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According to the Centers for Disease Control and Prevention (CDC, 2006), each year approximately 1.2 million Americans suffer from myocardial infarction (heart attack) each year. 40% of these people who a have heart attack will die from it. This equates to a person having a heart attack every 34 seconds, and a person dying from a heart attack every minute. Heart disease is the leading cause of death in the United States, causing over 26% of the deaths in 2006 (CDC, 2010). Additionally, heart disease is the leading cause of death for both women and men, and for most racial/ethnic groups, including African-American, Native Americans, Hispanics, and whites. For Asian-Americans, heart disease was the second leading cause of death after cancer (CDC, 2010). The CDC also estimates that in 2010, heart disease cost the United States $316.4 billion in health care services, medications, and lost productivity.
Myocardial Infarction…… [Read More]
MI Case Study: Myocardial Infarction
At 10:05 A.M., the blockage that had been silently growing in Paul
Parker's left coronary artery made its sinister presence known. The 54-year-old accounting executive had arrived with his family at the Denver zoo feeling fine, but suddenly a dull ache started in the center of his chest and he became nauseated. At first he brushed it off as the aftereffects of a company dinner the night before. However, when it
persisted, he told his wife who suggested that he go to the Aid Station.
"I'm not felling very well," he told the EMT at the station. "I think it may be indigestion." The EMT, on hearing Paul's symptoms and seeing his pale, sweaty face, immediately thought of a heart attack. "Let's get you over to the hospital and get this checked out."
The blockage in Paul's coronary artery had restricted blood flow to his…… [Read More]
Myocardial Infarction Risk for Women with Breast Cancer: Annotated Bibliography
Abdel-Qadir, H., Amir, E., Fischer, H. D., Fu, L., Austin, P. C., Harvey, P. J., ... & Anderson, G. M. (2016). The risk of myocardial infarction with aromatase inhibitors relative to tamoxifen in post-menopausal women with early stage breast cancer. European Journal of Cancer, 68, 11-21.
The rationale for this study was that a gap in the literature existed with respect to the possibility of aromatase inhibitors increasing cardiovascular risk relative to tamoxifen among breast cancer patients who were in the post-menopause phase of life. The participants consisted of more 9500 women over the age of 55 suffering from breast cancer (stage 1 to 3) in Ontario, Canada. The researchers conducted an observational cohort study to observe the myocardial infarction risk of aromatase inhibitors and tamoxifen. They examined cases of hospitalization of the population sampled as a result of myocardial infarction and…… [Read More]
Acute Myocardial Infarction
PATHOPHYSIOLOGICAL POCESS TEMPLATE
Acute Myocardial Infarction is a common disease with very grave consequences in morbidity, mortality and cost to the society (Boersma et.al, 2003) It has become the leading cause of death in the developed world. It has been estimated that about 450,000 people die from coronary disease per year in the United States.
Myocardial infarction primarily occurs when the blood supply to the heart is compromised. Just like all the cells of the body, the myocardial cells require a constant supply of blood and oxygen to keep working. Ischemia beyond a set threshold level exhausts the cells and causing them to be damaged. Authors have said that the word Myocardial Infarction should be used when there is evidence of necrosis of the myocardium in a clinical setting. There are five different types of MIs defined depending on the situation that occurs. Type 1 is…… [Read More]
Health Care Services for Myocardial Infarction:
Myocardial Infarction (MI) is commonly known as Acute Myocardial Infarction (AMI) is a heart attack disease in which blood supply to a part of the heart is interrupted resulting in ultimate irreversible damage and cell death in that part of the heart (Khan, 2010). As one of cardiovascular diseases, myocardial infarction can be regarded as one of the leading causes of death for men and women across the globe. While the condition is attributed to various causes, the major cause of myocardial infarction is partial or complete occlusion of the coronary arteries. The partial or total occlusion of the coronary arteries occurs because of a rupture of an atherosclerotic plaque. This paper provides a detailed analysis of the existing primary health care services used to target myocardial infarction in Australia. The analysis of the current primary health care services and initiatives that exist to…… [Read More]
5% while 70.5% took Aspirin within six hours after reaching hospital and 76.5% of patients admitted in the NICVD were receiving Aspirin therapy." (Jaiwa, 2006, p.1)
Jaiwa reports a more recent study that states findings that out of 52 patients with chest pain only 13 patients or 25% of the 52 received aspirin. The stated reason for not giving aspirin to the other 39 patients included that "chest pain was not felt to be cardiac in thirteen (33%), ten patients (26%) had already taken aspirin on that day, the medical provider was a basic level emergency medical technician who could not administer aspirin to six patients (15%), pain subsided prior to arrival of emergency medical services in three patients." (2006, p.1)
Conclusion of the investigators were that the primary reason that paramedics failed to administer aspirin was "...their belief that the chest pain was not of a cardiac nature while…… [Read More]
This thickening, hardening, calcification and the fatty deposits all work together to block the arteries causing the deprivation of blood.
Cigarette smoking is another contributor to the damaging process. It can cause an increased heart rate and hypertension, both of which causes the heart to work harder than what it should. "Cigarette smoke contains carbon dioxide" (MedicineNet.com, 2007) and when inhaled into the body can lead to less oxygen in the blood. These factors cause the heart to work even harder with a less than normal supply of oxygen.
The surgery you experienced re-opened those arteries by inflating a small balloon that allows for an increased blood flow, directly assisting your heart so it does not have to work so hard.
Please schedule additional time with your next appointment to talk with the nurse on how you can modify your lifestyle to decrease your risk of suffering another myocardial infarction.…… [Read More]
Heart attack or myocardial infarction occurs when there is an interruption of regular flow of blood to the heart. The blockage, which leads to the interruption of blood flow, has to be long enough that part of heart muscle dies or becomes damaged. This blockage makes the regular and required oxygen supply in the heart. This lack of oxygen supply leads to the death of numerous cells and the chance of survivor after a heart attack is how soon an individual accesses the hospital.
hat is exactly Heart Attack
The intrusion of oxygen supply to the heart makes the cells die making it stop functioning. Factors such as accumulation of lipids, cholesterol, calcium and inflammatory cells thicken the inside of the artery reducing the entry of oxygenated blood. The deposits can totally block the artery starving the heart of oxygen which results to the heart cells getting damaged or even…… [Read More]
Patient Self-Administration of Medicine
Although patient empowerment is valuable, it is essential that hospitals exercise control over the medications patients take. It is impossible to design an effective plan of care otherwise. However, many patients wish to self-administer medications within the hospital setting. For many patients, self-administration is a reasonable goal at home: it is particularly necessary for chronic conditions like diabetes, where patients must learn to self-administer their medications to remain independent over the course of their lives. There also appears to be a desire amongst patients to take control over their own medications even in a hospital context. In a qualitative study of self-medication: "seven participants had previously experienced self-administration of medications and six were in favour of this practice in the clinical setting. Nine managed their own medications at home, and one self-administered with some assistance from his family. Participants were very concerned about how nurses' heavily…… [Read More]
Life Changes After Illness
There are very many critical illnesses that people face everyday in life. Among these critical illnesses is Myocardial Infarction which is commonly known as heart attack. This comes about due to an interruption of blood supply to some parts of the heart muscles that result to the death of the damage or death of heart cells. Symptoms of this illness are sudden chest pains, nausea, sweating, palpitations and shortness of breath. Often when an individual is diagnosed with Myocardial Infarction the news come as a shock to the person. When one becomes aware that they are suffering from Myocardial Infarction there are various changes that will occur in their lives. This paper will look at the life changes that occur after Myocardial Infarction.
Myocardial Infarction is life threatening, stressful and its onset is sudden, unanticipated and uncontrollable. This means that the life of a…… [Read More]
Mr. Medicare's Myocardia
Mr. Medicare Patient and his wife Mrs. Medicare were sitting on the couch watching a football game one Sunday, when Mr. Medicare began to feel ill. It began with a feeling like indigestion, which he attributed to the spicy chicken wings that they were eating while watching the game. However, the initial indigestion feeling worsened, even after he chewed an antacid. He began to feel short of breath and broke out in a cold sweat. He told his wife, Mrs. Medicare, what he was feeling. ecognizing Mr. Medicare's symptoms as those of a heart attack, Mrs. Medicare brought him into the emergency room through the emergency department lobby as opposed to coming by ambulance.
Mr. Medicare did not complain of chest pain or of pain radiating down the arms, but his other symptoms prompted staff to treat him as a possible heart attack patient. For the staff…… [Read More]
Where the hypotheses were well-followed throughout the text, the conclusion ignores the relevance of these factors to the delay experienced by patients in seeking treatment. Instead of developing a correlation between the identified behavior and the subject matter, importance of creating awareness among the general public was the highly emphasized. Furthermore, the responsibility of nurses and government authorities in this regard, was also discussed.
The study itself had a rather limited scope. Selection of convenience sample along with a particular racial background and non-inclusion of patients who died within hours of reporting AMI acted as major drawbacks. Secondly, a selection of considerably small sample also raised questions on the reliability of the sample.
The evaluation of this research does not lead to a confident and reliable conclusion. The limited scope of the sample, controlled questionnaires, neglect of other factors and the comparative analysis instead of individual examination of…… [Read More]
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…… [Read More]
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…… [Read More]
quasi-randomly selected population, tests it under laboratory conditions using a reliable instrument to do so, and uses statistical data to assess results.
There is little reliable and consistent data existent on women's prodromal symptoms before acute myocardial infarction (AMI) rendering diagnosis of coronary heart disease (CHD) in women a challenging task. The problem statement in this study is relevant to nursing in that accurate description of women's prodromal and acute symptoms of CHD is crucial in providing a clear presentation of the situation. Researchers, accordingly, set out to determine the most frequent prodromal symptoms of AMI as well as to identify how these symptoms related to CHD risk factors and to determine whether prodromal symptoms were predictive of AMI condition.
The main variables in this study are independent variable -- prodromal symptoms, Dependent variable - acute myocardial infarction (AMI). Control factors were risk factors that may have been involved in…… [Read More]
Nurse Speech to Group of esidents in a Large Independent Living Facility
The information addressed today in this speech are those involving the body's regulation of the correct numbers and ratios of blood cells and how blood pressure homeostasis is achieved as well as age-related changes to the heart including coronary artery disease, congestive heart failure and myocardial infarction.
Homeostatis and the Body's Balancing Act
The work of Vikrant and Tiwan (nd) report that studies on the population indicate that blood pressure is a continuous variable and there is really not a line that divides normal and abnormal values. However, there is a point of balance also called internal equilibrium and this is known as homeostasis. This state of balance describes how the human body reacts to certain changes. This can be viewed by picturing a set of scales in which coins are poured in unevenly with one side heavier…… [Read More]
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…… [Read More]
Leadership and Management in Healthcare
Effective Leadership and Management
Leadership is much like communications in regards to the complexity inherent in these concepts. There are many different perspectives that are used to examine these issues and researchers study leadership and management from such disciplines includes Industrial and Organizational Psychology, Social Psychology, Business, and Sociology. There have been somewhere in the neighborhood of six to eight major approaches, depending on the vantage point, to leadership theory produced in the scientific literature over the last sixty years and even more have emerged from outside academia (Kilburg & Donohue, 2011). Competing theories include such perspectives as trait theory, situational theory, behavioral theory, competencies theory, network theory of leadership and many more.
Much of the work that a nurse-leader engages in on a daily basis rests in their ability to communicate with others; including clients, colleagues, superiors, and subordinates. Therefore, since this…… [Read More]
Hyponatremia in a 38-year-Old male
The constellation of signs and symptoms the patient presented with is consistent with a diagnosis of adrenal insufficiency (Betterle, Pra, Mantero, and Zanchetta, 2002, p. 330-331). These include a recent history of gastric distress, partial loss of consciousness, lethargy, dizziness, disorientation, weight loss, hyponatremia, borderline hyperkalemia, low serum and free cortisol levels, and the lack of a rapid cortisol response to ACTH stimulation (Wilson, 2008). Signs and symptoms that may not support a diagnosis of adrenal insufficiency include no mention of hyperpigmentation or pallor, and an unremarkable abdominal CT scan. A discussion of these signs and symptoms, and the possible relevance to a diagnosis of adrenal insufficiency follows.
True Hyponatremia Diagnosis
There are a large number of conditions and diseases that can lead to the development of hyponatremia, so this symptom alone has limited diagnostic utility (Wilson, 2008, p. 519). The combination of severe hyponatremia…… [Read More]
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…… [Read More]
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…… [Read More]
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…… [Read More]
" (AAF, nd)
The Health Maintenance Organization further should "…negotiate with both public and private payers for adequate reimbursement or direct payment to cover the expenses of interpreter services so that they can establish services without burdening physicians…" and the private industry should be "…engaged by medical organizations, including the AAF, and patient advocacy groups to consider innovative ways to provide interpreter services to both employees and the medically underserved." (AAF, nd)
One example of the community healthcare organization is the CCO model is reported as a community cancer screening center model and is stated to be an effective mechanism for facilitating the linkage of investigators and their institutions with the clinical trials network. It is reported that the minority-based CCO was approved initially by the NCI, Division of Cancer revention Board of Scientific Counselors in January 1989. The implementation began in the fall of 1990 and the program was…… [Read More]
Patient’s chief complaint: A man aged 69 comes to the emergency room with a sharp pain to his chest’s left side, lasting between 30 and 40 mins and then subsiding.
History of present illness: The pain has woken him up thrice in the last 7 days. He claims the pain first started roughly six months ago. Initially, however, the pain used to surface only occasionally, commonly while he was doing gardening. The patient’s past medical history reveals a diagnosis of hypertension twenty-five years back.
Precipitating/alleviating factors: The patient has been smoking a half-cigarette pack daily for the last forty-five years.
Family History: The patient has lost two brothers and his dad to heart disease. The patient does not report any other significant illness history in the family.
Social History: His typical pastimes include sharing a drink with pals and gardening.
Review of Systems: From a physical examination of…… [Read More]
The quality indicator examined herein is the measurement known as door-to-balloon time, which is a defined element in emergency cardiac care that refers to the time from patient entrance to an emergency department to the time a catheter wire passes the lesion responsible for a myocardial infarction. An increase in door-to-balloon time carries with it an increased risk for tissue damage and thus more permanent complications and detriments to patients' health, and thus certain standards have been set in an effort to promote best practices and measure the efficacy of emergency department treatment of myocardial infarctions. The current recommendation for door-to-balloon time is ninety minutes or less, and this is a number that should be strived for with every patient, not simply as an average for the emergency treatment of myocardial infarctions in a given department as a whole, as again increased time can means significant…… [Read More]
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.…… [Read More]
Nursing Staff Levels Affect Patient Mortality
Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety.
Litvak, E., Buerhaus, P.I., Davidoff, F., Long, M.C., McManus, M.L. & Berwick, D.M.
Date of publication: June 2005
Examination of the operational issues affecting health care delivery, including patient driven peaks in demand and effects of nursing shortages or inadequate staffing on clinical outcomes for patients.
esearch question and/or hypothesis:
In this study the researchers propose that increases in adverse clinical outcomes occur when hospital nurse staffing is inadequate. Further the researchers suggest that increases in census rates increase the potential for serious stresses for patients and nurses working in the field. Lastly the researchers suggest that if hospitals reduce unnecessary variability of staff levels in a hospital, the hospital can reduce the probability of negative patient outcomes, improve safety for patients and improve the overall quality of care.
Sample…… [Read More]
Coronary Artery Disease
Development of Coronary Artery Disease (CAD)
Coronary artery disease represents an obstruction or constricting (stenosis) of vessels and arteries which supplies the heart with oxygenated blood. The cause for CAD is atherosclerosis (arterial hardening), or a fatty plaque buildup on inner arterial linings. The resultant obstruction impedes blood flow across coronary arteries. The complete cut- off of blood flow leads to a heart attack (or myocardial infarction, in medical terms). CAD takes place when coronary arteries are partly obstructed or hindered, thus cutting off oxygen supply to heart muscles (i.e., myocardial ischemia). When the blockage is temporary or partial, angina (chest pain or pressure) may occur. The sudden, complete cut- off of blood flow due to the blockage leads to myocardial infarction (Milto, Costello, Davidson & Lerner, 2013).
CAD is a condition that sets it from a rather young age, a fact not many are aware of.…… [Read More]
voluntary, collaborative and active involvement of the patient in a course of behaviour that is mutually accepted in order to gain therapeutic result (Michael, H. et al., 2009). According to this definition it can be clearly observed that the patient has a clear choice to follow the goal and that the patient and well as the providers agree to make a medical regimen and treatment goals (Delamater, 2006).
There are two basic factors involved in the medical adherence, these are:
Whether the patients takes the medicine that has been prescribed to him/her.
Whether the patient keeps on taking the prescribed medicine or not.
Therefore, the adherence behaviour is divided into 2 main concepts which are: adherence and persistence. Although the concept of adherence and persistence is similar however, adherence means the intensity with which the drug was taken during the duration of the therapy while, persistence means the overall duration…… [Read More]
hen an heart needs more oxygen, such in times of exercise, stress or pharmacological stimuli, blood flow is increased to fulfill this demand. However, the physiological narrowing of arteries due to plaque build up found in coronary disease restricts blood flow to the heart, especially in times of when an increase in myocardial oxygen is needed. These restrictions mean a lessened CFR for the individual, which can lead to coronary ischemia, cardiac infarction, and several other dangerous effects. This physiological change in the coronary system, through the build up of plaque, occurs for several reasons. Lack of physical activity and poor nutrition, with the consumption of certain fats and cholesterols, can facilitate plaque build up. High blood pressure, obesity, depression, and anxiety are also contributing factors (Pazoki, Nabiour, Seyednezami, and Imami).
There are different treatment options for coronary artery disease. Two treatment clinical options include lifestyle modification and revascularization. Lifestyle…… [Read More]
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.
Diuretics would encourage the elimination of sodium and a lessened fluid retention, easing the pressure in his arteries.
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.
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
Aspirin inhibits the collection of platelets at the site of a plaque rupture, preventing a full blockage…… [Read More]
Meat has been considered to be a risk factor for the development of heart conditions due to its large concentration of saturated fats. This study also found there to be a significant relationship between the consumption of meats and the development of heart issues with the risk increasing as the amount of meat consumed increased. These findings did vary across types of meat with red meat being twice as likely to lead to an acute coronary syndrome as white meat.
Blisson, .M. (2010). Eat smart for a healthy heart. Agricultural esearch, 58(6), 12-14.
Bowden, J. (2010). Cholesterol: The real heart of the matter. Better Nutrition, 72(8), 36.
Eshak, E., Iso, H., Date, C., Kikuchi, S., Watanabe, Y., Wada, Y., Wakai, K., & Tamakoshi, A. (2010). Dietary Fiber Intake Is Associated with educed isk of Mortality from Cardiovascular Disease among Japanese Men and Women. The Journal of Nutrition, 140(8), 1445-1453.…… [Read More]
In the third trimester of pregnancy, caution must be taken concerning congestive heart failure, hypertension and decreased renal and hepatic function, interstitial nephritis, hyperkalemia, hyponatremia and renal papillary necrosis, anticoagulation abnormalities, leucopenia, granulocytopenia and thrombocytopenia. The use of Celecoxib is aimed primarily at suppressing pain and inflammatory stimuli, but it may contribute to NSAID gastrointestinal toxicity. The lowest possible dose of celecoxib should be prescribed and taken. On the whole, NSAIDs can mask the usual signs of infection, therefore, caution must be taken in the presence of existing controlled infection. The physician should investigate symptoms and signs, which suggest liver dysfunction or abnormal liver lab results.
On September 30, 2004, Merck and Company voluntarily withdrew rofecoxib from the American and world markets because of its association with an increase in cardiovascular incidence (Keldaya 2005). A major Food and Drug Administration study linked the medication to a three-fold rise in the…… [Read More]
reprogramming the injured" discusses the issue of regenerating damaged or injured heart tissues. The article seeks to show ways of improving cardiac function. The article cites the original works of L. Qian and K. Song together with their colleagues. The authors of the article state that L. Qian and his colleagues have induced scar-forming (fibroblasts) cells to change into muscle cells in live mice's damaged hearts. Scientists refer to muscle cells as cardiomyocytes. The authors, therefore, conclude that results of the experiment provide an avenue for cardiovascular investigation in translational medicine. The article talks of the discovery of MY0D1, a transcription factor that regulates expression of genes that play significant roles in the development of skeletal muscle. The article states that scientists discovered that they could reprogram somatic cells (non-germline) to pluripotent stem cells. Pluripotent cells are important because they can transform into any cell type. This happens by expressing…… [Read More]
Prior to the HQA initiative, the Centers for Medicare and Medicaid Services as well as the Joint Commission both collected data on these quality of care indicators; however, in the past, these reports were submitted in different forms making across-the-board comparisons difficult or impossible. As a result of the HQA initiative, though, it is possible to compare these quality of care indicators at the national level.
Using quality of care indicators for acute myocardial infarction, congestive heart failure, and pneumonia, these researchers assessed the quality of care being provided by 4,203 hospitals that submit data to the HQA database and determined quality of care exists along a broad continuum that ranges from superior care in these areas to some that are deficient, with acute myocardial infarction being rated among most disparate in the quality of care provided. Although generally rated as high on these metrics, the study found that the…… [Read More]
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…… [Read More]
The study in question was a multinational POBE classification trial (i.e., Prospective andomized Open Blinded End-point) that covered multiple private specialist and ambulatory cardiology centers (190, to be precise). It represented a comprehensive report centered on baseline elements of those patients potentially requiring screening. The study population constituted males and females aged below 80 years with confirmed heart attack (myocardial infarction; MI) history, and eligible for statin medication (Pedersen et al., 2005).
What is the study sample?
Sample comprised patients who have suffered one or more heart attacks, and for whom intensive reduction in LDL-C (low-density lipoprotein cholesterol) levels did not appreciably decrease primary outcome of serious coronary incidents, but decreased risks of non-fatal acute myocardial infarction and other combined secondary end points. No difference was found in all-cause or cardiovascular mortality cases. MI patients might gain from intensive LDL-C lowering without a rise in risk of non-cardiovascular mortality,…… [Read More]
Then other confounding variables were also introduced and eliminated systematically in order to identify where the true effects occurred. These confounders included body mass index, smoking, physical activity level, educational status, family history of coronary heart disease, hypertension, diabetes, and any medications that participants may have been taking (Kontogianni et al., 2008).
In general the experimental group consumed greater amounts of meat than their control counterparts. The investigators utilized multiple logistic regression analysis to assess the relationship between meat consumption and ACS and found that increasing meat intake by one portion per month increased the likelihood of the development of ACS by 56%. This was particularly evident when the meat consumed was red or processed increasing the risk by more than two fold (Kontogianni et al., 2008). While the consumption of white meat was also correlated to increased incidence of ACS, this risk was only 37% greater. When controlling for…… [Read More]
These studies demonstrate that there are several factors associated with patient noncompliance, regardless of the disease being treated. Medication side effects represent only one of these issues. Nurse practitioners could help to resolve many of these issues by being proactive and asking questions about side effects in patients at risk for becoming noncompliant. They may also be able to predict noncompliance in patients that are prescribed medications with known side effects. By informing the patient of the side effects and giving them practical ways to cope with them, the nurse practitioner can play an active role in helping to eliminate patient noncompliance.
Education was found to play an important role in patient noncompliance. The overall educational level of the patient was found to be important. The nurse practitioner can take positive action by being aware of the patient's overall educational background. Extra care must be taken with those of low…… [Read More]
As a result, it is not stable to say that the balance of benefits and harms of routine use of supplements of vitamins a, C or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease (U.S. Preventive Services ask Force (USPSF).
From other evidence, it does not seem that the experiments of this article were not conducted long enough to prove its thesis because supplements do not help with cancer. If they were trying to prove supplements did not help, their testing would be valid. As it can be seen from other evidence, the objective can be proven false because other research prove tat their thesis cannot be accurate.
he Canadian ask Force on Preventive Health Care (CFPHC) concludes that there is insufficient evidence to recommend for or against the use of routine vitamin E supplementation for the primary prevention of cardiovascular disease…… [Read More]
New Suppliers of Health Supplements
A promising new addition to the company's current line of health supplements was identified during a recent trip to Bangkok, Thailand, to meet suppliers of a promising antioxidant, coenzyme Q10. A growing body of research suggests this antioxidant is effective in improving cardiovascular function and may also be useful in alleviating the symptoms of angina pectoris, cardiac arrhythmia, high blood pressure, moderate gingival disease, congestive heart failure, dilated cardiomyopathy and severely impaired immune systems. Based on the documented efficacy, high quality and low costs of the health supplement offered by this vendor, this report provides the background and an overview of the supplier, a description of the health supplement, and current applications for coenzyme Q10. A summary of the business trip and meeting with the company's president is followed by recommendations and a brochure illustrating various aspects of the product.
esults of Business Trip to…… [Read More]
Stroke is identified as one of the leading causes of death and to decrease mortality rate a review of the causes is required. The importance of measuring and reviewing health care quality is no longer questioned. However quantifying quality is a difficult task one that involves a subjective element and judgment. Different methods are employed in measuring quality such as level of care provided, administration accuracy, staff sufficiency, hygiene level and therapies provided. The need to combine the facts and figures with judgments and evaluation is a complex process and needs to be done with utmost care. The quality measures need to be evaluated on a regular basis to ensure their relevance and validity in the given circumstances.
Measures used to monitor and review quality:
As the hospital administration began to realize the link between stroke patients death and the quality of service rendered the need to analyze data…… [Read More]
* 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…… [Read More]
Exercise and Proper Diet:
Solutions to Circulatory System Health and Coronary Heart Disease Management
Coronary heart disease is the nation's single leading cause of death." For American Heart Association's 2003 report on Heart Disease and Stroke Statistics, coronary heart disease will prove to be significant and responsible for almost 1.1 million Americans that have the potential of having "recurrent coronary attack." This figure implies the degree of significance that heart diseases does to the increasing mortality rate and deteriorating health of many Americans. Coronary heart disease is a "chronic illness in which the coronary arteries become narrowed and unable to carry a normal amount of blood" (Microsoft Encarta 2002). Heart diseases occur precisely because there occurs a clogging of the arteries that are vital for the regulation, supply, and flow of oxygen-containing blood in the circulatory system.
Two of the most common and prevalent cases of coronary heart diseases are…… [Read More]
dosage levels of Cholestease on Serum Cholesterol levels and the side effects associated with them in human beings.
Cholesterol has been a major media issue in recent years, especially the negative effects on the heart and its role in the development of heart disease. There have been many studies that indicate a connection between serum cholesterol heart disease and depression (1-3). Developing new methods to lower serum cholesterol has become a major industry in recent years. Currently the leaders in the industry are American Pharmaceutical giants, Pfizer, Merck, and Warner-Lambert (1), who have developed medications that lower cholesterol.
The Endicon corporation recognizes the potential market in developing a drug that will significantly lower serum cholesterol without the side effects associated with long-term use of the drugs currently on the market. In addition, we recognize the potential of developing a ritish Product, primarily marketed in Great ritain. Endicon has been conducting…… [Read More]
drowsy, confused, pale sweaty detect a fruity odour breath. You initiate a MET call a set vital signs a BGL. Questions 1 What complications occurring Tanya? Connect signs symptoms? 2 What pathophysiology complication? 3 What blood glucose reading situation ? 4 What nursing interventions required complication? 100 WODS EACH 1 reference Farrell & Dempsey 2014 Smeltzer Bare textbook medical surgical nursing 3rd edition.
Tonya is suffering from diabetic ketoacidosis. This condition, also known as DKA, generally occurs in patients that have Diabetes Mellitus 1 or 2. The most prevalent precipitating factors include non-compliance with insulin therapy, infection, or a stressful event like a myocardial infarction or undergoing surgery. A key indicator is the fact that, upon assessment, in was noted that Tonya's breath had a fruity odor to it. This is a characteristic trait that can distinguish DKA from other pathophysiologic causes. If untreated, DKA can quickly turn into a…… [Read More]
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…… [Read More]
Seniors have specific oral health needs. Meeting those needs requires an increase in personal hygiene, an improvement in lifestyle habits, and an increase in oral health service use. When these core needs are met, the specific oral health issues that affect seniors can be minimized, leading to improved health outcomes. Increasing personal hygiene requires shifts in attitudes toward oral health care, access to information, and access to affordable oral health care tools that are designed specifically for seniors. Lifestyle habits have a tremendous impact on oral health. Diet, smoking status, and drug and alcohol use are all factors that impact oral health. Accessing oral health services is difficult for many seniors. Some may live in rural areas where accessing oral health is physically difficult. Others may not be covered. In fact, most seniors do not have insurance coverage for oral health care. Not being able to afford oral…… [Read More]
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…… [Read More]
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…… [Read More]
The impact of stress on physical health has been fairly well documented, with emerging research detailing possible pathways or mechanisms of action. Such research has a tremendous impact on disease prevention strategies and best practices in healthcare. One of the areas revealing the strongest connection between stress and physical health is cardiology, with a strong correlation between environmental, psychological, and psychosocial stress and the etiology or exacerbation of heart disease. The following five articles provide an overview of recent research into the link between stress and cardiovascular disease.
Cohen, B.E., Edmondson, D. & Kronish, I.M. (2015). State of the art review. American Journal of Hypertension 28(11): 1295-1302.
Stress contributes to the etiology of cardiovascular disease, even in patients who had previously shown no other risk factors. Chronic stress—whether exposure to daily life stressors over time or the chronic stress associated with posttraumatic stress disorder—may be particularly damaging to heart health.…… [Read More]
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…… [Read More]
The pancreas is an important source of digestive enzymes and fluids, and plays a critical role in regulating blood sugar levels through the production of insulin and glucagon (NDDIC, 2012). Should the pancreas become inflamed there is the risk that the digestive enzymes will become activated within the pancreas, resulting in self-digestion. This disease is known as pancreatitis and even mild cases require hospitalization. This essay will review what is known about pancreatitis in the United States and the clinical guidelines for diagnosis and treatment.
Pancreatitis Pathophysiology, Epidemiology, and Etiology
The digestive enzymes produced by a healthy pancreas are secreted into the small intestine as zymogens, which are enzymes that have their catalytic domain blocked by a peptide group (Berg, Tymoczko, and Stryer, 2002). The intestinal brush border cells secrete enteropeptidase, which removes the peptide blocking the catalytic domain of trypsin. Trypsin then activates the digestive enzymes secreted by…… [Read More]
Although the severities of congestive signs may be similar, medical evaluation should be instructed to determine whether there is accompanying proof of cardiovascular disease. Physical proof of cardiovascular disease contains the narrow pulse pressure, cool arms, and legs, and sometimes changed mentation, with supporting proof sometimes provided by reducing serum sodium level and deteriorating renal function. Cardiovascular disease is frequently difficult to recognize through phone contact but may be suspected when previously effective diuretic increases fail, nurses report lower blood pressure, or patients explain improved lethargy.
Facilitators and barriers to optimal disorder management and outcomes
Environmental factors and cultural beliefs; motivators and hinders
In this case, the client thought he was suffering from a heart attack and feared to come to the hospital. The symptoms had presented for four days before the patient sought help. The patient had been suffering from similar symptoms for the past six months, but thought…… [Read More]
Carney, Robert M.; Kenneth E .Freedland. (2009). Treatment-resistant depression and mortality after acute coronary syndrome. The American Journal of Psychiatry, 166(4), 410-7.
Retrieved April 27, 2009, from ProQuest Medical Library database. (Document ID: 1671559601).
Major depressive episode. (2009). DSM IV. Retrieved April 27, 2009 at http://www.mental-health-today.com/dep/dsm.htm
Franklin, Donald. (2003). Major depression. Psychology Info. Retrieved April 27, 2009 at http://www.psychologyinfo.com/depression/major.htm
Khaled, Salma M.; Andrew Bulloch, Derek V. Exner, Scott B. Patten. (2009). Cigarette
smoking, stages of change, and major depression in the Canadian population. Canadian Journal of Psychiatry, 54(3), 204-8. Retrieved April 27, 2009, from ProQuest Medical
Library database. (Document ID: 1673587981).
Levinson, Douglas. (2005). The genetics of depression: a review. Biol Psychiatry.
Retrieved April 27, 2009 at http://depressiongenetics.med.upenn.edu/DLResearch/Levinson_GeneticsDepression.pdf
Marrie, A.; R. Horwitz, G. Cutter, T .Tyry, D. Campagnolo, & T. Vollmer. (2009). The burden of mental comorbidity in multiple sclerosis: frequent, underdiagnosed, and undertreated. Multiple Sclerosis, 15(3), 385-92.…… [Read More]
Health Maintenance Issues
Mrs. Gray is an 86-year-old woman who has been diagnosed with Type Two Diabetes. She has lived with the disease for three years. Mrs. Gray is single and lives in the area in a naturally occurring retirement community. Mrs. Gray, though 86, appears much younger than her stated age, which can be largely attributed to her active physical nature. Mrs. Gray boasts an exceedingly active social life, meeting her friends for lunch several times a week, and she strives to keep herself in good physical condition by going to the gym an average of four times a week. Mrs. Gray is further involved in the community through significant work in her church and as a member of the Senior Friends Program, which allows volunteers to interact with shut-ins by visiting with them and bringing them dinner once a week. Mrs. Gray's last A1C was 6.1%.
Health Maintenance…… [Read More]
sound rationale(s) for each component of the primary survey that the egistered Nurse will undertake.
The geriatric male patient was admitted to the Emergency Department under triage supervision. Primary survey assessment (Considine, 2011) determines the patient's immediate physical condition pertinent to life or death. These include the patient's Airway, Breathing, Circulation, Disability, Discomfort. The patient scores a 14/15, which indicates his eyes are open, appears oriented with succinct and clear verbal responses, and displays exacting and swift motor response and coordination.
Patient respiration is accelerated with shallow yet painful breathes. Lung capacity appears to be compromised, unsure of whether the left or the right is specifically effected but perhaps the onset of pneumonia is the thought. Blood pressure is low, rapid and painful breathing coupled with low blood pressure are symptomatic and are important to monitor for further changes.
Pulse of 90 bpm is somewhat rapid and irregular with 90%…… [Read More]
The basic work of the heart is to pump blood to the entire body. It performs two types of functions, electrical and mechanical. The electrical function of the heart is the periodic contraction that is triggered by the pacemaker. The pacemaker generates the pumping effect throughout the heart. This pumping action commonly known as action potential is carried in an electrical conduction system. The mechanical function is the fluidic movement of blood; the heart is a pump. The heart's anatomical features include; ventricle, which is the pump, heart valves; that allow blood to flow one way and the atria, which includes the four chambers of the heart. The heart is susceptible to disease and as a result if unable to pump blood can lead to failure in other body organs.
Treated Heart Conditions
Cardiology is generally a field of medicine focusing on diagnosis and treatment of the heart. Discussed…… [Read More]
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.
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…… [Read More]