ABSTRACT Pediatric abusive head trauma (AHT) is the leading cause of death from physical child abuse in the United States. The term "pediatric AHT" replaced the former descriptor, "shaken baby syndrome," to include all nonaccidental head injuries. AHT can present with a wide range of symptoms that are often vague, including lethargy, vomiting, and irritability, leading to missed diagnoses. Various clinical decision tools assist in the efficient and accurate detection of AHT. Nurses play a pivotal and opportune role in the prevention, screening, and education. This article discusses the risk factors, clinical presentation, key assessment findings, diagnostic criteria, screening tools, and educational approaches for nurses to better care for patients and families with this suspected diagnosis. Additionally, nurses can follow the Concern for AHT Guide, which initiates the outsourcing of resources through Child Protective Services and social work. Another tool discussed is the Period of PURPLE Crying, which is implemented in postpartum discharge teachings, well-baby appointments, and baby immunization appointments to decrease AHT.
ABSTRACT The United States is experiencing an increasing demand for health care services driven by an aging population, resulting in unprecedented pressure on the nursing workforce. Simultaneously, nursing academia is challenged by faculty shortages, decreased wages, policy changes, declining enrollment, increased work demands, and faculty burnout. These challenges adversely impact the stability of the nursing academic workforce and the profession's ability to educate the next generation of nurses. In acknowledging that burnout is a systemic problem that must be fixed by academic leadership, this article explores ways to bridge the adverse impact of burnout that extends beyond individual coping strategies. A socio-ecological framework is used to explore three complementary interventions that impact wellness: resilience education, structured mentorship, and co-teaching. Resilience is presented as an individual and organizational strategy to improve and maintain well-being. Mentorship is employed as a facilitator of belonging and a conduit for professional development. Additionally, co-teaching is explored as a collaborative tool to promote connectedness, provide support, and elicit the sharing of assigned workloads. Recommendations for implementation are provided to assist institutions of higher learning with the creation of supportive work environments to reduce burnout, strengthen the nursing academic workforce, and support the preparation of the next generation of nurses.
ABSTRACT Local anesthetic systemic toxicity (LAST) is a rare but life-threatening condition caused by the use of local anesthetics. LAST produces deleterious effects in the central nervous and cardiovascular systems. If these toxic effects are not recognized and treated in a timely manner, LAST can progress and lead to coma or cardiac arrest in the patient. This article discusses LAST with the aim to educate nurses and other health care professionals on the signs and symptoms, treatment, and prevention of toxicity from local anesthetics.
Abstract: Fournier gangrene (FG) is a form of necrotizing fasciitis that affects the genital and perineal tissues. This life-threatening condition is most often caused by a polymicrobial bacterial infection of the tissues. Predisposing factors include obesity, advanced age, chronic alcohol abuse, and immunosuppression. Although rare, FG can be life-threatening and can significantly impact the patient's quality of life. Adept nursing care can improve patient outcomes. This article discusses the pathophysiology and common complications of FG and outlines expected nursing considerations for patients with this type of infection.
