Kidney Influence on Fluid and Electrolyte Balance

The frontline nurse is confronted daily with patients that have some type of kidney dysfunction or disease. Some renal issues resolve themselves, some disorders can be reversed, and others are permanent. Major complications from kidney impairment discussed are fluid and electrolyte disequilibrium with common problems in volume overload, hyperkalemia, metabolic acidosis, hyperphosphatemia, and hormonal secretion. Each problem is presented with potential clinical manifestations and management.

Pharmacologic Interventions for Pain Management

Serious life-threatening respiratory depression may occur with pharmacologic pain intervention. The nurse has an ethical and legal duty to provide safe, quality, and accountable pain management. The nurse must acquire self-efficacy for the administration of pain medications for critically ill patients to prevent serious side effects and adverse reactions. This article presents a clinical toolkit for acute pain pharmacologic management by presenting professional guidelines, evidence-based pain assessment tools, common pain medication therapy, and focused monitoring specific to the drug. Medical adjustments owing to special populations is also discussed. Case reports demonstrate application of clinical reasoning skills needed for pain management.

Transforming home health nursing with telehealth technology

Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care.

Aging population

Our aging population is rapidly growing and accounts for 46% of critical care patients and 60% of medical-surgical patients in the hospital. These acutely ill patients are challenging to frontline nurses because they frequently have multiple chronic conditions. This article provides a tool kit of resources and clinical skills to develop safe, quality, and accountable care plans for positive patient outcomes; it presents several resources to assist in individualized care, the complexity of care, and the issues of transitions of care. This article empowers frontline nurses to develop gerontological skills and meet the unique needs of our aging population.

Electrodiagnostic studies

This article overviews electrodiagnostic tests that provide evidence-based data in the treatment and management of abnormalities in nerves and muscles. There is a focused review on cardiac tests, nerve-conduction tests, low-back pain tests, seizure and epilepsy tests, and obstructive sleep apnea electrodiagnostic tests. Case reports demonstrate how these electrophysiologic tests can provide specific data about the location and underlying causative factors of abnormalities in the nerves and muscles that routine diagnostic tests cannot differentiate.