Cannabinoid hyperemesis syndrome: A case study and discussion.

BACKGROUND AND PURPOSE: Cannabinoid hyperemesis syndrome (CHS) was first described in the literature in 2004. The pathophysiology of CHS remains largely unknown. The syndrome is becoming more prevalent in inpatient settings and emergency departments as the legal usage of cannabis proliferates, although it is often not recognized when encountered. While symptoms of CHS are becoming better defined, early recognition and comprehensive treatment plans with reproducible outcomes remain elusive. Symptoms can be further complicated by the presence of chronic conditions or comorbidities. The purpose of this article is to consolidate findings from the literature, identify commonalities in clinical characteristics and pathogenesis, and highlight diagnostic and treatment approaches. METHODS: Data collection methods include a review of the literature on CHS published in the past 10 years. Case study data were gathered from a patient interview and chart review. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Through better recognition of CHS, nurse practitioners and other providers can promptly and accurately diagnosis the condition and improve treatment plans for these patients.

Nurses' Use of Evidence-Based Practice at Point of Care: A Literature Review.

The article reports results of an interrogative literature review designed to study the acquisition of research-based knowledge among practicing nurses who provide direct patient care for decision making at the point of care. Findings reveal that despite the amount of research done on the use of evidence-based practice among nurses, gaps continue to exist between what is known and what is done in practice. Nurses often cite the lack of time and support and the lack of knowledge as predominant factors that keep them from using evidence-based practice at the point of care. The past research has primarily been completed using a retrospective approach. There is a paucity of research that evaluates specific nursing behaviors that support evidence-based practice in daily patient care.

Takotsubo cardiomyopathy: A discussion and case study.

BACKGROUND AND PURPOSE: Takotsubo cardiomyopathy (TCM), first reported by Japanese doctors, has gained an overall acknowledgment as an independent malady of international attention. It resembles the presentation of an acute myocardial infarction but lacks ischemic myocardial tissue. The objective of this article is to review the physiology, diagnostics, treatment, and complications of TCM and report a case study of a patient who developed TCM. METHODS: Observation through direct patient care allowed for data collection of this unique medical phenomenon. Supporting information was obtained via investigation of scholarly articles on TCM over the past 10 years. CONCLUSIONS: Although TCM is usually transient, it is important to quickly differentiate TCM from other more serious medical conditions, such as myocardial infarction, pulmonary embolism, and pheochromocytoma. Typical diagnostic workup includes electrocardiography, cardiac biomarkers, and echocardiography or coronary angiography. Complications include cardiogenic shock, left ventricular wall rupture, and life-threatening arrhythmias. IMPLICATIONS FOR PRACTICE: The advanced practice nurse (APN) is instrumental in differentiating between TCM versus acute myocardial infarction, heart failure, pulmonary edema, dynamic outflow obstruction, and cardiogenic shock. Because of these possible acute and critical presentations, prompt recognition and intervention for patients with TCM are priorities for nurse practitioners.