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Chronic Obstructive Pulmonary Disease
Cyanotic & Barrel-Chested: Cyanosis is a discoloration of the lips, nail bed, eyes, and/or palms (Potter, Perry, 1997). During the nursing assessment, the nurse inspects the patient according to the assessment chart, which includes the category of 'color'. Cyanosis is the appearance of a bluish discoloration (Potter, Perry, 1997) effecting the aforementioned parts of the body. The condition of barrel chested appearance is often a sign of emphysema in its later stages (osenow, 2010). The significance of these conditions indicates a circulation problem, certainly affecting the extremities including the phalanges.
Sputum Production, Cough, & Dyspnea: Sputum production as well as the coughing indicates mucus production and the practice of clearing the throat of excessive sputum production (Potter, Perry, 1997) Dyspnea is a clinician's term for hypoxia (Potter, Perry, 1997). Dyspnea is a sign that correlates to the diagnosis of an upper/lower respiratory disorder.
Bronchitis: The symptoms…
Bass, P. Forced Expiratory Volume-What Is Forced Expiratory Volume? 2009 http://asthma.about.com/od/glossary/g/def_fev1.htm
Leader, D. Arterial Blood Gases. Illustrated Guide to Diagnostic Tests. Springhouse Corporation. 1998. http://copd.about.com/od/glossaryofcopdterms/g/abgs.htm
Potter P., Perry AG. Fundamentals of Nursing Concepts, Process, and Practice. Fourth Edition. 1997. Mosby-Year Book, Inc.
Respiratory Assessment. http://www.scribd.com/doc/19239715/Respiratory-Assessment
Chronic Obstructive Pulmonary Disease (COPD)
COPD constitutes a major source of mortality and morbidity across the globe, with a considerable economic effect. New GOLD (Global initiative for chronic Obstructive Lung Disease) guidance modifications refined patient classification for therapy by employing spirometry, exacerbation rate and symptom evaluation combined. Therapy attempts at decreasing both extant disease symptoms and vulnerability to adverse health conditions in the future. On account of their established effectiveness, the class of drugs known as bronchodilators, with their long-lasting effects are considered the backbone of COPD therapy (Tashkin & Ferguson, 2013).
The heterogeneous disease known as COPD may be grouped into a number of diverse "phenotypes". Practicing doctors have, for several years, observed two highly divergent COPD patient subcategories: emphysema patients and chronic bronchitis patients. COPD ought to be accorded orphan status because: 1) it is heterogeneous; 2) Its multiple phenotypes probably represent distinct, fairly uncommon conditions. Long-acting drugs…
Antus, B. (2013). Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review. ISRN Pulmonology, 11.
BMJ. (2016). COPD Follow Up Monitoring. BMJ.
Brashier, B., & Kodgule, R. (2012). Risk Factors and Pathophysiology of Chronic Obstructive Pulmonary Disease (COPD). SUPPLEMENT TO JAPI, 17 - 21.
Cazzola, M. (2015). Introducing COPD Research and Practice. COPD Research and Practice, 1 - 2.
V. COMPONENTS of the PULMONARY REHA PROGRAM
There are several components of the pulmonary rehab program that is inclusive of the following:
Medical evaluation and management;
Program Results or Outcomes;
Oxygen Treatment; and Surgery. (National Heart, Lung, and lood Institute: Disease and Conditions Index, 2007)
VI. PREVENTION of PROGRESSION of COPD
Progression of COPD is, first and foremost, approached through addressing smoking cessation by the individual and this includes refraining from being with those who smoke and being in locations where smokers will be present. Secondly, it is important to keep away from other lung irritants to include: (1) pollution; (2) dust; (3) certain cooking or heating fumes; and (4) the outside air when air quality is rated as 'poor'.
VII. Management and PREVENTION of PROLEMS
Individuals with chronic obstructive pulmonary disease (COPD) are known to have symptoms of the disease that worsen suddenly causing…
Chronic Obstructive Pulmonary Disease (2003) Journal of the American Medical Association Vol. 290 No. 17 5 November 2003. Online available at http://jama.ama-assn.org/cgi/content/full/290/17/2362
COPD: Treating COPD (2006) NIH Senior Health 6 Jan 2006 national Institute on Aging. U.S. National Library of Medicine Online available at http://nihseniorhealth.gove/copd/treatingcopd/02.html.
How Can COPD Be Prevented from Progressing (2007) National Heart Lung and Blood Institute: Disease and Conditions Index. Online available at http://www.nhlbi.nih.gov/health/dci/Diseases/Copd_Prevention.html
How is COPD Treated? (2007) National Heart Lung and Blood Institute: Diseases and Conditions Index. Online available at http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_Treatments.html .
Chronic obstructive pulmonary disease (COPD)
year-old male -- pt known to me -- recently admitted to the ward with Non-STEMI & LVF.
Discharged five days ago.
as found collapsed in his house by his niece. Duration not known.
Could not get up from the floor, no chest pain/SOB. No dysuria/constipation -- ? Incontinence
Pt was discharged with a package of care last week.
Detailed history not available as the pt is confused and not answering any questions.
Rationale To Justify Choice Of The Aspect Of Care
Shortness of breath is an almost universal symptom in cor pulmonale. Incidents of leg edema, atypical chest pain, dyspnea on exertion, exercise-produced peripheral cyanosis, prior respiratory failure, and extreme daytime somnolence are all chronological clues suggestive of the presence of cor pulmonale. Chest pain could be connected to right ventricular ischemia. Cough and complaints of uncomplicated fatigability are common (Ghosh, et al. 1998).…
Abramson, M., et al. 2002. Prevalence of Respiratory Symptoms Related to Chronic Obstructive Pulmonary Disease and Asthma Among Middle Aged and Older Adults. Respirology 7: 325-31.
Bates, D.V. (1989), Respiratory Function in Disease, Philadelphia W.B. Saunders.
Besag, J., York, J., and Mollie, A. (1991), Bayesian Image Restoration With Two Applications in Spatial Statistics, Annals of the Institute of Statistical Mathematics, 43, 1-59.
Brillinger, D.R. (1986), The Natural Variability of Vital Rates and Associated Statistics, Biometrics, 42, 693-734.
Chronic obstructive pulmonary disease (COPD) is actually a family of diseases affecting the respiratory system including chronic bronchitis and emphysema. Primary risk factors include smoking and environmental pollutants. Therefore, most cases of COPD are preventable. According to the Global Initiative for Chronic Obstructive Lung Disease (2011), COPD is the fourth leading cause of death worldwide, and according to the American Lung Association (2015), is the third leading cause of death domestically. The disease is not only preventable, but also curable, particularly when it is detected early.
However, there is no actual cure for COPD. Once COPD has developed, it is irreversible, although symptoms can be managed. Pathophysiology centers on the inflammation or destruction of the airways and the destruction of lung tissues. With emphysema, the walls of air sacs become damaged and lose their shape, affecting the rate and quantity of air exchange in the lungs. Moreover, emphysema destroys…
American Lung Association (2015). Understanding COPD. Retrieved online: http://www.lung.org/lung-disease/copd/about-copd/understanding-copd.html
Global Initiative for Chronic Obstructive Lung Disease (2011). Retrieved online: http://www.goldcopd.org/uploads/users/files/GOLD_Report_2011_Feb21.pdf
HealthyPeople2020 (2015). Respiratory diseases. Retrieved online: http://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases
National Heart, Lung, and Blood Institute (n.d.). What is COPD? Retrieved online: http://www.nhlbi.nih.gov/health/health-topics/topics/copd
Pulmonary Disease and Exercise
Exercise may benefit pulmonary patients in a variety of ways. Pulmonary patients however face many unique challenges to exercising that other disease patients do not.
Pulmonary disease may affect the lungs and in a variety of manners. The condition includes respiratory disorders such as emphysema, chronic bronchitis and pulmonary hypertension. In the article "Comparison of Specific Expiratory, Inspiratory, and Combined Muscle Training Programs in COPD" from Chest Journal, Dr. Weiner and his colleagues explore the idea that weakness within the respiratory muscles may actually contribute to shortness of breathe, which in turn may limit the ability of patients with this disorder to exercise regularly at a significant pace (Weiner, 2003). In a second article, "Comparison of Effects of Strength Endurance Training in Patients with COPD, from the American Journal of Respiratory and Critical care, Francisco Ortega and colleagues examined the effects of different exercise modalities as…
Weiner, Paltiel, MD; Magadle, Rasmi, MD; Beckerman, Marinalla MD., Weiner,
Margalit PhD and Berar-Yanay, Noa, MD. "Comparison of Specific Expiratory, Inspiratory, and Combined Muscle Training Programs in COPD" Chest. 2003;124:1357-1364 Retrieved from, http://www.chestjournal.org/cgi/content/abstract/124/4/1357
Ortega, Francisco. Toral, Javier. Cejudo, Pilar, Villagomez, Rafael. Sanchez, Hildegard.
Castillo, Jose and Montemayor, Teodoro. Comparison of Effects of Strength and Endurance Training in Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care MedicineVol 166. pp. 669-674, 2002. Retrieved from, http://ajrccm.atsjournals.org/cgi/content/abstract/166/5/669
he most common progressive chronic lung situations that would require the rehabilitation include interstitial lung disease, chest wall disease, bronchiectasis, and pre and post thoracic surgery. he fourth category of patients to offered pulmonary rehabilitation is those with recent exacerbation of COPD requiring hospitalization, without the anticipated recovery path, and whose functional baseline has changed significantly ("Service Specification," 2012).
Chronic lung diseases have developed to become one of the most common respiratory illnesses across the country. As the diseases have become one of the major reasons for hospitalizations of patients, they usually affect individuals at the age of 35 years and above despite of the fact that these individuals are usually not diagnosed until they are 50 years and above. he growth and rapid increase of chronic diseases is attributed to the tendency of many people with the disease not to get medical assistance. While the conditions continue…
The most common progressive respiratory disease is the Chronic Obstructive Pulmonary Disease (COPD), which is a name that is also used to refer to a collection of lung diseases ("Introduction," 2012). The other common chronic lung diseases include emphysema, chronic bronchitis, chest wall disease, interstitial lung disease, chronic asthma, and obstructive airways disease. These chronic lung diseases usually involve a combination of three major factors i.e. airway diseases, lung circulation diseases, and lung tissue diseases. As the name suggests, the airway diseases affect the airways or tubes that transport oxygen and other gases to and from the lungs. In contrast, the lung tissues diseases affect the lung tissue structure through inflammation or scarring of the tissue. Lung circulation diseases affect the blood vessels in the lungs through scarring, clotting, or inflammation of these vessels. As a result, these diseases contribute to difficulties of the lungs to receive oxygen and release carbon dioxide. The severity of chronic lung diseases is basically dependent on the combination of these three conditions. However, most of the chronic lung diseases are attributed to the narrowing or blockage of the airways. For instance, emphysema, COPD, and chronic bronchitis are conditions that inhibit the ability of the tubes or airways to carry oxygen and other gases to and from the lungs. Generally, patients with chronic lung diseases such as COPD always have difficulties breathing because of airflow obstruction or narrowing of the airways.
As previously mentioned, these diseases account for a huge number of hospital emergency room visits and hospitalizations, although they are largely preventable. Despite being preventable, these diseases have become some of the major causes of death and key factors in the ever-increasing huge human and economic burden because of the tendency of patients to ignore their symptoms ('Emergency Department Support Fund Application," n.d). The major symptoms of these diseases include rising breathlessness, frequent chest infections, and constant cough with phlegm ("Introduction," 2012). The tendency to ignore these symptoms contributes to the many incidents of recidivism to acute care facilities.
The main cause of chronic lung diseases, especially chronic obstructive pulmonary disease is smoking. An individual enhances the risk of developing these diseases when he/she smokes more and for long periods of time. Smoking results in scarring that increases the risk of chronic lung diseases, through irritating or inflaming the lungs. The inflammation in turn results in permanent lung changes over many years. During this period, the walls of the tubes or airways thicken as more mucus is generated. In addition to making the lungs lose their normal elasticity, the damage or harm to the delicate walls of the air sacs in the lungs results in the development of emphysema. Moreover, the smaller airways or tubes become narrowed or scarred. The combination of these permanent changes to the lungs contributes to symptoms of cough, breathlessness, and phlegm linked to chronic obstructive pulmonary
Causes of Chronic Bronchitis in Workers
This review shows the literature and research available in the issue of respiratory diseases and the various occupations. The review shows that there is a pressing need to evaluate and conduct research in the known areas like coal, cement, and pesticides, but alarmingly agriculture and other industries have also to be included.
It is not only the factories that are hazardous. There are arguments to show that even farming can cause allergies. osenman (2012) in viewing "respiratory hazards that farmers and family members" argues that the grains that can be "contaminated with fungi, bacteria or microbial toxins; pesticides; solvents; gasoline and diesel fuels; and irritant gases such as oxides of nitrogen and ammonia." This may lead to occupational asthma and the allergens in such cases could be grain dust, cow dander, cow urine, egg yolk proteins, alternaria, aspergillus, cladosporium, meal worm, poultry mites, fungi,…
Attfield, Michael D; Hodous, Thomas K. (1992) "Pulmonary Function of U.S. Coal Miners
Related to Dust Exposure Estimates" Am. J. Respir. Crit. Care Med, vol. 145, no. 3, pp: 605-609.
Baumgartner, Kathy B; Samet, Jonathan M; Coultas, David B; Stidley, Christine A; et al.
(1999) "Occupational and Environmental Risk Factors for Idiopathic Pulmonary Fibrosis: A Multicenter Case-Control Study" American Journal of Epidemiology, vol. 152, no. 4, pp: 307-315.
Chronic asthma is considered to be a chronic inflammatory disorder of the bronchial mucosa that results in constriction of airways, bronchial hyper-responsiveness, and variable airflow obstruction that is reversible. Chronic asthma on the cellular level is characterized by an increase in the secretion of mucus and bronchoconstriction stimuli. Chronic asthma can be damaging to the epithelial cells found in the lungs, which can cause the reoccurrence a lot quicker leading to more severe cases of asthma. During the release of an inflammatory response, toxic neuropeptides and eosinophils are released, which can cause direct damage to tissue and this might result in an increased bronchial hyper-responsiveness (Huether & McCance, 2012). Oxygenation is normally compromised due to the restriction of the bronchial airway in chronic asthma. In particular, the arterial blood gas is affected in the patients by hyperventilation, which induces in hypoxemia and results in respiratory alkalosis (Gelb & Nadel, 2015).…
Pathologists are often called 'the doctor's doctor ' -- when other doctors are experiencing an impasse, they go to a pathologist for advice, to provide clarity. As someone who has always enjoyed working as a teacher and preparing teaching materials, I look forward to this role in relation to my fellow physicians.
pon arriving in the nited States to practice medicine, I gained experience in the field of pathology-related research, collecting data about survival rates of patients with colorectal cancer and inflammatory bowel disease. I came to learn how pathology touches all fields of medicine. Even in my work with patients suffering substance abuse and psychiatric problems, I saw how the progression of the addiction created a pathology in terms of the way that the body responded to the patient's negative behaviors. I hope that this residency program will expose me to the laboratory and clinical aspects of the field,…
Upon arriving in the United States to practice medicine, I gained experience in the field of pathology-related research, collecting data about survival rates of patients with colorectal cancer and inflammatory bowel disease. I came to learn how pathology touches all fields of medicine. Even in my work with patients suffering substance abuse and psychiatric problems, I saw how the progression of the addiction created a pathology in terms of the way that the body responded to the patient's negative behaviors. I hope that this residency program will expose me to the laboratory and clinical aspects of the field, and give me the ability to learn from -- and perhaps to teach -- others who are grappling with issues spanning from cancer to nephrology to infertility to lifestyle-related illnesses.
From birth to death, I have seen the many varied states the human body can take in health and illness. My desire to engage in a pathology rotation is based upon these past, formative experiences and my desire to place this diversity within the uniquely helpful paradigms particular the discipline. By the end of the residency I know I shall not have realized my goal of becoming a 'doctor's doctor' but I am eager to enter upon the path and begin this lifelong journey.
J. Carlos Manivel, "Choosing pathology as a specialty," the University of Minnesota, May 2, 2010, [August 21, 2010] http://residency.pathology.umn.edu/
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).
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
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).
The patient should be asked how long…
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
Outcomes to be Assessed:
The primary objective is to see that subjects of the program cease smoking and remain abstinent from tobacco use. This will be the primary outcome to be assessed therefore. Individuals in both the experiment and control groups would be consulted at the six-month juncture and the one year point in order to determine how many among them have remained abstinent from tobacco use in that duration and up to that point.
Other outcomes to be assessed would be long-term health factors relating to the use of tobacco. According to statistics compiled and sponsored by the T.J. Samson Community Hospital in Glasgow, Kentucky and most recently updated in the spring of 2006, habitual smokers of cigarettes are "fourteen times as likely to die of lung cancer" and twice as susceptible to fatality by heart disease. (T.J.S.C.H, 1) This means, according to the Community Hospital, that…
American Heart Association (AHA). (2009). Smoking Cessation. Americanheart.org.
Bickman, L. & Rog, D.J. (2009). Randomized Controlled Trials for Evaluation and Planning. The Sage Handbook of Applied Social Research Methods.
Euromonitor International (EI). (2009). Tobacco in Costa Rica. Euromonitor.com
Fiore, M.C.; Novotny, T.E.; Pierce, J.P.; Giovino, G.A.; Hatziandreu, E.J.; Newcomb, P.A.; Surawicz, T.S. & Davis, R.M. (1990). Methods Used to Quit Smoking in the United States. The Journal of the American Medical Association, 263(20), 2760-2765.
acial and Ethnic Approaches to Community Health (EACH 2010 Program)
The health objectives for the United States for the 21st century have been described in The Federal Initiative to Eliminate acial and Ethnic Health Disparities and Healthy People 2010. The national interest in the areas of racial and ethnic disparities has been renewed with the public health initiatives with the leadership for the discussion being taken by the Center for Disease Control and Prevention. The overall health of the nation has improved a lot, but the members of the minority groups in the ethnic and racial areas have not been benefited. This includes the African-Americans, Alaska Natives, American Indians, Asian-Americans, Hispanic-Americans and Pacific Islanders.
This segment of our population is more likely to have poor health and premature deaths than the white Americans. During 1992 to 1998, the deaths from breast cancer have come down noticeably, but there are more…
Author Unknown) (n.d) Chronic Diseases, Risk Factors, and Preventive Services, Alabama. Retrieved at http://www.4woman.gov/owh/reg/4/overview.htm. Accessed on 15/10/2003
Author Unknown) (n.d) Health Disparities and Non-insulin Type 2 Diabetes. Retrieved at http://www.medicalnewsservice.com . Accessed on 15/10/2003
Author Unknown) (n.d) HHS Awards more than 65 Million to eliminate health disparities. Retrieved at http://apps.nccd.cdc.gov/BurdenBook/DeathCause.asp?state=alAccessed on 15/10/2003
Author Unknown) (n.d) Overview of Region lV. Retrieved at http://www.cdc.gov/nccdphp/exemplary/racial.htm . Accessed on 15/10/2003
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…
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.
The focus of the article is upon the unique constitution and needs of the elderly, not upon herpes zoster or influenza as a national phenomenon particular to the United States. However, all of the studies it cites are based in the United States, and SV has been primarily studied as a phenomenon occurring in the U.S. The prevalence of nursing homes in the United States might also make the article more relevant to U.S. practitioners, and the regulatory and drug treatments it discusses are particular to North American, such as the FDA.
Supporting evidence: What scientific evidence does the author(s) present to support his or her claims?
The article's most conclusive evidence is found in its treatment of influenza. It notes that in the 40% to 60% of elderly patients in whom the influenza vaccine produces the desired immunity, an effective immune response can be mounted within 10 to 14…
Bader, Mazen & David S. McKinsey. (2005, Nov). "Viral infections in the elderly."
Postgraduate Medicine. 118.5: 45-54
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,…
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
T for Decision Makers in espiratory Care
X for COPD
Craig osebrock, MD, and James Donohue, MD
T for Decision Makers in espiratory Care
Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory-linked condition associated with airflow limitations to the lung tissue of a patient. Numerous disease states can be linked to the condition including asthma, bronchitis, emphysema and triggers associated with the presence of inflammatory inhalants. Epidemiologically, the strongest causative factor in COPD globally is cigarette smoke (Lopez, 2006). The authors present the prescription pharmacological factors associated with COPD treatment focusing on clinical pharmacology, clinical data and meta-analysis data to demonstrate treatment options and effectiveness. The primary recommendation for COPD management is cessation of smoking and avoidance of tobacco and nuisance particles. Following a discussion of smoking cessation, the authors discuss the types and use of pharmacotherapy in treating COPD.
Table 1 within the publication describes the recommendations for managing…
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, eds. (2006) Global Burden of Disease and Risk Factors. New York: Oxford University Press; Washington, DC: The World Bank.
RT: For Decision Makers in Respiratory Care - May 2008
RX for COPD
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).
Immunotherapists can provide sensitive and accurate cancer diagnostic tools for the successful treatment of the disease and to stop it well in its tracks (cancerresearch.org, 2009). The outward advantages of immunotherapy are as follows: certain drugs have fewer side effects and offer patients a higher quality of life, bolstered anti-cancer effectiveness and rates of survival, benefits are often reaped quickly for the patient (cisncancer.org). The disadvantages are as follows: some varieties of this treatment have serious side effects, are very expensive and occasionally offer just a short-term efficacy (cisncancer.org)
5. An overexpression of proto-oncogenes can cause cancer as mutated forms of these genes can promote unrestrained cell proliferation: "oncogenes actively promote proliferation (analogous to the gas pedal of the cell cycle). Mutations that convert proto-oncogenes to oncogenes typically increase the activity" (Hyland). An underexpression of tumor suppressor genes can also put an individual in a precarious situation. Tumor suppressor genes…
Cancer.gov. (n.d.). Understanding Cancer Series. Retrieved from Cancer.gov: http://www.cancer.gov/cancertopics/understandingcancer/cancergenomics/AllPages
Cancer.gov/topics. (n.d.). Tumor Markers. Retrieved from Cancer.gov: http://www.cancer.gov/cancertopics/factsheet/detection/tumor-markers
Cancer.org. (n.d.). Tumor Markers. Retrieved from Cancer.org: http://www.cancer.org/Treatment/UnderstandingYourDiagnosis/ExamsandTestDescriptions/TumorMarkers/tumor-markers-common-ca-and-t-m
Cancerresearch.org. (n.d.). Cancer and the Immune System: Advantages of Cancer Immunotherapy. Retrieved from Cancerresearch.org: http://www.cancerresearch.org/resources/cancer-immune-system/cancer-immunotherapy-advantages.html
I chose this topic because the H1N1 virus and the swine flu have taken over the news. The Ohio Department of Health is heavily committed in getting the word out. "During the week of October 18-24, 2009, influenza activity continued to increase in the United States as reported in FluView. Flu activity is now widespread in 48 states. Nationally, visits to doctors for influenza-like-illness continue to increase steeply and are now higher than what is seen at the peak of many regular flu seasons. In addition, flu-related hospitalizations and deaths continue to go up nation-wide and are above what is expected for this time of year." (ODH).
The story is both a local and national headline. The television news report '60 Minutes' lead off this week's show with a serious discussion about all aspects of the new viral spread of the H1N1 virus and issues regarding the production process…
American Society for Microbiology and (Corporate Author) Patrick R. Murray. (2003). Manual of Clinical Microbiology (Manual of Clinical Microbiology). 8th ed. American Society Microbiology.
CDC. (2009). H1N1. Retrieved on November 1, 2009, from Center For Disease Control web site at http://www.cdc.gov/h1n1flu/sick.htm .
Flu.Gov. (2009). Vaccination. Retrieved on November 1, 2009, from Department of Health web site at http://www.flu.gov/individualfamily/vaccination/index.html .
ODH. (2009). Ohio.Gov. Retrieved on November 1, 2009, from Department of Health web site at http://www.odh.ohio.gov/landing/phs_emergency/swineflu.aspx .
The success was remarkable, according to the researchers: Even muscles that had already lost half of its mass, recovered visible. (Leppanen et al. p5549-65) At the same time, the mice survived for several weeks longer than their untreated counterparts and also developed a healthy appetite again. (Mantovani, p296) The new study is therefore interesting in two respects: First, it demonstrates that the muscle loss at least in animal models in fact, affects the chances of survival, and secondly, it shows a way, may be how to prevent this degradation, and even reversed. (Bruera et al. p857)
Muscle atrophy is a medical term that refers to the decrease in the size of skeletal muscle, losing muscle strength because of the strength of muscle is related to its mass. (Burnfoot, p323-34)
All changes in cell morphological character may affect isolated cells or groups of them, therefore the modification of a…
* The effects on normal aging and metabolism is that after the age of forty, metabolism usually decreases by about 5% every ten years. That does not mean that metabolism cannot be controlled to some extent; it can. Metabolism is loosely defined as the chemical workings within our bodies that help us to maintain a certain level of energy use, calorie burning and general energy (even at rest). As we age, our metabolism rate slows down, meaning that we burn less calories and the ones we do burn are burned at a slower rate. It also means that we may have less energy and our overall health slows as well.
* As individuals grow older their muscle mass is less likely to maintain its composition. Bill Sonnemaker, the 2007 IDEA Health and Fitness Personal Trainer of the year states that building muscle mass at any age provides a number of…
American College of Sports Medicine (1995) Guidelines for Exercise Testing and Prescription, 5th Ed. Baltimore: Williams and Wilkins, pp. 1-373
American Diabetes Association (2011) Hyperglycemia, accessed on May 5, 2011 at http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html
Van Dusen, A. (2011) Tips to build your muscle mass at any age, accessed on May 1, 2011 at: http://www.msnbc.msn.com/id/20515088/ns/health-forbescom/
Structure and Function of the Respiratory System
Forty-five-year-old Brad has, ever since the age of 20, been working in the mines in the post of coal cutter. He is happy with his job as he earns a good wage and his father also worked in the very same mine. Akin to several co-workers of his, he suffers from chronic cough. However, Brad has neglected going for yearly health checks as is required for mine workers owing to his fear of being diagnosed with “black lung” (i.e., coal worker pneumoconiosis). This ailment results in fibrosis, lasting dilation of the small airways, and reduced diffusing capability. At more advanced stages of the disease, alveoli, airways and pulmonary capillaries get destroyed.
Chronic obstructive pulmonary disease (COPD)
COPD has been described as a persistent inflammatory lung ailment which obstructs flow of air from the patient’s lungs. Disease symptoms include difficulties in breathing, wheezing,…
M.K., a 45-year-old female who has a history of Type II diabetes mellitus and primary hypertension. In addition to this, M.K. is overweight and persists with a poor diet. The patient has also been smoking for the past 22 years, and has recently been diagnosed with chronic bronchitis. Current symptoms include chronic cough, which tends to be more severe in the mornings and productive with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increase urination at night. The patient is currently on several medications including Lotensin and Lasix for the hypertension, along with Glucophage for the Type II diabetes mellitus. From an analysis of M.K.'s lab results, this report will offer clinical findings and treatment recommendations, as well as suggestions for what other conditions M.K. may be at risk for given her health history, lifestyle, and lab results as follows:
158/98 mm Hg
American Heart Association (2015). Types of heart failure. Retrieved online: http://www.heart.org/HEARTORG/Conditions/Heartfailure/Aboutheartfailure/Types-of-Heart-Failure_UCM_306323_Article.jsp#.WEy-h6IrKRs
CDC (2016). High blood pressure facts. Retrieved online: http://www.cdc.gov/bloodpressure/facts.htm
Cheung, M.M. & Li, C. (2012). Diabetes and Hypertension: Is There a Common Metabolic Pathway? Curr Atheroscler Rep. 2012 Apr; 14(2): 160 -- 166.
Elliot, W.J. (2003). The economic impact of hypertension. J Clin Hypertens (Greenwich). 2003 May-Jun;5(3 Suppl 2):3-13.
Echo Valley Council
Case eport: Mr. William Doe
Director, Community Options Program
Proposed Interventions and Treatment Plan for Mr. William Doe
Like other developed Western nations, the elderly in Australia are confronted with numerous challenges to living independently as they grow older, including coping with age-related diseases processes such as dementia and obstructive airways disease as well as adjusting to the loss of a spouse. This case report provides a discussion concerning the application of the overarching and practice functions of the case management model described within the organisational and community contexts. A reflective discussion concerning the proposed approach to practice that focuses on decisions and reasons for practice, the effectiveness of the proposed practice and alternative approaches, skills or techniques that may be required to provide appropriate levels of care for Mr. William Doe who is described further below.
eview and Discussion
Overview of Client: "Mr. William…
Calver, J., Holman, C.D. & Lewin, G. (2004, January 1). A preliminary casemix classification system for home and community care clients in Western Australia. Australian Health
Review, 27(2), 27-33.
Cameron, M., Chahine, N. & Selig, S. (2008, August). A pilot program of physical activity promotion among clients receiving home and community care. Australian Health Review,
This particular aspect is what most medical trainers miss when dealing with interns or newly appointed nurses. They found that oxygen use, if below the necessary requirement can be damaging, so can its overuse. In another study, it has been found that using oxygen below the prescribed level can instigate damage in the organs, respiratory structures and can be especially damaging for patients who have chronic obstructive pulmonary disease (Danchin et al., 2009). Hence, the training and instructions that are given must follow be thorough enough to let the health caretakers realize that the monitoring is not merely a game of reading and recording, but it can have serious repercussions if handled carelessly.
Some of the common mistakes, which can be avoided through proper and accurate transference of instructions and training, occur in different medical circumstances. Sometimes nurses tend to miss the monitoring deadline. For instance, if a patient is…
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge…
Respiratory Issues Complicated by Economic Disadvantage
Socio-economic status, commonly referred to as SES can be describes as the economic or social standing of an individual, and is a measure of the person’s economic or social position in a social group. SES is a composition of different measures such as education, earnings, location of housing or job. According to studies, a lower socio-economic status can be related to unequal access to healthcare in several illnesses. There exists emerging data and information on respiratory diseases such as asthma, COPD, pulmonary hypertension, cystic fibrosis and other pulmonary ailments which suggest a similar observation also noticed in other chronic ailments (Sahni, Talwar, Khanijo & Talwar, 2017).
Asthma is a chronic inflammatory illness that presents permanent condition with varying severity levels all through the life of the affected persons. It affects individuals of all ages and presents its highest frequency in childhood. Latest data gathered…
Developmental perspective was the concept that the nursing students participating in this study were typically younger than they patients they were caring for. This made it difficult for them to ask the "older" patient questions about a lifestyle they had been practicing for many years.
Environmental constraints were noted that prevented the participants in the study from fully implementing best practice guidelines. The primary of which was time. They noted that because of other duties and paper keeping requirements, they had little time to properly present the best practice guidelines. Some noted that they had little time to do expected things such as breathing, much less introduce the patient properly to best practice guidelines.
During their third year of training the nurses were introduced to a comprehensive program concerning cigarettes and cessation programs. In addition they had already been taught more efficient time management training. With these new tools they…
10) Sanders, D., Fowler, G., Mant, D., Fuller, a., Jones, L., & Marziller, j.
Randomized controlled trial of anti-smoking advice by nurses in General practice. Journal of the Royal College of General
Practitioners, 1989, 39, pp 273-276.
Benchmark-esearch Critique and PICOT statement
This article is a research critique on the paper titled 'Home Telehealth for Patients with Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis' by J. Franek. The research paper under review was published by the Ontario Health Technology Assessment Series.
Although there isn't a direct statement that refers to Problem statement, there is a title that highlights the "Objective of the Analysis." There is an excerpt of the objectives below. The discussion in the objective statement is only centred on the evaluation steps. There is evidence in the literature that the effects of COPD were openly revealed as being core elements of the problem statement in the first place.
"For patients experiencing multiple comorbidities, it is essential to observe routine self-management support. Such support consists of the necessary education to enlighten parents to pick out the symptoms in good time. They will consequently manage their…
Bernocchi, P., Scalveni, S., Galli, T., Volterani, M., & Vitacca, M. (2016). A multidisciplinary telehealth program in patients with combined chronic obstructive pulmonary disease and chronic heart failure: study protocol for a randomized controlled trial. Trials.
Brown, J. (2014). Improving care for COPD. North East Quality Observatory System.
Irzarry, R., Peng, R., & Leek, J. (2013, August 28). Evidence-based Data Analysis: Treading a New Path for Reproducible Research. Retrieved from Simply Statistics: http://simplystatistics.org/2013/08/28/evidence-based-data-analysis-treading-a-new-path-for-reproducible-research-part-2/
Riva, J., Malik, K., Burnie, S., Endicott, A., & Busse, J. (2012). What is your research question? An introduction to the PICOT format for clinicians. Journal of the Canadian Chiropractic Association, 167-171.
The study will also be important to those in the future, because scientists have not yet found ways to cure these chronic illnesses or correct some of these problems that are seen today, and therefore it stands to reason that there will be more people in the future who will have to face the same problems as those with chronic illnesses and traumatic injuries today.
Scope of the Study
The scope of the study is relatively large, simply because there has been a great deal written about chronic illness and injuries from the perspective of the physician and from the perspective of the patient. Both sides are important, although the focus here will remain largely on the patient perspective. Because there are so many people today that suffer from a chronic illness or traumatic injury, much study has been done about these individuals. Despite these studies, however, not a lot…
Anderson, B.L. (2002). Biobehavioral Outcomes Following Psychological Interventions for Cancer Patients. Journal of Counsulting and Clinical Psychology, 70(3), 590-610.
Brannon, L., & Fiest, J. (2004). Health Psychology: Vol.. An Introduction to Behavior and Health (Fifth ed.) Belmont CA: Thompson/Wadsworth.
DiMatteo, M. (2004). Social Support and Patient Adherence to Medical treatment: A Meta- analysis. Health Psychology, 23(2), 207-218.
Eitel, P., Hatchett, L., Friend, R., Griffin, K.W., & Wadhwa, N.K. (1995). Burden of Self-Care in Seriously Ill Patients Impact on Adjustment. Health Psychology, 14(5), 457-463.
Innovative Nursing Care Delivery Models a.This website detailed profiles 24 successful innovative nursing care delivery models. These profiles developed part a research project conducted Health Workforce Solutions LLC (HWS) funded obert Wood Johnson Foundation (WJF).
Innovative nursing care model: The Care Transitions Intervention
Innovative nursing care model
I chose the Care Transitions Intervention Model on which to focus because of the increasing importance of geriatric care in the field of nursing. Although my organization serves the needs of persons of all ages, elderly patients are an increasingly large proportion of the patient base. The Model stresses the need for the empowerment and self-care even of patients with high-risk conditions. The Care Transitions Intervention Model allows elderly patients the maximum amount of mobility and autonomy possible given the limits of the patient's condition and enables them to stay in a home setting as long as possible. As its name suggests, the…
Care Transitions Intervention. (2013). Innovative Care Models. Retrieved:
Kurt Lewin Change Model. (2013). Change Management Coach. Retrieved:
2008).. This points to the ethical responsibility of nurse educators -- it is not enough to treat the disease, bit one must treat the patient.
Failure to provide the proper level of education to a patient is certainly one way to fail them both ethically and medically, bit the opposite can also be true. That is, it is possible to provide too much care -- what is deemed "medically futile care" -- and this also raises very serious ethical issues in the realm of respiratory illnesses (Sibbald et al. 2007). This particular stuffy found that insufficient communication among the medical team was one of the primary causes for prolonging futile care, which often means increasing and/or prolonging a patient's discomfort without any reasonable expectation of an improvement in their condition (Sibbald et al. 2007).
The ethical choice here, of course, is to end care (with the consent of the patient…
Efraimsson, E.; Hillverik, C. & Ehrenberg, A. (2008). "Effects of COPD self-care management education at a nurse-led primary health care clinic." Scandinavian journal of caring sciences, 22(2), 178-85.
Selecky, P.; Eliasson, A.; Hall, R.; Schneider, R.; Varkey, B. & McCaffree, D. (2005). "Palliative and end-of-life care for patients with cardiopulmonary diseases." Chest 128(5), pp. 3599-610.
shiao, J.; Koh, D.; Lo, L.; Lim, M. & Guo, Y. (2007). "Factors predicting nurses' consideration of leaving their job during the SARS outbreak." Nursing Ethics, 14(1), pp. 5-17.
Sibbald, R.; Downar, J. & Hawryluck, L. (2007). "Perceptions of 'futile care' among caregivers in intensive care units." Canadian medial association journal, 177(10), pp. 1201-8.
Cigarette smoking is the major cause of cancers of the lung, mouth, larynx, esophagus, and pharynx. In addition, cigarette smoking is a contributing cause of cancers of the stomach, colon, rectum, bladder, pancreas, uterine cervix, and kidney. Finally, cigarette smoking is a contributing factor in some leukemias. Currently, cigarette smoking is responsible for approximately 180,000 cancer deaths every year. However, quitting smoking immediately can reduce the risk of cancer. Ten years after quitting smoking, an ex-smoker's risk of lung cancer is about half that of a current smokers. Furthermore, quitting smoking reduces the risk of developing cancers of the mouth, esophagus, throat, bladder, cervix, and pancreas within a ten-year period.
Finally, cigarette smoking increases the risk of heart disease. Heart disease is the number one cause of death in America, and smoking cigarettes is the number one risk factor for heart disease. Smoking is the main cause of sudden heart…
If left untreated it may lead to tetany, seizures and decreased mental status. It also decreases coronary blood flow and predisposes persons to refractory arrhythmias. This condition may also cause hypoventilation, leading to hypoxemia and impair weaning from mechanical ventilation. This is also associated with hypokalemia and may precipitate hepatic encephalopathy in susceptible patients.
Third simple acid-base disorder is respiratory acidosis. This is a clinical disturbance due to alveolar hypoventilation. The production of carbon dioxide increases and there is a failure of ventilation, which increases the partial arterial pressure of carbon dioxide. This in turn decreases the HCO3-/PaCO2 and decreases pH. This condition can either be acute or chronic. Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs, whereas, chronic respiratory acidosis may be secondary to many disorders, including COPD. This disorder can be manifested depending on the severity and on the rate of development of hypercapnia. Patients…
Jackie a Hayes, MD, FCCP, Respiratory Acidosis. E-medicine. 2005. ( http://www.emedicine.com/med/TOPIC2008.htm )
Sameer Yaseen, MD, Metabolic Alkalosis. E-medicine. 2007. ( http://www.emedicine.com/med/TOPIC1459.htm )
Karen L. Stavile, MD, Metabolic Acidosis. E-medicine. 2005. ( http://www.emedicine.com/emerg/topic312.htm )
Working With the Aging
Ladies and gentlemen, I stand here before you at a time in which the health care of older Americans has become a critical issue. Or should I say issues? We have more people needing more and more specialized care -- this is critical. We have fewer and fewer people being asked to do more and more -- that is critical. Current healthcare policy, especially for the aging, seems inadequate to address the challenges of what lies ahead. The situation seems very bleak at times. All signs seem to show that it will get bleaker. Well, I am here to tell you that I am the weatherman. I have weathered this storm with you. And I can tell you that the forecast looks good, if we can just keep our eyes on what is important and understand what tools we have to get through this, and overcome…
Vectura Group PLC is a product development business based in the UK, focusing on the advance of pharmaceutical therapies for the treatment of airways illnesses or airways-related illnesses. The market for such pharmaceutical therapies (inhaled therapies) is growing as it encompasses both COPD (chronic obstructive pulmonary disease) and asthma and is projected to be worth globally, $44 billion. With eight products marketed through partners via increasing international royalty streams as well as a portfolio of drugs currently in clinical development, Vectura has positioned themselves to gain a large market share ($25 billion) in the near future. In addition to clinical development, the company has also licensed some of their drugs to major pharmaceutical companies like Sandoz, UCB, Baxter, Novartis, Ablynx, Janssen Biotech, GlaxoSmithKline, and Tianjin KingYork Group Company.
The company's turnover (m) is 58.0 with a market cap (m) of 718.43. Founded in 1999 and headquartered in Chippenham, UK, it…
Klein, M. and Shambaugh, J. (2010). Exchange rate regimes in the modern era. Cambridge, Mass.: MIT Press.
Markets.ft.com. (2016). Vectura Group PLC, VEC:LSE forecasts - FT.com. [online] Available at: http://markets.ft.com/research/Markets/Tearsheets/Forecasts?s=vec:lse [Accessed 10 Apr. 2016].
Mossialos, E., Mrazek, M. and Walley, T. (2004). Regulating pharmaceuticals in Europe. Maidenhead: Open University Press.
Pilbeam, K. (2013). International finance. Palgrave Macmillan.
At any rate, the identity of the subjects may not be significant. hat will be needed are basic demographic information (such as age, level of family income etc.), and the direct answers to the survey questions.
A second ethical consideration is the use of other research paper or reports as references. But this can be easily solved by citing all the references that I will be using though a credible citation style. This then shows that the research abides with the copyright law of those published journals, articles and/or reports.
Summary of the reviewed literature will serve as one major factor for the conclusion. This will provide amble information regarding the subject matter. From the said literature review, statistics and other vital information regarding parent smokers and children smokers will be revealed. This information is not limited from one country or area alone, because for sure, the epidemiology and…
Smoking Statistics. March 1999. http://unr.edu/homepage/shubinsk/whosmok1.html . June 4, 2004.
What Smoking Does to Your Body? http://www.click2quit.co.uk/why_quit/WQ01i.aspJune 4, 2004.
A Solution Refinement for Individual Smoking Cessation
Cigarette-smoking, tobacco addiction and nicotine dependency are widespread and permeating public health concerns. Indeed, the combination of the high rate of addiction to tobacco products and the clear empirical relationship between these products and a number of critical negative and even fatal health outcomes qualifies this is a substantial problem requiring a direct solution. According to the National Cancer Institute (NCI), "smoking is a leading cause of cancer and death from cancer. It causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix, as well as acute myeloid leukemia. Smoking also causes heart disease, stroke, aortic aneurysm (a balloon-like bulge in an artery in the chest), chronic obstructive pulmonary disease (COPD) (chronic bronchitis and emphysema), asthma, hip fractures, and cataracts." (NCI, p.1)
This constitutes a very compelling motive for pursuing resolution of the problem…
Centers for Disease Control (CDC). (2011). Smoking Cessation. CDC.gov.
CDC Online Newsroom. (2011). New study shows smokers underutilize proven treatment and services for quitting. CDC.gov.
Jaslow, R (2011). Great American Smokeout spotlights smoking cessation: What works best? CBS News.
National Cancer Institute (NCI). (2011). Harms of Smoking and Health Benefits of Quitting. Cancer.gov.
management of fatigue in patients on peritoneal dialysis and respond to the following critique questions. Do not provide simply yes or no answers to the questions. Provide examples to support your responses. Submit the assignment through the assignment link in Moodle
Identify the study design. Identify the specific type of quasi-experimental design used in the study.
The quasi-experimental design of this research was to implement exercise interventions within a patient population undergoing continuous ambulatory peritoneal dialysis. There was no random sampling because of the very small population that met the inclusion criteria. The independent variable was the level of exercise, while the dependent variable was the reported measures of fatigue experienced by the participants. These measurements were then statistically analyzed using
For the specific design, what are the threats to internal validity? What are the threats to external validity?
There were threats to validity based on the individuals who participated…
tatistics regarding bed availability are indeed provided, but perhaps the public could benefit from more information about how the collaboration actually takes place.
Another area that could be addressed is the county's educational facilities. Currently it seems that many of the health indicators are focused on cure rather than prevention. Although immunization pracitces are mentioned, education regarding healthy living is a pertinent part of disease prevention. I would therefore like to see this added to the health indicators.
In conclusion, I find the indicators that are present comprehensive and sufficient, but it is important to educate the public regarding strategies implemented on their behalf, as well as regarding individual practices for optimal disease prevention and cure.
Georgia Division of Public Health. (2005). Health Data & Information. http://health.state.ga.us/healthdata/index.asp
Gwinnet County Health Department. (2001). Gwinnet Community Health tatus Report: Working Together for a Healthier Community. http://health.state.ga.us/pdfs/regional/gwinnethealthstatus.01.pdf
Georgia Division of Public Health. (2005). Health Data & Information. http://health.state.ga.us/healthdata/index.asp
Gwinnet County Health Department. (2001). Gwinnet Community Health Status Report: Working Together for a Healthier Community. http://health.state.ga.us/pdfs/regional/gwinnethealthstatus.01.pdf
The author of this report is put in a case study situation where a patient is aging and encountering some health issues. The patient is grumbling that her immediate family has not had the health problems that she has had. Those health problems include a heart attack within the last week, diabetes, chronic obstructive pulmonary disease, rheumatoid arthritis and osteoporosis. She is doing this grumbling while her hygiene is being attended. For the purposes of this story, it is the author of this report that is providing the hygiene and thus must give answers to these grumblings based on the perspective of an informed caregiver. The author is also charged with including the biologic aging theory in the overall answer and the patient's overall care plan. While genetics is indeed a major precursor for many major health issues, it is far from being the only one and this patient…
Jin, K. (2010). Modern Biological Theories of Aging. Aging And Disease, 1(2), 72. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995895/
Worcester, A. (2015). Social Gerontology: The Biology of Aging. Trinity.edu. Retrieved 28 September 2015, from http://www.trinity.edu/mkearl/ger-biol.html
While global warming is still hotly debated global pollution is already a fact. An environmentally sustainable development plan is the need of the hour.
1) University of East Anglia (2009, November 17). 'Fossil fuel carbon dioxide emissions up by 29% since 2000.' ScienceDaily. Retrieved December 9, 2009, from http://www.sciencedaily.com/releases/2009/11/091117133504.htm
2) NGC, 'Acid Rain', retrieved Dec 9th 2009, from,, http://environment.nationalgeographic.com/environment/global-warming/acid-rain-overview.html
3) WHO, (2006), 'Indoor air pollution. 4000 deaths a day must no longer be ignored', retrieved Dec 9th 2009, from, http://www.who.int/bulletin/volumes/84/7/editorial30706html/en/index.html
4) lacksmith Institute, (2009) 'Pollution Facts, Retrieved December 9, 2009, from, 'http://www.worstpolluted.org/pollution-facts-2009.html
5) U.S. PIRG Education Fund, (Jan 2005), 'Pollution on the Rise: Local Trends in Power Plant Pollution', retrieved Dec 9th 2009, from http://cdn.publicinterestnetwork.org/assets/0kExFsxeEE6g_YLDhOxTAA/Pollution_On_The_Rise.pdf
6) NASA, 'NASA Satellite Measure Pollution from East Asia to North America', retrieved Dec 9th 2009, from, http://www.nasa.gov/topics/earth/features/pollution_measure.html
7) EEA Report, (2008) 'Greenhouse Gas Emission Trends and Production in Europe 2008', retrieved Dec 9th…
1) University of East Anglia (2009, November 17). 'Fossil fuel carbon dioxide emissions up by 29% since 2000.' ScienceDaily. Retrieved December 9, 2009, from http://www.sciencedaily.com/releases/2009/11/091117133504.htm
2) NGC, 'Acid Rain', retrieved Dec 9th 2009, from,, http://environment.nationalgeographic.com/environment/global-warming/acid-rain-overview.html
3) WHO, (2006), 'Indoor air pollution. 4000 deaths a day must no longer be ignored', retrieved Dec 9th 2009, from, http://www.who.int/bulletin/volumes/84/7/editorial30706html/en/index.html
4) Blacksmith Institute, (2009) 'Pollution Facts, Retrieved December 9, 2009, from, ' http://www.worstpolluted.org/pollution-facts-2009.html
Cross-Border Acquisitions Acquisition
International cross-border acquisitions: Takeda's acquisition of Nycomed
In May 2011, the Japanese Takeda Pharmaceuticals bought Nycomed, a Swiss pharmaceutical company. Although Asia's largest drug manufacturer Takeda paid 9.6 billion Euros for Nycomed it will be able to operate the company debt-free, primarily because of the strong Japanese Yen's value in relation to the Euro (Harner 2011). Although Japanese companies have been famously insular in the past, doing business abroad at present is so cheap in comparison with the costs of operating domestically, more and more Japanese companies are looking to enhance their value through international cross-border acquisitions.
Nycomed would add considerable value to Takeda. Nycomed "would broaden Takeda's reach in emerging markets and add products for heartburn and smokers' cough. Takeda will focus on medicines for unmet needs and tapping new markets as blockbuster pills become harder to find" (Torsoli, Matsuyama & Ewing 2011). Takeda is concerned…
Harner, Stephen. (2011, August 20). Strong Yen fueling Japanese cross-border acquisitions.
Forbes. Retrieved September 2, 2011 at http://www.forbes.com/sites/stephenharner/2011/08/20/strong-yen-fueling-japanese-cross-border-ma/2/
Takeda to Acquire Nycomed. (2011). Nycomed. Retrieved September 2,
2011 at http://www.nycomed.com/media/news-releases/2011/takeda-to-acquire-nycomed/
Sentinel Event Activity
A sentinel event is described as an unexpected event that involves a severe physical or psychology injury or death or the risk of such incidents. In this case, the serious physical or psychological injury specifically incorporates loss of function or limb. Sentinel incidents are seemingly sporadic though they are clear-cut incidents that take place regardless of the patient's condition ("Sentinel Events," 2012). However, these events usually reflect the hospital and procedure deficiencies, which contribute to unnecessary patient outcomes. Some of the most common sentinel events include medication error that result in death, suicide in inpatient wards, clinical process involving the wrong patient, and maternal deaths. As part of enhancing patient safety and quality of health care, nurse administrators play a crucial role in identifying these events, barriers that contribute to them, and developing measures to correct the barriers.
Sentinel Event Example
An 88-year-old male has been diagnosed…
Ballard, K.A. (2003). Patient Safety: A Shared Responsibility. The Online Journal of Issues in Nursing, 8(3). Retrieved August 21, 2015, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume82003/No3Sept2003/PatientSafety.html
"Lessons Learned: Fires in the Home Care Setting." (2001, March 1). Sentinel Event Alert. Retrieved August 21, 2015, from http://www.jointcommission.org/sentinel_event_alert_issue_17_lessons_learned_fires_in_the_home_care_setting/
"Sentinel Events (SE)." (2012). CAMH Update. Retrieved August 21, 2015, from http://www.jointcommission.org/assets/1/6/CAMH_2012_Update2_24_SE.pdf
Mining on the Denniston Plateau
Towards the northwestern side of South Island of New Zealand is situated a small settlement that is known by the name of Denniston. The area formed by this settlement is the West Coast region of the country. This small town is situated on the small Mount ochfort Plateau in the mountain ranges of Papahaua, which measure around 600 meters above sea level, meanwhile the distance from Westport is 18 kilometers towards northeast.
At the start of the 20th century, the population of this small settlement was recorded to be about 2000, because of the huge coal mine that is situated quite close to where the people had settled. Speaking of now, the area has become more of a ghost town and hardly 50 people live here. It will not be wrong to say that the fate, location and history of Denniston are not very different…
Barnden, A., & Harding, J. (2005). Shredders and leaf breakdown in streams polluted by coal mining in the South Island, New Zealand. University Of Canterbury. School Of Biological Sciences..
Cashdollar, K., & Sapko, M. (2006). . -- EXPLOSION HAZARDS OF COAL DUST IN THE PRESENCE OF METHANE. Handbook For Methane Control In Mining, 147.
Greenpeace International. (2010).
Mfe.govt.nz,. (2014). Laws and treaties | Ministry for the Environment. Retrieved 21 August 2014, from http://www.mfe.govt.nz/laws/
Does taking Metoprolol before cardiac surgery reduce the incidence of post-op atrial fibrillation
Postoperative atrial fibrillation (POAF) remains a prevalent supraventricular arrhythmia. PoAF has associated effects such as deteriorating hemodynamic, increased risk of stroke and increased probability of death. Beta-blockers have been recommended as effective intervention mechanism of preventing PoAF. Metoprolol is one such beta-blocker that is commonly administered to prevent the incidence of PoAF. The systematic review below entails an analysis of six clinical trials that explore the effectiveness of metoprolol. The analysis identifies reduced hospitalization length, reduced mortality and reduced financial burden as the beneficial impact associated with the administration of prophylactic. The small number of studies reviewed limits the validity of the conclusion warranting future large sample size research.
Annually, approximately 750,000 cardiac surgery are performed globally with postoperative atrial fibrillation (PoAF) being the prevalent complications (George, et al., 2018). With the increasing proportion of elderly population…
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
Because patients have an active role in their care plan and are in
more frequent contact with their healthcare provider, they gain a better
understanding of their condition and become more compliant in their care."
(Moore, 1) This speaks directly to the challenges in healthcare relating
to diabetes, which is a condition that can best be controlled through
effective personal lifestyle habits and a sound treatment of one's body.
Being able to take proper routine measures to monitor, medicate and treat
one's self can be facilitated through telehealth consultation, reducing the
need for travel and doctor visits for those who might be less mobile due to
age and infirmity.
The importance of reducing hospital visits for both cost to
healthcare and strain on the patient can be especially appealed to where
diabetes is concerned. The chronic nature of the condition and the related
ability of the patient to control certain…
B2B Media. (2002). General Telemedicine. Telemedicine Today. Online at
Bull, C.N. (1993). Growing old in rural America: New approach needed in
rural healthcare. BNet. Online at
Offered under the same roof are "consultative, diagnostic, and treatment services" which are stated to be provided "by board-certified practitioners in the fields of pulmonary medicine, otolarngology, family medicine and more." (2006)
Smith reports that the laboratories experiencing the most dramatic growth are two which are located the "farthest from the Hillsboro flagship" as they are located in two areas that were "formerly underserved." (2006) Smith additionally reports that the demand is stronger in the areas where the two fastest growing centers are located which supplies "plenty of fuel for expansion."
Smith states that the Sleep Health & Wellness NW is attempting to "fill a gap so that patients who previously were overlooked or not being reached or who fell through the cracks no longer are," she says. "We have no plans to open centers in areas where there are already quality sleep services programs. We only want to go…
Inspiration! Sleep Study Results & Analysis (2006) Q&a with Ron Richard, senior vice president of strategic marketing initiatives at ResMed HME Business April 2006. Online at http://www.hme-business.com/articles/55305/
Johnson, Duane, PhD (2008) Are you Really Managing Your Sleep Lab? The Business of Sleep. Focus Journal May/June 2008. Online at http://www.foocus.com/pdfs/Articles/MayJune08/Duane.pdf
Kay DC, Pickworth WB, Neider GL. Morphine-like insomnia from heroin in nondependent human addicts. Br J. Clin Pharmacol. 1981;11(2):159-169
MacFarlene, James (2009) the Painful Pursuit of Sleep. Sleep Review Journal Jan/Feb 2009. Online available at http://www.sleepreviewmag.com/issues/articles/2009-01_07.asp
Conventional Tomography outlining the various aspects, issues and methods used. It has 10 sources.
The field of medical imaging has been in existence for over one hundred years but new research and scientific breakthroughs have changed both its image and its role. adiology is not only diagnostic but is expanding to encompass curative techniques as well. The most common radiological investigation remains the conventional X-ray but a wide range of new and more efficient modalities have also been available for the past several decades. Amongst these methods is tomography, specifically in reference to this paper, Conventional Tomography.
adiographs deal with the internal anatomy of bodies, commonly used to view bones, calcified material, and soft tissue masses. This area has branched out since the use of fluorescent dyes but still is limited by the fact that a conventional radiography is unable to display within the framework of two-dimensional…
Author not available. (2003). The Encyclopedia of Medical Imaging Volume III: 1. Retrieved October 26, 2003, from Amersham plc
Flake M., Kinder C. (2003) Conventional Radiography Tomography and Their Biological Effects. Retrieved October 26, 2003, from Yale-New Haven Teachers Institute
teaching and learning to patients with dysphagia. The situation involves the researcher's own personal experience teaching a Mom of 16-month-old diagnosis with dysphagia and how to learn how to feed him. This paper discusses the client's background, learning objectives, learning needs, outcomes, teaching strategies, and evaluation of outcomes and provides guidance for a mother facing these same issues.
Infants and children need to consume sufficient amount of nutrients in order to grow. Swallowing difficulties has an effect on dietary intake and affects a child's growth and development. For this reason, it is important to manage dysphagia in pediatrics.
Dysphagia is a disruption in swallowing that compromises safety, efficiency, or adequacy of nutritional intake. Swallowing and breathing share a common space in the pharynx, and problems in either of these processes can affect a child's ability to protect their airway during swallowing and ingestion of fluid or food safely.
Dysphagia and swallowing disorders. Retrieved from http://nursing.advanceweb.com/Regional-Articles/Features/Nurses-Role-With-Dysphagia.aspx .
East, L., Nettles, K., Vansant, A. & Daniels, S. Evaluation of Oropharyngeal Dysphagia With the Videofluoroscopic Swallowing Study. Journal of Radiology Nursing.
Gosa, M. & Coleman, J. Thickened Liquids as a Treatment for Children with Dysphagia and Associated Adverse Effects A systematic Review.
Nurses' Role With Dysphagia. Retrieved from https://consultgeri.org/try-this/general-assessment/issue-20 . Preventing Aspiration in Older Adults with Dysphagia
Taking the history of a patient is a crucial aspect of patient assessment and treatment. A good history can mean the difference between a successful patient outcome and unsatisfactory outcomes. However, taking a complete and useful history is a skill that is developed by means of training and practice; it is not some talent that is innate (Bickley & Szilagyi, 2007; McKenna et al., 2011). According to Craig (2007) nurses are increasingly being asked to take patient histories. Given these growing responsibilities nurses need training and guidelines to taking an adequate patient history. The following is a summary and critique of Craig, L. H, (2007), A "Guide to Taking a Patient's History" in Nursing Standard, volume 22, issue 13, pages 42-48.
Craig (2007) takes a comprehensive approach to explaining the interview and history taking process. This approach is applicable for most any patient population; however, Craig does not…