Chest Pain Essays (Examples)

About two thirds of major chest trauma cases are associated with motor vehicle accidents. About 25% of injuries from motor vehicle accident related to chest trauma. The outcome out of the study made by the North American Major Trauma Outcome Study indicated that about 70% of trauma cases are blunt in nature. About 50% of chest trauma injuries are associated with chest wall. The initial recovery from chest trauma concentrates on the ABCs-airway, breathing, and circulation- subject to all major trauma resuscitation instances. After completion of initial resuscitation and stabilization a concurrent evaluation of a patient is done with suspected chest trauma. Normally chest injuries are diagnosed by chest radiograph alone. The recognition of treatment of chest trauma mostly relies upon a high index of suspicion mixed with the appropriate diagnostic tests. (Lesson 18: Blunt Chest Trauma)

The rate of recovery varies from person to person at various rates. The…

References

Athletic & Sports Injury Treatment" Retrieved at  http://www.scotiachiropractic.co.uk/treatment/sporting-injury.html . Accessed 26 October, 2005

Rib injuries" Retrieved at  http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Rib_injuries-open . Accessed 26 October, 2005

Rib Injury" Retrieved from  http://www.fairview.org/healthlibrary/content/sma_ribinjur_sma.htm . Accessed 26 October, 2005

Sako, Edward Y. "Lesson 18: Blunt Chest Trauma" PCCU Update. Vol: 15.

History of RSD

The history and the discovery of RSD (Reflex Sympathetic Dystrophy) Syndrome and its symptoms have typically been associated with wars. While there is no doubt that RSD from physical stress and injury existed earlier, it was left up to war physicians to assign pathology to it. Silas Weir Mitchell, an army doctor during the Civil War, described the symptoms of "burning pain" left in soldiers long after the bullets have been removed. He attributed these residual and long lasting pains to major nerve injury. Weir was the first to call RSD causalgia (currently, specifically known as CRPS-2), which is Greek for "burning pain." He wrote that, "Under such torments, the temper changes, the most amiable grow irritable, the soldier becomes a coward, and the strongest man is scarcely less nervous than the most hysterical girl." Weir accurately reflected the symptoms. (PARC, 2004). Mitchell accurately described the symptoms…

Bibliography

Allen, G., Galer, B.S., & Schwartz, L. (1999). Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients. Pain, 80(3), 539-544.

Aronoff, G.M., Harden, N., Stanton-Hicks, M., Dorto, A.J., Ensalada, L.H., Klimek, E.H., Mandel, S., & Williams, J.M. (2002). American Academy of Disability Evaluating Physicians (AADEP) Position Paper: Complex Regional Pain Syndrome I (RSD): Impairment and Disability Issues. Pain Med, 3(3), 274-288.

Bakewell, S. (1995). The Autonomic Nervous System. Update in Anesthesia, 6(5), 1.

Barolat, G., Schwartzman, R., & Woo, R. (1989). Epidural spinal cord stimulation in the management of reflex sympathetic dystrophy. Stereotact Funct Neurosurg, 53(1), 29-39.

Perception of Pain

Uses of Pain in nursing

Definitions of Pain from Dictionaries

Uses of Pain in psychology

Defining attributes

Model case

elated Case

Contrary Case

Antecedents and Consequences

CONCEPT ANALYSIS OF PECEPTION OF PAIN

The aim of this paper is to increase the understanding of the perception of pain. The researcher purpose to clarify describe the characteristics of pain and recognize antecedents that effect the idea of pain and the likely outcomes of pain by utilizing Avant's and Walker (2005) theory of study. Also, a model case shows how pain is connected to these serious characteristics contrary case and a borderline case are shown to distinguish the perception of pain from other notions. Empirical referents show the current point-of-view of the perception of pain. (Akyol & Salmond, 2009)

Concept Analysis of Characteristics of Pain

Introduction

The goal of this paper is to expand the understanding of the concept of…

References:

Akyol, O., Karayurt, O., & Salmond, S. (2009). Experiences of pain and satisfaction with pain management in patients undergoing total knee replacement. Orthopedic Nursing, 28(2), 79-85.

Chan, S., Hadjistavropoulos, T., Carleton, R.N., & Hadjistavropoulos, H. (2012). Predicting adjustment to chronic pain in older adults. Canadian Journal of Behavioral Science, 44(3), 192-199.

Eggermont, L.H.P., Bean, J.F., Guralnik, J.M., & Leveille, S.G. (2009). Comparing pain severity vs. pain location in the MOBILIZE Boston study: Chronic pain and lower extremity function*. The Journals of Gerontology, 64A (7), 763-70.

Gelinas, C., Fortier, M., Viens, C., Fillion, L., & Puntillo, K. (2004). PAIN ASSESSMENT AND Management IN CRITICALLY ILL INTUBATED PATIENTS: A RETROSPECTIVE STUDY. American Journal of Critical Care, 13(2), 126-35.

Personal Health History

Yes (Please list medications and reasons for usage below)

Medication

eason for usage

Tiotropium Breathlessness

Emsam Depression

Are you taking any vitamins or dietary supplements?

Yes (If yes then please list supplements and reasons for usage below)

I am taking Vitamin C through consuming multitude of fruits in order to fight muscle spasms, fatigue, and joint pain.

Do you now, or have you had in the past: Yes No

History of heart problems, chest pain or stroke?

Increased blood pressure?

Any chronic illness or condition?

Do you ever get dizzy, lose your balance or lose consciousness?

Difficulty with physical exercise?

Advice from physician not to exercise?

ecent surgery (last 12 months)?

Yes

Yes

Yes

Yes

No

Yes

No

No

No

History of breathing or lung problems? No

Swollen, stiff, or painful joints? Yes

Foot problems? No

Back problems? Yes

Any significant vision or hearing problems? No

14.…

Reference Article

National comprehensive cancer network (NCCN). NCN clinical Practice Guidelines in Oncology: Myeloid growth factors. Version 1. 2006

Psychological Perspective Scenario

Anyone can experience stress in his or her life, but how the person responds to that stress is affected by the person's personality and upbringing, as well as other factors (Fernald, 2008). For someone like Lester, the issues he is facing are serious and immediate, but they also appear to have been (and will continue to be) ongoing. That is highly significant, because there is no "quick fix" for Lester. Despite that, he will be able to move forward if he addresses the issues he has and learns how to face them more clearly and in a way that is healthier for him. Psychological distress can have physical causes, but the reverse can also be true in that physical issues can be manifestations of what is taking place psychologically (Hockenbury & Hockenbury, 2010; Overskeid, 2007).

In Lester's life, he faces several causes of stress. The main one…

References

Fernald, L.D. (2008). Psychology: Six perspectives. Thousand Oaks, CA: Sage Publications.

Hockenbury, DH & Hockenbury, S.E. (2010). Psychology. New York, NY: Worth Publishers.

O'Neil, H.F.; cited in Coon, D. & Mitterer, J.O. (2008). Introduction to psychology: Gateways to mind and behavior. Stamford, CT: Cengage Learning.

Overskeid, G. (2007). Looking for Skinner and finding Freud. American Psychologist 62(6), 590 -- 595.

pneumothorax.We identify the two main types of Pneumothorax with its causes and possible treatments. We also analyze a case study involving a 33-year fruit vegetable merchant, who, while delivering merchandise a mini supermarket developed chest pain difficulty breathing. And then subsequently admitted to casualty and diagnosed with pneumothorax.

Pneumothorax which is defined by Light (1995) as the unprecedented entry of air into an individual's pleural space is a serious ailment. Its pathophysiology described by Combulsier in 1747 (Mohebbi and ad, 2007). This was after realizing that the noted reduction in the pulmonary function was as a result of lung compression caused by air present in the pleural space as outlined by Sadiron et al., (1997).

Types and causes of Pneumothorax

Simple pneumothorax

This type of pneumothorax is caused by the presence of air within a victim's pleural space. It is a consequence of a blunt or a penetrating trauma with…

References

Al-Tarshihi, MI, Khamash, FA, Al Ibrahim, AEO (2008). Thoracostomy tube complications and pitfalls: an experience at a tertiary level military hospital http://www.rmj.org.pk/ram_july_dec_08/original_articles/thoracostomy_tube_complications/pdf.pdf

American Thoracic Society (2004). Chest Tube Thoracostomy.

 http://patients.thoracic.org/information-series/en/resources/chest-tube-thoracostomy.pdf 

Gupta, D., Hansell, A. And Nichols, T. et al. 2000. Epidemiology of pneumothorax in England.

Nurses are considered the backbone of the medical care-giver community. Good quality patient care centers on having a competent educated nursing labor force. There is a wealth of empirical evidence that has demonstrated Baccalaureate (BSN) nurses are associated with fewer medication errors, lower mortality rates, and greater overall positive patient outcomes than nurses at lower levels of educational achievement. For example, Brady, Malone, and Fleming (2009) performed an extensive literature review and found that BSN nurses made fewer medication errors than their less educated counterparts. Aiken and associates (2003) found a strong link between N education level and patient outcomes. Their findings indicated that for every ten percent increase in the proportion of BSN nurses in a surgical unit there was a four percent decrease in the risk of death to patients. In a large study of nearly 47,000 patients conducted at the University Toronto it was found that hospital…

References

Aiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M., & Silber, J.H. (2003). Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, 290, 1617-1623.

Brady, A.M., Malone, A.M., & Fleming, S. (2009). A literature review of the individual and systems factors that contribute to medication errors in nursing practice. Journal of Nursing Management, 17(6), 679-697.

Friese, C.R, Lake, E.T., Aiken, L.H., Silber, J.H. & Sochalski, J. (2008). Hospital nurse practice environments and outcomes for surgical oncology patients. Health Services Research, 43(4), 1145-1163.

Profetto-McGrath, J. (2003). The relationship of critical thinking skills and critical thinking dispositions of baccalaureate nursing students. Journal of Advanced Nursing, 43(6), 569- 577.

Cardiology Nursing

This is a 12 lead ECG taken for Mr. Long at the Emergency Department. He presented with a two hour history of chest pain radiating to his left arm. The ECG is suggestive of an antero-septal Myocardial infarction. Further scrutiny of the ECG displays a normal sinus rhythm, with a rate of 75 bpm that is regularly regular. There is no axis deviation with a P interval of 200 ms and normal qrs complexes. Leads I and aVL also show a q wave which may be suggestive of an old high lateral wall MI. Leads I, V1, V2, V3 and aVL show ST segment elevation of greater than 2 mm and ST segment depression in leads II and III. Mr. Long is suffering from a fully evolved ST-segment elevation myocardial infarction.

A correlation can be made with the area of myocardium involved and the vessel involved. The antero-septal…

REFERENCES:

B, Deborah, Diercks. (2010). Mission Lifeline: Developing a STEMI regonal care. American Heart Association. -. Print.

Jois, P. (2011). Nstemi and stemi: therapeutic updates 2011. The Practical Journal for Emergency Physicians, 32(1), 1-7.

Katzung, B., & Masters, S. (2011). Katzung's pharmacology. (9 ed.). United States of America: Mc-Graw Hill.

Kumar, V., & Robbins, (2007). Basic pathology. (8 ed.). London: Saunders Company.

Since they have experience, they would serve as a great source and wealth of information for her as well as a sounding board when she is frustrated about certain aspects of the job. There will also be greater opportunities to meet, converse with and work with people from a variety of backgrounds.

The new cardiologist would also fare well by working in a clinic right after training. The pace of a clinic may sometimes be slower than that of a hospital and the patients treated there are usually not in a state of emergency. This does not diminish the importance of any cardiologist choosing to work in a medical clinic over a hospital. This slower pace may give the new cardiologist ample time to get acclimated to the procedures that she will be performing. It will also give her a longer time to perfect her surgery skills. Because clinics are…

health promotion strategies that can be implemented upon the predictive characteristics of the family.

My health promotion strategy program will center around a Cuban-American family called the Garcias whose primary health issues center on hypertension, and the need for greater information about the importance of establishing a healthy lifestyle. This includes the importance of screening, exercise, establishing healthy habits, and monitoring one's lifestyle. Several members of the family indicate stress and hypertension whilst the grandmother also has cardiac disease and osteoarthritis, but is resilient to receiving information on how to alleviate her symptoms. In a similar way, Angelo, an addicted smoker, refuses to stop smoking and to deal with his chronic cough and mild chest pain, stating that, as man of the family, he has to continue working his overwhelming hours. Gerardo, the son, being active homosexually, seems to be vulnerable to AIDS; it is unclear whether or not he…

References

Boswell, T.D. & Curtis, J.R. (1984) The Cuban-American Experience. Culture, Images and Perspectives. NJ: Rowman & Allanheld Publishers

Cuban Americans  http://www.everyculture.com/multi/Bu-Dr./Cuban-Americans.html

Interventions

Home health visits can be a useful method of identifying potential and actual health issues. Visiting the patient's home may provide the opportunity to identify issues which may not be readily apparent at a medical office. The home health visit is meant to assist in the promotion of the patient's health maintenance; limit further disability, and increase baseline health.

The visiting nurse will gain the ability to build a caring, professional, trusting, patient focused relationship. The home health nurse will be able to assist the patient by identifying, procuring and providing education for interventional items. The nurse will also know how to facilitate the communication of identified patient needs, in the home, to interdisciplinary members of the health care team (Liebel, Powers, Friedman, & Watson, 2012, p. 80).

Problem #1

The patient has been prescribed oxygen for home use by her physician. The patient states the she has not…

Heart Disease

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.

Cardiac Arrest

Cardiac…

References

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

Aortic dissection is a disease of the wall of the aorta in which the aortic blood bursts into the muscular layer of the great artery, thus forming a blood filled channel along the planes of the muscularis layer. This false lumen can re-rupture back into the true lumen, through a second distal intimal tear, creating a biluminal or double barrelled aorta. Due to weakened walls, there is threat of rupture into the surrounding tissue with fatal consequences. (Boon, , Colledge, Walker, & Hunter, 2010)

The pathophysiology behind the condition is often a spontaneous or iatrogenic tear in the intima. However, in about five to ten percent of patients, these tears are absent. An intimal tear can occur anywhere along the aorta, although a vast majority of tears are found within ten centimeters of the aortic valve. The dissection may extend towards the heart, affecting the coronary arteries, or it may…

REFERENCES:

Duranki. (n.d.). Type an aortic dissection - the silent killer. Retrieved from  http://duranki.hubpages.com/hub/Beware-High-Blood-Pressure-It-will-Kill-You  -- You-Wont-See-It-Coming

Erbel, R., Alfonso, F., Boileau, C., & Dirsch, O. (2001). Diagnosis and management of aortic dissection*.European Heart Journal, 22(18), 1642-1681. Retrieved from  http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-aortic-dissection-FT.pdf 

Multum, C. (2012, Feburary 12). Morphine injection. Retrieved from  http://www.drugs.com/pro/morphine-injection.html 

Nicholas A. Boon, Nicki R. Colledge, Brian R. Walker, John A.A. Hunter.(2010). Davidson's Principles and Practice of Medicine . India, Elsevier.

McClure Case Study

Patient Overview -- Patient, Mr. M., is 49 years old and has smoked for 25 years, quit three years ago when diagnosed with emphysema. He indicates he as shortness of breath for the past 48 hours, with sputum so thick he has difficulty coughing it out. Skin is warm and dry with slight clubbing of fingers noted. Lung sounds diminished with crackles and expiratory wheezes and barrel chest. Vitals are 101.8 Temp, pule 110, respiratory 32, BP 150/82. Blood gases show decreased O2 and increased C02 with an increase in red blood cells and twice the normal white cells.

M's risk factors for emphysema are high. Smoking for so long contributed to decrease of long function and is an abnormal dilation and destruction of the alveolar ducts and air spaces in the lungs. It usually occurs in people over 50, so Mr. M is at the lower…

REFERENCES

Cash, J. And Glass, C. (2011). Family Practice Guidelines. New York: Springer.

Dains, J., et al. (2012). Advanced Health Assessment & Clinical Diagnosis in Primary Care.

St. Louis, MO: Mosby/Elsevier.

Mortelli, M., et al. (2002). Acute respirator distress syndrome. American Family Physician. 65 (9): 1823-30.

Patient Overview -- Mr. C. is a 52-year-old business executive with indigestion that an entire roll of TUMS did not help. Initially he blamed this on his lunchtime pizza, but his staff convinced him to go to the E where he presented epigastric pain. An EKG was done indicating ST segment elevation. Additionally, the pain remained unrelieved after three sublingual nitroglycerine tablets. Three doses of morphine sulfate given intravenously relieved the pain enough for a transfer to the cardiac unit. Mr. C's skin is clammy and cool; he has inspiratory crackles, temp of 98.6, 120 pulse, and respiration 24, BP 90/62. The Cardiac monitor showed sinus rhythm with occasional premature ventricular contractions (PVCS). Labs showed elevated isoenzymes, topponis, creatin kinase myocardial bound, and lactic acid dehydrogenase. We find out also that Mr. C has been having dental pain for the past 48 hours.

Part 1 -- The ST segment is…

REFERENCES

ST Elevation. (2012). Family Practice Notebook. Retrieved from:  http://www.fpnotebook.com/cv/exam/StElvtn.htm 

Dains, J., et al. (2012). Advanced Health Assessment & Clinical Diagnosis in Primary Care.

St. Louis, MO: Mosby/Elsevier.

Hudson, K. (2012). Congestive Heart Failure. DynamicNursingEducation.com. Retrieved from:  http://dynamicnursingeducation.com/class.php?class_id=130&pid=23

Demographic Perception Survey of Patients with Atypical CP Who Present to Cardiac Care Doctors and Patient Outcomes

This study intends to examine gender differences in individuals who present to cardiac doctors with chest pain and specifically, atypical chest pain in women. The work of Debra L. Issac (2000) states that over the past ten years "there has been increasing awareness of both the importance of CAD in women and of the significant differences between men and women who have the disease. Potential gender biases, both within the medical community and within the general population of women themselves also have been identified. These gender differences and biases have the potential to influence investigation and management of suspected or confirmed CAD in women, and should be taken into consideration when faced with a woman with potential cardiovascular disease." (p.157)

Issac also states that chest pain in women is "common and often non-ischemic.…

References

Cayley, WE (2005) Diagnosing the Case of Chest Pain. American Family Physician. 15 Nob 2005. Retrieved from:  http://www.aafp.org/afp/2005/1115/p2012.html 

Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. (1):CD001877, 2011.

Issac, DL (2000) Women with Ischemic Heart Disease. Presented at the Canadian Cardiovascular Congress, Vancouver, British Columbia, October 2000. Retrieved from:  http://www.stacommunications.com/journals/cme/images/cmepdf/oct01/womencv.pdf 

Khan, JJ, Albarran, JW, Lopez, V, and Chair, SY (2010) Gender Differences on Chest Pain Perception associated with Acute Myocardial infarction in Chinese patients: A Questionnaire Survey. J Clin Nurs. 2010 Oct, 19 (19-20)2720-0. Retrieved from:  http://www.ncbi.nlm.nih.gov/pubmed /20846222

Intravenous access should be obtained and 12 lead ECG/continuous monitoring plus blood draw for enzymes. The patient with angina will respond to sublingual nitroglycerine given 0.3 mg to 0.4 mg repeated every 5 minutes for up to three doses. If pain persists after the third dose, suspicion for MI should be high (Harvey, 2004). An ECG is the next step in assessment of the patient with angina vs. MI, although it should be noted that only 45% of all the patients with MI will have obvious ischemic changes on their ECG. Patients should be monitored for minor changes. ST segment elevations with tall T. waves will usually be the first changes (Docherty, 2003). Evaluators should also be sensitive to ST segment depression in leads which are opposite the site of the injury. T-wave inversion and the development of Q. waves are considered to be pathologic evidence of evolving MI. Changes…

Reference:

Docherty, B. (2003). 12-lead ECG interpretation and chest pain management: 1. British Journal of Nursing, 12(21), 1248-1255.

Harvey, S. (2004). The nursing assessment and management of patients with angina. British Journal of Nursing, 13(10), 598-601.

Sommers, M & Johnson, S. (2002). Diseases and Disorders: A Nursing Therapeutics Manual (2nd Ed.). Philadelphia: F.A. Davis.

Tough, J. (2004). Assessment and treatment of chest pain. Nursing Standard, 18(37), 45-53.

Pleural Effusion in Children -- An Overview

Pleural Effusion is a disease resulting from excess production of fluids or a decrease in absorption or in some instances both thereby leading to an abnormal collection of fluids in the pleural space. It is the commonest pleural disease and has etiologies that include symptomatic inflammatory, cardiopulmonary disorders and malignant diseases that require speedy evaluation as well as treatment (Jeffery ubins 2016).

Disorders like an infection are some of the primary afflictions that could lead to the collection of fluids in the pleural space leading to pediatrics pleural effusion. The fluid accumulation can result from poor absorption or an increase in filtration. While mild effusion is asymptomatic, complications like septicemia, pneumothorax, pleural thickening, bronchopleural fistula, and respiratory failure might accompany it (Shahla Afsharpaiman, et al. 2016). a chest ultrasound or lateral decubitus indicates the probability of the existence of a large pleural effusion.…

References

Andrews CO & Gora ML., 1994. Pleural effusions: pathophysiology and management. SAGE Publications - Anual Pharma, 28(8), pp. 894-903.

Hyeon Yu, 2011. Management of Pleural Effusion, Empyema, and Lung Abscess. Seminars in Interventional Radiology, 28(1), pp. 75-86.

Jeffrey Rubins, 2016. Pleural Effusion. [Online]

Available at:  http://emedicine.medscape.com/article/299959-overview

new respiratory drugs that have been approved for medical use over the past decade. The paper will highlight the diagnoses of the drugs i.e. when and why it is prescribed, how it is meant to be used and how often, its side effects, the impact for a missed dose or an overdose along with any other relevant information that will add depth to it appropriate use.

The main purpose for the respiratory drugs is to help cure the ailments directly or indirectly related to the functioning of lungs or general breathing of an individual. There are numerous sectors where studies on new respiratory drugs can be carried out and some of the most recent studies to include this particular aspect include allergies, asthma attacks, Acute espiratory Distress Syndrome (ADS), pneumonia and sinus infections.

In this paper we will focus on the following new respiratory drugs: Arcapta, Daliresp, Dulera, Tyvaso, Alvesco,…

References

Beeh, K.M., Derom, E., Kanniess, F., Cameron, R., Higgins, M., van As, A. (2007). "Indacaterol, a novel inhaled beta2-agonist, provides sustained 24-h bronchodilation in asthma." Eur. Respir. J. 29 (5): 871 -- 8.

Cerner Multum, Inc., (2010). Dulera Inhaler. Accessed 02-02-12 from:  http://www.drugs.com/dulera.html 

Cerner Multum, Inc., (2010a). Tyvaso. Accessed 02-02-12 from:  http://www.drugs.com/tyvaso.html 

Cerner Multum, Inc., (2010b). Alvesco. Accessed 02-02-12 from:  http://www.drugs.com/alvesco.html

Dumont, C.J., Keeling, A.W., Bourguignon, C., Sarembock, I.J., and Turner, M.

"Diagnostic cardiac catheterization and percutaneous coronary interventions."

Dimensions of Critical Care Nursing, Vol. 25, No. 3.

In general, nurses are responsible for the postoperative care of patients after cardiac catheterization and percutaneous coronary intervention procedures. The consequences of postoperative complications can be extremely serious. Therefore, it is essential that research be conducted to correctly identify the specific risk factors for vascular complications associated with both of these procedures so that effective protocols can be developed to enable nurses to mitigate those risks as much as possible.

Purpose Statement

The purpose of this research study is to establish baseline data detailing the incidence and types of the vascular complications experienced by patients during the postoperative-care phase of cardiac catheterization and percutaneous coronary intervention procedures. This study is intended to identify and quantify the relative significance of risk predictors for complications…

(American Society of Health-System Pharmacists, Inc. 2009 )

IV. Side Effects of Sildenafil

Side effects of taking Sildenafil include those as follows:

headache heartburn diarrhea flushing (feeling of warmth)

nosebleeds difficulty falling asleep or staying asleep numbness, burning, or tingling in the arms, hands, feet, or legs muscle aches changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)

sensitivity to light (American Society of Health-System Pharmacists, Inc. 2009 )

Serious side effects are the following and occurrence of this requires immediate notification of the physician:

sudden severe loss of vision (see below for more information)

blurred vision sudden decrease or loss of hearing ringing in ears

erection that is painful or lasts longer than 4 hours dizziness or lightheadedness fainting chest pain worsening shortness of breath itching or burning during urination rash (American Society of Health-System Pharmacists, Inc. 2009…

Bibliography

Sildenafil (2009) AHFS Consumer Medication Information. American Society of Health-System Pharmacists. Online available at:  http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=meds&log$=drug_bottom_one&part=a699015 

Swearingen, S. And Klausner, J. (2009) Sildenafil Use, Sexual Risk Behavior, and Risk for Sexually Transmitted Diseases including HIV infection. The American Journal of Medicine, Vol. 118, Issue 6. Online available at:  http://linkinghub.elsevier.com/retrieve/pii/S0002934305000860 

Rosenfeld, Dana and Faircloth, Christopher a. (2006) Medicalized Masculinities. Temple University Press 2006. Online available at:  http://books.google.com/books?id=8rXT7-EL0jcC&dq=SEXUAL+ENHANCEMENT:+viagra,+levitra+and+cialis&lr=&source=gbs_navlinks_s 

Loe, Meika (2004) the Rise of Viagra: How the Little Blue Pill Changed Sex in America. NYR Press 2004. Online available at:  http://books.google.com/books?id=h25piGXAHukC&dq=SEXUAL+ENHANCEMENT:+viagra,+levitra+and+cialis&lr=&source=gbs_navlinks_s

Pressure on the superior vena cava may produce SVC syndrome, a swelling of the head and arms. SVC syndrome involving the brain can be fatal and must be treated immediately. But enlarged lymphatic tissue in the chest cavity generally tends to displace -- rather than press upon or encase -- adjacent structures. Therefore, compromised breathing and SVC syndrome are relatively uncommon signs of lymphoma. (Hodgkin's Disease, 1998-2008)

Effects on Bone Marrow

Night sweats, fevers or anemia (a low red-blood-cell count), fevers may indicate Hodgkin's disease has spread to an individual's bone marrow. In these scenarios, a physician may order bone marrow aspiration and biopsy. In biopsy, medical staff uses a large needle to remove a narrow, cylindrical piece of the patient's bone. In another option, medical staff performs an aspiration, a process utilizing a needle to remove small bits of bone marrow. Generally, in both instances, to help determine cancer…

Works Cited

Atlas of the Body: The Lymphatic System." (1999). American Medical Association. 2 June 2008  http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZG0S6CGJC&sub_at=518 .

Carson-DeWitt, Rosalyn S; Alic, Margaret. "Hodgkin's Disease," Gale Encyclopedia of Cancer, January 1, 2002. 2 June 2008  http://www.highbeam.com/doc/1G2-3405200219.html .

Detailed Guide: Hodgkin Disease What Is Hodgkin Disease? American Cancer Society. Revised: 08/30/2007. 2 June 2008  http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Is_Hodgkin_Disease.sp?rnav=cri .

Hodgkin's Disease Signs and Symptoms. (1998-2008). 3 June 2008 http://www.oncologychannel.com/hodgkins/symptoms.shtml.

Pulmonary Sarcoidosis

Sarcoidosis is a sometimes-lethal disease affecting primarily the lungs and thoracic lymphatic system, and its hallmark feature is noncaseating granulomas in multiple tissues and organs (Hoang and Nguyen, 2010, p. 36; American Thoracic Society, 1999, p. 736). Over 90% of all sufferers have pulmonary involvement, but granulomas are frequently found in other organs and tissues, including the skin, eyes, liver, spleen, parotid glands, central nervous system, muscles, bones, and genitourinary tract (Hoang and Nguyen, 2010, p. 36). When death does result, it is typically due to pulmonary fibrosis. What follows is a review of pulmonary sarcoidosis from a clinical perspective.

Causes and isk Factors

The cause of sarcoidosis is unknown, but research into the nature of the resulting granulomas suggests immune dysregulation in genetically susceptible individuals is the primary causative factor (American Thoracic Society, 1999, p. 738-740). The genetic contribution appears to be significant, as evidenced by an…

References

American Thoracic Society. (1999). Statement on Sarcoidosis. American Journal of Respiratory Critical Care Medicine, 160, 736-755.

American Lung Association. (2010). State of lung disease in diverse communities 2010. Lung.org. Retrieved 5 Mar. 2012 from  http://www.lung.org/assets/documents/publications/lung-disease-data/solddc_2010.pdf .

Baughman, Robert P., Lower, Elyse E., and du Bois, Roland M. (2003). Sarcoidosis. Lancet, 361, 1111-1118.

Drent, Marjolein, De Vries, Jolanda, Lenters, Merinke, Lamers, Rob J. s., Rothkranz-Kos, Snjezana, Wouters, Emiel F.M. et al. (2003). Sarcoidosis: Assessment of disease severity using HRCT. European Radiology, 13, 2462-2471.

Medical/Nursing Education

Nurses are required to make many immediate decisions in their assigned duties. Unfortunately, in recent years, patient care has often been compromised as a nursing shortage crisis has escalated to epic proportions. Increased patient loads have resulted in often hasty nursing decisions as responsibilities and hours worked have increased. Although precious time must be spread thin to accommodate higher numbers of patients, nurses must exercise their morals through consistency in ethical behaviors. According to Peggy Chinn (1), "Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain."

As a result, nurses are held accountable for a variety of decisions in nursing practice and in many instances, a patient's life depends on such decisions to survive. Gastmans (496) states that "Generally, the goal of nursing…

References

Chinn, P. (2001). Nursing and ethics: the maturing of a discipline. Advances in Nursing Science

Erlen, J. (2001). Moral distress: a persuasive problem. Orthopaedic Nursing 20(2): 76-80.

Erlen, J. (2001). The nursing shortage, patient care, and ethics. Orthopaedic Nursing 20(6):

Gastmans, C. (2002). A fundamental ethical approach to nursing: some proposals for ethics education. Nursing Ethics 9(5): 494-507.

Empyema Clinical Manifestation

Empyema: Lung Sounds and other Clinical Manifestations

Over the past decade, empyema has consistently been recognized as an acute, potentially life-threatening respiratory disease. A large number of studies have been conducted over the last years that address the unique symptomatology of empyema and the clinical implications of these symptoms.

The biggest diagnostic challenge of empyema is that patient often present with symptoms very similar and difficult to distinguish from an uncomplicated pneumonia. A patient typically shows symptoms such as fever and chills, excessive sweating, malaise, cough, dyspnea, pleuritic chest pain and unintentional weight loss (Sahn, 2007). These symptoms individually do not warrant a diagnosis of empyema. They do, however, require precautionary follow-up testing that should include a pleural fluid aspiration. The presence of pus -- an opaque, whitish-yellow viscous fluid consisting of serum coagulation proteins, cellular debris and fibrin deposition -- aspirated from the pleural space is…

References:

1. Walker W, Wheeler R, Legg J. (2011). Update on the causes, investigation and management of empyema in childhood. Archives of Disease in Childhood, 96, 5, 482-488.

2. Sahn SA. (2007). Diagnosis and management of parapneumonic effusions and empyema. Clinical Infectious Diseases, 45, 11, 1480-1486.

3. Heffner JE, Klein JS, Hampson C. (2010). Diagnostic utility and clinical application of imaging for pleural space infections. Chest, 137, 2, 467-479.

4. Froudarakis ME. (2008). Diagnostic Work-Up of Pleural Effusions. Respiration, 75, 4-13.

Gender variation in clinical decision-making was measured, including (1) the number, types, and certainty levels of diagnoses considered and (2) how diagnoses vary according to patient characteristics, when patients have identical symptoms of CHD (Maserejian et al., 2009).

This was a factorial experiment presenting videotaped CHD symptoms, systematically altering patient gender, age, socioeconomic status (SES) and race, and physician gender and level of experience. The primary end point was physicians' most certain diagnosis. The results: Physicians (n=128) mentioned five diagnoses on average, most commonly heart, gastrointestinal, and mental health conditions. Physicians were significantly less certain of the underlying cause of symptoms among female patients regardless of age, but only among middle-aged women were they significantly less certain of the CHD diagnosis. Among middle-aged women, 31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts. An interaction effect showed that females with high…

Works Cited

Chou, Anne F., Sarah Hudson Scholle, Carol S. Weisman, Arlene S. Bierman, Rosaly

Correa-de-Araujo, & Lori Mosca (2007). "Gender Disparities in the Quality of Cardiovascular Disease Care in Private Managed Care Plans." In Women's Health

Issues 17: 120 -- 130.

DeVon, H., Ryan, C.J., Ochs, a.L., & Shapiro, M. (2008). "Symptoms Across the Continuum of Acute Coronary Syndromes: Differences Between Women and Men." In Am J. Crit Care 17:14-24.

Coccidioidomycosis Erythema Nodosum

Also known as valley fever or desert rheumatism, coccidioidomycosis is a fungal disease commonly reported in the Western Hemisphere, especially South-western U.S. (mainly California, Arizona, and Texas), Northern Mexico, as well as parts of Central and South America (Chen, Lee & Li, 2010). In the U.S., estimates indicate that 150,000 people in the South-western region are infected every year (Garcia et al., 2015). As the disease is mainly concentrated in South-western U.S., its national prevalence remains unknown. The disease is commonly characterized by coughing, fever, shortness of breath, headaches, chest pain, night sweating, loss of weight, and erythema nodosum (Garcia et al., 2015). This paper reports a case of coccidioidomycosis characterized by erythema nodosum

Subjective

A 31-year-old Asian male visited his primary care doctor's clinic complaining of cough and malaise for two months. He had been a construction worker in Fresno County, California, for eleven months and…

References

Chen, C., Lee, H., & Li, S. (2010). Coccidioidomycosis with cutaneous manifestation of erythema nodosum in Taiwan. Dermatologica Sinica, 28: 154-158.

Garcia, S., Alanis, J., Flores, M., Gonzalez, S., Cabrera, L., & Candiani, O. (2015). Coccidioidomycosis and the skin: a comprehensive review. Anais Brasileiros de Dermatologia, 90(5): 610-619.

Odio, C., Marciano, B., Galgiani, J., & Holland, S. (2017). Risk factors for disseminated coccidioidomycosis, United States. Emerging Infectious Diseases, 23(2), 308-311.

Wilken, J., Sondermeyer, G., Shusterman, D., et al. (2015). Coccidioidomycosis among workers constructing solar power farms, California, USA, 2011-2014. Emerging Infectious Diseases, 21(11), 1997-2005.

Nursing 201 Nursing Process PaperClient ProfileThe patient is a white 80year old whose religion is unknown and was admitted on February 2, 2022, for a UTI infection. Care for the patient began on the day of admission. He is a father of three and a grandfather of five, living with his spouse. The social-economic status of the patient is low to middle class had a career as a factory worker. The patient had a full code status of Contrast Dye allergy. The history records reflected an altered mental state, and dementia and frustration were noted, hypertension, Gastroesophageal Reflux Disease (GERD), and Stage 4 chronic kidney disease. Blindness in the left eye was detected, but no challenges were observed with hearing. The patient denies any pain, can move with minimal assistance, has a good appetite, and shows the adjustment to aging since his hobby is spending time with his grandchildren.The patients…

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…

References

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.

Care of Cancer:

In the past few years, cancer has developed to become one of the major leading causes of deaths across the globe. The disease can be described as the uncontrolled growth or development of abnormal cells in the body even as cancerous cells are also known as malignant cells. Since cells are the building blocks of humans and other living things, cancer develops out of the normal cells within the body. Generally, the normal cells multiply when needed by the body and die when the body does not need them. When the growth of the cells in the body is out of control and cells divide too quickly, cancer appears to occur. Nonetheless, cancer also appears to happen when cells in the body forget how to die.

Causes of Cancer:

There are various kinds of cancer because the disease can develop in nearly every tissue or organ like…

Reference:

Barraclough, J. (2002). Integrated Cancer Care. Retrieved from Royal College of Psychiatrists

website:  http://www.rcpsych.ac.uk/PDF/barraclough.pdf 

"Cancer Complications." (n.d.). Info.com. Retrieved August 31, 2012, from http://topics.info.com/Cancer-Complications_3416

"Cancer Staging." (2010, September 22). National Cancer Institute Factsheet. Retrieved from National Cancer Institute website:  http://www.cancer.gov/cancertopics/factsheet/detection/staging

Also no pill will change everything. One must be willing to change their lifestyle as well.

hy do some people still need an antihyperlipidemic agent even though they have reduced their dietary intake of cholesterol and saturated fats?

hy is it better to sue selective beta2 agonists, rather than non-selective beta-adrenergic agonists, for a patient who has both asthma and heart disease?

hy is the combination of a glucocorticoid and a beta2 adrenergic agonist used sometimes in treating asthma? hat is the difference in their mechanisms of action?

Use

http://lungusa.org/asthmato answer: (a) what is a peak flow meter and how is it used in asthma clients? (b) Is low or high humidity in the home better for asthma clients? - hat aspects of weather are triggers for asthma?

Based upon your knowledge of the mechanism of action of the following drug classes, explain the rationale for using the following to…

It is believed that this is related to some basic dissimilarity in women's the way women's hearts work (icciotti, 2012).

Women are just as liable to have a heart attack as men, but the fact that they are more apt to die after their first heart attack may be because the signs of a heart attack are different in women. Doctors and patients frequently point chest pains in women to non-cardiac causes, leading to a misdiagnosis of their condition. Men generally experience crushing chest pain during a heart attack. Women may have a larger inclination to have pain just under the breastbone, or complain of abdominal pain, heartburn, trouble breathing, sickness and mysterious exhaustion. Women are consequently easily misdiagnosed of indigestion, gall bladder disease, or even an anxiety attack. The probability of misdiagnosing a heart attack in women is also augmented by the fact that women tend to have heart…

References

Braunstein, G.D. (2010). Gender Differences in Heart Disease: Nation's No. 1 Killer Kills

Differently. Retrieved from  http://www.huffingtonpost.com/glenn-d-braunstein -

md/gender-differences-in-hea_b_773366.html

Gender Difference In Heart Failure. (2009). Retrieved from  http://www.medicalnewstoday.com/releases/158956.php

Chronic Illness: Coronary Heart Disease

Outline of Coronary Heart Disease

The Coronary Heart Disease (CHD) has been on the increase of late across the globe and this disease, alongside stroke have been the top causes of death in many countries like Australia (Baker Heart and Diabetes Institute, 2017). There have been cases of people succumbing to complications occasioned by the CHD hence the need for any medic or clinician to fully furnish themselves with the CHD and the causes and effects as well as how it can be managed.

CHD is a disuse characterized by the development of a waxy substance called plaque building up in the inner walls of the coronary arteries. These are the arteries responsible for supplying oxygen-rich blood to the heart muscles. The buildup of plaque on the inner walls of the arteries results into atherosclerosis and this takes many years to pile up to harmful…

References

Baker Heart and Diabetes Institute, (2017). Heart disease and stroke are the top two causes of death -- and among the leading causes of disability -- in Australia. Retrieved April 9, 2017 from  https://baker.edu.au/health-hub/fact-sheets/cardiovascular-disease?gclid=Cj0KEQjwt6fHBRDtm9O8xPPHq4gBEiQAdxotvNmN_YV05am6ts6wLgbbEPubE3I2Z6wwGSNl0AaycX0aAnFy8P8HAQ 

Cleveland Clinic, (2017). Coronary Artery Disease Symptoms. Retrieved April 9, 2017 from  https://my.clevelandclinic.org/health/articles/cad-symptoms 

Mayo Clinic, (2017). Coronary Heart Disease: Symptoms and Causes. Retrieved April 9, 2017 from  http://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/dxc-20165314 

Southern Cross, (2017). Coronary heart disease - causes, symptoms, prevention. Retrieved April 9, 2017 from  https://www.southerncross.co.nz/group/medical-library/coronary-heart-disease-causes-symptoms-prevention

The "pain" caused to the heart due to tissue damage can be misplaced in the body due to these nerve pathways and connections; heart attacks are often felt in the left arm and elsewhere on that side of the body between the heart and brain.

5)

Diuretics would encourage the elimination of sodium and a lessened fluid retention, easing the pressure in his arteries.

6)

The increased acidity in J.M.'s blood indicates reduced heart functionality and creatine phosphokinase levels are elevated which indicates muscle damage; low-normal lactate dehydrogenase suggest no recent prior infarctions, however, and without further tests this particular measure is not especially edifying.

7)

The drug relaxes blood vessels, allowing easier passage of blood reducing chest pain (which elevates stress and blood pressure) and easing the underlying problem, as well

8)

Aspirin inhibits the collection of platelets at the site of a plaque rupture, preventing a full blockage…

Methylphenidate is part of a therapy regimen for the control of the symptoms of Attention Deficity Hyperactivity Disorder or ADHD in adults and children (Ogbru 2013, Medline Plus 2012). It stimulates the central nervous system similarly as amphetamines but more mildly. The effects of methylphenidate are also more noticeable on mental activities than in physical movements. It also is used in treating narcolepsy and Attention Deficit Disorder or ADD. Stimulants control these symptoms by changing the amount of natural substances in the brain responsible for the conditions. ut both classes of stimulants are carefully used because of their potential abuse. They calm the patient, reduce their hyperactivity and increase attention span. FDA approved methylphenidate in 1955 (Ogbru, MedlinePlus).

Generic and Trade Names

Generic names -- methylphenidate, Methylphenidylacetate hydrochloride

Trade names -- Concerta, Metadate, Methylin, Ritalin, Adderall

Toxicity and Side Effects

It is to be used with cause on patients with…

BIBLIOGRAPHY

Medline Plus. Methylphenidate. National Library of Medicine: National Institute

Health, 2012. Retrieved on August 24, 2013 from  http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682188.html 

NIDA. Drug Facts. National Institute on Drug Abuse: National Institute of Health,

2009. Retrieved on August 24, 2013 from http://www, drugabuse.gov/publications/drugfacts/stiulant-adhd-medications-methylpheidate-amphetamines

Broken Heart Syndrome

Cardiovascular Case Study

Broken heart syndrome, otherwise called stress or Takotsubo cardiomyopathy (TTC), represents an adverse physiological response to an acute psychological or physical stressor (Derrick, 2009). The death of a loved one or experiencing a physically traumatic event, represent two examples of life stressors that can cause this reversible form of cardiomyopathy. Although effective treatment is available, the seriousness of the condition is such that it explains how a person can literally die of a broken heart.

TTC Demographics

An estimated 1.2 million people suffered from an myocardial infarction (MI) in 2007 and approximately 1% (Derrick, 2009, p. 50) to 2% (Wittstein, 2012, p. 2) of MI events was probably due to TTC. Women are far more susceptible to TTC than men and represent approximately 89% of all cases (Derrick, 2009, p. 50). This gender bias shifts the estimated prevalence of TTC among female MI patients…

References

American Heart Association, American Stroke Association. (2011). Women & cardiovascular disease: Statistical fact sheet 2012 update. Heart.org. Retrieved 4 Feb. 2012 from  http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319576.pdf 

Derrick, Dawn. (2009). The "broken heart syndrome": Understanding Takotsubo cardiomyopathy. Critical Care Nurse, 29, 49-57.

Fitzgerald, Helen. (2000). Helping a grieving parent: Working through Grief. AmericanHospice.org. Retrieved 4 Feb. 2012 from  http://www.americanhospice.org/index.php?option=com_content&task=view&id=84&Itemid=8 

Liao, Joshua. (2011). Takotsubo: Octopus trap. Journal of Medical Humanities. Published ahead of print online Aug. 9. Retrieved 4 Feb. 2012 from http://www.springerlink.com/content/ak0776051x43w701/

Epidemiological considerations anthracis originates in soil in a lot of regions of this world in which we live. Environmental aspects (for example plentiful precipitation subsequent to a phase of water dearth) might improve spore mass in soil, even though the precise impact of such features remains badly understood (Bell, Kozarsky, Stephens, 2002).

The organism by and large subsists in the endospore shape in environment; germination of spores exterior to an animal congregation might take place when the subsequent situations are encountered (Bell, Kozarsky, Stephens, 2002):

elative humidity >95%

Presence of sufficient nutrients

Temperature amid 8°C and 45°C

PH amid 5 and 9 (Bell, Kozarsky, Stephens, 2002)

Endospores are opposed to heat, drying, gamma radiation, ultraviolet light, and various antiseptics. Spores can continue in soil for decades, as exemplified by organic combat researches all through World War II on the Scottish island of Gruinard. All through 1943, as well as 1944,…

References

Bell, D.M., Kozarsky, P.E., Stephens, D.S. (2002). Clinical issues in the Prophylaxis, Diagnosis, and Treatment of Anthrax. Emerging Infectious Diseases, 8(2), 222-225.

Centers for Disease Control and Prevention. (2001). Anthrax Disease Information

Centers for Disease Control and Prevention. (2201). Notice to Readers: Considerations for Distinguishing Influenza-Like Illness from Inhalational Anthrax. Morbidity and Mortality Weekly Report, 50(44), 984-6.

Centers for Disease Control and Prevention. (2201). Notice to Readers: Update: Interim Recommendations for Ant microbial Prophylaxis for Children and Breastfeeding Mothers and Treatment of Children with Anthrax. Morbidity and Mortality Weekly Report, 50(45), 1014-6.

Cialis is the brand name of the drug tadalafil, which is most commonly prescribed for erectile dysfunction. The formula for tadafil is C22H19N3O4. Tadalafil is a phosphodiesterase-5 type (PDE-5) inhibitor; it inhibits the PDE-5 enzyme, which in turn prevents the destruction of cyclic guanosine monophosphate (cGMP). The resulting muscle relaxation increases blood flow to the penis.

Tablets are usually almond-shaped, and come in 2.5, 5, 10, or 20 mg doses. When manufactured by the Indian pharmaceutical company Cipla under the brand name Tadacip, the pills are also almond-shaped and light orange in color (Tadafil, 2016). Generally, doses of 10mg are recommended as a starting dose for complaints of erectile dysfunction. Some patients may respond to doses as low as 5 mg, whereas others may need 20 mg to notice effects. Effects last up to 36 hours, and can start working in about 30 minutes. The drug should not be taken…

References

"Cialis," (n.d.). Rxlist. Retrieved online:  http://www.rxlist.com/cialis-drug.htm 

Cialis.com. Retrieved: https://www.cialis.com/

Cialis vs. Viagra. Retrieved online: http://cialis-vs.-viagra.biz/

"Highlights of Prescribing Information," (2003). Retrieved online:  http://pi.lilly.com/us/cialis-pi.pdf

Prior to Launching Technology Initiatives

Over the past seven years, many healthcare organizations, like OUUCH, have begun to transition from the traditional paper-based systems to EH systems. esearch has shown that over a period of time. EH systems can improve quality of care for patients, provide more accurate information, and overall improve safety issues relating to reducing mistakes with patients. In the exploratory study, "Change factors affecting the transition to an… [EH] system in a private physicians' practice: An exploratory study," Aaron D. Spratt, Social Security Administration and Kevin E. Dickson (2008), Southeast Missouri State University, report that the U.S. health care industry reportedly ranks among the world's leading inefficient information enterprises. Although the system needs major changes, the transition process however, creates a high change in the business aspect of an organization. Spratt and Dickson (2008) explain that for an EH system to be successful, doctors must be involved…

REFERENCES

Amatayakul, M. (2009). EHR vs. EMR: what's in a name? Healthcare Financial

Management. Healthcare Financial Management Association. Retrieved May 13, 2010

from HighBeam Research:  http://www.highbeam.com/doc/1G1-202487730.html 

Bennett, D. (2009). EMR market includes small and large system vendors. Managed Healthcare

However, with large nuclear weapons the majority of the harm is caused by the explosion itself and the harm caused by the radioactivity is peripheral, although obviously still potentially horrific.)

The damage caused by a dirty bomb would be twofold: There would be damage caused by the conventional parts of the bomb (in this case, the det cord) and damage caused by the radioactive elements. A dirty bomb's effects would be greater in terms of the conventional aspects of the weapon, and we are not given enough information in this scenario to determine the amount of energy that will result in an explosion of the detonation cord. There is no single standard for detonating cord, although given that we know that it has come from a mining company we can assume that it is some of the stronger -- or more explosive -- type. We also do not know how…

Being able to merge the resources of a variety of different specialists is one strength of the Memorial Herman approach. In the future, as the interrelationship between the body and the brain, and psychological disorders and overall functioning has become an accepted part of mainstream science: studies such as these will be even more important for research institutes. Memorial Herman is clearly on the cutting-edge of the field in this regard.

Because of its impressive outreach, the hospital is also able to draw upon a wide array of specific populations, as in the case of studies such as the "Evaluation of cardiovascular effects of smoking cessation in HIV-infected patients" (Bell 2009). Few other hospitals would be able to draw from a large amount of HIV-positive patients who were smokers and willing to participate in research studies. The study may prove beneficial to the research subjects as well as to the…

References

About us. (2009). Memorial Hermann. Retrieved November 12, 2009 at  http://www.memorialhermann.org/aboutus/ 

Bell, Tanvir. (2009). Evaluation of cardiovascular effects of smoking cessation in HIV-infected patients. Memorial Herman. Retrieved November 12, 2009 at http://www.memorialhermann.org/locations/texasmedicalcenter/heartandvascularinstitute/content.aspx?id=5772 

Frazier, Lorraine. (2009). Interactions among depressive symptoms and genetic influences on cardiac outcomes. Memorial Herman. Retrieved November 12, 2009

In order to implement these new techniques, an understanding of where handoffs occur is also crucial. Knowing where handoffs are frequent enables the healthcare facility to expect and enable these techniques effectively.

Handoffs as mentioned previously, occur in high traffic units of the health care facility, when specialists are needed, and in large facilities such as hospitals. Handoffs generally occur under these circumstances: shift-to-shift handoff, nursing unit-to-nursing unit handoff, nursing unit to diagnostic area, special settings (operating room, emergency department), discharge and interfacility transfer handoff, and physician-to-physician handoffs. In 2011, stricter national regulations, offered to minimize the continuous-duty hours of first-year resident physicians from 30 to 16 to help decrease incidences of ineffective handoffs. Some argue this will be ineffective, but considering how many residents and interns make mistakes because of their fatigue from long work hours, it seems to help more than hurt.

Ultimately it takes a lot to…

References

Aarts, J., & Nohr, C. (2010). Information Technology in Health Care: Socio-technical Approaches 2010: from Safe Systems to Patient Safety. IOS Press.

Clinical Handover and Patient Safety: Literature Review Report. (2005). Darlinghurst, N.S.W.: The Commission.

Handoff Communications: Toolkit for Implementing the National Patient Safety Goal. (2008). Oak Brook, IL: Joint Commission Resources.

Lippincott Williams & Wilkins (1989). Academic Medicine: Journal of the Association of American Medical Colleges. Philadelphia, Pa: Hanley & Belfus.

ole of Family Physician

It is important for us to understand the role of a family physician before we begin our discussion on the importance of family physicians in any health care system of the community. Many reforms have been made in the health care systems of various communities all over the world. Almost all of these reforms lay their focus on the prevention as well as the treatment of any disease along with the promotion of health and management of conditions that have become a chronic problem for the patients. All of these areas are the center of the family physicians and therefore family medicine has a huge role to play in here.

In this paper, we shall look at the current health care system in Libya and see how the government and other organizations like WHO are playing their role to improve the health care system in the…

References

(2005). Libya country profile. Library of Congress Federal Research Division (April 2005).

(2004). Pfizer Clear Health Communication Initiative. What it Health Literacy? [Online].

(2004). The American Heritage Dictionary of the English Language, Fourth Edition; 2000. [Online].

Kates N. (1997). Psychiatry and family medicine: sharing care. Can J. Psychiatry. Vol. 42:913-14.

Home Visit With Sallie Mae Fisher

Good morning, Sallie Mae, my name is Alexis Jorgenson and I will be your nurse today. I understand you are not feeling well today?

Sallie: Hello Nurse, I am feeling a little better than last time but still finding it hard to cope.

I understand you are having problems with chronic congestive heart failure.

Sallie: This disease is giving me a lot of problems that range from frequent hospitalizations to excessive medications. I just feel sick when I think about the medication and usually feel like avoiding them.

That's sad to hear. I am here to help identify why you are not feeling very well today.

Sallie: Thank you, I really appreciate your help and hope that I'll be feeling much better very soon.

Nurse: Your medical history shows that you have been hospitalized four times in the past 6 months for exacerbation of…

References

Adams, M. (n.d.). How to Find Help Treating a Grief Management Problem. Retrieved December 15, 2015, from  http://www.psychguides.com/guides/how-to-find-help-treating-a-grief-management-problem/ 

Haiken, M. (n.d.). Blood Pressure: 90/50. Retrieved December 15, 2015, from  https://www.caring.com/charts/blood-pressure-90-50 

Orenstein, B.W. & Bass, P.F. (2011, March 30). Bowel Movements: What's Considered Normal? Retrieved December 15, 2015, from  http://www.everydayhealth.com/hs/guide-to-constipation-relief/bowel-movements-whats-normal/

The digestive fluids that are secreted by the stomach glands aimed at breaking down solid food and to kill bacteria in the stomach are referred to as gastric juices. Gastric acid is produced by the gastric parietal cell located on the walls of the stomach. The region where the gastric juices are secreted into the lumen is the most acidic environment in the human body and is known as the secretory canaliculus (Schubert & Peura, 2008). The secretion of the gastric acid into the lumen occurs in response to a variety of messages from the paracrine, hormonal, and neurocrine inputs. Gastrin, produced by the G cells that are located in the pyloric mucosa of the stomach is the primary hormonal stimulation for gastric acid production. There are various inputs that will stimulate the parietal cells in order for them to secrete hydrogen ions that will flow into the gastric lumen,…

Performance Measures for (50,000 call per year) EMS

EMS ORGANIZATIONAL PERFORMANCE MEASUREMENT

That the organization implements additional clinical performance measures, including those to evaluate the quality of the EMS.

That the organization uses survey data to evaluate and analyze customer and employee satisfaction and that a proper feedback and control mechanism is in place to use this data to implement required changes.

This report starts from the premise that Emergency Medical Services will be treated as any other service. As a consequence, this type of service reflects the relationship between the service recipient (in this case the patients) and the service provider (in this case the medium-sized organization being analyzed in this report).

This means that this report will use many of the existing research and business literature and apply business principles such as customer and employee satisfaction in presenting and analyzing a comprehensive set of recommended performance measures for…

Bibliography

1. Balridge National Quality Program (2002). Criteria for performance excellence. Gaithesburg: National Institute for Standards and Technology

2. The Customer Communicator (TCC) (2005). Alexander Communications Group, 28 (1) 2.

3. National Highway Traffic Safety Administration (2009). Emergency Medical Services: Performance Measures, Recommended Attributes and Indicators for System and Service performance.

4. Bruce, J. (2004). Application of EMS Customer Satisfaction Survey Data to Improve Service Delivery at Rialto Fire Department.

Review of History and Physical Findings
The client is a 56-year-old Caucasian female who presents with complaints of fatigue that reportedly began 2 to 3 months prior to her visit. She reports that the fatigue is generalized and constant in duration, and has been progressively worsening since onset. The client reports feeling tired all the time and lacking the energy to do anything‘she could normally do’despite sleeping eight hours per night. No relieving factors were identified, although the client reports exertion as a possible aggravating factor. The client is married, has two grown kids, and works as a full-time office manager in an internal medicine office. She reports missing a day of work two weeks ago because she ‘couldn’t get out of bed’. She denies pain, fever, chills, or recent illnesses, but has gained 5 pounds since the last visit 6 months ago.
The client denies visual changes, ear pain,…

References
FDA (2017). LEVO-T: Highlights of Prescribing Information. Food and Drug Administration. Retrieved from  https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021342s023lbl.pdf 
Lassale, C., Curtis, A., Abete, I., Van der Schouw, Y., Verschuren, M., Lu, Y., & Mesquita, B. (2018). Elements of the Complete Blood Count Associated with Cardiovascular Disease Incidence: Findings from the EPIC-NL Cohort Study. Scientific Reports, 8(1), doi: org/10.1038/s41598-018-21661-x
Samuels, M. H., Kolobova, I., Antosik, M., Niederhausen, M., Purnell, J., & Schuff, K. (2017). Thyroid Function Variation in the Normal Range, Energy Expenditure, and Body Composition in L-T4 Treated Subjects. Journal of Clinical Endocrinology & Metabolism, 102(7), 2533-42.
Soh, S., & Aw, T. (2019). Laboratory Testing in Thyroid Conditions – Pitfalls and Clinical Utility. Annals of Laboratory Medicine, 39(1), 3-14.
Dunphy, L.M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2019). Primary Care: The Art of Science of Advanced Practice Nursing (5th ed.). Philadelphia, PA: F.A Davis Company

Stress

Definition of stress

esearchers define stress as a physical, mental, or emotional response to events that causes bodily or mental tension. Simply put, stress is any outside force or event that has an effect on our body or mind. Acute stress is the most common form of stress. It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. Acute stress is thrilling and exciting in small doses, but too much is exhausting. Acute stress can be episodic or chronic.

Depending on the stressors and the types of changes or events, stress can manifest itself physically, emotionally and/or mentally. Physical stress occurs when the body as a whole starts to suffer as a result of a stressful situation. Symptoms can manifest in a variety of ways and vary in their seriousness. Emotional stress are responses due to stress affecting the mind…

References

AIS (NDI). Stress, definition of stress, stressor, what is stress?, Eustress?" The American institute of stress. Retrieved October10, 2011, from http://www.stress.org/topic-definition-stress.htm

Barr, N. (2008, August 14) What stress does to your body. Marie Claire. Retrieved October 10, 2011, from  http://www.marieclaire.com/health-fitness/news/stress-effects-body 

Mayo Clinic Staff (2010). Stress symptoms: Effects on your body, feelings and behavior. American psychological association's "Stress in America report." Mayo Clinic. Retrieved October 10, 2011, from  http://www.mayoclinic.com/health/stress-symptoms/SR00008_D 

Miller, L.H. & Smith, A.D. (1993). Stress: The different kinds of stress. American psychlolgical association. In The Stress Solution. Retrieved October 10, 2011, from http://www.apa.org/helpcenter/stress-kinds.aspx

eferences

Breggin, Peter, . "Psychostimulants in the Treatment of Children Diagnosed with ADHD: isks and Mechanism of Action. International Journal of isk and Safety in Medicine 12.3 (1999): 3-35.

Hyman, Steven E. "Statement for the ecord on Methylphenidate (italin) for Children with ADHD." Meeting of the Committee before the House Education and the Workforce Subcommittee on Early Childhood, Youth, and Families. Washington, DC: U.S. Dept of Health and Human Services, 2000. 5 November 2005. http://www.hhs.gov/asl/testify/t000516c.html.

National Institute for Mental Health (NIMH). "The Numbers Count: Mental Disorders in America." NIH Publication No. 01-4584. Fact Sheet. Washington, D.C.: NIMH, 2001. 5 November 2005. http://www.nimh.nih.gov/publicat/numbers.cfm#23.

National Institute for Mental Health (NIMH). "Attention Deficit Hyperactivity Disorder." NIH Publication No. 3572. Washington, D.C.: NIMH, 2003. 5 November 2005. http://www.nimh.nih.gov/publicat/adhd.cfm.

O'Meara, Kelly Patricia. "New esearch Indicts italin." Insight on the News 1 Oct. 2001: 22. Questia. 5 Nov. 2005 http://www.questia.com/PM.qst?a=o&d=5000885567.

White, Hazel L., and Baton ouge.…

References

Breggin, Peter, R. "Psychostimulants in the Treatment of Children Diagnosed with ADHD: Risks and Mechanism of Action. International Journal of Risk and Safety in Medicine 12.3 (1999): 3-35.

Hyman, Steven E. "Statement for the Record on Methylphenidate (Ritalin) for Children with ADHD." Meeting of the Committee before the House Education and the Workforce Subcommittee on Early Childhood, Youth, and Families. Washington, DC: U.S. Dept of Health and Human Services, 2000. 5 November 2005.  http://www.hhs.gov/asl/testify/t000516c.html .

National Institute for Mental Health (NIMH). "The Numbers Count: Mental Disorders in America." NIH Publication No. 01-4584. Fact Sheet. Washington, D.C.: NIMH, 2001. 5 November 2005.  http://www.nimh.nih.gov/publicat/numbers.cfm#23 .

National Institute for Mental Health (NIMH). "Attention Deficit Hyperactivity Disorder." NIH Publication No. 3572. Washington, D.C.: NIMH, 2003. 5 November 2005.  http://www.nimh.nih.gov/publicat/adhd.cfm .

Learning Objectives:

In support of the Terminal Objective, several key learning objectives will drive the content and curriculum for nurses undergoing the present training course. Primary among them, the training course is designed to create a standardized set of behaviors amongst nurses that conform with existing and evolving best practices in the perioperative care of CABG patients. This means that course content and design will be geared toward achieving procedural and professional consistency amongst attending nurses where preoperative, intraoperative and postoperative care are concerned.

An additional learning objective is to ensure that outgoing students are informed in the ethical and personal dimensions of the profession. Coronary surgical procedures are inherently serious in nature as are the heart and circulatory conditions that typically require such procedures. Therefore, it is of critical importance that nurses are trained in the proper bedside manner to approach patients, families and extended support systems with potentially…

Works Cited:

Aroesty, J.M. (2010). Patient information: Recovery after coronary artery bypass graft surgery (CABG). Up To Date, 19(2).

Cleveland Clinic (CC). (2011). Diseases and Conditions. my.ClevelandClinic.org.

Kulick, D. & Shiel, W.C. (2011). Coronary Artery Bypass Graft Surgery. MedicineNet.com.

National Heart Lung and Blood Institute (NHLBI). (2010). What is Coronary Artery Bypass Grafting. National Institute of Health.

, 1998). It is hard to know where the boundary stops between psychological and physical illness, since the two are, often intimately combined with one affecting the other.

QOL, as De Vries and Drent (2008) point out is often confounded with state of physical health but actually it reflects one's emotional and psychological welfare. Nonetheless, the two are intimately related in that each affects the other.

Conducting a through review on the subject with key words involving 'Sarcoidosis and health status', Sarcoidosis and quality of life" or Sarcoidosis and fatigue" De Vries and Drent (2008) ended up with 15 studies that they considered relevant to their subject.

Counter-intuitively, they discovered that the greatest challenge on QOL as effected by was the patient's fatigue caused by the disease. Breathlessness, reduced exercise, and impaired working and physical activities were the most frequent reported hindrances. The instrument used was the World Health Organization…

References

American Thoracic Society (1999) Statement on Sarcoidosis, 736-749

The report provides a thorough overview of Sarcoidosis discussing new developments and demonstrating how much in the field remains enigmatic.

Bona, J. et al. (1998) Neurosarcoidosis as a Cause of Refractory Psychosis: A Complicated Case ReportAm J. Psychiatry 155:8, 1100-1107

The report describes Sarcoidosis and gives a case history as example.

She should take drugs for rapid onset of symptoms only when called for but drugs that keep her level as time goes on should be taken consistently (Brasher, 2012).

Question 11

The girl needs to not mow the lawn anymore or otherwise expose herself to situations that can lead to attacks (Brasher, 2012).

2. Chapter 6: COPD

Question 1

The patient should be asked if she is currently smoking, is around someone that is smoking or has a closely-related person (a parent in particular) that does. The patient should be asked if she or anyone in her family has a history of heart issues (due to the ankle swelling combined with the shortness of breath). Should be asked if there have been any notable changes in weight in either direction and whether there is any sputum or other symptoms (Brasher, 2012).

Question 2

The patient should be asked how long…

References

Asthma - PubMed Health. (n.d.). National Center for Biotechnology Information.

Retrieved August 25, 2012, from  http://www.ncbi.nlm.nih.gov/pubmed  health/PMH0001196/

Chronic obstructive pulmonary disease - PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved August 25, 2012, from

Arrhythmias cause irregular hearts beats in ways that can be life-threatening but there are a number of different types of arrhythmias that require different interventions. To determine the facts, this paper reviews the relevant literature to provide the etiology and pathogenesis, prevalence, clinical signs and symptoms, diagnostic pathways and optimal therapeutic approaches for paroxysmal atrial tachycardia, ventricular fibrillation and Brady arrhythmias, followed by a summary of the research and important findings concerning these three disease states in the conclusion.

Paroxysmal Atrial Tachycardia

Etiology & Pathogenesis. This type of arrhythmia can occur in individuals who have normal hearts as well as in people who have structurally abnormal hearts including those with congenital heart disease, especially following surgical repair of valvular or congenital heart disease (Budzikowski & ottman 2015).

Common causes of the arrhythmia, risk factors, definition of rhythm via EKG findings. Paroxysmal Atrial Tachycardia (PAT) is caused by irregular firing of…

References

Brady arrhythmias. Boston Medical Center. [cited 2016]. Available: https://www.boston cardiovascular.org/handler.cfm?event=practice, template&cpid=50108.

Budzikowski, AS, Rottman, JN. Atrial Tachycardia. Medscape: News and Perspectives. [cited 2016]. Available:  http://emedicine.medscape.com/article/151456-overview .

Burke, MM, Laramie, JA. Primary Care of the Older Adult: A Multidisciplinary Approach. St. Louis, MO: Mosby, 2009.

Gialama, F, Prezerakos, P. The Cost Effectiveness of Implantable Cardioverter Defibrillators: A Systematic Review of Economic Evaluations. Applied Health Economics and Health Policy, February 2104, 12(1), 41-45.

Parents can team up with teachers and schools by asking for school conferences where they can address the issue of bullying, (Barreto). The parents can also keep a record of incidents of harassment and the ways in which the school handled these situations. They should also insist on the putting up of a bullying prevention committee if one is not already in place. In order for the committee to be effective, it needs to have representatives from administration, teachers, school mental health teams and parents.

2. Teachers should be encouraged to involve the students in creating rules for the classroom regarding bullying. They should have a serious talk with the bully and explain the unacceptability of the behavior as well as its negative consequences. Reports of bullying should not be left to deal with bullying on their own in the hope that the experience will make them stronger individuals, bullying…

Works cited

Barreto, Steven. Bullying and Harassment Stop When Parents Help Break the Silence. 2005.

23 May, 2010



Batsche, G.M., & Knoff, H.M. "Bullies and their victims: Understanding a pervasive problem in the schools." School Psychology Review, 22.6 (1994): 165-174.

During stage two, if the stress continues, the body adapts to the stressors that it is exposed to. There are changes at different levels take place in order to reduce the effect of the stressor, which indicates they are starving. At this point, thee person might experienced a reduced desire for physical activity to conserve energy, and the absorption of nutrients from food might be maximized (General adaptation syndrome).

The second stage is the body's response to long-term protection. It secretes further hormones that increase blood sugar levels to sustain energy and raise blood pressure. The adrenal cortex produces hormones called corticosteroids for this resistance reaction. Overuse by the body's defense mechanism in this phase eventually leads to disease. If this adaptation phase continues for a prolonged period of time without periods of relaxation and rest to counterbalance the stress response, sufferers become prone to fatigue, concentration lapses, irritability and…

Inhalants refer to the ordinary household products that are sniffed or inhaled by individuals so as to get high. There are many household products that are misused as inhalants. Some of these products include gasoline, hair spray, fabric protector, air conditioner fluid, nail polish remover, and correction fluid, propellants in aerosol, cleaning fluids and cooking spray. These products are mainly bagged, sniffed, snorted so as one to get high. They can be sniffed directly from the containers. In most cases when an individual is under the influence of such inhalants one is likely to engage in anti-social or criminal behavior (Ksir, 2002). This report endeavors to explain the theoretical and empirical literature regarding theories of drug information and addiction.

The intoxicating inhalants that have volatile vapors are ingested through the trachea and nose. However, some inhalants are used for medical reasons as in the case of nitrous oxide. The inhalation…

References

Dick, DM & Bierut, LJ (2006). "The Genetics of Alcohol Dependency." Current Psychiatric Reports 8 (2): 151 -- 7

Ksir, Oakley Ray; Charles (2002). Drugs, society, and human behavior (9th Ed.). Boston

[u.a.]: McGraw-Hil

Morse, RM & Flavin, DK (August 26, 1992). "The definition of alcoholism, The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism." The Journal of the American Medical Association 268 (8): 1012 -- 4

demands of contemporary society and the accelerated pace that contribute to stress in the home, office, or workplace. By sheer economic necessity, organizations and individuals must be ready at all times to glean as much productivity per worker per day as possible. The complexity of the modern workplace combined with the realities of life have consequences -- stress (U.S. Department of Labor, 2010). But thinking of stress as only an inhibiting or negative factor may not always be correct -- in fact, there are numerous positive results of stress that can increase attention to detail, ideation and creativity, and increased output (Linden, 2006).

Stress is clearly an adaptive response to stimuli -- external or internal. It is the body's reaction to events that can be distributing, discomfiting, or threatening. When humans perceive such an event, chemicals are released from the brain that can cause elevated heart rate, greater sensitivity to…

REFERENCES

Carter, R., et al. (2009). The Human Brain Book. New York: Penguin.

Cordon, S., Brown, K., Gibson, P. (2009). The Role of Mindfulness-based Stress

Reduction on Perceived Stress. Journal of Cognitive Psychology.

23 (3): 258-65.