The American journal of nursing
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Nurses are often faced with the challenge of starting an IV line in a patient who is dehydrated, has suffered trauma, or is in shock. Even the efforts of the most skilled clinician may fail, while valuable time is lost. ⋯ Yet many clinicians remain unaware of the procedure. This article outlines the procedure and devices used, describes support for use in the literature, and discusses various considerations and nursing implications.
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Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. It's estimated that more than 13 million U. ⋯ Even when patients receive optimal COPD therapy, they periodically experience exacerbations, which reduce lung function and quality of life, increase risk of death from COPD, and account for the majority of costs related to COPD treatment. This article, the second in a two-part series on COPD, outlines current guidelines and evidence-based recommendations for identifying, assessing, and managing COPD exacerbations (the first article in the series, "An Evidence-Based Approach to COPD," March 2012, focused on the management of stable COPD in the outpatient setting).
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Nearly 40% of all surgeries in the United States are performed on adults ages 65 and older. One of the most common surgical complications in this population is postoperative delirium, which is associated with extended lengths of stay, higher patient care costs, increased morbidity, and greater risk of death. This review evaluates risk factors for postoperative delirium in elderly patients, discusses screening and assessment instruments, and examines intervention strategies.
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Conventional medical treatment of osteoarthritis often successfully relieves pain but can also produce adverse gastrointestinal and cardiovascular effects, especially with long-term use. Hence, many patients use complementary and alternative medicine (CAM) to prevent, control, and manage the pain of osteoarthritis. The author reviews the evidence on the efficacy and safety of several CAM therapies often used for osteoarthritis management, including mind-body therapies, supplements, and body-based treatments.