Journal of infusion nursing : the official publication of the Infusion Nurses Society
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Review Case Reports
Parenteral hydration and nutrition in the geriatric patient: clinical and ethical issues.
A common ethical and legal issue in elder care involves the decision to withhold or withdraw parenteral hydration and nutrition (PHN) at the end of life and in the terminal stage of dementia. The aging of the population will impact the frequency with which nurses face this situation in their practices and with their families. The ethical, legal, and clinical issues involving PHN discussed in this article will assist the nurse in his or her practice.
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Pain is a common experience for many elderly adults that has negative consequences for their health, functioning, and quality of life. Effective pain management requires thorough assessment, appropriate intervention, and systematic reassessment. This article will discuss strategies for assessing and measuring pain in elderly adults, as well as barriers to effective pain assessment. Pain treatment strategies, including both pharmacological and non-pharmacological approaches will also be covered and special considerations for administering medications to elderly adults will be highlighted.
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Peripherally inserted central catheters (PICCs) provide reliable access for pediatric patients requiring infusion therapy. Our multidisciplinary team includes nurses, physicians, child life specialists, and radiology technicians. In preparing and educating the patient and parent for the procedure, cultural and developmental levels are assessed and planned accordingly.
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The purpose of this project was to assess if the presence of a mediastinal mass adversely influences peripherally inserted central catheter (PICC) positioning. A retrospective review of all PICC placements over an 18-month period in a pediatric oncology hospital was conducted in which patients were categorized by the presence or absence of a mediastinal mass. ⋯ A significant proportion of the malpositioned catheters in patients with a mediastinal mass terminated in the right heart chambers. These findings show that clinicians must be vigilant about checking for PICC malpositioning in this patient population.
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The authors present major epidemiological findings from the EPINet multihospital research database of the International Healthcare Worker Safety Center, and discuss how the data has been used to promote protective policies for healthcare workers. The authors also take a comparative look at US, Italian, and Japanese EPINet data, and highlight key differences.