Journal of infusion nursing : the official publication of the Infusion Nurses Society
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Inappropriate intravenous fluid therapy results in increased patient morbidity and mortality. By far the most common fluid and electrolyte problems that confront both chronically and critically ill patients are disturbances in sodium and water balance. Thus, it is important for the infusion therapy nurse to understand the basic pathophysiology of sodium imbalances as well as therapeutic approaches for their correction. Adding to this need is the recognition that, in hospital settings, disorders of sodium and water balance are often iatrogenic.
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Infants and children are typically undertreated for pain. Many treatment options are available to prevent and diminish the pain experienced by children during venipuncture. Infusion nurses must employ pharmacologic and nonpharmacologic treatment options to make the experience more positive for the child, the family, and the nurse. These treatment options are explored in this article.
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Sepsis is a major cause of patient morbidity and mortality. Many critically ill patients are septic, and red blood cell transfusion is often part of their treatment plan. Studies have shown that red blood cell transfusion is associated with a dose-dependent increase in patient morbidity and mortality. ⋯ In addition, there are similar effects in the pathophysiology of sepsis that may overlap with the changes that occur with storage of red blood cells. This article will discuss recent literature addressing red cell transfusion in critically ill and septic patients and discuss general guidelines for red cell transfusion in this patient population. This article will also discuss the epidemiology and pathophysiology of sepsis and relate how storage and transfusion of red cells may potentially contribute to changes observed in a septic patient.