Understanding equianalgesic dosing.

Over the past several years, improving pain management has become a major initiative. Nurses play a vital role in this effort. To be most effective in this pain relief role, nurses need to develop a clearer understanding of the opioid analgesics and how to use them. The purpose of this article is to outline basic questions that are helpful as one considers either changing routes of opioid analgesic administration or changing drugs. Use of the equianalgesic table is discussed with specific examples of use in clinical practice.

Patients with long-term vascular access devices: care and complications.

Orthopaedic nurses will be dealing with more long-term vascular access devices, such as tunneled catheters, implanted ports, and peripherally inserted central catheters as antibiotic and other supportive intravenous therapy is administered over longer periods. Caring for patients with these devices requires an understanding of the purpose and design of the device, use and maintenance of the catheter or port, and actions to take if complications arise. Knowing the cause and response to the most common clinical problems, such as infection, occlusion, and thrombosis, will help in problem solving and support a variety of teaching strategies for patients. Nurses who are familiar with these central venous devices will be able to provide safe and effective care for patients in the hospital and at home.