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Biomedical subjects

M McCaffery

Publications and source records attributed to M McCaffery.

At least 145 records · Page 8Linked to original sources
PubMed1980

Evidence for renal tubular leakage in maleic acid-induced Fanconi syndrome.

Micropuncture and microinjection studies were performed in Sprague-Dawley rats 20 h after subcutaneous injection of buffered maleic acid (MA) or buffer alone in experimental and control rats, respectively. Collections were made from earliest and latest accessible portions of proximal tubule (PT). Lissamine green injections and microperfusion of PT demonstrated leakage of lissamine green from late PT sites in MA-treated rats, whereas inulin leakage occurred at a more distal site. Whole kidney GFR was 58% lower in MA-treated rats despite comparable single nephron GFR in PT of both groups. Microinjections of PT with [methoxy-3H]inulin resulted in injected inulin recovery from the contralateral kidney in MA-treated rats of 24.0 +/- 2.0 compared with 4.7 +/- 0.89% in controls, suggesting that tubular leakage of inulin accounted for the lower whole kidney GFR. Net sodium and phosphate transport in early PT was similar in both groups but was decreased in late PT segments in MA-treated rats. Sodium and phosphate excretion in final urine were, however, comparable in both groups. The significantly lower plasma phosphate concentration might account for the blunted phosphaturia in MA-treated rats. These studies demonstrate a segmental effect of MA on 1) tubular leakage to lissamine green from late PT and inulin beyond the late PT, and 2) decreased net sodium and phosphate transport in the PT.

Animals↗
PubMedDate not supplied

Assessment and relief of pain in chemically dependent patients.

The growing number of patients admitted to acute care settings with the dual problem of pain and chemical dependency is bringing this major dilemma to the forefront of clinical nursing practice. Orthopaedics is one of the clinical areas likely to encounter an increased proportion of such patients. The care of chemically dependent patients with pain is not only often enormously challenging but also potentially frustrating. Planning care for these patients is best accomplished with a team approach that includes the expertise of several specialties, particularly pain and addiction. Although considerably more research is needed to identify the most effective approaches to the care of chemically dependent patients with pain, sufficient information now exists to support suggestions for guidelines. This article addresses definitions of pain and chemical dependency, methods of identifying the chemically dependent patient, the prevalence of pain and addiction, clinical conflicts and dilemmas related to relieving pain in addicted patients, a framework for planning care, and specific guidelines for individualizing the plan of care. Orthopaedic nurses are challenged to accept a leadership role in improving the care of chemically dependent patients with pain by evaluating these guidelines and developing additional approaches.

Education, Nursing, Continuing↗
PubMedDate not supplied

Analgesic administration via rectum or stoma.

The rectal and stomal routes for administering analgesics are discussed as alternatives to invasive, parenteral routes when a patient is unable to take medication by mouth. The ET nurse has an important role in reminding members of the health care team about these routes and in teaching patients and family members (i.e., caregivers) to use them properly.

Administration, Rectal↗
PubMedDate not supplied

Influence of professional vs. personal role on pain assessment and use of opioids.

Previous surveys have revealed that patient characteristics such as behavior may influence nurses decisions about pain assessment and analgesic use. This survey suggested that the role assumed by the nurse, professional versus personal, also influences these decisions. The findings further suggested that continuing education aimed at improving pain management needs to include not only knowledge about pain assessment and safety in the use of opioid analgesics, but also teaching methods that increase empathy.

Adult↗
PubMedDate not supplied

Opioid analgesics: nurses' knowledge of doses and psychological dependence.

Lack of education of health professionals, including nurses, is frequently cited as a major reason for undertreatment of pain. Very recent surveys have revealed an urgent need for basic and continuing nursing education to address this problem. For example, little time is spent on the topic of pain in many baccalaureate nursing programs, nursing textbooks lack correct information about opioid addiction, and most practicing nurses currently do not possess knowledge about opioid analgesics that would enable them to administer opioids effectively. The authors report on a survey of 1,781 practicing nurses' specific knowledge deficits regarding opioid analgesics and propose some solutions.

Adult↗