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Gluten-Free DietDash DietDietary Fat and Risk for CancerPreprocedural FastingForeign Accent SyndromeAutonomic DysreflexiaMediterranean DietVitamin B12 DeficiencyDementia and NutritionCogan Syndrome
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Nursing Reference Center Peer Review
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| Welcome! | |
Welcome back to our free evidence-based Nursing Reference Center Update. We will periodically send news on the latest evidence in nursing. Please share this with your colleagues, students, practitioners and others who would appreciate awareness of this information.
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| Nursing Reference Center in Daily Practice | |
Carpal Tunnel Syndrome: Non-Surgical Management
The nurse is assigned to Mrs T, a 76 year old patient with idiopathic low back pain and osteoarthritis, who is hospitalized following a total hip replacement. The patient has complained of wrist pain and hand paresthesias after ambulating on the unit with a walker. The treating physician has diagnosed Mrs T with carpal tunnel syndrome.
The nurse wants to find some information on treating patients with carpal tunnel syndrome. She consults Nursing Reference Center, keying in carpal tunnel syndrome. She consults the Evidence Based Care Sheet "Carpal Tunnel Syndrome: Non-Surgical Management."
She reads about carpal tunnel syndrome, including presentation, signs/symptoms, and treatment. The nurse talks to Mrs T about the various treatment options, encourages her to adhere to the physician's prescribed treatment, and educates her on the various complications of treatment.
Note: The above referenced Evidence Based Care Sheet is freely accessible to all readers of the Nursing Reference Center Update.
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| Quick Overview | |
Caring for Patients with Vitiligo
Vitiligo is a dermatologic condition characterized by the destruction of functional melanocytes in the epidermis, resulting in depigmented, sharply delineated patches of skin. The etiology of vitiligo is thought to be multifactorial with genetic and nongenetic components including autoimmune destruction of melanocytes; intrinsic abnormality of melanocytes, polygenic (i.e., involving many susceptibility genes); autotoxicity (i.e., toxicity of intermediates in the melanin pathway); defective melatonin receptors (melatonin controls melanin synthesis); emotional stress resulting from difficult life events and situations, particularly in the year prior to onset; vitamin deficiencies (vitamins B, C, and E); and L-phenylalanine deficiency.
Diagnosis is based on clinical presentation and physical examination. Treatments for vitiligo include topical steroids, immunomodulators, vitamin D, salicylic acid, psoralen drugs combined with UVA/B phototherapy, chemicals to bleach unaffected skin, skin grafting, laser therapy, and dermabrasion.
Nurses should reinforce clinician's explanation of treatment options, administer medications, and provide emotional/psychological support and educate.
Please login to your Nursing Reference Center subscription to read the Quick Lesson on "Vitiligo."
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Evidence-based Content Update
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Recently, the evidence-based care sheet Infections, Surgical Site: Prevention was revised following review under the systematic literature surveillance program. Information of value to nursing practice regarding surgical site infections was a systematic review.
The results of a systematic review of randomized controlled trials indicate that in patients with surgical wounds healing by primary intention, there is no evidence to support the idea that use of wound dressings (compared to leaving wounds exposed) reduces risk of surgical site infections.
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