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Blood Pressure Measurement
Everyone doctoral or other nursing student takes their own path and has their own reflections when it comes to their college journey. One of the common facets of nursing and the associated research that nursing students tend to ponder to varying degrees is what is known as evidence-based practice, or EBP. Even with the common sense behind EBP, there are a number of students and even practitioners that are not fully versed in the best practices and such of their job that have come from the EBP. One such nagging habit that many people have is the improper measurement of blood pressure. Indeed, if the measurement of blood pressure is done incorrectly, it can cause shoddy readings and this is something that can be avoided so easily. While it seems like a simple problem to fix, the improper measurement of blood pressure remains a nagging issue that…
Wexler, R. (2010). Ambulatory Blood Pressure Monitoring in Primary Care. Southern Medical
Journal, 103(5), 447-452. http://dx.doi.org/10.1097/smj.0b013e3181d82404
blood pressure will be affected by drinking a large, caffeinated coffee.
The researcher believe caffeine does have some kind of an effect on a persons' blood pressure, for the reason that we recognize that Caffeine is a drug that is naturally produced in the seeds and leaves of a lot of plants. It's similarly made artificially and added to definite foods. Caffeine is defined as a drug for the reason that it arouses the central nervous system, producing increased attentiveness. Caffeine provides most individuals a temporary energy boost. Which is lactated in coffee, tea, chocolate, numerous energy drinks.
Why was the patient's blood pressure recorded before he drank the coffee?
One of the reasons why it was recorded was because he wanted to measure the blood pressure at various time points using a home blood pressure monitor. It was important to record it before they drank the coffee because that…
calculates the 95% confidence intervals of two data sets, one for the reading of systolic blood pressure and one for the reading of diastolic blood pressure. There was a sample size of 9 total patients included. The steps of reaching the confidence interval are outlined below. Excel was used to find the mean for each data set as well as the standard deviation using the formula provided. From there, the steps were manually calculated.
The confidence interval must be calculated through a number of steps. Some of these were done on excel, while others had to be calculated manually. The first step was to find the average of the data set for each type of blood pressure measured. The systolic average was 131.1 repeating, while the diastolic mean was 75.5 repeating. Next, standard deviation was found using the following formula:
The standard deviation for systolic blood pressure was 23.15407332, while…
Accurate measurement of blood pressure is critical for making appropriate clinical decisions in the management of high blood pressure in order to reduce cardiovascular risk and prevent organ damage. This is important because an inaccurate measurement of blood pressure could lead to a patient being falsely classified as hypertensive or falsely classified as having high normal or normal blood pressure. It could also lead to faulty clinical decisions regarding patient progression in an exercise program (White et al., 2013). This topic is one that is worth examining because blood pressure reading is one of the most inaccurately performed measurements in clinical medicine (White et al., 2013). Efforts are ongoing to increase hypertension awareness, treatment, and control among adults, but the high prevalence of undiagnosed (22%) and uncontrolled (36%) hypertension remains a challenge (White et al, 2013). For that reason, this DNP aims to address that issue.
An assessment of…
Badeli, H., & Assadi, F. (2014). Strategies to reduce pitfalls in measuring blood pressure. International Journal of Preventive Medicine, 5(1), S17-S20. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990924/
Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & Emilia, I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies, 52(1), 240-249.
Cooper, L., Andrew, S., & Fossey, M. (2016). Educating nurses to care for military veterans in civilian hospitals: An integrated literature review. Nurse Education Today, 47, 68-73. doi: 10.1016/j.nedt.2016.05.022
Creswell, J. W. (2014): Research design. Qualitative, Quantitative, and Mixed Methods Approach. Lincoln: Sage publications.
Deepak, K. K. (1992). Blood Pressure Simulation Model: A Teaching Aid. Indian Journal of Physiology and Pharmacology, 36, 155-155.
Dichter, M. E., Haywood, T. N., Butler, A. E., Bellamy, S. L., & Iverson, K. M. (2017). Intimate partner violence screening in the Veterans Health Administration: demographic and military service characteristics. American Journal of Preventive Medicine, 52(6), 761-768.
Fallon, N. (2015). The challenge of measuring blood pressure accurately. British Journal of Cardiac Nursing, 10(3), 132-139. doi:10.12968/bjca.2015.10.3.132.
Gillespie, C. D., Hurvitz, K. A., & Centers for disease control and prevention. (2013). Prevalence of hypertension and controlled hypertension-United States, 2007–2010. Morbidity and Mortality Weekly Report Surveillance Summaries, 62(3), 144-8. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/su6203a24.htm
For African Americans with Hypertension (P), Does Telemonitoring Blood Pressure Education (I), Compared to Usual Care (C), Improve Blood Pressure Control (O), Within Three Months (T)
With the advent of technology, telemedicine has gained its popularity over the past few years. Various researches are now being conducted to see whether this emerging trend is effective in controlling diseases remotely. Patients need to be educated about technology, especially for the most common and most complicated chronic disease called hypertension. African Americans are believed to have higher rates of this disease, and data have been collected from numerous scholarly articles in this paper to support whether telemonitoring would be helpful for their hypertension control. A background and significance of the problem are mentioned, and then, an assessment of the phenomenon is provided. To highlight the societal perspective of the problem, details are added for further elaboration of the chosen clinical problem.…
Barton, A.B., Okorodudu, D.E., Bosworth, H.B. & Crowley, M.J. (2018). Clinical inertia in a randomized trial of telemedicine-based chronic disease management: Lessons learned. Telemedicine and e-Health, 24(10), 742-748. DOI: 10.1089/tmj.2017.0184
Buis, L.R., Dawood, K., Kadri, R., Dawood, R., Richardson, C.R., Djuric, Z., Sen, A., Plegue, M., Hutton, D., Brody, A., McNaughton, C.D., Brook, R.D. & Levy, P. (2019). Improving blood pressure among African Americans with hypertension using mobile health approach (the MI-BP app): Protocol for a randomized control trial. JMIR Research Protocols, 8(1), e12601. DOI: 10.2196/12601
Buis, L., Hirzel, L., Dawood, R.M., Dawood, K.L., Nichols, L.P., Artinian, N.T., Schwiebert, L., Yarandi, H.N., Roberson, D.N., Plegue, M.A., Mango, L.C. & Levy, P.D. (2017). Text messaging to improve hypertension medication adherence in African Americans from primary care and emergency department settings: Results from two randomized feasibility studies. JMIR mHealth and uHealth, 5(2), e9. DOI: 10.2196/mhealth.6630
Centers for Disease Control and Prevention. (2020, September 8). Facts about hypertension. Retrieved https://www.cdc.gov/bloodpressure/facts.htm
Champoux, E., Price, R., Cowdery, J.E., Dinh, M., Meurer, W.J., Rehman, N., Schille, C., Oliver, A., Brown, D.L., Killingsworth, J. & Skolarus, L.E. (2020). Reach out emergency department: Partnering with an economically disadvantaged community in the development of a text messaging intervention to address high blood pressure. Health Promotion Practice, 21(5), 791-801. https://doi.org/10.1177/1524839920913550
Skolarus, L.E., Cowdery, J., Bailey, S., Baek, J., Byrd, J.B., Hartley, S.E., Valley, S.C., Saberi, S., Wheeler, N.C., McDermott, M., Hughes, R., Shanmugasundaram, K., Morgenstern, L.B. & Brown, D.L. (2018). Reach out churches: A community based participatory research pilot trial to assess the feasibility of a mobile health technology intervention to reduce blood pressure among African Americans. Health Promotion Practice, 19(4), 495-505. DOI: 10.1177/1524839917710893
Quantitative and Qualitative Study about Blood Pressure
The process of conducting a qualitative research study about blood pressure first begins with the design of the study. As the method is qualitative, the approach is what next needs to be decided: what exactly is to be studied and how will data be collected and analyzed? For example, in the qualitative study by Bergdall et al. (2016), the researchers used a telemonitoring intervention, using focus groups and the interview method of collecting data. The qualitative process requires researchers to obtain information on the subjective experience of a phenomenon in most cases. The process is based on the notion that the researcher is seeking to understand what variables are impactful in a given scenario. There is no emphasis on testing variables; instead, the emphasis is on understanding what the variables are that make a difference among the population studied. A population…
Bergdall, A. R., Sperl-Hillen, J. M., O\\\\'Connor, P. J., Asche, S. E., Crabtree, B. F., Smith,
E. A., ... & Trower, N. K. (2016). Qualitative Data from a Trial of Home Blood Pressure Telemonitoring and Pharmacist Management. Journal of Patient-Centered Research and Reviews, 3(3), 182-183.
van Dipten, C., van Berkel, S., de Grauw, W. J., Scherpbier-de Haan, N. D., Brongers, B.,
van Spaendonck, K., ... & Dees, M. K. (2018). General practitioners’ perspectives on management of early-stage chronic kidney disease: a focus group study. BMC Family Practice, 19(1), 81.
Woolsey, S., Brown, B., Ralls, B., Friedrichs, M., & Stults, B. (2017). Diagnosing
hypertension in primary care clinics according to current guidelines. The Journal of the American Board of Family Medicine, 30(2), 170-177.
Endocrine control of BP
Hormonal Control of Osmotic pressure: Stimulation
Arterial blood pressure (BP) is under tight control by the mammalian nervous system, cardiovascular system, kidneys, and endocrine system (Vivas et al., 2014). The VII, IX, and X cranial nerves conduct peripheral taste, osmo-sodium, volume, and baroreceptor information to the solitary tract, while the distinct bundles of neurons in the lamina terminalis respond to changes in plasma and cerebral spinal fluid sodium levels, osmolality, and angiotensin II levels. The information thus received is transmitted to the median preoptic, supraoptic, paraventricular, lateral parabrachial, and dorsal raphe nucleus for integration. The neurotransmitter systems involved include angiotensin, vasopressin, oxytocin, and serotonin.
The overall response to reductions in BP and electrolyte content of bodily fluids is to trigger the sympathetic nervous system, endocrine system, and appropriate behavior to correct the deficiency (Vivas et al., 2014). The most important arm of BP control is the…
Chopra, S., Baby, C., & Jacob, J.J. (2011). Neuro-endocrine regulation of blood pressure. Indian Journal of Endocrinology and Metabolism, Suppl. 4, S281-8.
Duka, A., Duka, I., Gao, G., Shenouda, S., Gavras, I., & Gavras, H. (2006). Role of bradykinin B1 and B2 receptors in normal blood pressure regulation. American Journal of Physiology, Endocrinology and Metabolism, 291(2), E268-74.
Farrao, F.M., Lara, L.S., & Lowe, J. (2014). Renin-angiotensin system in the kidney: What is new? World Journal of Nephrology, 3(3), 64-76.
Vivas, L., Godino, A., Dalmasso, C., Caeiro, X.E., Macchione, AF., & Cambiasso, M.J. (2014). Chapter 9: Neurochemical circuits subserving fluid balance and baroreflex: A role for serotonin, oxytonin, and gonadal steroids. In L.A. De Luca Jr., J.V. Menani, & A.K. Johnson (Eds.), Neurobiology of body fluid homeostasis: Transduction and integration (pp. 141-166). Boca Raton, FL: CRC Press.
The renin-angiotensin-aldosterone system (RAAS) plays a very important role in the regulation of systemic vascular resistance and blood volume. Its role helps ensure hemodynamic stability when the body loses water, salt, and blood. The baroceptor reflex always corrects these imbalances in a short-term window while the RAAS helps keep the balance when the imbalances are chronic. The RAAS is made up of three main compounds: angiotensin II, aldosterone, and rennin (Weir & Dzau, 1999). The three compounds help in the elevation of blood pressure when renal blood pressure decreases and when there is a decrease in the delivery of salt to the distal convoluted tube. It also increases arterial pressure during beta-agonism. Its characteristics and functions make it possible for the body to regulate blood pressure for long periods of time. While it is mainly linked to the kidneys, its functions also have effects on the adrenal glands, blood…
Carey, R. M. (2015). The intrarenal renin-angiotensin system in hypertension. Advances in chronic kidney disease, 22(3), 204-210.
Fountain, J. H., & Lappin, S. L. (2018). Physiology, Renin Angiotensin System. Treasure Island Florida, StatPearls Publishing.
Macia-Heras, M., Del Castillo-Rodriguez, N., & Navarro González, J. F. (2012). The renin-angiotensin-aldosterone system in renal and cardiovascular disease and the effects of its pharmacological blockade. J Diabetes Metab, 3(171), 2.
Otte, M., & Spier, A. (2009). The renin–angiotensin–aldosterone system: Approaches to cardiac and renal therapy. Compendium: Continuing Education for Veterinarians,, 31.
Weir, M. R., & Dzau, V. J. (1999). The renin-angiotensin-aldosterone system: a specific target for hypertension management. American journal of hyper
Airway Pressure on Cardiovascular Performance
The Influence of Mean Airway Pressure on Cardiovascular Performance
reathing, also known as pulmonary ventilation, is the basic connection between the heart and lungs (Williams & Whitney, 2006). The connection allows air between the lungs and the atmosphere and the exchange of gases between the air and the alveoli in the lungs. ody receptors can detect changes involved in the movement of air and the pressure that accompanies it. These receptors can either increase or decrease breathing rate. They encourage slower breathing when blood pressure rises and faster breathing rate if the blood pressure goes down. Meanwhile, an exchange of gases between body tissues and capillaries is needed to maintain life. It brings in the gases living tissues need for survival. lood carries oxygen molecules when leaving the heart and distributes it throughout the body. Very small capillaries coordinate in the flow and…
Byrd, R.P. And Mosenifar, Z. (2010). Mechanical ventilation. Medscape: WebLLC.
Retrieved on August 18, 2011 from http://emedicine.medscape.com/article/304068-overview
Daoud, E.G. (2007). Airway pressure release ventilation. Vol 2 (4) Annals of Thoracic
Medicine: Pub Med Central. Retrieved on August 12, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732103
THE EFFECTS OF AIRWAY PRESSURE RELEASE VENTILATION AND HIGH FREQUENCY OSCILLATION VENTILATION ON THE HEART - SPECIFICALLY WHEN THE PATIENT HAS CONGESTIVE HEART FAILURE.
CONGESTIVE HEART FAILURE
AIRWAY PRESSURE RELEASE VENTILATION (APRV)
APRV & CONGESTIVE HEART FAILURE
HIGH FREQUENCY OSCILLATION VENTILATION (HFOV)
HFOV & CONGESTIVE HEART FAILURE
Mechanical Ventilation refers to the process of helping the normal breathing process of an individual when his breathing patterns are compromised due to either a pathology within the lung or due to a collective collapse of the related organs. Mechanical ventilation can be of two types: negative pressure ventilation where the air is made to suck into the lungs or positive ventilation where air is forced into the lungs through the airway. During the process of providing ventilation to the lungs it becomes important to "secure the airway" which means that the air should go through the…
Calzia E, R.P. (1997). Airway pressure release ventilation and biphasic positive airway pressure:a 10-year literature review. Clinical Intensive Care, 8:296-301.
Cartotto R, E.S. (2004). High frequency oscillatory ventilation in burn patients with the acute respiratory distress syndrome. Burns, 30(5):453-463.
Dickstein K, C.-S. A. (2008). "ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Hear. Eur. Heart J., 29(19):2388-442.
dorland's medical dictionary . (2009).
The picture to the left depicts the various elements that are responsible for thermoregulation in human skin. The illustrations shows the various layers of skin along with the veins, arteries and capillaries of the circulatory system that assist in insuring that the thermoregulatory system works properly. The sweat glands are responsible for selectively removing materials from the blood the sweat glands then concentrates or alters these toxins, and secretes them for elimination from the body. The perspiration or sweat is then removed through the sweat pore. This has a twofold purpose: to remove toxins and thermoregulation (in this case cooling the body).
Thermoregulation involving perspiration is brought about by both internal and environmental heat and exercise. As it relates to the latter, there have been many studies related to exercise and thermoregulation. According to Marino (2004)
"thermoregulatory effector responses of humans and concluded that temperature regulation during exercise is dissimilar…
Caterina MJ, Schumacher MA, Tominaga M, Rosen TA, Levine JD, Julius D. The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature. 1997;389:816-824.
Dugan SA, Powell LH, Kravitz HM, Everson Rose SA, Karavolos K, Luborsky J (2006)
Musculoskeletal pain and menopausal tatus. Clin J. Pain 22: 325 -- 331
Deecher, D.C.K. Dorries (2007)Understanding the pathophysiology of vasomotor symptoms
pressure? How respo
There was a time when I was under extreme duress to get to work on time. Although I can look back on the situation fondly now and apply the lessons learned, back then it could have had serious negative ramifications for my career. I had recently moved and was beginning a new nursing position. I was supposed to fly in on the Friday before I started the following Monday, but I missed the flight and had to catch the next one. By the time I arrived, I barely had a chance to get a full night's rest in my own bed, let alone plot the route from my new residence to my job. I remember feeling so pressured as I drove around the downtown streets which all looked alike since I had just moved. At the time, the last thing I wanted to do was start a…
Arterial Blood Gas Samples
Instructions for the Sampling of Arterial Blood for Blood Gas Analysis
This document provides the procedure for the drawing of arterial blood from human patients for use in the analysis of blood gasses.
This document is intended to provide proper and safe steps in the procedure used by respiratory therapists, phlebotomists, nurses and doctors for the procurement of human blood from extremity arteries for subsequent analysis of blood gases (Browning 1989).
This document covers recommended clinical practice for the sampling of arterial blood (Bruck1985). Because the nature of this procedure uses human clinical subjects and a biohazardous substance, human blood, significant explanation of safety and best clinical practice are covered in the information. Topics covered include:
Clinical Practice Guidelines
I. Safety Guidelines
Blood is considered a toxic and/or pathogenic substance;…
rong Blood in Tube
In a hospital environment, it can sometimes be difficult to pay attention to detail with many tasks. However, it is often the case that paying close attention to detail can save lives in many instances. Blood in the wrong tube (BIT) can occur when a blood specimen is taken from a patient and labeled incorrectly for a variety of reasons. Blood can be taken from the wrong patient and mislabel or the blood from the correct patient can be also labeled with the wrong patient information. hen this happens a patient can be given the wrong pathology results and may receive the wrong treatment which can significantly reduce health outcomes.
ithin 35 days within the Orange County Hospital has experienced 11 BIT specimens. The accompanying investigation of each BIT has uncovered a wide spread problem within the institution. There was mostly likely user error in these…
Bolenius, K., Lindvist, M., Brulin, C., Grankvist, K., Nisson, K., & Soderberg, J. (2013). Impact of a large-scale educational intervention program on venous blood specimen collection practices. BMC Health Services Research, 1-19.
Szallasi, S. (2011). "Wrong blood in tube": solutions for a persistent problem. The International Journal of Transfusion Medicine, 298-302.
Tinegate, A., Robertson, J., & Iqbal, A. (2013). Factors predisposing to wrong blood in tube incidents: a year's. Transfusion Medicine, 321-327.
Airway pressure release ventilation (APV) is an alternative to mechanical methods used to aid oxygenation in patients with conditions like acute lung injury or acute respiratory distress syndrome (Daoud, 2007). It is a continuous positive airway pressure system allowing brief and intermittent releases in airway pressure (Frawley & Habashi, 2001). APV is heralded for its ability to "allow unrestricted spontaneous breathing in any phase of the mechanical cycle," as well as to minimize the use of heavy sedatives or muscle relaxants (Petensen & Wrigge, 2004, p. 492).
Other benefits to using APV with some patients with acute lung injury or acute respiratory distress syndrome include the fact that it may decrease the risk for barotrauma and alveolar damange due to APV providing "better alveolar recruitment at a lower end-inflation pressure," (Myers & Macintyre, 2007, p. 452). APV may also minimize the potential for ventilator-induced lung injury (VILI) by using lung…
Daoud, E.G. (2007). Airway pressure release ventilation. Annals of Thoracic Medicine 2(4): 176-179.
Daoud, E.G., Farag, H.L. & Chatburn, R.L. (2012). Airway pressure release ventilation: What do we know? Respiratory Care 57(2): 282-292.
Frawley, P.M. & Habashi, N. (2001). Airway pressure release ventilation: Theory and practice. AACN Clinical Issues 12(2): 234-246.
Habashi, N.M. (2005). Other approaches to open-lung ventilation. Critical Care Medicine 33(3).
Workflow Analysis Of A Selected Nursing Activity
The Tele-Management System
Medication errors have resulted to numerous injuries, which has led to some healthcare providers adopting IT systems such as electronic records and information systems as a measure to minimize the errors. The adoption of these technologies involves several stakeholders, but most importantly, the informatics nurses. These nurses play an important role in optimization by representing the needs of clinicians. In addition, they also assist in improving technological solutions in case of technological hitches with the IT systems. When hospitals adopt technology solutions, it will influence their workflow process (McGonigle and Mastrian, 2012).
The informatics nurses come in to redesign the workflow to accommodate the solution, through evaluation of tasks that will require the utilization of technology. However, the solutions adopted should allow for exchange of information across different hospitals to improve or eliminate dependence on one…
Hussain, A.A. (2011). Meaningful use of information technology: A local perspective. Ann Intern Med, 154, 690-692.
Logan, G.A. et al. (2007).Mobile Phone -- Based Remote Patient Monitoring System for Management of Hypertension in Diabetic Patients. AJH, 20, 942-948.
McGonigle, D., & Mastrian, K.G. (2012). Nursing informatics and the foundation of nursing (2nd ed.). Burlington, MA: Jones and Barlett Learning.
Pickering, T.G., Gerin, W., Holland, J.K. (1999). Home blood pressure teletransmission for better diagnosis and treatment. Curr Hypertension Rep, 1, 489 -- 494.
esearch shows that Social media is playing a huge part when it comes to the health care industry. One study done by DC and Interactive Group shows that beyond 90% of individuals from the ages 18-24 mentioned they would rely on health data discovered on social media channels. The study showed that one in two adults utilize their smart phone to find health information. Even patients are going to the internet to converse about the care they are getting: 50% of individuals mentioned they would share negative or positive situations of a medical facility or hospital, and 52% made the point they would not waver to post comments about a nurse, doctor, or healthcare supplier on social media (iberio, 2013).
Monitoring Patient Vital Signs via Mobile Computing vs. In-Patient Visits
The Internet is exceptional for the reason that it provides the chance to the public and healthcare professionals…
Freeman, K. (2012, May 23). How Social Media, Mobile Are Playing a Bigger Part in Healthcare. Retrieved from http://mashable.com/2012/12/18/social-media-mobile-healthcare/
Riberio, A.M. (2013, August 7). Wireless Monitoring of Patients Vital Signs. Retrieved from http://cdn.intechopen.com/pdfs/31522/InTech Wireless_monitoring_of_patient_s_vital_signs.pdf
VanVactor, J.D. (2011). Strategic health care logistics planning in emergency management. Disaster Prevention and Management,, 21(3), 299-309.
Nursing Case Study
The first concern is that Mrs. Baker is taking a new drug that has side effects such as she is experiencing. Although the other high blood pressure medication has similar side effects (Drugs.com, 2012), she has been taking it for a long period of time and should not be experiencing as much difficulty. It seems germane to ask her how long she has been taking the hydrochlorothiazide though. One of the first thoughts is how well do the two medications work together, which is something her doctor understands, and if she can have an increase in side effects because of the increase in medication. The second question the symptoms, especially the fact that she seemed "confused and beside herself" on the phone, is to determine if there are other symptoms of stroke. Her breathing difficulties could be a symptom of the medication, and so could the confusion,…
Drugs.Com. (2012). The side effect of Lisinopril. Retrieved from http://www.drugs.com/sfx/lisinopril-side-effects.html
blood ion levels, particularly sodium, potassium, and calcium levels, if there is a decrease in overall blood flow to the kidneys. A full credit answer will discuss the mechanisms at the cellular and chemical level.
Kidney failure: What occurs when there is a decrease in blood flow to the kidneys?
A decrease in blood flow to the kidneys can lead to complete organ failure at worst or at minimum severely disrupt the body's state of homeostasis. The kidneys play a critical role in the regulation of electrolytes, particularly sodium, potassium, and calcium. As their name suggests electrolytes, or ions, "are the charged particles in body fluids that help transmit electrical impulses for proper nerve, heart, and muscle function" (Astle 2005). In a healthy organism, positive and negative ions are in a state of equal balance. Decrease in blood flow to the kidneys severely disrupts the body's ability to not only…
Astle, S. (2005). Restoring electrolyte balance. Modern Medicine. Retrieved:
Fluid and electrolyte balance. (n.d). Berkeley. Retrieved:
elationship between cardiac arrest and coronary cardiac disease
The heart is an essential organ in the human body, it keeps the individual alive. Understanding how the heart operates and functions is essential to help protect your heart from heart disease. Cardiac arrest and coronary heart disease are significant heart related illness that has a high mortality rate. It is important for individuals with pre-existing heart disease to understand the symptoms of cardiac arrest and coronary heart disease, since these are both leading causes of fatality in the United States. Understanding how the heart works, the individuals risk for heart disease, and how to prevent or delay heart disease is essential. In this paper I will address the relationship between cardiac arrest and coronary heart disease. I will also explain how the heart functions and discuss some ways of preventing cardiac arrest and coronary heart disease.
Antonini-Canterin et. al. (2009). Association between carotid and coronary artery disease in patients with aortic valve stenosis: an angiographic study. Angiology 60 (5) 596-600
CDC. (2010). Heart disease. Retrieved from http://www.cdc.gov/heartdisease/
Dewey et. al. (2004). Coronary artery disease: new insights and their implications for radiology. European Radiology. 14 (6) 1048-1054
Escolar et. al. (2006). New imaging techniques for diagnosing coronary artery disease. Canadian Medical Association Journal. 174 (4) 487-495
Biology -- Patient Scenario
What are the components of physical examination? Describe each component.
Physical examination consists of 5 basic components after obtaining a patient's description of the history of his/her systems. First, the provider observes the patient for physical signs of disease and evaluates such factors as mobility, posture, facial expression, alertness, responsiveness to stimuli and changes in skin color (Jarvis, 2011, pp. 33, 127-9). Secondly, one must take a patient's vital signs, including blood pressure, heart rate, breathing rate and temperature, and compare the patient's results with the reference ranges (Jarvis, 2011, pp. 136-150). Third, one must perform auscultation, using a stethoscope to listen to the patient's lungs, heart and bowel (Jarvis, 2011, p. 118). Fourth, one performs percussion by tapping on the patient's chest and abdomen to listen for sounds indicating normal conditions, fluid, excess air, size of the lungs and size of the affected area (Jarvis,…
Reference values) for each laboratory tests in the table above from the second set of tests.
The second round of Mr. Smith's tests, when compared with the normal ranges, indicate that: his blood potassium level is below the normal range; his
CT scan or MA may result in the clinician oversight of some of the more subtle findings. It is expensive and the availability is limited.
It is possible to evaluate AS via angiogram, bet evaluation of the size of the stenosis tends to be imprecise. Additionally, angiography does not allow a cross-sectional assessment of the stenosis, and in the case of FMD, it is not possible to distinguish the different histological types, although intervention at the time of assessment is a possibility. Doppler sonography is able to measure the amount of blood flow, and is non-invasive. It tends to be highly invasive and is able to demonstrate problems with slow patterns and other issues which are highly suggestive of significant stenosis. Doppler ultrasound tends to be very operator dependent and the exam takes a significant amount of time. Additionally, the exam may be limited by abdominal girth, patient movement and…
1. Paven G; Waugh R; Nicholson J; Gillin a; Hennessy a Nephrology (Carlton). 2006; 11(1):68-72
2. Agency for Healthcare Quality and Research (AHRQ)
Comparative Effectiveness of Management Strategies for Renal Artery Stenosis: AHRQ Executive Summary,), Rockville, Maryland; http://hcup.ahrq.gov/HCUPnet.asp
3. Dejani H, Eisen TD, Finkelstein FO: Revascularization of renal artery stenosis in patients with renal insufficiency. Am J. Kidney Dis 2000 Oct; 36(4): 752
Health Promotion Lesson Plan
The concept of health promotion is thought of as "the science and art of helping people change their lifestyle to move toward a state of optimal health" (Dunphy et al., 2011, p 25). Serious heart conditions can be prevented, which is why it is so important to utilize community education techniques in order to help try to warn community members of the complications before they occur. This current lesson plan works to create three separate community lesson plans, based on specific age ranges. The age 18-29 focuses primarily on the use of social media and health advocacy efforts in association with the American Heart Association. For ages 30-49, there is also a focus on these two, combined with more community oriented issues, and for 50-60, there is much more of a focus on financial training along with community organized workshops.
Prevention has become a major issue…
References McLeod, Saul. (2010). Erik Erikson. Developmental Psychology. Simply Psychology. Web. http://www.simplypsychology.org/Erik-Erikson.html
"Participants were instructed to drink no more than 3 caffeinated beverages and no more than 2 alcoholic beverages per day" (pg. 2457).
Two features from this study that stand out when compared to the previous study (as read about earlier) was that this study sought to keep the participants weight relatively stable and that the participants were not obese and old, but were young and healthy. The goal of this study was measurably the same as the pervious study, but was set in entirely different circumstances. This is important to individuals seeking entry to the nursing field because it provides ammunition for lifestyle interventions even before the patient may think it is necessary.
The study's primary interest was to ascertain "the contrasts between the carbohydrate and protein diets and between the carbohydrate and unsaturated fat diets" (pg. 2459). What the study found was that for each diet (when compared to…
Appel, L.J.; Sacks, F.M.; Carey, V.J.; Obrazanek, E.; Swain, J.F.; Miller III, E.R.; Conlin, P.R.; Erlinger, T.P., Rosner, B.A., Laranjo, N.M.; Charleston, J.; McCarron, P.; Bishop, L.M.; (2005) Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: Results of the OmniHeart randomized trial, Journal of American Medical Association, Vol. 294, No. 19, pp. 2455-2464
Trichopoulou, A.; Bamia, C.; Trichopoulos, D.; (2005) Mediterranean diet and survival among patients with coronary heart disease in Greece, Architecture of Internal Medicine, Vol. 165, pp. 929-935
Villareal, D.T.; Miller III, B.V.; Banks, M.; Fontana, L.; Sinacore, D.R.; Klein, S.; (2006) Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults, American Journal of Clinical Nutrition, Vol. 84, pp. 1317-1323
Nursing elated Case Study
Tom's vitals, in the emergency department, revealed an elevated respiratory rate, heart rate and blood pressure. His oxygen saturation was also considerably low. Tom's Body Mass Index (BMI) falls in the overweight category. He was also a-febrile, at presentation, indicating that infection was not a precipitating cause.
Initially the ABGs were normal, indicating an acute severe exacerbation or life threatening asthma. Later, when the ABGs were repeated, carbon dioxide levels were above normal. A raised carbon dioxide level is the differentiating bench mark between life threatening and near fatal asthma. The ABG analysis also reveals acidemia which cannot be solely attributed to a respiratory or metabolic cause alone, and hence can be safely classified as a mixed disorder.
Tom's history is typical of atopic asthma which usually begins in childhood and is triggered by antigens from the environment, such as pollen, animal dander or dust. Upper…
Brandis, K. (n.d.). The physiology viva. Retrieved from http://www.anaesthesiamcq.com/downloads/odc.pdf
Guyton, A., & Hall, J. (2011). Guyton and hall textbook of medical physiology. (12 ed.). Mississippi: Elsevier.
Kumar Abbas, & Robbins, (2007). Basic pathology. (8 ed.). London: Saunders Company.
Myron, K. (2005, May 10). Is obesity a risk factor for asthma. Retrieved from http://www.medicalnewstoday.com/releases/24118.php
Lee is only the first step in the process of building a team that is able to cover all aspects of Mrs. Lee's care. The team approach involving a social worker, nurse, physician, pharmacist, and physical therapist affords Mrs. Lee a full range of professionals attending to her various needs.
Although Mrs. Lee has a number of problems that need to be addressed the one problem that must be addressed immediately is her elevated blood pressure. Hypertension is an important risk factor for the development and worsening of many complications of diabetes and an elevated blood pressure is like walking around with a detonated bomb. Within moments, and with little warning, a diabetic patient can suffer a stroke or heart attack as a result of an elevated blood pressure. Well over fifty percent of diabetics suffer from hypertension and proper treatment of hypertension can minimize most of the tangential problems…
Calle-Pascual, A.L. (2002). A preventive foot care programme for people with diabetes with different stages of neuropathy. Diabetes Research and Clinical Practice, 111-117.
Caminal, J. And Barbara Starfield, et. al.(2004). The role of primary care in preventing ambulatory care sensitive conditions. European Journal of Public Health, 246-251.
Deichmann, R.E. (1999). Improvements in Diabetic Care as Measured by HbA1c After a Physician Education Project. Diabetes Care, 1612-1616.
Epstein, M. (1997). Diabetes and hypertension: the bad companions. Journal of Hypertension, 55-62.
Anger and Its Effects
Anger is a very intense feeling, and can be characterized by a number of behaviors. These include grinding teeth, an increased heart rate, rising blood pressure, clenched fists, and other signs of aggravation or frustration (Hendricks, et al., 2013). Each person reacts to anger in a different way, and some of the manifestations of anger may not be outwardly apparent. ises in blood pressure and heart rate, for example, are not easily noticed by others, but they can still be very damaging to the person who is struggling with the anger itself (Hendricks, et al., 2013). People also get angry for a number of different reasons, and they may react in an angry manner when they feel hurt, threatened, frustrated, or disappointed (Hendricks, et al., 2013). This is a relatively natural reaction for the majority of people, but that does not mean it is healthy or…
Hendricks, L., Bore, S., Aslinia, D., & Morriss, G. (2013). The effects of anger on the brain and body. National Forum Journal of Counseling and Addiction, 2(1): 2-11.
patient most likely manifest hypervolemia?
A patient would most likely develop hypervolemia through eating sodium-based foods, from blood transfusions, medications and diagnostic contrast dyes. (Silverstein, 2006)
What blood pressure, central venous pressure, and arterial pressure would be indicative of hypervolemia?
Any individual who is suffering from hypervolemia would have higher levels of blood (160 / 100), central venous (179 / 109) and arterial pressure (180 / 110). (Silverstein, 2006)
How would a nurse recognize that a hypovolemic patient had received adequate volume replacement?
The way a nurse would recognize a hypovolemic condition is to look for swelling in the legs and arms. At the same time, there will be an increase in the patient's weight. When there is adequate replacement, these levels will come down dramatically. (Silverstein, 2006)
How do neurohormonal mechanisms contribute to the development of heart failure?
Neurohumoral adaptations are impacting the systemic pressure through vasoconstriction. This leads…
Silverstein, A. (2006). Heart Disease. Minneapolis, MN: 21st Century Books.
Shock is a condition of inadequate tissue perfusion, which results in decreased amount of oxygen in the vital tissues and organs (Metrng 2010, Klabunde 2010, Sarathy 2010, Spaniel et al. 2007). It reduces the rate of elimination of waste products of metabolism. Causes are heart attack, severe or sudden blood loss from injury or severe illness, blood poisoning from major infections, large decrease of body fluids, and exposure to extreme heat or cold for long duration. The American College of Surgeons classified shock into four, namely distributive, obstructive, cardiogenic, and hemorrhagic (Metrng, Klabunde, Sarathy & Spaniel et al.).
Hemorrhagic shock is a serious and life-threatening condition, which affects all body systems (Sarathy 2010). Cardiac output is reduced and depriving tissue of adequate oxygen. Hemorrhagic shock is further classified into four, according to the amount of blood lost. In Class I hemorrhage, there is a 15% or less blood…
Klabunde, R.E. 2010, 'Pathophysiology of hemorrhagic shock,' University of Ohio
[Online] Available at http://www.oucom.ohiou.edu/dbms-witmer/Downloads/Klabunde-08-10-00.pdf
Medtrng 2010, Treat for shock, Medtrng.com [Online] Available at http://www.medtrng.com/blackboard/treat_for_shock.htm
Sarathy, T.K. P, editor 2010, 'A clinical diagnosis to watch out for, MedIndia [Online]
The authors recommend that the patient, a women of 35 years, should drink no more than 14 units (where one unite is half a pint of beer or two thirds of a small glass of wine) of alcohol per week or three units in a given day. Ideally, 1-2 units per day are recommended. While the patient does not drink during the week, she does tend to drink somewhat excessively over weekends. Her goal is to reduce her alcohol intake gradually towards only one or two units per day on weekends, while maintaining her non-drinking habit during the week. To reach this goal, the patient has enlisted the help of her friends. pecifically, she will reduce her exposure to alcohol by at first reducing her times at pubs and parties. he has asked her friends to help her by holding parties at their homes or in restaurants rather than in…
Connection-Fitness (2007). Benefits of Exercise. http://www.connection-fitness.co.uk/health-fitness/health/benefits-exercise.aspx
Delahanty, Linda M. & McCulloch, David K. (2008, June 13). Patient Information: Type 1 diabetes and diet. Up to Date. http://www.uptodate.com/patients/content/topic.do?topicKey=~P8PrVHkHijO4w
Henderson, Roger. (2008). Exercise, heart disease and high blood pressure. NetDoctor. http://www.netdoctor.co.uk/heartdisease/exercise.htm
Kenny, Tim & Kenny, Beverley. (2008). High Blood Pressure (Hypertension). EMIS&PIP. http://www.patient.co.uk/showdoc/23068761
Expressive functioning is related to communication such as emotional, verbal, and nonverbal communication, problem solving and roles within the family. Beliefs within the family are also a part of expressive functioning.
For the purpose of the Calgary Family Assessment Model, a family is defined as who they say they are. It is very important that the clinician performing the assessment not assign their own beliefs upon what he or she believes a family is, and take into account what the patient feels about family as to the patient is may mean not only the people who actually live within the household but can also address past, present and future emotional attachments.
Calgary Family Intervention Model:
The immediate family is composed of Mr. Herbert Schelley (the patient), Mrs. Annette Schelley (his wife), and their son Thomas Schelley. The extended family consists of the Schelley's two married daughters, their husbands and their…
Brownwald H. ed. (2003) Harrison's Textbook of Internal Medicine, 15th edition,
McGraw-Hill, New York
Clement S. (2004) Guidelines for glycemic control. Clin Cornerstone. 6(2):31-9
Echeverry D.M., Dike M.R., Washington C., Davidson M.B.. (1995). The impact of using a low-literacy patient education tool on process measures of diabetes care in a minority population J. Natl Med Assoc. (11):1074-81
Multisystem Failure in a Geriatric Patient
Multisystem Failure in a Geriatric
eflect on your analysis of the geriatric patient in multisystem failure by doing the following:
Explain key immediate assessments you should make that would help assess the patient's homeostasis, oxygenation, and level of pain.
There are various diagnoses undertaken in assessing the patient's homeostasis, oxygenation, and level of pain. The immediate objective that nurses prioritize on is checking the patient's vital symptoms. Vital symptoms form the baseline of the assessment by providing significant information that illustrates whether the most essential organs function as required.
The assessment may involve checking the health status of the patient in the laboratory (Kane, 2004). In the laboratory, there is an assessment of the patient's capillary tube, urine test and blood pressure. When there is simultaneous malfunctioning of the body organs, nurses refer to this condition as multiple organ dysfunction (MODs).
Multiple organ dysfunction…
Esteban, A., Anzueto, A., Frutos-Vivar, F., Alia, I., Ely, E.W., Brochard, L., et al. (2004).
Outcome of older patients receiving mechanical ventilation. Intensive Care
Medicine, 30(4), 639 -- 646. Evidence Level IV: Nonexperimental Study.
Happ, M.B., Baumann, B.M., Sawicki, J., Tate, J.A., George, E.L., & Barnato, A.E. (2010).
controversy and disagreement have plagued the world of medical ethics, especially in terms of "dying with dignity." However, as physicians, we need to recognize that a patient needs dignity not only at the end of his or her life, but also during life, when being examined by a physician for particular complaints (Dresser, 2008). So, in the case of Mr. Hodor, I will have to take into account several aspects of his experience of dignity. First, he is very concerned about his health risks as a result of his family history. According to Dresser (2008), this fear needs to be addressed with as much understanding as possible. I will therefore begin the session by communicating with him about his fears and his reasons for these, as well as his concerns about his symptoms.
Patient privacy is part and parcel of ensuring dignity for the patient. Again, by communicating with Mr.…
AMA. (2013). Code of Medical Ethics. Retrieved from: http://www.ama-assn.org/ama/
Baba, R., Koketsu, M., Nagashima, M., Inasaka, H., Yoshinaga, M., and Yokota, M. (2007, May). Adolescent obesity adversely affects blood pressure and resting heart rate. Circulation Journal, 71(5). Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/17456998
Dresser, R. (2008, March). Human Dignity and the Practice of Medicine. From: Human Dignity and Bioethics: Essays Commissioned by the President's Council on Bioethics. Retrieved from: http://bioethics.georgetown.edu/pcbe/reports/human_dignity/chapter19.html
Thompson, E.G., and Kloner, R.A. (2011, Apr. 5). Physical exam for High Blood Pressure. Web MD. Retrieved from: http://www.webmd.com/hypertension-high-blood-pressure/physical-exam-for-high-blood-pressure
Constipation, Hypertension, Seizure
This is the infrequent or difficult bowel evacuation (Mayo Clinic Staff, 2012). While there are no strict standard for bowel elimination, it is generally believed that fewer than thrice a week constitutes constipation. Stools are usually hard and dry. Other common symptoms associated constipation include excessive straining during bowel evacuation, a sense of rectal blockage, a sense of incomplete evacuation and the need to perform manual measures to evacuate the bowels. Constipation may be the consequence of insufficient fluid intake or dehydration, inadequate fiber in the diet, foregoing elimination, irritable bowel syndrome, lack of physical activity, illness, abuse of laxatives and certain medical conditions. Those more likely to develop constipation are older adults, those who are sedentary, confined in bed, dehydrated, on low-fiber diet, on certain medications and undergoing chemotherapy. It is more common in women and children. Causes for alarm include fewer…
Makoff, D. (2012). High blood pressure. MedicineNet: MedicineNet.com. Retrieved on March 7, 2012 from http://www.medicinenet.com/high_blood_pressure/page
Mayo Clinic Staff (2012). Constipation. Mayo Clinic: Mayo Foundation for Medical
Education and Research. Retrieved on March 7, 2012 from http://www.mayoclinic.com/health/constipation.DS0063/METHOD=print&DSECTION=all
PubMed Health (2011). Seizures. ADAM Medical Encyclopedia: ADAM, Inc. Retrieved
Nurse Speech to Group of esidents in a Large Independent Living Facility
The information addressed today in this speech are those involving the body's regulation of the correct numbers and ratios of blood cells and how blood pressure homeostasis is achieved as well as age-related changes to the heart including coronary artery disease, congestive heart failure and myocardial infarction.
Homeostatis and the Body's Balancing Act
The work of Vikrant and Tiwan (nd) report that studies on the population indicate that blood pressure is a continuous variable and there is really not a line that divides normal and abnormal values. However, there is a point of balance also called internal equilibrium and this is known as homeostasis. This state of balance describes how the human body reacts to certain changes. This can be viewed by picturing a set of scales in which coins are poured in unevenly with one side heavier…
Vikrant, S. And Tiwan, SC (nd) Essential Hypertension -- Pathogenesis and Path physiology. Retrieved from: http://medind.nic.in/jac/t01/i3/jact01i3p140.pdf
Carl must be psychologically prepared to make such changes, however. Thus, as well as taking Carl's blood pressure and submitting a blood sample to have his cholesterol screened (getting his blood glucose level assessed, even though there were no problems in the past with this reading might also be wise), the nurse should try to obtain a full assessment of Carl's lifestyle. When and what does he eat? What are his work habits? His sleep habits? Has anything changed recently in his life? All of these factors could make a potentially meaningful impact upon both the test results and the eventual prescription for Carl to improve his health.
Carl is still very young to run the risk of having a heart attack: the risk of having a heart attack increases dramatically after age 65) so engaging in positive changes now is wise and prudent (Heart health screening, 2013, AHA). It…
Drug therapy for cholesterol. (2013). AHA. Retrieved:
Heart health screening. (2013). AHA. Retrieved:
statistical analyses used.
List the statistical procedures used to describe the sample.
Power analysis was used in order to discover power of effect. The power was set to 0.8 with a significant level of 0.05. Differences between the intervention and the control group were tested with Pearson's Chi. A t-test was used for the other perimeters. ANCOVA was used for testing changes between the two groups over time.
Was the level of significance or alpha identified? If so, indicate the level (.05, .01, or .001).
The level of significance was described. The power of the effect size was set to 0.8 with a significant level of 0.05. 0.05 was used throughout as perimeter of significance.
Complete the table below with the analysis techniques conducted in the study:
Identify the purpose (description, relationships, or differences) of each analysis technique.
Power analyses was used in order discover whether the test actually did…
traumatic experience with a patient a few years ago that still left me with a bad feeling. It was a hit-and-miss instance, and the fact that it was so, more closely being miss than hit, has stayed with me ever since. It was the first time that I ever came so breathtakingly close to being implicated in causing another to die. I hope it will be the last. As to the lessons that it can teach me -- there are several.
The story was the following: It was one fine, not especially busy aturday morning when this patient was wheeled in for a percutaneous transfemoral aortic valve implantation. While the cardiology team was inserting the femoral guide wires and sheath for valve placement the ventricle was perforated. Usually we have more time and can proceed more placidly, but in this particular case, we had to rapidly respond and open the…
Brennan, TA et a l (1991). Incidence of Adverse Events and Negligence in Hospitalized Patients -- Results of the Harvard Medical Practice Study I. N Engl J. Med 1991; 324:370-376
Greenlaw, J. (1981). Understaffing: Living with the Reality, 9 L. Med. & Health Care 23- 41
Diabetes and Obesity: What Are the Choices?
Diabetes is becoming an increasingly serious health problem across the United States, and indeed across the world. The majority of cases of diabetes, both in terms of new diagnoses and of current cases, are those of Type II diabetes, which is a condition generally brought on by overweight or obesity and lack of exercise, that prevents an individual's body from being able to metabolize the glucose in food in an efficient and healthy way. Individuals with Type II diabetes (as opposed to individuals with Type I diabetes) can generally be quite successfully treated by losing weight and increasing exercise. Individuals with Type II diabetes can often bring their symptoms and risks under control and even potentially eliminate them through good diet and weight loss.
Given that Type II diabetes can have very serious long-term consequences (including early death due to stroke or heart…
Early Release / Vol. 59 August 3, 2010. Retrieved from www.cdc.gov/mmwr/pdf/wk/mm59e0803.pdf.
Laska, M.N. et al. (2009). Latent class analysis of lifestyle characteristics and health risk behaviors among college youth. Prevention Science 10: 376 -- 386.
Laska, M.N. et al. (2011). The Differential Prevalence of Obesity and Related Behaviors in Two- vs. Four-Year Colleges Obesity 19: 453 -- 456.
Nelson, M.C. et al. (2008). Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change. Obesity 16: 2205 -- 2211.
Supplements for Athletes
ipped Fuel © is a weight loss supplement used widely by individuals who are trying to improve their physical and athletic performance (Brown). These capsules are utilized as a method of rapidly burning fat, while quickly gaining muscle; they are popular among athletes because of this. The supplements work in a way that allows the burning of fat -- which is the most difficult part of body shaping -- to occur in a rapid fashion. Desired results are achieved in a limited amount of time, therefore adding to the appeal of this supplement to young athletes who are just beginning their journey through sports and are essentially attempting to make themselves stand out from the hundreds of other athletes. However, the components of these supplements have been of great concern due to their potential undesired effects (Brown). Despite the glorious results that the particular coach at hand…
Brown, E. (2011). What do ripped fuel capsules do? LIVESTRONG. Retrieved 22 April 2013 from http://www.livestrong.com/article/401862-what-do-r ipped-fuel-capsules-do/
OneResult. (2012). NCAA Legal and Illegal Supplements. ONERESULT: Look Like an Athlete. Retrieved 22 April 2013 from http://www.oneresult.com/articles/supplements/ncaa -legal-and-illegal-supplements
IV. TESTING ON HUMANS
The only thing that is lacking at this point according to all reports is for testing on humans to be completed. The Time Asia articles states: "The last step for the ace-2 inhibitor, as for any drug, is human clinical trials. ecause the U.S. Food and Drug Administration requires such rigorous testing, this is by far the most expensive part of drug development. So for human trials in some cases, Millennium has formed partnerships with large pharmaceutical companies that have the necessary resources and will share in any eventual profits." (2001)
SUMMARY & CONCLUSION
According to the work entitled: "rave New Pharmacy" published in Time Asia (2001) "When the human genome was sequenced...scientists finally gained access to the full text of God's reference manual; the 3 billion biochemical 'letters' that spell out our tens of thousands of genes. These genes, strung out along the 46 chromosomes…
Drug Design in the Fast Lane: Speeding Drug Design (nd)
Elmer-Dewitt, Phillip (2001) The Future of Drugs. Time Asia 22 January 2001 Vol. 57, No. 3 Online available at http://www.time.com/time/asia/magazine/2001/0122/cover1.html .
Lemonick, Michael, D. (2001) Brave New Pharmacy - Time Asia 22 Jan 2001 Vol. 157. No. 3 Online available at http://www.time.com/time/asia/magazine/2001/0122/drug.impact.html
Pharmaceutical industries have to operate in an environment that is highly competitive and subject to a wide variety of internal and external constraints. In recent times, there has been an increasing trend to reduce the cost of operation while competing with other companies that manufacture products that treat similar afflictions and ailments. The complexities in drug research and development and regulations have created an industry that is subject to intense pressure to perform. The amount of capital investment investments required to get a drug from conception, through clinical trials and into the market is enormous. The already high-strung pharmaceutical industry is increasingly investing greater amounts of resources in search of the next "blockbuster" drug that can help them gain market position and profits. Laws, regulations and patents are important to the industry while spending billions of dollars in ensuring the copyright of their products.
It is the intention of this…
Ansoff, H.I. (1957). Strategies for diversification. Harvard Business Review, 35(5), 113-124.
Ansoff, H.I. (1965). Corporate Strategy. New York, NY: McGraw-Hill.
Ashour, M.F., Obeidat, O., Barakat, H., & Tamimi, A. (2004). UAE Begins Examination of Patent Applications. Tamino.com. Retrieved January 18, 2004, from the World Wide Web: http://www.tamimi.com/lawupdate/2001-01/intprop.htm
Bain, J.S. (1954). Economies of scale, concentration, and the condition of entry in twenty manufacturing industries. American Economic Review, 44, 15-36.
Working in a team is a skill set that everyone must learn. There are many classes and professions that require individual work, and nearly just as many that require teamwork at some point as well. In my experience, I have had successes and failures working in teams. Last semester in a physiology course, I had to work as part of a team for a final presentation. The presentation took place before the class, the department, and faculty members of the departments, so at least I know I felt some pressure to do well. My team prepared for several weeks. The preparation was not entirely smooth. Management of the team proved difficult. Conflicting opinions and tensions ran rampant throughout the group. We disagreed about many aspects of the experiment and the presentation. The disagreements were fierce and proved to be the greatest challenge of the experience.
I had more…
Risk Factors for Mr. Jablonski
CHD: Mr. J is a classic case for a potential Coronary Heart Disease (CHD) patient. His history shows several risk factors, which can be divided into uncontrollable and controllable risk factors. The uncontrollable factors are his age (48 years old) -- older people are more susceptible to CHD, his sex (male) -- men are more likely to get CHD, and his family history. The controllable risk factors are his obesity, his smoking habit, lack of physical activity, high blood pressure, and his high LDL cholesterol.
Hypertension: The risk factors for Mr. J are his age, gender, obesity, excessive salt intake, and his inactive lifestyle.
The risk factors described as 'controllable' can be mitigated by dietary control and medication. If his condition remains untreated Mr. J is a potential candidate for a severe heart disease and possible stroke.
In order to lower his high…
Tracy Folsom is a 28-year-old female who was brought to the Emergency Department by her neighbor. The neighbor stated that Miss Folsom was found lying semi-conscious in the shower. The patient was received in the ED by the on call nurse. The nurse's performance with Miss Folsom's management is reviewed in this article.
Emergency evaluation of a patient is supposed be in a systematic manner. A systemic approach prevents the examiner from missing out important clues that may point to a patient's diagnosis. This approach is divided into primary and secondary.
As part of the Primary Assessment, the patient's Airway, Breathing, Circulation and degree of Disability was evaluated, as per protocol. Miss. Folsom's airway was patent, breathing was shallow, and her skin color was pink, indicating good perfusion. She was obeying commands and pupils were equal in size and reactive to light. It is also helpful to state…
Canadian Medical Association. (2007, July). Putting patients first ®: patient-centred collaborative care a discussion paper. Retrieved from http://fhs.mcmaster.ca/surgery/documents/CollaborativeCareBackgrounderRevised.pdf
Dean, R & Mulligan, J, 2009, 'Initial management of patients in an emergency situation', Nursing Standard, vol. 24, no. 5, pp. 35-41, (Academic Search Complete).
Gilbert, G., Souza, P., & Pletz, B. (2009). Patient assessment routine medical care primary and secondary survey. San Mateo County EMS Agency, 1-5. Retrieved from http://smchealth.org/sites/default/files/docs/243322118Patient_Assessment.pdf
Institute of Medicine. (2001) Crossing the quality chasm. Washington, DC: National Academy Press.
Health Sciences 101
The Health Impact of Acetaminophen Overdose
Acetaminophen (APAP) is a common over-the-counter (OTC), antipyretic, anti-inflammatory, analgesic that is more commonly known as Tylenol®, a product of Johnson & Johnson1. Overseas the drug is called paracetamol and is manufactured and sold by countless generic drug makers.
A number of concerns regarding the safety of APAP have arisen over the past several years, including liver and kidney toxicity and adverse cardiovascular and cardiopulmonary effects. This essay will provide an overview of APAP, its uses, and safety issues, with an emphasis on the cardiopulmonary system.
Mechanisms of APAP Activity
The analgesic and antipyretic activity of APAP was thought to be similar to other non-steroidal anti-inflammatory medications because it was believed to inhibit prostaglandin (PGE2) synthesis2,3. This assumption has not withstood the test of time, for either APAP or other popular OTC non-steroidal anti-inflammatory drugs (NSAIDs). The main evidence…
1. National Center for Biotechnology Information, U.S. National Library of Medicine. Tylenol (TN): Substance summary (SID 7847284). PubChem 2011. Accessed 5 Nov 2011 at http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=7847284
2. Hamza M, Dionne RA. Mechanisms of non-opioid analgesics beyond cyclooxygenase enzyme inhibition. Curr Mol Pharmacol 2009; 2(1):1-14.
3. Kaufman G. Basic pharmacology of non-opioid analgesics. Nurs Stand 2010; 24(30):55-61.
4. Chan AT, Manson JE, Albert CM, Chae CU, Rexrode KM, Curhan GC, et al. Nonsteroidal anti-inflammatory drugs, acetaminophen, and the risk of cardiovascular events. Circulation 2006; 113(12):1578-1587.
People often ignore the importance of humor in their lives and this can lead to a series of problems as a result of them failing to use this concept as a tool to improve life in general. Sharing laughter is likely to improve social relations as individuals feel happy and the level of intimacy increases. In addition to this, laughter also causes healthy physical changes in the body, as humor and laughter improve the condition of a person's immune system, reduce the level of pain, and are probable to reduce one's chances to become stressed. To a certain degree, one could consider humor to be a type of medicine that is effective, cheap, and particularly easy to use.
Even with the fact that it was not until modern technology was actually able to prove that humor can have a positive effect on people's well-being, humanity has long suspected this…
Hockenson, Jan. "The Idea of Comedy: History, Theory, Critique." (Fairleigh Dickinson Univ Press, 1 Jan 2006)
McGhee, Paul Edward. "Humor: The Lighter Path to Resilience and Health." (AuthorHouse, 20 Jan 2010)
These different elements are important, because they are indicating that Ms. Lee needs to seek out regular treatment. As a result, some kind of consistent assessment must take place, in order to ensure that she is not subject to having a serious fall. This is because, of the overt signs that she is exhibiting from the side effects of the medication and her age. (Henrich, 2007, pp. 50 -- 57)
ased on the fact that Ms. Lee does not want to have an extensive diagnostic evaluation at the hospital, how would one approach her care?
The most logical approach is to have Ms. Lee go through a series of evaluations inside her home with health care professionals. This could be accomplished by having the doctor visit her apartment at least once per week. At the same time, select caregivers could begin to work with Ms. Lee on a regular basis.…
Hydrodiuri. (2011). EMEDTV. Retrieved from: http://hypertension.emedtv.com/hydrodiuril/hydrodiuril.html
Lopressor. (2011). EMEDTV. Retrieved from: http://blood-pressure.emedtv.com/lopressor/lopressor-side-effects.html
Henrich, A. (2007). How to Try This. American Journal of Nursing, 107(11), 50 -- 58.
Mark, J. (2011). Zolft. Medicinenet. Retrieved from: http://www.medicinenet.com/sertraline/article.htm
More objectivity is however expected from scientists, but their opinions also vary. Specifically, the opinions of those who support growth hormones and those who reject them are all derived from scientific evidence. This in turn means that the results of scientific research could be manipulated and influenced so that the findings are indicative of the desires of those who initiated the study. In this particular sense, the most pertinent situation is revealed by the beef and dairy producers, who hire their own scientists to lead the research process in the direction desired by them.
Aside from these situations however, the scientists who have conducted studies tend to link various health problems with the growth hormones. Some of the side effects to consuming products with residual matters from growth hormones include the onset of early puberty in girls, an increase in the risk of breast cancer, an increase in the risk…
Leonard, a., the story of stuff, the Story of Stuff Project, http://www.storyofstuff.org / last accessed on February 21, 2012
McLaughlin, a. 2011, the effects of growth hormones in food, Live Strong, http://www.livestrong.com/article/98816-effects-growth-hormones / last accessed on February 21, 2012
Artificial hormones, Sustainable Table, http://www.sustainabletable.org/issues/hormones / last accessed on February 21, 2012
EU scientists confirm health risks of growth hormones in meat, Organic Consumer Association, http://www.organicconsumers.org/toxic/hormone042302.cfm last accessed on February 21, 2012
Jerry McCall Dr. Williams Office Assistant
Licensed Practical Nurses and Medical Assistants: Legal and Ethical Implications
According to recent reports from the U.S. Bureau of Labor Statistics, medical assistants and licensed practical nurses (LPN) are two of the fastest growing jobs in the country (Bureau of Labor Statistics, 2010). In an effort to save costs, the demand for these professionals is increasing in both in-hospital and outpatient settings. The licenses and registrations, however, remain unstandardized; while LPNs are required to receive a license, some medical assistants receive a one or two-year degree and still others are only trained on the job. The responsibilities and restrictions of the profession are likewise only loosely regulated and vary between states. This has both ethical and legal implications for patient care. The following case scenario illustrates these ramifications and discusses the appropriate course of action for medical assistants working in a clinical setting.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Medical Assistants, on the Internet at http://www.bls.gov/oco/ocos164.htm (visited October 17, 2011).
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Licensed Practical and Licensed Vocational Nurses, on the Internet at http://www.bls.gov/oco/ocos102.htm (visited October 17, 2011).
Couch, C., Minchella, K., Walker, R., Watson N. Occupational Analysis of the CMA (AAMA). (2008). American Association of Medical Assistants, 2007-2008. Available from http://www.aama-ntl.org/resources/library/OA.pdf .
Ferrell, C.W., Aspy, C.B., Mold, J.W. (2006). Management of Prescription Refills in Primary Care: An Oklahoma Physicians Resource/Research Network (OKPRN) Study. Journal of the American Board of Family Medicine, 19, 1, 31-38.
A parks recreational leader can encourage visitors through a brochure or other handout to talk with their doctors about their health and wellness. On the other hand, park recreational leaders can also talk with healthcare providers and team up. By doing this, recreational parks may provide some tests for visitors, like blood pressure checks or physical fitness and body mass index checks that offer visitors or those staying at the recreational facility an opportunity to find out whether they are in shape, and if not, what they can do about it.
Park leaders can also organize events like marathon races or shorter races like a 3k race for children and adults with various small prizes or tokens like a ribbon for the leader. They can encourage visitors to fill out forms or surveys where they would have an opportunity to write down what types of physical fitness activities they would…
Allen, L. (2005 Mar) Becoming good sports: professionals need to exercise their power by helping community youth develop through parks and recreation. Parks & Recreation Online, Available: BNet Research Center, March: http://findarticles.com/p/articles/mi_m1145/is_3_40/ai_n13787656
Parks & Recreation
For a fifty-seven-year-old man with a fairly unremarkable past medical history, surgery was recommended. Also, performing the surgery could have a positive impact upon his diverticulosis, urinary hesitation, Gerd, BPH (benign prostrate hyperplasia, or enlarged prostate) and mild anemia. A surgery to correct the inguinal hernia had been successfully performed in 1998 without incident, as did the patient's other surgeries, including his varicose vein stripping done in 1987 and eye surgery in 1995.
During an inguinal hernia repair procedure, first, the surgeon makes an incision and separates the muscle and tissues to expose the hernia sac. The sac is cut open and the contents are replaced into the abdomen, the neck of the hernia sac is tied, and the muscles and tissues are sutured. During a laparoscopic procedure the procedure is performed through tiny incisions, using an instrument with a camera attached and a video monitor to guide the repair.…
Culvert, Lee L. (2004). "Inguinal Hernia Repair." Gale Encyclopedia of Surgery.
General Anesthesia Information." (2007). Surgery. Retrieved 15 Sept 2007 at http://www.justbreastimplants.com/surgery/general_anesthesia.htm
Goverman, Jeremy (23 Jan 2006). "Hernia" Medline Encyclopedia Online. Retrieved 15 Sept 2007 at http://www.nlm.nih.gov/medlineplus/ency/article/000960.htm
R'os, J. Rodr'guez, P. Munitiz, D. Alcaraz, P. Perez, Flores. (Sept 2001)."Parrilla using a prosthesis." Hernia. 5(3): 1265-4906 (Print) 1248-9204 (Online). http://www.springerlink.com/content/a04wbnfjp82v60t2/
It provides health-related advice on its website that all readers can benefit from, not simply those who use its services. As well as reaching out to the wider population of patients, it honors those within its fold who serve the organization with nights such as its "Celebrating Our Talent" ceremony designed to honor organizational members who have shown excellence in their duties (Boyd 2012).
The climate at the organization stresses valuing employees as well as clients, and serving the needs of its employees is included in the organization's statements of its critical functions. This acknowledges the need for caregivers to be cared for as well as patients. There is also a commitment to technological change to facilitate care: the organization was praised in 2003 for completely reconfiguring the way in which it kept track of patient data, switching to an entirely online system, to comply with changes in regulation and…
Boyd, Tracey. (2012). VNSNY home care agency praises nursing talent. VNSNY. Retrieved:
Mission and vision. (2013). VNSNY. Retrieved:
Again, all groups were by the end of the study essentially the same in that they had each served as controls, placebo recipients, and recipients of either one or two interventional medicines. The same periods of medication and testing were utilized for all participants in all groups of the study throughout the period during which the research took place.
According to the researchers, the completion of a crossover study such as this by forty-five participants is equivalent to 80% power at 5% statistical significance that the results could be extrapolated to the wider population. Though a higher level of certainty could be desired, this study's findings are still worthwhile.
The results are presented as average rates of the effects of the varying interventions (or lacks thereof) among the participants during the different phases of the trial. The differences between these averages were compared as different levels of…
Wald, D.; Law, M.; Mills, S.; Bestwick, J.; Morris, J. And Wald, N. (2008). "A 16-Week, Randomized, Double-Blind, Placebo-Controlled, Crossover Trial to Quantify the Combined Effect of an Angiotensin-Converting Enzyme Inhibitor and a f3-Blocker on Blood Pressure Reduction." Clinical therapeutics 30(11), pp. 2030-9.
Carrots and Fiber
I used "carrot fiber" as my search term to find fiber related articles that talked about carrots and fiber. I also used "fiber +disease" to find articles relevant to how fiber helps fight off disease. I found numerous articles, and most were relevant to this assignment, while some were not relevant at all.
In "Crunch time," the author talks about how vegetables like carrots, that contain a lot of fiber are good for the dieter, because they help you feel full longer, and they help slow digestion, too. They help keep you healthy, and they can help fight diseases like obesity if you rely on them as a steady part of your diet. In "High Fiber Cereals," the author states that research has not been conclusive on fiber helping fight diseases like colon cancer, but it is well documented that it helps fight heart disease, diabetes, can…
Broihier, K. (2009). High-fiber cereals: Still a very smart health move. Environmental Nutrition Vol. 32 Issue 7, p5.
Kadey, M.G. (2006). Crunch time. Joe Weider's Muscle & Fitness, Vol. 67 Issue 12, p137-142.
Turner, L. (2009). Eat well, eat cheap. Better Nutrition, Vol. 71 Issue 3, p52-54.
The Topic Company: DN.
1) Does the organization treat management and leadership as one in the same? YES or NO
2) Does the organization rely heavily on employee training and development? YES or NO
3) Does the program use employee feedback at the lowest levels in its overall decision making process? YES or NO
4) Do you believe all stakeholders are aware of the organizations goals and objectives and are willing to work towards the achievement of those goals? YES or NO
5) in your opinion is the organization structured in a way that inhibits innovation? YES or NO
6) Are there any other aspects that you believe should be improved within the organization? If so, how?
1) Bulmer, M. And Warwick, D. (1993). Social research in developing countries: surveys and censuses in the Third World. London: outledge.
2) Ebbutt, D. (1998). Evaluation of projects…
1) Bulmer, M. And Warwick, D. (1993). Social research in developing countries: surveys and censuses in the Third World. London: Routledge.
2) Ebbutt, D. (1998). Evaluation of projects in the developing world: some cultural and methodological issues. International Journal of Educational Development, 18, pp. 415-424.
3) Potter, C. (2006). Program Evaluation. In M. Terre Blanche, K. Durrheim & D. Painter (Eds.), Research in practice: Applied methods for the social sciences (2nd ed.) (pp. 410-428). Cape Town: UCT Press.
4) Potter, C. (2006). "Psychology and the art of program evaluation." South African journal of psychology 36 (1):
Australian Tax on Wine
usiness Submission - Australian Tax on Wine
With the Australian government seeking to impose additional taxation upon the use and sale of wine, there have been many outcries of indignation arguing how this would affect the Australian wine industry, and eventually the Australian economy. However, what needs to be considered are the consequences and the public cost of continuing with the discounted taxation to which wine makers in Australia are currently subjected to. The effect on the Australian GDP needs to be taken in to account with the harms that alcoholism in the increasingly youth population is set to unleash, if made available readily and at subsidized prices.
The risks and problems that have arose from the increased alcohol consumption by the Australian public in recent years, especially the young generation, point towards a possible increase in the health deterioration of most Australians while also impacting…
ABS. (2013, February 22). Australian Wine and Grape Industry, 2011-12. Retrieved from Australian Bureau of Statistics: http://www.abs.gov.au/ausstats/[email protected]/mf/1329.0
Anderson, K. (2010, May). Reforming taxes on wine and other alcoholic beverage consumption. Wine Economics Research Centre Working Paper No. 0810 . Australia: University of Adelaide.
Andrews, T. (2013). Stop the wine Supertax! Retrieved from Australian Taxpayers' Alliance: https://www.taxpayers.org.au/nowinesupertax/
Government, A. (2011). Australian National Preventive Health Agency. Retrieved from australia.gov.au: http://australia.gov.au/directories/australia/anpha
Currid, T. (2008).Experience of stress in acute mental health nurses.Nursing Times, 104 (2), pp.39-40.
The author talks about how the stress in acute mental health nursing needs instant attention and further elaborates that with statistics. As per the results of a recent survey conducted by Nursing Times, 70% of nurses are suffering from work related stress which has affected their physical or mental health problems. From acute mental health units in London, eight individuals belonging to grading levels were interviewed. The results showed that the management didn't pay attention to them and their professional opinions were being ignored. Along with ignorance, they were not allowed to use the skills they had. Thus, here Currid basically uses a real world example in which a nurse is subjected to mental stress. Their tasks included more of filling out the paper work and performing administrative duties. In the entire paper, the identified causes…
Currid, T. (2008).Experience of stress in acute mental health nurses. Nursing Times, 104 (2), pp.39-40.
Finn, P. (1981). The effects of shift work on the lives of Employees. Monthly Labor Review, pp.31-35.
Hypertension.(2002). In Natural Medicine Instructions for Patients. Retrieved from http://www.credoreference.com/entry/nmifp/hypertension
Managing Stress. (2009). In Business: The Ultimate Resource. Retrieved from http://www.credoreference.com/entry/ultimatebusiness/managing_stress
Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).
Prioritize the Nursing Care Needs of Margaret
The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…
Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.
Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.
Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.
Journal of Cardiovascular Nursing,25(3), 207-220.
Stroke is widely regarded one of the leading causes of deaths in the U.S. Indeed, recent statistical figures paint a grim picture with regard to the number of people who suffer a stroke in the U.S. each year. In basic terms, strokes are triggered by an interruption of blood flow into the brain. In this text, I concern myself with the physiological processes associated with stroke. In so doing, I will amongst other things define the disease and the body systems it affects, its causes, manifestation, and complications. Further, I will also discuss the hereditary or familial factors commonly associated with stroke.
Stroke: An Overview
In basic terms, stroke is said to be "an abrupt onset of neurological functions caused by a sudden reduction of cerebral blood flow, which is due in turn to either an ischemic occlusion or a hemorrhagic episode" (Gulini, Gianelli, Quaglia, and Marrucci, 2000, p. 239).…
Eisenberg, M.G., Glueckauf, R.L. & Zaretsky, H.H. (Eds.). (1999). Medical Aspects of Disability: A Handbook for the Rehabilitation Professional (2nd ed.). New York, NY: Springer Publishing Company.
Gulini, M., Gianelli, M., Quaglia, W. & Marrucci, G. (Eds.). (2000). Receptor Chemistry Towards the Third Millennium. Amsterdam: Elsevier Science.
Huether, S.E. & Mccance, K. (2012). Understanding Pathophysiology (5th ed.). Philadelphia, PA: Elsevier Science.
Mohr, J.P., Grotta, J.C., Wolf, P.A., Maskowitz, M.A., Mayberg, M.R. And Kummer, R.V. (2011). Stroke: Pathophysiology, Diagnosis, and Management (5th ed.). Philadelphia, PA: Elsevier Health Sciences.