Winter 2016, Volume 7, Issue 1

EBSCO Health Nursing Newsletter including topics on Air Embolism in Newborns, Dysmenorrhea, and Melanoma Risk Factors and Prevention

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Welcome back to EBSCO Health's free evidence-based nursing newsletter. We will periodically send news on the latest evidence in nursing. Please share this with your colleagues, students, practitioners and others who would benefit from this information.

Nursing Reference Center™ Plus in Daily Practice

Air Embolism in the Newborn

Baby M is a newborn with respiratory distress who needs mechanical ventilation. The nurse wants to learn more about air embolism, a rare side effect of mechanical ventilation in newborns, so she consults Nursing Reference Center Plus, keying in the words "air," "embolism" and "newborn." She retrieves the quick lesson "Air Embolism in the Newborn."

The nurse learns a great deal about air embolism in the newborn, including etiology, risk factors, diagnostic tests, signs and symptoms, and treatment goals and interventions. Based on the information in the quick lesson, the nurse carefully monitors the patient for signs and symptoms of air embolism. She provides the family with emotional support.

Note: The above-referenced quick lesson is freely accessible to all readers of the EBSCO Health Nursing Newsletter.

Quick Overview

Caring for Patients with Dysmenorrhea

Dysmenorrhea is a condition that is characterized by painful menstruation and other symptoms that vary in severity, including cramping, dizziness, nausea, vomiting, headache and diarrhea. Dysmenorrhea is the most common, underreported and undertreated gynecologic condition in women. Severe dysmenorrhea can be physically debilitating and psychologically taxing, leading to work and school absenteeism and reduced quality of life.

There are two types of dysmenorrhea, primary and secondary. Primary dysmenorrhea is menstrual pain that occurs without evidence of a causal condition. The etiology of primary dysmenorrhea is not fully understood. Prostaglandins and vasopressin may play a role because elevated levels of both are found in women with dysmenorrhea. Prostaglandins are released from endometrial cells during menstrual sloughing of the endometrial lining, and cause uterine ischemia as a result of vasoconstriction and myometrial contraction. Vasopressin, an antidiuretic hormone that regulates water retention, has been thought to contribute to dysmenorrhea, but its role has not been fully established. Secondary dysmenorrhea is menstrual pain that occurs as a result of a disease, condition or anatomical abnormality. Prostaglandins may have a role in secondary dysmenorrhea, but by definition abnormal pelvic pathology must be present. Common causes of secondary dysmenorrhea include endometriosis, fibroids, adenomyosis, endometrial polyps, chronic pelvic inflammatory disease (PID) and cervical stenosis.

Primary dysmenorrhea usually lasts 8-72 hours, starting just before or after menstrual flow begins and gradually diminishing over the course of menstruation. Secondary dysmenorrhea usually lasts 10-16 days, increasing progressively during the luteal phase of the ovulation cycle and peaking around the start of the menstrual flow. Diagnosis of dysmenorrhea is generally clinical, although laboratory tests and imaging studies may be performed to identify the cause of secondary dysmenorrhea.

Treatment for primary dysmenorrhea includes analgesics (e.g., NSAIDs) to relieve pain, birth control pills to regulate hormone levels and/or antidepressants to improve mood. Supportive and alternative methods used to alleviate pain and reduce symptoms include the use of heating pads, elevating the legs, walking, taking warm showers, meditation, yoga, and herbal and other natural products. Various traditional Chinese methods have been used to treat primary dysmenorrhea, including Chinese medicinal herbs, acupuncture and acupressure, although there is no evidence of their effectiveness. Treatment of secondary dysmenorrhea is specific to the underlying cause.

Please log in to your Nursing Reference Center or Nursing Reference Center Plus subscription to read the quick lesson on "Pain Management: Dysmenorrhea," which includes additional information about assessment and treatment of this condition.

Evidence-Based Content Update

Recently, the evidence-based care sheet "Melanoma: Risk Factors and Prevention" was revised following review under the Systematic Literature Surveillance Program. Among new information of value to nursing practice were clinical guidelines regarding risk factors for and prevention of melanoma.

Recent National Comprehensive Cancer Network guidelines indicate that excessive exposure to ultraviolet light (UV) is the most important risk factor for development of melanoma. The impact of UV exposure on melanoma risk may vary according to numerous individualized factors that contribute to increased melanoma risk, including the presence of nevi or dysplastic nevi, or a personal history of melanoma or other types of skin cancer.

We invite you to log in to Nursing Reference Center or Nursing Reference Center Plus to read updated content as it becomes available.


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