This chapter explores traumatic grief and loss and discusses various treatments for it. It focuses on mindfulness-based interventions for specific use in traumatic grief with bereaved parents. Traumatic grief appears relatively responsive to the psychosocial approach, particularly when it includes exposure elements, such as retelling the story of the loss, reutilization, and building tolerance to the emotions associated with loss. More recently, Thieleman, Cacciatore, and Hill have presented evidence for a mindfulness-based, psychosocial approach for specific use in traumatic grief with bereaved parents. Western culture’s interest in mindfulness has grown exponentially, and practices have been integrated into a variety of general, psychotherapeutic treatment approaches including acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), mindful- ness-based cognitive therapy (MBCT), and mindfulness-based stress reduction (MBSR). Of all mindfulness practices, one of the most cost-effective strategies to help providers working with bereaved parents is meditation.

Multiple physical changes can impair the mental health of the aging individual. These changes include: acid-based imbalances, dehydration, electrolyte changes, hypothermia or hyperthermia, and hypothyroidism. This chapter reviews the most common mental health disorders affecting the elderly population and trends affecting care delivery. Moreover, chronic, unresolved pain has been associated with an increased risk of a mental health disorder such as depression, suicide, or anxiety. The aging individual may exhibit signs and symptoms of insomnia such as sleeping for short periods during the night, sleeping during times of normal social activities, arising early in the morning while others sleep, and experiencing daytime sleepiness. The chapter concludes by applying the nursing process from an interpersonal perspective to the care of an elderly patient with a mental health disorder.

Musculoskeletal disorders are some of the most common causes of illness and hospitalization in children due to their active nature. This chapter reviews common pediatric musculoskeletal disorders, etiology of pediatric musculoskeletal disorders, and pediatric-specific care of musculoskeletal disorders. The musculoskeletal system supports the body structure and provides for client movement. Skeletal growth is most rapid during infancy and adolescence. Injury to the epiphysis can affect bone growth. The most common pediatric musculoskeletal disorders involve pediatric trauma. Torticollis is a symptom that causes a child’s chin to be rotated to one side and the head to the other side. The two most common disorders that can cause torticollis include: Congenital muscular torticollis, and Acquired torticollis. Osteomyelitis is an infection of the bone that occurs most often in infancy or between the ages of 5 and 14 years.

The endocrine or ductless glands work with the nervous system to regulate the body’s metabolic processes. Hormones interact with specific target organs to create an effect on the body. This chapter reviews the pathophysiology behind the metabolic system in pediatric clients. It describes nursing care required for pediatric clients with various metabolic conditions. The chapter explores instruction necessary for families of clients with metabolic conditions. Most of the glands and structures of the endocrine system develop during the first trimester of fetal development. Hormonal control is immature until approximately 18 months of age, leaving the infant prone to dysfunction of the endocrine system. Hundreds of hereditary biochemical disorders affect the metabolism. As the infant adjusts to life, symptoms can rapidly emerge that are life-threatening. The most common endocrine dis.

The Senior House Calls program (SHC) was started as a component of the Texas Tech University Health Sciences Center School of Nursing (TTUHSC SoN) practice program through a 2-year grant from a local foundation. Operated as part of the Larry Combest Community Health and Wellness Center (LCCHWC), it primarily serves the needs of vulnerable elders in the area. SHC is a nurse-managed clinical service for homebound elders that provides comprehensive primary care through advanced practice nurses who are employees of the SoN. The goal of this program is to provide access to a continuum of community-based services for the elderly population in the city of Lubbock, as an alternative to institutional care. Family therapy services are provided in the SHC program; those needing more intensive therapy are referred to appropriate services. SHC is largely funded through Medicare since almost 99” of its patient volume is covered by Medicare.

The 19130 Zip Code Project at the Community College of Philadelphia (CCP) started as a curriculum innovation: the CCP Department of Nursing’s response to the national shift toward community-based health care. The project resulted in the refocusing of the nursing curriculum and the development of partnerships with CCP’s neighbors in the 19130 zip code. It also is an excellent example of a nurse-managed wellness center without walls. The Zip Code Project has put down deep roots in the neighborhood and in the nursing curriculum. It has produced a community-based model for educating local health professionals and a service-learning model for enhancing health service delivery by local agencies. The faculty arranged community-based clinical experiences for nursing students in the neighborhood surrounding CCP. Although CCP sits in the middle of the zip code, faculty knew little about community-based health care services in the community.

This chapter talks about monitoring equipment, and procedural sedation and analgesia (PSA). In addition to respiratory suppression, the medications used for PSA may suppress the autonomic nervous system’s ability to adequately respond to hypovolemia; therefore, close monitoring of vital signs is important for the well-being of patients. PSA medications promote a rapid recovery stage with minimal postprocedure impairment. Patients need to be observed until there is no risk of cardiorespiratory depression or compromise; monitoring vital signs, including level of consciousness (LOC), with ability to intervene quickly with resuscitation efforts if needed. The rapid response system (RRS) provides critical care expertise when intensive care unit (ICU) level care is needed for compromised patients outside of the ICU, including radiology. The RRS is the radiology nurse’s resource when patients have adverse reactions to sedation, procedures, or diagnostic tests.

This chapter describes nursing care for sleep disorders in the primary care setting. The most prevalent sleep disorders in adults and older adults, and those most commonly seen in primary care settings are insomnia, sleep-disordered breathing, and restless legs syndrome. There is a compelling need for widespread access to sleep assessment and treatment among the large population of primary care clients who have sleep disorders-many of which are currently undetected. Primary care providers, especially nurses, are in an ideal position to assess, implement, and evaluate sleep promotion and sleep disorders treatment in primary care clients. The reach, adoption, implementation, and long-term maintenance of sleep promotion and sleep disorders treatment is most likely to be successful if implemented at the practice/organizational level. Nurses, especially advanced practice nurses play a pivotal role in implementing and evaluating policies and procedures to assure the translation and uptake of these important services.

This chapter discusses the characteristics of sleep, factors associated with sleep, and evidence-based strategies to promote sleep in acute and critical care settings. It discusses implications for nursing practice and research. Disordered sleep is common in patients hospitalized in demographical and clinically diverse acute and critical care settings. Careful assessment for factors that increase the risk for sleep disturbance and its consequences during hospitalization is needed. Although randomized clinical trials are sparse, the available evidence suggests the promise of multimodal interventions that reduce environmental stimuli or their impact. Given the high prevalence of obstructive sleep apnea (OSA) in the general population and its underdiagnosis, there is a compelling need for assessment and preventative interventions for this condition. Research is needed on the short- and longer-term outcomes of sleep-promoting interventions on patients’ function, quality of life, and morbidity.

This chapter reviews normal physiological and anatomical changes that occur during pregnancy and discusses common sleep disorders that can occur during pregnancy as well as postpartum. It also discusses the adverse effects of poor sleep on labor and delivery outcomes and reviews postpartum sleep patterns within the context of risk for postpartum depression. The chapter examines the nurses’ role in sleep promotion in relation to sleep hygiene behaviors that can be adapted for pregnant women and new mothers and their families during the first 6 months postpartum. It describes alternative strategies nurses can use to safely promote sleep during perinatal period. Restless legs syndrome (RLS) and sleep-disordered breathing (SDB) or obstructive sleep apnea (OSA) the most critical causes of disturbed sleep during pregnancy and require urgent assessment and referral for effective and non-pharmacologic interventions. The chapter explores sleep during the postpartum period, when women’s experience with sleep deprivation is expected.