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Biomedical subjects

K R Wren

Publications and source records attributed to K R Wren.

10 recordsLinked to original sources
PubMed2001

Opioid use during the perianesthesia period: nursing implications.

Opioids are used extensively for pain management during the perianesthesia period. These compounds exhibit varying degrees of agonism and antagonism at mu, kappa, and Delta opioid receptors. Stimulation of these receptors cause similar and distinctive actions such as analgesia, euphoria, dysphoria, and respiratory depression. It is imperative that perianesthesia nurses have a clear understanding of opioid receptor site physiology so that maximum analgesic effects are obtained while side effects are minimized.

Analgesics, Opioid↗
PubMed2001

Learning from a nurse anesthetist perspective: a qualitative study.

This study explored the learning and problem-solving experiences of Certified Registered Nurse Anesthetists (CRNAs) using a qualitative case study design. Through interviewing and observation techniques, 5 expert CRNAs provided information on learning and problem solving in daily clinical practice. Data were analyzed using the Tesch 8-step model. Three themes emerged from the data. In their learning, expert CRNAs first desire to know the pharmacological, physiological, or pathophysiological ("basic") principles needed to understand clinical situations. Once they are comfortable with their grasp of the basic principles, CRNAs will then "try out" the new agent or technique in their clinical practice. As experiences accumulate, CRNAs create complex practice structures and demonstrate increased levels of confidence, comfort, and expertise in practice. In understanding how expert nurse anesthetists learn and develop, perhaps educators and students will be more able to identify and design learning activities that prepare students for competent and successful anesthesia practice.

Clinical Competence↗
PubMed2000

Detrimental effects of hypothermia: a systems analysis.

Hypothermia influences body functions in many positive and negative ways. Hypothermia may be purposely induced during neurological or cardiac surgery for its cerebral protectant effects. However, hypothermia during the perioperative period is often detrimental, leading to increased bleeding and blood product utilization, as well as prolonged stays in the PACU. This article presents an overview of the physiology of temperature regulation and risk factors for the development of perioperative hypothermia. The effects of hypothermia on various body systems also are discussed and perioperative concerns explored.

Humans↗
PubMed2000

Limitations to self-care in the ambulatory surgical patient.

Myalgia, or muscle pain, is a common postoperative phenomenon. Causes of myalgia include age, gender, medication, positioning, and abdominal insufflation for laparoscopic surgery. For some patients, myalgia may be more severe than surgically induced pain. This study explored postoperative myalgia from the perspective of self-care limitations. Sixty-three individuals were surveyed, and responses were analyzed using unidimensional and multidimensional scaling techniques. Subjects reported back pain and the inability to accomplish high-energy activities of daily living to be most incapacitating after surgery. Results of this investigation may be used to structure preoperative teaching and perianesthetic nursing interventions.

Activities of Daily Living↗
PubMed1999

Legal implications of evaluation procedures for students in healthcare professions.

Evaluation of students is an integral part of teaching and instruction. Evaluations take on added dimensions when students are enrolled in healthcare training programs, such as nurse anesthesia. Not only must students master a body of knowledge, but they also must be able to integrate, process, and apply this knowledge appropriately in a clinical setting on a human patient. Thus, societal and legal issues enter into the training and credentialing of a healthcare practitioner. Conversely, today's students are more aware of their rights and freedoms and are more willing to appeal to the legal system for satisfaction of their grievances. Thus, evaluation must meet many needs; most important, evaluation must be fair and objective for society, school, and the student. In order to develop and implement a just evaluation system, instructors and administrators should be cognizant of the legal parameters and ramifications of evaluation processes.

Education, Nursing, Graduate↗
PubMed1999

Employee and independent contractor relationships.

Most practitioners find themselves at a disadvantage in dealing with business issues and relationships. As health care continues to change, knowledge of contracts and business relationships will help CRNA practitioners navigate new as well as traditional practice settings. This article discusses the advantages and disadvantages of two business relationships: employee and independent contractor.

Contract Services↗
PubMed1999

Critical pathways: a means of managing the operating room.

Critical pathways help institutions in efficient and appropriate resource use to increase the quality of health care and minimize health care costs. However, many opportunities for pathway development and implementation are unexplored. This article delineates the development process for critical pathways and discusses the outcomes realized from use of the total joint pathway at the Medical College of Georgia, Augusta, GA.

Critical Pathways↗
PubMed1998

Nitric oxide: a primer for the practicing anesthetist.

Nitric oxide (NO) is receiving interest because of its use in patients with acute respiratory distress syndrome. Because more studies are being conducted, researchers are discovering a vast array of physiological effects attributable to NO. NO has been implicated as having a role in the endogenous regulation of blood pressure; smooth, skeletal, and cardiac muscle relaxation; renal and immune system functioning; and selective pulmonary vasodilation. This article looks at the pharmacological and physiological effects of NO and its current use in the clinical setting.

Adult↗
PubMed1994

Ventilation monitoring during monitored anesthesia care: a review.

The use of capnography during general anesthesia has become not only state of the art but also a recommended standard of care. In intubated patients, measurements of partial pressure of carbon dioxide in exhaled pulmonary gases approximate partial pressure of carbon dioxide in arterial blood under stable conditions. End-tidal carbon dioxide measurement has allowed anesthetists to continuously follow carbon dioxide concentration in exhaled gases; indirectly, it has enabled them to continuously monitor carbon dioxide concentration in arterial blood. This information has proven indispensable in the care of patients receiving general anesthesia, with its accompanying respiratory depressant effects. Recently, attention has focused on the utilization of capnography in sedated, nonintubated patients to follow carbon dioxide concentrations and access respiratory system function. This review of the current body of literature outlines development in capnography monitoring for sedated, nonintubated patients. Emphasis is placed on current techniques of measurement, the degree of correlation, and ramifications for clinical practice.

Anesthesia↗