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Nurses must know about effect and indication ofl.V-Fluid Therapy. Priciples of WMuid therapy consist of:Appropriate solutions and the rate of administration of fluid, types of parenteral solutions and the factors that indicate whether a solution is appropriate or not, definition of smolarity andm smolality and how to use the standard formula. Knowing a pateint's body fluid concentration , or fluid status, is one way to determine how I.Vsolutions will infuse in specific situations. Cellularmembrance are permeable, water will shift into a compartment with a higher concentration or osmolality. The appropriate rate to infuse a solution depends on severalfactors, including the paitent's condition and type of solution. Other specific considerations ofpatients include: weight, urinary output, laboratory values, kidney Junction, length of illness, and assessment of skin turgor.

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Background & Aim: Decreasing mechanical ventilation and early extubation after cardiac surgery are the important scientific subjects that their clinical and financial benefits had been demonstrated. There are some variables that are associated with extubation time so, determination of them will help nurses to plan appropriate care aimed at doing an early and safe extubation.

Methods & Materials: The purpose of this descriptive-analytic study was to determine whether any preoperative variable had a significant effect on extubation time after CABG. The research was conducted in one of hospitals in Tehran city. In this retrospective study, data were collected by reviewing of files of eligible patients who were undergoing CABG from December 2003 to March 2005. 93 files reviewed by convenience sampling method. Collecting data tool was a checklist consists of three parts: 1) demographic characteristics 2) health and disease history 3) physiologic status. Samples divided into two groups: early and delayed extubation (>6h). Data analysis was performed by descriptive methods, chi square, fisher exact test and regression analysis.

Results: Mean and standard deviation of duration time of intubation was 7.19±3.00 with range of 3-18.25 hours in all samples. Totally 43% of subjects extubated in ≤6h and 57% of them in >6h. Age was the only preoperative variable that was found to be statistically significant to extubation time (p=0.01).

Conclusion: According to our findings age is associated with postoperative intubation time after CABG. It means older patients need to be under long mechanical ventilation. So, nurses should make a decision on extubation in older patients, carefully.

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Background & Aim: Asthma, as a chronic respiratory disease, is a major health problem worldwide. The quality of life of asthmatic patients is affected by long-term treatment and continuous episodes of asthmatic attacks. The aim of this study is to assess the quality of life in asthmatic patients.

Methods & Materials: This descriptive study carried out among randomly selected asthmatic patients (n=386) referred to lung clinic in Imam Khomeini hospital, Tehran. Data were collected using a two-section questionnaire. The first section was to assess demographic characteristics of the subjects and the second section was to assess the quality of life. Validity of the questionnaire was evaluated using content validity and reliability was determined using a-kronbach.

Results: The results showed that the majority of subjects were female, married, illiterate, and in the 41-50 age group. 45.1 per cent of study subjects had relatively appropriate quality of life. Quality of life in 45.3 per cent of the patients was inappropriate. There were significant statistical relationship between sex, age, education, economic status and quality of life (P<0.05).

Conclusion: According to the findings, in general, quality of life was inappropriate and relatively appropriate. So comprehensive programs for treatment and care of these patients should be planned.

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Background & Aim: High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient&aposs life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process.

Methods & Materials: In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape (5-10 minutes) of a familiar voice for 30 minutes. The Glasgow Coma Scale (GCS) was used for measuring the level of consciousness (LOC). LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms (blood pressure, pulse rate, and mean arterial pressure) were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software.

Results: The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention (P<0.001), but not in the control group (P=0.769). Although 2 groups were similar in LOC of the first day (P=0.605) but there were a significant difference between their LOC at the fourteenth day (P=0.001).

Conclusion: The results showed that the auditory stimulations with familiar voice were effective in increasing LOC in the comatose patients. It is suggested that nurses expose comatose patients with auditory stimulations using a recorded tape of familiar voice in ICU.

 

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Background & Aim: Anxiety is one of the emotional conditions among patients scheduled for surgery that can result in increasing postoperative pain, increasing analgesic and anesthetic requirements and prolonging hospital stay. The aim of this study was to assess the effectiveness of acupressure (acupuncture without needle) in reducing patients&apos anxiety before abdominal surgeries.

Methods & Materials: In this randomized, blinded, sham controlled trial, 70 patients who were scheduled to undergo abdominal surgery in Tehran University of Medical Sciences&apos hospitals were selected using convenience sampling method. The patients were randomized to an acupressure group (n=35) or a placebo group (n=35), receiving acupressure either at the right points (Yintang and Shen men) in acupressure group or at sham points in the placebo group for 10 min. Anxiety was recorded on a Visual Analog Scale (0-10). Vital signs were measured before and after pressure application in both groups.

Results: The anxiety was decreased in both groups following pressure application for 10 min (P<0.001). The amount of anxiety was significantly different between the groups (P<0.001). The heart rate, respiratory rate, and diastole/systole pressure (P<0.001) were decreased in the case group. Only heart rate (P=0.016) and respiratory rate (P=0.007) were decreased in the placebo group. Changes in respiratory rate and systole pressure following pressure application were statistically significant between two groups.

Conclusion: Acupressure at the right points can decrease anxiety before abdominal surgeries but it has no clinical effect on vital signs.

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Background & Aim: Modification of unhealthy life style is a preventive method in cardiovascular diseases. It seems that education which results in enhancing knowledge would improve the life style. For developing effective educational plans, it is required to evaluate the knowledge and performance of the patients. So, this study aimed to determine the relationship between the teachers&apos preventive behaviors and their knowledge on cardiovascular risk factors.  

Methods & Materials: This cross-sectional study was conducted in five zones of Ministry of Education in Tehran. Seven hundred and three teachers participated in the study. Multi-stage sampling was used to gather data using a self-report questionnaire consisted of demographic characteristics, risk factors of CAD, and related modifiable behaviors. Data were analyzed using Pearson coefficient test to determine correlations.

Results: The results showed that the majority of participants (67%) had good knowledge on cardiovascular risk factors with the mean scores of 15.20±2.63 out of 20. Stress was found to be the most recognized risk factor (95.3%). Knowledge about diabetes (61.2%) and gender (17.6%) were in the lowest level. Regarding prevention, just 27.7% of the participants reported healthy nutrition. Some of the patients (35.6%) exercised regularly and majority of them (77.7%) were not active or passive smokers. Pearson coefficient did not find any significant relationship between knowledge level and preventive behaviors among teachers.

Conclusion: According to our findings, teachers&apos knowledge level on cardiovascular risk factors was good but it did not result in healthy practice. Therefore, providing effective educational programs about healthy life style can improve their daily life practices, as well as it can affect the knowledge and practice of their students about prevention of CAD.

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Background & Aim: Diabetes education does not assure adherence to diabetic regimen. The aim of this study was to investigate the effect of nurse-led telephone follow ups (Tele-Nursing) program on adherence to diabetic diet among type 2 diabetic patients.

Methods & Materials: This was a quasi experimental study. Sixty patients who were registered at Iranian Diabetes Society were selected using convenience sampling method. Data gathering instruments included a data sheet to record glycosylated hemoglobin and a questionnaire. Data were gathered at baseline and 12 weeks after the intervention. First, all participants attended in a three-day self-care education and dietary consultation program at Iranian Diabetes Society. Then, they were randomly assigned to the experiment and control groups. Telephone follow ups were applied in experiment group for 3 months, twice a week for the first month and then weekly for the second and third months. Data were analyzed using SPSS version 13.

Results: Results showed that there were significant statistical differences between control and experiment groups in adherence to diabetic diet (P=0.035). There were significant differences in glycosylated hemoglobin between control and experiment groups after the intervention (P<0.000).

Conclusion: According to the results of the study, it is concluded that the nurse-led telephone follow ups can improve HbA_1c and diet adherence in type 2 diabetic patients.

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Background & Aim: One of the nurses' roles in patient care is frequent position change in patients undergoing mechanical ventilation. Because of attaching many lines and tubes to these patients, they are in supine or lateral positions most of the time. Nurses prefer these positions due to making care simple. Many studies have shown that prone position has positive effects on oxygenation and ventilation. However, other studies have shown some negative effects. The aim of this study was to determine the effect of prone position on oxygenation in patients undergoing mechanical ventilation.

Methods & Materials: In this quasi-experimental study, 36 patients were selected using simple sampling method. Data were collected using a questionnaire and oxygenation data sheet. First, patients were put in supine position. After 30 and 120 minutes, oxygenation was assessed. Then they were changed to prone position and after 30 and 120 minutes oxygenation was reassessed. Data were analyzed using paired t test, spearman, and fisher exact tests in SPSS.

Results: The results indicated that there was significant differences between prone position and the amount of spo2 and sao2 oxygenation after 30 and 120 minutes (P<0.001).

Conclusion: Prone positioning was effective on oxygenation after 30 and 120 minutes so nurse should use this position in their care.

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Background & Aim: The prevalence of cardiovascular diseases is high in most of the countries. Cardiac catheterization is a routine diagnostic test for coronary heart diseases. In order to minimize the post-procedure complications, patients are restricted to bed for 8-24 hours in flat position. The aim of this study was to assess the effect of changing position and early ambulation on back pain and the amount of bleeding after cardiac catheterization.
Methods & Materials: In this quasi-experimental study, 90 patients undergoing diagnostic angiography were selected using convenience sampling method in Shariati hospital. The patients were allocated in two intervention and control groups. The control group remained in supine position for 8-24 hours and the sandbag remained for eight hours. The patients&apos position in the intervention group was intermittently changed during the first hour after catheterization. The head of bed was set at 15 degree angle. In the second hour, the position changed to flat and the head of bed raised to 30 degree. In the third hour, the head of bed angle was set in 45 degree. In the first three hours sandbag was placed in catheter insertion site. After the third hour, patients could rest in any position (15-30 degree). Patients were ambulated in the sixth hour. Back pain intensity and level of bleeding were assessed immediately after admission, in the sixth, 24^th hour and after the seventh day of catheterization.
Results: The results indicated that there was no statistically significant difference in age, gender, education level, back pain intensity, and the level of bleeding immediately after the catheterization. Back pain intensity was lower in the intervention group than the control one after 6 and 24 hours of catheterization (P<0.001). There was no statistically significant difference between the intervention and control groups in the level of bleeding after 6 hours, 24 hours, and seven days of catheterization (P>0.05).
Conclusion: Patients should be allowed to change their positions in bed cardiac catheterization. Patients can be ambulated earlier (in the sixth hour) after cardiac diagnostic catheterization.

 

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Background & Aim: Oral care and using mouthwash help to prevent stomatitis. The aim of this study was to investigate the effect of two mouth wash protocols on prevention of head and neck radiotherapy induced-stomatitis.

Methods & Materials: In this single blind clinical trial, 120 individual were recruited. The experiment group (N=40) gurgled with 3cc of Matrices mouthwash and the control group used water mouth wash. The participants were assessed using the WHO grading scale. Data were analyzed using the Fisher exact test and Mann-Whitney U test as appropriate.

Results: There was not significant differences between the experimental and control groups regarding stomatitis intensity in the first day (P=0.371). Tere were significant differences between the two groups regarding stomatitis intensity in days 7 and 14 (P<0.001).

Conclusion: Oral stomatitis is a common condition in patients with head and neck radiotherapy. It makes painful ulcers, dehydration, malnutrition, and potentially life-threatening infection. Matrica mouth wash could prevent and treat induced-radiotherapy ulcer stomatitis.