Authors: Barbara A. Alliod MSN APN ACNP-BC CCNS-BC CPAN, Rebecca A. Ash MSN APN CPNP-AC
More patients suffering with Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are presenting to perianesthesia settings for emergent and nonemergent treatment and care. A group of collaborative health care providers at Rush University Medical Center in Chicago developed a multidisciplinary DMD/BMD Task Force to study this disorder and create a set of guidelines to aid those engaging in the planning, execution of care, and recovery of this unique population in the perianesthesia setting. Attention to detail, well-executed preplanning, meticulous awareness of the patient, and prearranged implementation and intervention has proven to offset potential problems and complications and is the key to a successful perianesthesia period.

Authors: Debbie Smith BSN RN TNS, Jackie Murauski MSN APN CCRN CPAN
Pulmonary embolism (PE) is a complication that can occur at any time during the perioperative period. The patient undergoing surgery to repair a hip fracture is at a high risk of developing a PE due to venous thrombosis, tissue, or fat emboli. The signs and symptoms of a PE are often nonspecific and can be obscured in the patient receiving or recovering from general anesthesia. This case study describes the presentation, diagnosis, and treatment of a patient experiencing a pulmonary embolism in the postanesthesia care unit (PACU) after surgery to repair a hip fracture.

This module includes the mechanism of nociception and multimodal therapy as well as opioids and adjuvants used in multimodal therapy.

This module includes patient care priorities for the Parkinson’s patient.

This module includes preprocedural assessment, intraoperative positioning, possible complications & interventions and patient teaching.

This module includes the etiology, rick factors, incidence, signs & symptoms, and treatment for PTSD/PTSS.

This module includes strategies for to handle crucial conversations in stressful situations.

Authors: Lyerla Frank PhD RN, Jamie Danks BSN RN MSHI
Nursing malpractice claims are escalating, which equates to a higher risk of being named in a lawsuit and possibly defending one's actions in court. The perianesthesia nurse is at particular risk because of patient involvement before, during, and after surgical procedures. To minimize this risk nurses should have a clear understanding of how a malpractice claim proceeds and the common incidents involved. Three perianesthesia case studies are presented that identify potential nursing litigation threats and strategies to reduce those threats.

Authors: Esmihan Almontaser MA RN CPAN, Carmel Ritchie BSN RN, John Madison MSN CRNA, Pascal Jabbour MD
Retinoblastoma (RB) is a rare cancer of the eye, most commonly seen in children. Intra-arterial chemotherapy for RB is a relatively new treatment modality that has gained increasing popularity worldwide. The principal underlying the intra-arterial approach is delivery of chemotherapeutic agents directly to the site of the tumor. This avoids system toxicities normally associated with higher dose of these drugs. The purpose of this continuing education article was to review the features of RB and its treatment, with a focus on the perioperative management of children undergoing intra-arterial chemotherapy at our institution. Intra-arterial chemotherapy for RB is an outpatient procedure and is well tolerated. Adverse events, most often bronchospasm, occur most often during the procedure itself, and tend to be easily managed. We focus on the role of perianesthesia nursing in the care of the pediatric RB patient, before, during, and after intra-arterial chemotherapy.

Author: Sabrina Valentine MSN RN CCRN CPAN
Abnormal placental implantations can result in postpartum hemorrhage and poor outcomes. With proper diagnosis and preplanning, complications can be minimized and aligned with maternal wishes of abstaining from blood and blood product transfusions.