Evaluation of High-Interval Education to Improve Outcomes for Bariatric Patients With Health Disparities.

A correlation of health disparities, socioeconomic barriers, and health literacy were hypothesized as causative factors of poor weight loss, weight regain, and loss to clinical follow-up in postbariatric patients. This study explored nurse practitioner-led interventions to address health disparities and improve outcomes. This pilot project evaluated 3-month weights of an intervention cohort as compared with a retrospective cohort.

Acute ischemic stroke or migraine with aura? Triage considerations.

This article discusses the complex relationship between acute ischemic stroke and migraine with aura, and critical nursing interventions.

Anesthesia for Patients Who Self-Report Cannabis (Marijuana) Use Before Esophagogastroduodenoscopy: A Retrospective Review.

Increasing numbers of patients are using cannabis before procedures that require anesthesia. This study set out to examine the impact of cannabis use on anesthetic agent requirements, associated cardiac and respiratory morbidity, and overall satisfaction levels in patients undergoing esophagogastroduodenoscopy (EGD). This involved a retrospective review of patients undergoing EGD at a single center.

Thrombocytopenia: Effect in Ischemic and Hemorrhagic Stroke.

Background: There are 2 classification of strokes: ischemic, if caused by an arterial occlusion from a clot or obstruction by atherosclerosis, and hemorrhagic, if caused by the rupture of a vessel and subsequent bleeding. Each type of stroke is influenced by platelet counts and platelet function. The intention of this article is to discuss the role of the platelet in the pathophysiology of acute stroke processes.

Tolvaptan for Autosomal Dominant Polycystic Kidney Disease: Pharmacokinetics and Implications for Practice.

Autosomal dominant polycystic kidney disease (ADPKD) is incurable and occurs once in every 1,000 births. Confirmation of AKPKD is made through imaging and a positive family history. Symptoms typically appear in mid-life and include kidney, side, and/or back pain related to the rupture of kidney cysts, renal stones, infection, pressure of cysts against other organs, and stretching of the renal capsule.

Perioperative Considerations in Patients With Concussion.

Concussions affect the normal functioning of the autonomic nervous system and glucose metabolism, impair cerebral autoregulation to Paco₂, and produce abnormal variances in myogenic and vagal tone. Because anesthesia also has an impact on these same processes, it is vital to delineate the best practice in the perianesthesia period to minimize additional damage to the concussed brain. There are currently no practice guidelines surrounding perianesthesia management of patients with concussion to guide practice.

Bone Cement Implantation Syndrome: Key Concepts for Perioperative Nurses.

Bone cement implantation syndrome (BCIS) is a potentially fatal complication of orthopedic surgeries that use cement. The symptoms of BCIS occur primarily during femoral fracture repairs, but this complication has been reported in a wide variety of cemented procedures. Clinical presentation of this syndrome begins as a cascade with hypoxia and hypotension; if it is not reversed, it ends with right-sided heart failure and cardiac arrest.

Periprocedural Considerations for Anticoagulated Atrial Fibrillation Patients.

Periprocedural patient instruction and coordination is an important piece in achieving safe outcomes for patients needing procedures and receiving anticoagulants for atrial fibrillation. Balancing the needs for anticoagulation versus bleeding during the procedure requires clinical reasoning and preparation. In this article, the current guidelines for use of anticoagulants with atrial fibrillation, the relevant pharmacology, and the use of standardized tools to quantify the risks of thrombus or bleeding in the procedures will be discussed.

Gastrointestinal Manifestations of Autoimmune Diseases Requiring Critical Care.

Proper functioning within the gastrointestinal (GI) system is essential to immune integrity. Autoimmune diseases (ADs) can disrupt GI integrity and cause serious derangements of organ function. ADs exist on a continuum of mild to severe.

Valproic Acid: Special Considerations and Targeted Monitoring.

Valproic acid (VPA) is a medication used to treat multiple neuroscience conditions. It is an inexpensive and useful medication, with a low incidence of adverse drug events. Nonetheless, optimal clinical outcomes require that a series of screening and laboratory steps be followed before the initiation of VPA therapy.

Drug-Induced Liver Injury.

Drug-induced liver injury (DILI) can result from both idiosyncratic and intrinsic mechanisms. This article discusses the clinical impact of DILI from a broad range of medications as well as herbal and dietary supplements. Risk factors for idiosyncratic DILI (IDILI) are the result of multiple host, environmental, and compound factors.

Angioedema: Clinical Presentations and Pharmacological Management.

Angioedema (AE) is a unique clinical presentation of an unchecked release of bradykinin. The origin of this clinical presentation can be either genetic or acquired. The outcome within the patient is subcutaneous swelling of the lower layers of the epidermis.