Summer 2017, Volume 8, Issue 4

EBSCO Health Nursing Reference Center™ Plus Newsletter including topics on Colorectal Cancer: Fruit and Vegetable Intake, Substance Abuse: Inhalants and Case Management: Pregnancy in Adolescence –Outcomes

Nursing Reference Center in Daily Practice

Colorectal Cancer: Fruit and Vegetable Intake

Mr. W is a 60-year-old man with a recent history of colorectal cancer who is being seen in the outpatient clinic for an annual physical exam. The nurse would like to know more about the optimal diet for patients with colorectal cancer. She consults Nursing Reference Center™ Plus, keying in the word “colorectal cancer diet.” She retrieves the Quick Lesson “Colorectal Cancer: Fruit and Vegetable Intake.”

The nurse reads about colorectal cancer, including risk factors, signs and symptoms, potential complications, treatment goals, and interventions. Based on the information in the Quick Lesson, the nurse conducts a diet analysis and assesses the patient for anxiety and depression. She educates the patient about physical exercise and a healthy diet and requests a referral to a registered dietitian.

Note: The above-referenced Quick Lesson is free and accessible to all readers of the EBSCO Health Nursing Newsletter.

Quick Overview

Substance Abuse: Inhalants

Inhalant abuse refers to deliberate inhalation of toxic vapors from man-made chemical preparations like cleaners and solvents to create psychoactive effects. Inhalants cause a pleasurable sensory experience that is characterized by a quick onset, rapid dissipation, and minimal “hangover” signs and symptoms. Except for nitrates, inhalants act as CNS depressants and affect the respiratory, cardiovascular, neurologic, gastrointestinal, and renal systems. Nitrates increase heart rate and are typically inhaled to enhance sexual activity. Inhalant use is often an adolescent’s first experience with mind-altering substances, and their use can lead to experimentation with and abuse of other substances.

Potential complications of inhalant abuse include bronchospasm, acute respiratory distress, pneumonitis, asphyxiation, aspiration, suffocation, pulmonary edema, neuropathy, renal and/or liver failure, bone marrow depression, seizures, encephalopathy, coma, permanent brain damage, arrhythmias, and cardiac arrest. Negative social outcomes associated with inhalant abuse include family conflict, truancy, dropping out of school, and unemployment. Intoxication can impair judgment and coordination, which increases risk for automobile and other accidents. Inhalant use disorder can be diagnosed in individuals who display a problematic pattern of inhalant abuse that leads to clinically significant impairment.

Detection of inhalant abuse is difficult because signs can be subtle. No antidote exists for reversal of acute inhalant intoxication; treatment is generally supportive and is directed at control of arrhythmias and stabilization of respiratory status and circulation. Long-term treatment strategies are similar to those prescribed for other substance abusers, including referral to a mental health clinician for cognitive-behavioral therapy and referral to a 12-step program.

Please log in to Nursing Reference Center Plus subscription to read the Quick Lesson “Substance Abuse: Inhalants.”

Evidence-Based Content Update

Case Management: Pregnancy in Adolescence –Outcomes

Recently the Evidence-Based Care Sheet "Case Management: Pregnancy in Adolescence --Outcomes" was revised following review under the Systematic Literature Surveillance Program. New information of value to nursing practice regarding case management and pregnancy in adolescence was found in recently published guidelines. The authors recommended comprehensive case management based on the philosophy of a client-focused caring model to meet the pregnant adolescents’ social, financial, and healthcare needs and to decrease the risks associated with having a low-birth-weight infant. They recommended performing a thorough patient assessment including testing and treatment for STDs, as well as providing frequent home visits.

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