Winter 2017, Volume 8, Issue 1
Marshall is a 7-year-old first grader who has been referred to the school nurse for a headache. He tells the nurse that he hasn’t eaten breakfast or lunch. The nurse notices that Marshall is wearing dirty clothes and suspects that - he may be a victim of neglect. The school nurse would like to know more about child neglect, so she consults Nursing Reference Center Plus, keying in the words “child neglect.” She retrieves the quick lesson “Child Abuse: Neglect.”
The nurse reads about child neglect, including risk factors, signs and symptoms, potential complications, laboratory tests, treatment goals and interventions. Based on the information in the quick lesson, the nurse establishes rapport and trust with the child, and follows facility protocols for evaluating and documenting patient history and physical findings. She completes a psychosocial assessment and follows facility protocols and legal requirements for filing a report of suspected child abuse.
Note: The above-referenced quick lesson is freely accessible to all readers of the EBSCO Health Nursing Newsletter.
A pleural effusion is an excess accumulation of fluid within the pleural space, the potential space between the visceral and parietal layers of the pleurae. Pleural effusion occurs when alterations in the flow and/or absorption of this fluid lead to its accumulation. The pleural space then becomes distended and mild to severe signs and symptoms can develop, including dyspnea, hypoxia (i.e., decreased level of oxygen in the blood), chest pain, coughing, decreased breath sounds, fever and infection.
Pleural effusions are classified as infectious or noninfectious. Infectious pleural effusions caused by viral pneumonia are the most common type in neonates and are usually self-limiting. Noninfectious pleural effusions can occur in association with lymphatic drainage abnormalities caused by congenital conditions or secondary to trauma or surgery.
Chest X-ray is typically the first imaging modality used to work up pleural effusion, but it cannot confirm the diagnosis; a CT scan and/or ultrasound of the chest can be useful for more precise localization. Small, asymptomatic pleural effusions are merely observed until they resolve, including those of infectious origin because they are typically self-limiting; infectious pleural effusions are treated with antibiotic therapy prior to thoracentesis (i.e., use of a needle to aspirate or drain excess pleural fluid, which would identify bacterial or viral origin but is not attempted unless respiratory distress develops). Most neonatal pleural effusions are caused by infection; eradication of the infectious organism typically results in a complete recovery. Any patient with pleural effusion that results in respiratory distress can require thoracentesis, chest tube placement or surgery. Palliative treatment includes oxygen therapy, sedatives and analgesics, as necessary. Neonates who have congenital conditions requiring extensive surgery are at increased risk for complications (e.g., bleeding, sepsis, hypoxia) and death.
Please log in to Nursing Reference Center™ or Nursing Reference Center Plus subscription to read the quick lesson on “Pleural Effusions in the Neonate.”
Recently, the evidence-based care sheet "Human Papillomavirus Infection During Pregnancy: Complications" was revised following review under the Systematic Literature Surveillance Program. Among new information of value to nursing practice was a research study regarding complications of human papillomavirus infection during pregnancy. New evidence in a recent small study indicates a strong association between women impregnated by men with HPV-infected semen and an increased rate of miscarriage, as well as a prevalence of antisperm antibodies in infertile couples undergoing assisted reproductive technology.
We invite you to log in to Nursing Reference Center or Nursing Reference Center Plus to read updated content as it becomes available.