Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
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Patients with obstructive sleep apnea are at risk of mortality and morbidity related to the administration of sedatives, anesthetics, and opioids. Commonly employed sedatives and analgesics promote pharyngeal collapse and alter normal respiratory responses to obstruction and apnea. ⋯ The purpose of this article is to provide the reader with a review of normal airway patency, the effects of obstructive sleep apnea on airway patency, and the impact that analgesics and sedatives may impart on the airway of patients with obstructive sleep apnea. The goal of this article is to increase awareness, stimulate discussions within the gastroenterological community, and encourage research regarding sedation in this at-risk population.
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This article provides the reader with information and education regarding the use of capnography for both adult and pediatric patients undergoing procedural sedation during endoscopy by: reviewing the basics of capnography, in addition to the physiology of ventilation and oxygenation; illustrating how capnography may provide an earlier warning of hypoxemia than does pulse oximetry; briefly discussing current guidelines for procedural sedation and the potential role of capnography; and reviewing clinical situations causing changes in the capnogram waveforms and the nursing interventions that should be made in response to such changes.
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Review Comparative Study
The stool DNA test: an emerging technology in colorectal cancer screening.
The stool DNA test is considered an emerging technology in screening for colorectal cancer. The stool DNA test detects DNA markers which are shed from cells of premalignant adenomas and cancers into the stool. Potentially, both preclinical and clinical colorectal cancer may be detected. ⋯ Some limitations of the stool DNA test include the need for clinical studies in average-risk populations and marker refinement. An automated testing system may help reduce costs and turnaround times. Despite recognized limitations, the stool DNA test is a promising new diagnostic tool with the potential to improve effectiveness of colorectal cancer screening.
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Providing nutrition to patients is a vitally important aspect of care. Enterally feeding even critically ill patients remains the method of choice for most prescribers; however, the decision to provide nutrition via the enteral route comes with the added concern of bronchopulmonary aspiration as a complication. The majority of the literature and research on enteral feeding is out of date and focuses primarily on ways to identify aspiration, rather then preventing it. ⋯ These recommendations are synthesized in this article in an effort to improve the quality and safety of administration of enteral nutrition to critically ill patients. However, this compiled information is limited to the current resources. More research should be done to decrease the risk of aspiration in this delicate population.