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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 | |
Latex Allergy in Children
The nurse is assigned to Andrew, a 4 year old boy with spina bifida and latex allergy.
The nurse wants to find some information on latex allergy in children. She consults Nursing Reference Center, keying in latex allergy in children. She consults the quick lesson "Latex Allergy in Children."
She reads about latex allergy in children, including signs and symptoms, treatment goals, and red flags. The nurse talks to Andrew's parents about latex allergy, and educates them about its treatment and the prevention of exposure. Based on the information in the quick lesson, she assesses all physiologic systems and monitors vital signs. She assesses child/family anxiety level and coping ability. The nurse requests referral to physician so that the parents can ask about carrying injectable epinephrine.
Note: The above referenced Quick Lesson is freely accessible to all readers of the Nursing Reference Center Update.
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| Quick Overview |
Caring for Patients with Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized by a series of disruptive physiological and psychological symptoms related to the menstrual cycle.
The etiology of PMDD is unclear; however, serotonin deficiency and altered sensitivity in the serotoninergic system in response to hormonal fluctuations during the menstrual cycle may play a role. PMDD symptoms occur approximately 2 weeks prior to the onset of menses and end a few days after the onset of menses. Physical symptoms may mimic those of premenstrual syndrome and include physiologic discomfort such as water-weight gain, headaches, backaches, abdominal cramps, breast tenderness, food cravings, acne, and bowel problems. However, PMDD differs from PMS in that PMDD has more severe psychological symptoms. In order for PMDD to be diagnosed, severe symptoms must have been present for at least 12 months. A diagnosis of PMDD also requires the patient to exhibit at least 5 of 11 mood, behavioral, or physiological symptoms, with at least 1 severe psychological or mood symptom (e.g., depressed mood, anxiety, affective lability, irritability) present during each menstrual cycle. These symptoms occur in addition to classic PMS symptoms such as decreased concentration, extreme fatigue, and periodic insomnia or hypersomnia. PMDD symptoms are often severe enough to interfere with social and occupational functioning. The key to diagnosing PMDD is the recognition of monthly, cyclical symptoms that are often severe enough to be highly disruptive to normal social and occupational functioning. Individuals with PMDD may have suicidal ideation.
Treatment of patients with PMDD involves nonpharmacologic and pharmacologic interventions. Lifestyle modifications-reduction in intake of caffeine, refined sugars, and salt; increased aerobic exercise; smoking cessation; alcohol restriction; getting regular sleep; and stress reduction and management-may reduce symptom severity in some patients. Selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine, sertraline, paroxetine) are indicated for use in PMDD and are the preferred pharmacologic treatment. Patients unresponsive to SSRIs may be treated with benzodiazepines or tricyclic antidepressants. The oral contraceptives Yaz® and Yasmin® (both drospirenone/ethinyl estradiol) may be prescribed for the treatment of PMDD. Additional hormonal intervention (e.g., injections of the gonadotropin-releasing hormone [GnRH] agonist leuprolide) is reserved for patients who are refractory to other therapies. Ovariectomy may be considered in severe, refractory cases. Nutritional supplementation (e.g., vitamin B6, vitamin E, calcium, magnesium) reduces symptom severity in some patients.
Please login to your Nursing Reference Center subscription to read the Quick Lesson on "Premenstrual Dysphoric Disorder."
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Evidence-based Content Update
| Recently, the evidence based care sheet Phenylketonuria: Parental Adjustment was revised following review under the systematic literature surveillance program. Information of value to nursing practice regarding parental adjustment to phenylketonuria was a research study.
The results of a research study indicate that parents of preschool children < 6 years of age diagnosed with PKU may need higher levels of social support. An established routine diet regimen among school-aged (i.e., 6-12 years of age) and adolescent children (i.e., > 12 years of age) is predictor for higher levels of parental quality of life (QOL). Implications for nursing practice is that clinicians should identify and empower parents with preschool children to seek additional social support for an improved QOL.
We invite you to login to the Nursing Reference Center to read updated content as it becomes available. |
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