March Issue: Preventing Functional Decline in Hospitalized Older Adults, Tumor Lysis Syndrome, More

“Nurses do the big things, but I am thankful for all the small things: for bringing peace in the eye of the storm…for providing us coordinates when we felt lost…for making us laugh—for doing the things that we remember, the things that last years later.”—Holly Bills in this month’s Reflections article, “The Little Things Nurses Do”

The March issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

CE: Tumor Lysis Syndrome: An Oncologic Emergency

What nurses need to know about preventing and treating this serious condition, including recognizing its clinical presentation, identifying at-risk patients, and monitoring and managing symptoms and laboratory values.

Original Research: Impact of a Bedside Activity Device on the Functional Status of Hospitalized Older Adults: A Randomized Controlled Trial

This pilot study evaluated the use of a device equipped with exergames—interactive video games that incorporate physical exercise—in preventing functional decline and increasing patients’ independence in basic activities of daily living.

Skin Assessment in Patients with Dark Skin Tone

The authors provide basic information about the assessment of dark skin tone and call for action in academia and professional practice to ensure the performance of effective skin assessments in all patients.

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2023-02-27T09:43:34-05:00February 27th, 2023|Nursing|0 Comments
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Food or Meds? The Lose-Lose Choice Facing Some Older Americans

Food insecurity was already common in older adults before the pandemic.

image by congerdesign from Pixabay

Years ago, when I worked as an ED nurse at Bellevue Hospital, one patient who became a favorite was a charming octogenarian named Sam. He would frequently present in congestive heart failure or pulmonary edema. He always responded quickly to treatment and often just needed a bit of furosemide to get rid of excess fluid.

After one of his almost monthly admissions, we found out that Sam relied on canned soup for much of his diet. The high salt content would cause him to retain too much fluid. He knew the salt wasn’t good for him, but soup was cheap and sometimes all he could afford.

What is food insecurity?

The United States is one of the world’s richest countries, yet we know that hunger is a common problem for many people. Older adults, especially those over 65 with multiple chronic conditions and who take multiple medications, are especially at risk for food insecurity—the inability to afford healthy and nutritious food.

Hard choices for elderly on a fixed income.

Many older adults live on fixed incomes and many don’t have supplemental insurance to cover medications. Some may have to choose between paying for medication or paying for other necessities like housing and food.

Many rely on programs like Meals on Wheels or food banks, but a number of these programs were suspended, at least for a time, during the early days of […]

2020-06-16T15:26:38-04:00June 16th, 2020|Nursing, Patients, Public health|1 Comment
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Polypharmacy in the Elderly: The Risks Often Outweigh the Benefits

“…the single greatest adverse drug event risk factor is the number of medications a patient takes.”

Lessons from speaking to elders about their medications.

Early in my career, I taught groups of seniors about common medications as part of a hospital-based community health program. I traveled around the Chicago area, speaking to groups at senior centers, apartment buildings, and places of worship about their health and medications.

As part of our program’s mandate to educate physicians and nurses as well, we interviewed many elders on film, asking them to tell us about their medications. I will always remember one lady, relating a friend’s problems with adverse drug effects. “He’s dead now,” she stated with finality. She made it clear that she blamed his demise on the drugs his doctor had prescribed.

My experience in the Chicago medication education program influenced my pharmacology lectures to nursing students. Students may remember me most for the many times I repeated this statement: “The first sign of an adverse drug reaction in an older person is often a change in mental function.” This is a central reality of drug effects on the elderly.

Paying attention to unexplained cognitive changes.

Yet even today, the default response of many […]

2020-02-03T08:54:32-05:00February 3rd, 2020|Nursing|0 Comments
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Hidden in Plain Sight: What Nurses Need to Know About Food Insecurity

Are any of the people you see in your office or clinic “food insecure?” How about the college friends of your children? Or perhaps your own coworker?

Food insecurity is all around us.

The United States Department of Agriculture describes food insecurity as the lack of “consistent, dependable access to adequate food for active, healthy living.” Recent data indicate that food insecurity affects about 13% of U.S. households. In some states, the rate approaches 20%. Certain populations are particularly vulnerable: 27% of veterans who served in Iraq or Afghanistan and as many as 37% of college students are food insecure.

Twice monthly, the Muslim Food Pantry in Flint, MI, distributes free food to anyone who needs it. The pantry is run by volunteers and offers food, bottled water, and hygiene products to those with limited or no food or clean water—the latter a result of the Flint […]

2019-01-14T11:45:33-05:00January 14th, 2019|Nursing, Public health|0 Comments
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Meeting the Nutritional Needs of Older Patients and Family Members

When copies of the print version of this month’s issue arrived in the office, AJN staff found different meanings in the Albert Anker painting (circa. 1895) that graces the cover. Is the man enjoying a cup of tea in peace and quiet, or is he isolated and lonely, perhaps sipping tea to stave off hunger because there isn’t much food in the house?

The artist’s intent may be open to interpretation, but we chose this cover because it suggests one of the many social, cognitive, physical, and economic factors that can affect the nutritional status of older adults: eating alone.

Many older adults are at risk.

In a March CE article, “Malnutrition in Older Adults,” registered dietitian Ann Reed Mangels, PhD, RD, FADA, summarizes the latest information on malnutrition in older adults, including risk factors, assessment tools, and practical ways in which nurses as well as family and friends can help to ensure good nutrition for elders in the community or in long-term care. Writes Mangels:

“Malnutrition diminishes quality of life, is a strong predictor of short-term mortality, and is associated with higher health care costs.”

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2018-03-19T09:05:08-04:00March 19th, 2018|Nursing, Patients|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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