Gerontology Nursing Care Questions

Niacin and Increased Cholesterol Levels

For most people struggling with undesirable levels of cholesterol that cannot be enhanced sufficiently through diet and exercise, prescribed statin drugs are usually the recommended treatment options. One of the most commonly recommended treatment options is niacin, which is a vitamin that is also known as B3 that is administered in very large doses. This vitamin is recommended because it can enhance the levels of cholesterol while lessening the risk of heart attacks (Berkeley Wellness, 2011). Cholesterol is a waxy substance that is found in an individual’s blood and his/her body cells. While most of the cholesterol comes from the liver, a significant portion is obtained from foods an individual eats. Niacin raises high-density lipoprotein (HDL), which is the healthy form of cholesterol since it helps in transporting extra cholesterol from the arteries to the liver. Additionally, niacin lowers triglycerides, which are fats in the blood that can enhance the risk of heart attack.
Medical treatment has continued to evolve over the years in attempts to enhance the health and well-being of patients and contribute to enhanced patient outcomes. This evolution has contributed to the emergence and wide acceptance of complementary and alternative medicine procedures. CAM therapies are increasingly used by older adults for self-care in order to prevent and cure illnesses as well as enhance their wellbeing. Older adults increasingly use CAM therapies since they view them as effective complement to conventional medicine. However, Schnabel, Binting, Will & Teut (2014) contend that CAM therapies are increased used by older adults without adequate knowledge of the risks and benefits associated with these medical treatment alternatives.
For Registered Nurses working in delirium care unit at a hospital, the consideration of CAM therapies as complement to conventional medicine needs to be approached with caution. While these therapies are relatively effective complements to conventional medicine, they are associated with some risks and benefits. Most of the existing CAM therapies such as herbal drugs and products have well-known side effects that older adults may not know when using them for self-care. According to Anlauf et al. (2015), numerous CAM therapies and treatments can never meet the requirement of demonstrating efficacy in a way that is compatible with evidence from natural sciences. Most of these treatments and therapies have been justified with scientific and non-scientific paradigms, which contributes to lack of sufficient knowledge of their real benefits and risks in the clinical setting.
Assessment of Patients with Delirium
Delirium is one of the most common and complex neuropsychiatric conditions that occurs in the acute care settings and intensive care units in hospitals (Sweet et al., 2014). This condition is characterized by severe or sub-acute changes to the patient’s mental status including impaired cognition, attention, and consciousness. As a result, assessment and treatment of patients with delirium has become a major issue for healthcare providers in the acute care setting and intensive care units (ICUs). Delirium has received significant attention from healthcare providers because it’s a major determinant of healthcare costs and patient outcomes in these settings. As a result, nurses and other healthcare providers in these settings utilize various tools in assessment of delirium in order to enhance treatment of the condition. Assessment of delirium is conducted as the first step to alleviate suffering and enhance the quality of life of patients at end-of-life stages (Sweet et al., 2014).
However, the use of assessment tools for delirium by nurses in the hospital has been characterized by various ethical issues that need to be addressed. Some of these ethical issues that nurses experience when using delirium assessment tools in the hospital include patient autonomy, respect for human dignity, cultural issues, and capacity and consent. These ethical issues emerge from the need for nurses to ensure that they follow professional, legal, and ethical standards as they conduct the assessments. The status of patient i.e. end-of-life stage generate challenges for nurses to comply with these standards, which generates ethical challenges.
One of the solutions to these ethical issues involving the patient and his/her family in decision-making capacity as part of demonstrating respect for human dignity and autonomy. This would require explaining the assessment process, the tools to be utilized, and risks and benefits associated with the tools and assessment process. Secondly, nurses should seek for informed consent from the patient and his/her family before utilizing the assessment tools (Lamont, Stewart & Chiarella, 2017). This should be done once the patient and his/her family fully understands the assessment process, tools, risks, and benefits. The final solution to these ethical issues is acknowledgment of cultural and/or international dimensions when conducting the assessment. This implies that nurses should incorporate cultural considerations in their practice when using delirium assessment tools.


References
Anlauf et al. (2015, June 23). Complementary and Alternative Drug Therapy Versus Science-oriented Medicine. German Medical Science, 13. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480118/
Berkeley Wellness. (2011, November 30). Niacin and Cholesterol. Retrieved September 17, 2017, from http://www.berkeleywellness.com/supplements/vitamins/article/niacin-and-cholesterol
Lamont, S., Stewart, C. & Chiarella, M. (2017, January 17). Capacity and Consent: Knowledge and Practice of Legal and Healthcare Standards. Nursing Ethics. Retrieved from https://doi.org/10.1177/0969733016687162
Schnabel, K., Binting, S., Witt, C.M. & Teut, M. (2014, March 26). Use of Complementary and Alternative Medicine by Older Adults – A Cross-sectional Survey. BMC Geriatrics, 14(38). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974184/
Sweet et al. (2014, August 11). Ethical Challenges and Solutions Regarding Delirium Studies in Palliative Care. Journal of Pain and Symptom Management, 48(2), 259-271.