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Biomedical subjects

C Stewart-Amidei

Publications and source records attributed to C Stewart-Amidei.

At least 19 recordsLinked to original sources

Assessing the comatose patient in the intensive care unit.

Consciousness is a complex phenomenon comprising arousal and awareness. These functions are mediated by the reticular activating system that begins in the brainstem and projects to higher cortical structures. Abnormalities directly or indirectly affecting this system may produce coma. Detailed neurologic assessment consists of evaluation of history, skeletal motor response, pupillary size and reactivity, eye movement, and respiratory patterns. Information obtained may be useful in localizing the contributory lesion, predicting outcome, and determining brain death. Several scales have been used to quantify coma, each with limitations. In the United States, the most widely used scale is the Glasgow Coma Scale.

Coma

Meningioma: nursing care considerations.

In spite of over 100 years of surgical experience with the brain tumor, meningioma, it continues in many cases to be a challenge. Although benign by nature, meningiomas may be difficult to resect and a small percentage may recur. Surgical intervention is the treatment of choice for complete abolition of the tumor. Following surgery, astute nursing care is required to promote physiological stability while monitoring for life-threatening complications.

Brain Neoplasms

Leading the way.

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Humans

Hypervolemic hemodilution: a new approach to subarachnoid hemorrhage.

Subarachnoid hemorrhage (SAH) refers to the sudden accumulation of blood in the subarachnoid space or in the ventricular system. The hemorrhage may occur with cerebral anomalies, tumors, or trauma. The presence of SAH has been associated with decreases in cerebral blood flow (CBF), which may be attributed in part to increased blood viscosity and hematocrit. Hypervolemic hemodilution is a new therapy that is used in the patient with decreased CBF. The therapy is designed to decrease the hematocrit and the viscosity of blood, subsequently increasing CBF. The patient must have a documented SAH and have a baseline neurologic status compatible with aggressive intervention to qualify for the therapy. The infusion technique is begun with 5% albumin and continued for 3 to 7 days. The dosage is gradually tapered before discontinuation. Effectiveness of the therapy is measured through improvement in neurologic function and regional CBF measurements. The critical care nurse plays a vital role in administering and monitoring the therapy and in educating the family about the disease process and interventions.

Albumins

Quality of life following cerebral bypass surgery.

Information available for nurses on counseling cerebral bypass patients regarding the outcomes of surgery is limited. In order to assess the impact of surgery on the patient's quality of life, a questionnaire was mailed to a sample of cerebral bypass patients who were at least three months postoperative and had suffered an ischemic event prior to surgery. Objective and subjective indicators were used to assess quality of life. Objective measures included type and frequency of symptoms most often associated with ischemic events, as well as return to work status. Subjective aspects included an overall assessment of life satisfaction as measured by the Cantril Self Anchoring Scale and satisfaction with these related domains of life: family, social, sex and occupation. Perceptions of body image were also examined. One hundred and two questionnaires were analyzed. Results indicated that for patients who were working before surgery, return to work was significant (p less than .0001). The signs and symptoms most often associated with an ischemic event were identified and overall, the number of reported symptoms was significantly decreased (p less than .0001) after surgery. In addition, an analysis of variance (ANOVA) with repeated measures indicated that patients viewed present and future life as better than life prior to surgery. Patients also reported greater satisfaction with family life (p less than .0001) and body image (p less than .01) following surgery. This information will be useful to nurses in diagnosing and counseling patients with stroke symptoms as well as in developing a comprehensive plan of care for patients who may undergo cerebral bypass surgery.

Activities of Daily Living