Background: cancer pain has emerged as a leading stressor for patients with cancer in the intensive care unit (ICU).Unrelieved pain gives rise to negative physiologic and psychological events that can be detrimental to critically ill patients" health outcomes Aim of the study: evaluate the impact of an educational program about cancer pain management on nurses' knowledge, attitudes and practice at intensive care unit. Subject and methods: Quasi-experimental design was utilized in this study. A convenience sample of 55 ICU nurses 30 were nursing diploma, 17 were technical degree and 8 bachelor degree. The data were collected using the tool I Pre/post-test nurses' knowledge and attitudes assessment questionnaire sheet for assessment of nurses' knowledge and attitudes, tool II pre/post observation checklist to assess nurse practices. Results: The result reveals that the majority of nurses had unsatisfactory of knowledge and negative attitudes regarding cancer pain management pre-education program. The mean scores were improved significantly (P=0.001) post education program, also, the majority of nurse's practice were an inadequate pre-education program; they improved significantly (P=0.001) post education program. Conclusion:The study concluded that the education program leads to significant improvement in nurse's knowledge attitudes and practices about cancer pain management.

Background: Respiratory acid-base disorders are commonly seen in the critical care setting and can occur independently or coexist with metabolic acid-base disorders. Aim of the study: To explore the pattern of respiratory acid-base disorders and related risk factors in critically ill patients. Design: the descriptive design was utilized in this study. Setting: This study was carried out in the Trauma and general Intensive Care Unit at Assiut university hospital. Sample: fifty patients admitted to trauma and general Intensive Care Unit. Tools: Four tools were used in this study, patient assessment tool, APACHE II tool, Acid-base parameters assessment tool, and Risk factors assessment tool. Result: A total of 50 patients most of them were male with a mean age of 40.37 ± 13.86 in the survivors versus 47.75 ± 11.86 in non-survivor. APACHE II score was significant in non-survivor group confirmed by (P = 0.000), (P = 0.003) respectively.The incidences of respiratory alkalosis (52%), respiratory acidosis (24%) were higher in the survivor group. The significant risk factor was iatrogenic(drugs, mechanical ventillation). Conclusion:Respiratory acid-base disorders are common in critically ill patients mainly respiratory alkalosis and the major related risk factor was an iatrogenic.

Background: Acid-base disturbances are common in critically ill patients and pose a great burden in the management of the underlying condition. Aim: To explore the common types of acid-base disturbances among the critically ill patients in ICU. Design: A descriptive study design was utilized. Setting: This study was carried out in the Trauma and general Intensive Care Units at Assiut university hospital. Sample: Eighty adult male and female patients admitted to trauma and general ICUs. Tools: Three tools were used in this study, patient assessment tool, APACHE II tool, and Acid-base parameters assessment tool. Result: Eighty patients suffered from acid-base disorders with mean age (41.88 ±13.39) years. The mean pH on admission was (7.34 ±0.13), the mean length of ICU stay was (10.90 ±7.86). Respiratory alkalosis was the most frequent of simple acid-base disturbance (73.8%) followed by metabolic alkalosis (33.8%), respiratory acidosis (32.5%). Mixed acid-base disorders were relatively less frequent, the common combination was metabolic acidosis with respiratory acidosis (15.0%). Conclusion: Acidbase disturbance are common among critically ill patients presenting at the ICU. Respiratory alkalosis was the most frequent simple acid-base disturbance was observed among such group of patients. Recommendation: Acid-base disturbance should be monitored closely, diagnosed early, and managed correctly during hospitalization.