"Do I exist in this world, really, or is it just her?" Youths' perspectives of living with a sibling with anorexia nervosa.

Little is known about how severe anorexia nervosa (AN) in youths affects siblings and siblings' experiences of family-based treatment for AN. Thirteen youths (M age = 15.5 years, SD = 3.0; 23% boys) who had been co-admitted with their sibling with AN and parents at an inpatient clinic for eating disorders 3 to 6 years earlier participated in qualitative interviews. Interviews were analyzed using systematic text condensation. Results showed AN is difficult to understand, particularly at onset, and is associated with confusion and lack of information for siblings. AN evokes difficult emotions, including fears of death, frustration about rigid behavior, and sadness about changed life situations. AN affects family dynamics and relations, including conflicts and disruptions at home, limited and divided family life, and less attention from parents and extended family. Siblings pay attention to other people eating habits, strive for a balanced view on eating, and experience family meals as conflictual. Siblings experience increased knowledge and personal development, and are ambivalent to family treatment. Ways of coping include creating distance, seeking social support, rationalizing, and keeping hope. In conclusion, siblings' experiences of severe AN are complex and ambiguous. Family-based treatment for AN in young people should address siblings' perspectives.

Empowering versus enabling in academia.

The literature endorses empowered nurses as essential to changing not only the nursing profession but also the current health care system. Nurse educators have embraced the concept of empowering students. However, faculty frequently enable students rather than empower them in both clinical and classroom settings. This article describes the difference between enabling and empowering. Collegiality, communication, accountability, and autonomy are components of a model used to compare empowering versus enabling in the academic setting. Nurse educators will become aware of behaviors that sabotage the empowerment of students. Strategies designed to facilitate students' development of empowering behaviors will be provided throughout the article.

Achieving spiritual wellness: using reflective questions.

Health care professionals are increasingly recognizing the importance of spiritual health as a precursor of physical health. As we emerge into the 21st century, we must place greater emphasis on promoting spiritual wellness so that clients do not develop spiritual distress. Assisting clients in developing their spiritual wellness is a rewarding experience for nurses. As health care providers, we have the opportunity to educate the public about spiritual wellness to prevent physical problems. Attentiveness to one's spirit is a key component to healing and becoming a whole person. With guidance, clients can initiate a plan to maintain their own spiritual needs.

Promoting mental wellness in children and adolescents through positive coping mechanisms.

Children and adolescents frequently experience stressful events such as moving to a new city, divorce of parents, or peer pressure. Parents may be unavailable or unable to model effective coping mechanisms for their children. Without adequate coping mechanisms children frequently are unable to adapt to a stressor; thus a crisis develops. School nurses and other school professionals are in a key position to help young people handle stressful life events and prevent a crisis. This paper reviews stress and suggests techniques to assist children and adolescents to identify and utilize coping strategies while in crisis.

Inhalants: the instant, but deadly high.

There is an alarming increase in the number of children and adolescents inhaling chemicals for euphoric purposes. This trend merits serious concern, as abuse of inhalants can cause cardiac arrest, asphyxiation, and accidents. Substances such as gas, butane, and lighter fluid are highly toxic and destroy organs, and in some cases, inhalants have caused death on the first use. Pediatric nurses are in a key position to identify abusers and educate parents and children about these potentially fatal chemicals.

Identifying the manifestations of inhalant abuse.

Inhalants are frequently the first mood-altering drugs used by children. They are popular because of peer influences, low cost, availability, and rapid mood-elevation effects. Inhalants cause a fleeting sense of well being, but users frequently are also affected psychologically and physically. Substances such as gasoline and paint thinners are highly toxic and destroy major organs. The abuse of inhalants can cause cardiac arrest, asphyxiation, and accidents. This article focuses on the clinical manifestation of inhalants, altered lab values, the specific agents used, and their effects on the various organs. Health care professionals are in a key position to identify inhalant abusers when clients are seeking treatment for medical problems caused by inhalants. If health care professionals are cognizant of the manifestations of inhalant abuse, they can save a client's life.

Chemical dependency and hyperkalemia in adolescents and adults: supportive findings.

The present study was undertaken to explicate findings of elevated blood potassiums (K+) among inpatient addiction treatment patients. A higher mean blood K+ level was established to exist for these patients compared to reference groups. This was investigated by comparing "high" and "normal" K+ groups within our patient group on several demographic variables and on the usage of various drugs. Multiple regression analyses were computed in an attempt to predict K+ levels. Age alone was found to be the best predictor after elimination of nonsignificant variables. Adolescents and young adults may differentially favor substances that raise K+ levels. Elevated blood K+ levels among adolescents and young adults may alert practitioners to specifically explore substance use disorders.

Inhalant abuse: assessment guidelines.

It is important that nurses have full access to information that would help them identify inhalant abuse. Nurses need to take the leadership in assessing clients, in educating health care professionals and the public, and in promoting legislation to prevent minors from obtaining inhalants.