Updating Care of Cesarean Section Patients

At a time when prepared childbirth and the participation of both parents in labor and delivery is being stressed, nurses need to reexamine the impact of a cesarean section on the family. Nurses need to he active in modifying those experiences of a cesarean section family that may he in direct conflict with their expectations: loss of participation in delivery, separation of the couple during delivery, diminution of the father's role, and prolonged isolation of the infant front the parents after delivery. Nursing cure of these patients should be maternity-oriented rather than surgery-oriented.     

Neonatal Heat Loss in Heated Cribs vs. Mothers' Arms

One hundred and fifteen infants were studied to determine whether neonates who are dried well and adequately covered can be held by their mothers on the delivery table for If minutes after birth without significant loss of body heat. All subjects were dried and swaddled. Their rectal temperatures were taken at 5 and at If minutes after birth. Temperatures of infants placed in heat beds were compared with temperatures of those held by their mothers on the delivery table. The temperatures of both groups remained within the acceptable range of heat loss (9°F per f minutes; 2.7°F per If minutes). The difference in the mean temperatures of the two groups was not significant. Results indicate that removing the normal neonate from his mother and placing him in a heated bed to "keep him warm" may be unnecessary.     

The Relationship of Age to Nurses' Attitudes Toward Abortion

An attitude questionnaire was distributed to 200 nurses to study the relationship of age to nurses' attitudes toward abortion. Of 139 responses, 128 were usable. The data showed that for this sample a combination of age and religion had the greatest influence on attitudes. With the exception of Catholic nurses, nurses 30 years of age and over were found to have attitudes at least as approving as those of nurses under 30.     

Marked Hypocalcemia and Ventricular Fibrillation in Two Pediatric Patients Exposed to a Fluoride-Containing Wheel Cleaner

In two separate cases, pediatric patients exposed to Armor-All Quicksilver Wheel Cleaner exhibited systemic toxicity including mental status changes, marked hypocalcemia, and ventricular fibrillation. One child also demonstrated profound hypomagnesemia. These are the first pediatric reports of near-fatal outcomes after ingestion or inhalation of a hydrofluoric acid-like product, namely, ammonium bifluoride. [Klasner AE, Scalzo AJ, Blume C, Johnson P, Thompson MW: Marked hypocalcemia and ventricular fibrillation in two pediatric patients exposed to a fluoride-containing wheel cleaner. Ann Emerg Med December 1996;28:713-718.]     

Venous Ulcers: A Nursing Challenge

The prevalence of individuals with venous ulcers is estimated to be over 500,000 in the United States. Management should be based on an understanding of the pathophysiology of venous insufficiency and venous ulcers. This article presents a review of the anatomy venous system of the lower leg and the pathophysiology of venous insufficiency. In addition, a current theory of the etiology of venous ulcers, their complications, and management options are discussed. Emphasis is placed on patient education, compression therapy, and dressing choices.     

Health status and health care use in persons with inflammatory bowel disease

We randomly surveyed 997 members of the Crohn's and Colitis Foundation of America with inflammatory bowel disease (320 ulcerative colitis and 671 Crohn's disease) in order to: (1) assess their health status, (2) compare members with ulcerative colitis and Crohn's disease, and (3) determine the correlates of health care use. Data collection included variables relating to physical and psychological symptoms, medication use, daily functional status, perceptions of health, and coping styles. The findings indicate that: (1) despite a number of symptoms and complications related to inflammatory bowel disease, the health status of this population is generally good and may be a result of effective coping styles; (2) those with Crohn's disease have more psychosocial difficulties, which appear related to greater symptom severity; (3) both psychosocial and physical health variables are related to number of physician visits, while primarily physical health variables are related to number of hospitalizations and surgeries. Further studies are needed to determine the representativeness of this self-selected sample with others having IBD. In this study, we have provided the basis for developing a more sensitive measure of health status than currently exists, and one which may have implications for future clinical studies.     

A proposed framework for evaluation of support courses in a nursing curriculum

Evaluation of nursing educational programmes has received increased attention since the early 1970s. Many evaluation models have been proposed; they are intended for evaluation of the total educational programme, but provide little evidence on the relevancy of the support courses to nursing practice. This paper describes one nursing school's experience in evaluation of a support course. The nature and sources of problems and difficulties encountered during the evaluation process are also discussed. The authors propose a framework for evaluation of support courses in a nursing curriculum. This framework is an application of the Glaser, Stufflebeam and Stake models of programme evaluation. It is designed to assist nurse educators to strive for sound curriculum decisions.