Are the Benefits of Nutrition for Cardiovascular Health Being Undersold ?

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

By Eric Hunt/via Wikimedia Commons By Eric Hunt/via Wikimedia Commons

A nutrition conference at which physicians and medical students outnumber either nurses or dietitians is a rare event. This was the case at last month’s International Conference on Nutrition in Medicine: Cardiovascular Disease in Washington, DC, cosponsored by the Physicians Committee for Responsible Medicine (PCRM) and George Washington University.

The speakers, shared a wealth of data on the influence of different types of diets on weight, blood pressure, lipids, serum inflammatory markers, hemoglobin A1c levels, and diseased coronary arteries. More than one pointed out that we too often overestimate the benefits of drugs and medical procedures and discount the effectiveness of diet and lifestyle changes. Some highlights:

Does heart disease begin in utero? Children who are large for gestational age (> 95th percentile) and those born to overweight mothers are at increased risk for cardiovascular disease (CVD). Vascular physiologist Michael Skilton, PhD, associate professor at the University of Sydney in Australia, has also identified microscopic lesions in aortic endothelium of babies born small for gestational age (< 10th percentile). He suggests that their diets include the American Heart Association’s recommendations for omega-3 fatty acid intake beginning in childhood (breast milk, flax seeds, walnuts, or child-friendly omega 3 supplements can be used in lieu of fish-derived omega 3s when mercury is a concern).

Children and […]

2017-03-15T16:58:14-04:00September 14th, 2015|Nursing, personal health practices|1 Comment
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How Should We Measure Temperature in Young Children?

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Photo courtesy of Exergen Corporation. Photo courtesy of Exergen Corporation.

Do you dread taking rectal temperatures in pediatric patients, knowing that your action will leave you with a screaming, distrustful child as well as a distressed parent? Rectal temperature measurements have long been considered the “gold standard” for accuracy. But are they essential in very young children, especially when infection is not suspected?

“Improving Pediatric Temperature Measurement in the ED” in our September issue relates how a group of ED nurses explored possible alternatives to routine rectal temperature measurements during triage. Their ED protocol had been to use this method in all children under the age of five. However, this practice extended the time needed for triage, was often upsetting to parents, and seemed potentially unnecessary when the reason for the ED visit did not suggest infection (where there would be a need for more careful fever assessment).

An existing emergency services committee made up of ED staff nurses from the hospital’s two campuses set out to explore their options. The committee’s first move was to clearly define the practice problem:

Using PICOT format (Patient population, Intervention of interest, Comparison intervention, Outcome, Time frame), the committee initially formulated the following clinical question: For pediatric patients younger than five years of age (P) who require temperature […]

2016-11-21T13:02:01-05:00September 10th, 2015|Nursing, Patients|0 Comments
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Coming Home to Nursing: A Career Change Eases a Return to a Small Town

“Working as a nurse in the county where your family has lived for seven generations has a social complexity that can’t be prepared for.”

The Reflections essay in the September issue of AJN isn’t focused on a dire clinical situation, a wrenching ethical quandary, or a challenging coworker or boss. Called “Coming Home to Nursing,” the essay describes the many ways becoming a nurse helped the author begin to feel a sense of belonging when she returned to her small town. Here’s the opening:

Illustration by Gingermoth for AJN. All rights reserved. Illustration by Gingermoth for AJN. All rights reserved.

I had been taking care of people, in one way or another, for as long as I could remember, first growing up in Maine and then for 20 years in New York City. I had returned to my small town to help care for my mother, who had end-stage Parkinson’s disease. After she died, I felt a void. I looked around at this tiny place, where people are considered to be “from away” even if they’ve lived here for multiple generations. I wondered what I had to give back to the supportive community I’d grown up a part of—and I also wondered if I could fit in after 20 years away. Could I turn my love of taking care of […]

2016-11-21T13:02:02-05:00September 8th, 2015|career, narratives, Nursing, nursing perspective|1 Comment
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AJN in September: Pain Management in Opioid Use Disorder, STIs in the U.S., Teaching Vs. Unit Needs

AJN0915.Cover.OnlineOn this month’s cover, perianesthesia nurse Carolyn Benigno helps prepare a young patient for surgery at Children’s National Medical Center in Washington, DC. The photo, the first-place winner of AJN’s 2015 Faces of Caring: Nurses at Work photo contest, shows Benigno practicing “Caring through Play.” The art of working at a pediatric hospital, she says, is “learning how to play with children so that part of your nursing care is play.” Such play can both distract a child in the moment and help the child cope with the disorienting experience of hospitalization.

For another piece on how nurses try to make hospitalization less stressful for children, see this month’s Cultivating Quality article, “Improving Pediatric Temperature Measurement in the ED.”

Some other articles of note in the September issue:

CE Feature: “Acute Pain Management for Inpatients with Opioid Use Disorder.” Inpatients diagnosed with opioid use disorder (OUD) commonly experience acute pain during hospitalization and may require opioids for pain management. But misconceptions about opioids and negative attitudes toward patients with OUD may lead to undermedication, unrelieved pain, and unnecessary suffering. This article reviews the current relevant literature and dispels common myths about opioids and OUD. […]

2016-11-21T13:02:02-05:00September 2nd, 2015|career, Ethics, infectious diseases, Nursing, nursing perspective|1 Comment
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Revisiting Katrina’s Lessons 10 Years Out, from a Nursing Perspective

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Hurricane Katrina Hits New Orleans, August 29, 2005/ Wikimedia Commons Hurricane Katrina Hits New Orleans, August 29, 2005/ Wikimedia Commons

This past week we’ve seen many media retrospectives on the devastation Hurricane Katrina visited on the Gulf Coast on August 29, 2005. I remember it vividly—as AJN’s news director at the time, I cut short a Labor Day vacation and flew to Mississippi on September 10 to report firsthand on how relief efforts were progressing.

I visited the emergency shelter staged at the Meridian Naval Air Station and then drove as far as I could south from Meridian toward the Gulf of Mexico. I got as far as Hattiesburg, Mississippi, before I had to turn around because there were no open gas stations and my gas tank was at half-empty. The devastation along the highway was remarkable; trees were completely flattened and debris of all sorts was scattered about as if a giant trash can had been overturned. And this was still about 70 miles inland from the Gulf.

Over the following months and then years, AJN published a number of articles and reports on health-related issues that arose from Hurricane Katrina (see the list below). We highlighted the heroics of many nurses who found ways to deliver care with few resources, discussed ethical […]

2016-11-21T13:02:05-05:00August 31st, 2015|career, Ethics, Nursing, nursing perspective|0 Comments
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