Roy adaptation model and perspectives on the family.
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Adaptation, Psychological↗
Biomedical subjects
D R Hanna
Publications and source records attributed to D R Hanna.
Incidence and clinical consequence of the purple glove syndrome in patients receiving intravenous phenytoin.
OBJECTIVE: To determine the incidence, risk factors, and long-term sequelae of the purple glove syndrome (PGS) in hospital patients receiving IV phenytoin. BACKGROUND: PGS is a poorly understood, potentially serious local complication of IV phenytoin administration characterized by progressive distal limb edema, discoloration, and pain. METHODS: The pharmacologic records of the Mayo Foundation hospitals were reviewed to identify 179 consecutive patients who had IV phenytoin ordered during a 3-month period. Their hospital records were then reviewed to confirm IV phenytoin treatment, the frequency of PGS (defined as the progressive development of edema, discoloration, and pain in the limb after administration of IV phenytoin), and the outcome of PGS. RESULTS: A total of 152 patients received IV phenytoin, and nine (5.9%) developed PGS. PGS patients received a greater median initial dose of phenytoin, total 24-hour dose, and total number of doses (all p < 0.05). In addition, the median age of the PGS patients was older, their infusion was more often given for acute seizures, it was less likely to be administered in the operating room, and the length of their hospital stay was longer (all p < 0.05). One patient required surgical therapy, and all other patients resolved within 3 weeks with conservative management. CONCLUSIONS: PGS is not rare and elderly patients and individuals receiving large, multiple doses are particularly at risk. This iatrogenic complication may be preventable by substituting fosphenytoin for IV phenytoin.
Adolescent↗
Purple glove syndrome: a complication of intravenous phenytoin.
Intravenous phenytoin, available for use since 1956, has several well known adverse effects, such as hypotension, arrhythmias and toxicity. Purple glove syndrome is a less common complication that can have serious consequences. Fasciotomies, amputations and permanent disuse of the hand and forearm have been reported. The etiology of purple glove syndrome is still unknown, but possible etiologies and risk factors have been suggested. Three stages of purple glove syndrome have been identified: appearance, progression and resolution. During the second stage, progression, purple glove syndrome can be identified as either mild or severe. Mild cases may heal uneventfully when nursing measures such as elevation, application of dry, gentle heat and measures to prevent secondary injury are instituted. Severe cases may require emergency surgical intervention such as fasciotomy to relieve pressure and restore blood flow. Therapeutic nursing interventions aimed at maximizing healing and promoting comfort are essential.
Aged↗
Using simulations to teach clinical nursing.
Incorporating play into formal teaching strategies was introduced in theory over 75 years ago by John Dewey and the Gestalt theorists. Play, in the form of simulations, has had a significant role in contemporary nursing education. Simulations can teach more than a skill or an idea, since they can be designed to teach the complexification of ideas. The author explores the theoretical and historical development, the advantages and disadvantages, and future uses of simulations.
Clinical Competence↗