart Brand BSc PhD Roy Smith BA PhD 《Journal of advanced nursing》1997,26(3):470-474
There is an ongoing debate in nurse education concerning the role and delivery of the biological sciences in the nursing curriculum. One of the fundamental questions raised by this debate asks how best can teachers impart biological knowledge in a manner that can be readily applied by students and qualified nurses to inform their clinical practice. This paper will include a discussion of some of the features of pre-registration education that may have influenced the manner in which biological sciences are perceived, taught and used by nurses. It will be argued that nursing may have developed a form of incomplete holism and that this may be in part responsible for the challenges that remain to be met within this area of the nursing curriculum. As a response to incomplete holism an innovative approach within pre-registration education will be introduced. This development involves the use of linked teaching sessions which aim to develop the analytical skills necessary to apply physiological knowledge to nursing practice. 相似文献
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Jill Macleod Clark PhD BSc RGN Jill Maben MSc BA RGN Karen Jones BA RHV RGN 《Journal of advanced nursing》1997,26(1):161-168
This is the first of two papers which address aspects of the findings of a large scale study commissioned by the English National Board which set out to examine the impact of Project 2000 on perceptions of the philosophy and practice of nursing. The findings presented here suggest that there have been fundamental shifts in perceptions of the nature and discipline of nursing. Students and diplomates of the course perceive themselves as knowledgeable doers, with their practice well grounded in theory and research. They value the interpersonal skills teaching and place the patient firmly at the centre of care delivery, viewing the patient holistically and being prepared to be fierce patient advocates where necessary. It is difficult to determine the extent to which these shifts can be attributed to the Project 2000 course, although the Project 2000 approach to education appears to be an important factor. 相似文献
59.
E.K. Lavu FRCPA M. Nelson M.Sc PhD H.J. Popp AAIMS BA J. Gibson FRCP FRCPA PhD H. Kronenberg DCP FRCP FRCPA FRCPath H. Pearson FAIMS A. Child FRCOG 《The Australian & New Zealand journal of obstetrics & gynaecology》1997,37(2):180-183
Summary: regnant women who attended antenatal clinics at King George V Hospital, the Birth Centre or were referred by obstetricians from February to July. 1996 were screened for the platelet antigen HPA-la by flow cytometry. Forty out of 2300 (1.7%) were found to be negative for this antigen . Of the 28 women followed throughout their pregnancy, none developed antibody to HPA-la. Platelet counts performed on samples from 17 babies born to 17 of these mothers were all normal. This study proves the simplicity and rapidity of flow cytometry for platelet antigen screening. The results were comparable with the Solid Phase Red Cell Adherence (SPRCA) method and with PCR. The lack of a plentiful supply of specific antibody and the rarity of fetomaternai alloimmune thrombocytopenia (FMAIT) argue against the introduction of routine screening for maternal HPA-la status at the present time. 相似文献
60.
Dr. Paul Russo MD Young Kim MD Sanuj Ravindran BA William Huang BA Murray F. Brennan MD 《Annals of surgical oncology》1997,4(5):421-424
Background: Complete resection of a retroperitoneal sarcoma often requires removal of adjacent organs. In this study we evaluated the
role of nephrectomy during operation for retroperitoneal sarcoma.
Methods: Between July 1982 and July 1995, 75 of the 371 (20%) patients who underwent resection of retroperitoneal sarcoma at MSKCC
underwent concommitant nephrectomy. Data concerning the reasons for nephrectomy, degree of sarcomatous renal involvement,
and survival were retrospectively analyzed.
Results: Fifty-four patients (72%) underwent nephrectomy during the initial resection, and 21 (28%) during a resection of a recurrent
or persistent tumor. The most common reason for nephrectomy was total encasement by sarcoma (n=40; 53%), followed by dense
adherence of the tumor to the kidney (n=21; 28%), and the direct invasion of the kidney by tumor (n=2; 3%). Pathology demonstrated
an absence of kidney invasion in the majority of cases (55 of 75; 73%). Renal capsular invasion was present in 11 of 75 (15%),
renal parenchymal invasion in 7 of 75 (9%), and renal vein invasion in 2 of 75 (3%) of cases. There were no significant differences
in survival based on degree of sarcoma involvement of the kidney, tumor grade, or whether the resection was for primary or
recurrent disease. The 53 patients who underwent a complete gross resection of all tumor had a significantly improved long-term
survival compared to the 20 patients who did not (50% versus 20% DFS at 5 years, respectively; p<0.001).
Conclusions: Decisions for concomitant nephrectomy during resection of retroperitoneal sarcoma should be based on whether this maneuver
will provide a complete resection of all gross tumor, in which case the long-term disease-free survival of 50% is comparable
to the reported 5-year survival of all patients with retroperitoneal sarcoma who are completely resected.
Presented at the 49th Annual Cancer Symposium of the Society of Surgical Oncology, Atlanta, Georgia, March 21–24, 1996. 相似文献