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It has also been suggested that low-level viral replication associated with SV may be a driver in chronic inflammation in some sufferers of chronic lung disease, although this is so far uncertain (Openshaw, 2005). It is estimated that infants who develop a wheeze as a result of SV contraction develop a recurring wheeze in around two thirds of all cases. It is also estimated that around half of these children will develop some form of asthma (Lehtinen et al., 2007). It is unclear why there are some who experience delayed onset of SV, although both immune 'imprinting' and viral persistence have been implicated (Openshaw and Tregoning, 2005).
The condition is diagnosed through rapid antigen-detection tests. It is difficult to diagnose SV in adults as the tests are insensitive in persons other than children, and practitioners rarely request tests for SV in adults. This means that it is difficult to…… [Read More]
In fact it has been proposed that the positive impact observed of PBL on motivation may come from these academically talented individuals rather than the intervention itself (Hwang & Kim, 2006). GPAs and demographic characteristics were not found to be correlated to PBL (Ceconi et al., 2008).
White et al. (2004) found in a study regarding that PBL was not shown to be superior to other learning styles in assisting students to acquire or retain knowledge regarding asthma management. This finding is consistent with the majority of research that has not found greater knowledge acquisition or retention amongst PBL students vs. traditional teaching methods (Albanese, 2000; Beers, 2005; Rogal & Snider, 2008). However, it is not that PBL produces inferior results, most studies have found that there are no significant differences between PBL students and those from traditional curricula on standardized knowledge tests (Beachey, 2007). Beers (2005) points out that…… [Read More]
PBL vs. Traditional
Two of the methods of pedagogy that are currently employed in respiratory therapy are Problem-Based Learning and Traditional Teaching. Both instructional methods can provide a strenuous curriculum for the student interested in comprehensive training in the field of respiratory therapy, and each method has its advantages and (of course) its disadvantages. The focus of this study will be to determine which pedagogical methodology provides the most efficient and effective results in a respiratory therapy educational setting.
To accomplish that objective, the study will administer surveys in questionnaire form to students attending two separate schools that offer training in respiratory therapy. The questionnaires will provide a quantifying response to qualitative, and quantitative, information. Each school's pedagogy will represent either problem-based or traditional teaching methods and students from each school will be asked to complete pre and post training questionnaires and surveys. Additionally, students will be tested on their…… [Read More]
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…… [Read More]
espiratory distress syndrome (DS) in preterm infants/Neonates
Prophylactic and early surfactant administration
Later surfactant administration
O: educed mortality and pulmonary complications (Bronchopulmonary dysplasia-BPD and other)
Surfactant therapy involves intervention via various methods like oxygen, CPAP, mechanical ventilation, and surfactant. Many ask if surfactant therapy works. They also ask what is the ideal dose and when to administer the dose. Too much and too late could cause problems versus early with a low dose. When surfactant was introduced in neonatology, it reduced VLBW infant deaths by 30%. Surfactant use two decades ago also led to an 80% decline in neonatal mortality in the United States.
However, surfactant can fail and normally does so because of certain factors like when infants are extremely preterm and developed poorly structured longs and when there an infant develops perinatal asphyxia. When those factors are not present, surfactant reduces incidence of PDA, sepsis pneumonia, and most…… [Read More]
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,…… [Read More]
Evidence has been cited suggesting that ECT is particularly efficacious with psychotic depression. Experimental research and reviews of the literature tend to conclude that ECT is either equal or superior to antidepressant medication in the treatment of severe depression. In one study both depressed men and women were helped by ECT, but women tended to improve more with ECT than with imipramine, a tricyclic antidepressant. Men tended to improve more with imipramine. Both men and women improved more with ECT than with phenalzine, a monoamine oxidase inhibitor (MAOI). It has been suggested that MAOIs and serotonin-specific reuptake inhibitors (SSIs) may be less clinically effective than heterocyclic antidepressants for severe depression. Thus, ECT's favorable comparison with imipramine is a strong endorsement.
The side effect of ECT that has received the most attention is memory loss. ECT results in two kinds of memory loss. The first involves quick forgetting of…… [Read More]
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…… [Read More]
69). Petting a dog lowered blood pressure and respiratory rate -- even if the dog was somebody else's. Pet owners that have heart surgery recover faster and stand a better chance of full recovery. Touching a warm furry animal gives them relief.
Moreover, pet ownership is a predictor of survival after hospitalization for any serious illness (Gunter & Furnham, 1999).
Demello (1999) found that the "mere presence of an animal" could lower blood pressure and that the effect persisted even after the animal was gone. Visual contact with an animal, although it helped, was not as good as touching. Heart rates decreased significantly in a three-minute period of physical contact with the animal (Demello, 1999).
A story in Time magazine (2001) tells how a brain-injured man needed help to get back his sense of balance. Ginger, an Australian shepherd, liked to fetch, so physical therapy for this man was to…… [Read More]
North Dakota: ole of Lpn in IV Therapy
LPN IV Therapy Guidelines
The use of intravenous therapy is not without its risks (David, 2007). A saline bolus, for example, will cause edema as three quarters of the fluid leaves the vascular bed immediately after administration. In contrast to a lay person's expectations, common isotonic solutions, such as Lactated ingers solution, can induce an inflammatory response. The inflammation is caused by neutrophils destroying tissue through apoptosis and the release of reactive oxygen species, possibly triggering respiratory distress.
Kim David (2007) provides an overview of intravenous solutions in common use and their inherent dangers. She also discusses ongoing controversies concerning when to use intravenous fluids to resuscitate trauma patients. For example, most trauma patients will do better if hypotension is left untreated, except for patients who have suffered traumatic brain injury. esearchers have also shown that giving too much fluid perioperatively to…… [Read More]
Some of the major objectives of the strategy include lessening regional alveolar distension, atelectasis, oxygen mediated injury, diaphragm injury, and inflammation. The other approaches that can be used to lessen the injury include using high frequency oscillatory ventilation, positioning, neuromascular blocking agents, fluid therapy, and immunomodulation.
Ventilator Induced Lung Injury is one of the common illnesses that occur among patients with acute lung injury. This disease is mainly attributed to the use of mechanical ventilator to save these patients though there are other risk factors that contribute to the injury.
Dreyfuss, D. & Saumon, G. (1998, January 1). Ventilator-induced Lung Injury -- Lessons from Experimental Studies. American Journal of espiratory and Critical Care Medicine, 157(1), 294-323. etrieved from http://ajrccm.atsjournals.org/content/157/1/294.long
Feng et. al. (2011, July 19). Pediatric Acute espiratory Distress Syndrome Treatment and Management. etrieved September 26, 2012, from http://emedicine.medscape.com/article/803573-treatment
Galvin, S. & Granton, J. (2011, March 3). educing…… [Read More]
As Epstein suggested earlier, there seems to be no downside to this process.
James Colliver (2000) would disagree. He dismisses the assertions that favor the efficacy of PBL; his misgivings parallel Hmelo-Smith's earlier remarks. For instance, Colliver contends that the popularity of PBL is predicated on a kind of mass enthusiasm rather than empirically
based scientific evidence (p.259). Colliver asserts that PBL has not proven valid and lacks confirmation as successful teaching model. His article is largely a condemnation of the assertions that proponents of PBL assert. (He also implicates the cognitive sciences that underscore PBL.)
Colliver believes medical educators must abandon their support of PBL until there is sufficient empirical proof that PBL is, in fact, an effective way to teach people.
After ten years of administering Problem-Based Learning at the University of Missouri's
School of Medicine, Hoffman and her research team sought to examine the overall efficacy of…… [Read More]
education at Valencia College, where I am studying to be a respiratory therapist. I want to continue my education, with the hope of attending the University of Central Florida. The University of Central Florida does not offer a Bachelor of Science degree in respiratory therapy, but does offer a wide range of degrees related to the medical field. I intend to pursue a B.S. In Health-Sciences, Pre-Clinical undergraduate degree. I feel that this will give me the educational background I need to place me in a competitive position for graduate or professional training, while exposing me to a wide variety of occupations in the medical field.
The four-year university that I have selected is the University of Central Florida in Orlando, Florida. It is a competitive university with a student body of just under 50,000 (49,900) students (Petersons, 2013). The average in-state tuition rate seems reasonable at $6,247 per academic…… [Read More]
Improvement of Human esource Management in a espiratory Care Center
When individuals play as a team they tend to achieve greater clinical and organizational outcomes in a healthcare institution like the respiratory care center. Clinical and financial improvements have been reported in cases where there has been teamwork between the healthcare team. Whenever there is an organizational breakdown, the departments in any organization can conspire to sabotage each other and this hampers the progress of any care giving institution (Hoff 2004).
Overall patient care is achieved whenever there is total cooperation and teamwork between the workers, this is because each worker works with only one sole aim and that is to meet the needs of the patient. In such a case the main goal is to achieve an improved respiratory care. Teamwork exist in two levels in any respiratory care center, the first instance is when there is cooperation between…… [Read More]
Ely, E.W., et al. (1999). Large-scale implementation of a respiratory therapist-driven protocol for ventilator weaning. Vol 159 American Journal of Respiratory Critical
-(2001). Mechanical ventilator weaning protocols-driven by non-physician health-care professionals. Vol 120 Chest: Clinical Investigation in Critical
Harbrecht, .G., et al. (2009). Improved outcomes with routine respiratory therapist evaluation of non-intensive care unit surgery patients. Vol 54 # 7, Respiratory Care:
Daedalus Enterprises. Retrieved on November 23, 2012 from http://www.upmc.com/careers/pathways/allied-health/respiratory/Documents/ImprovedOutcomes_NICU_Patients.pdf
Hess, D.R.(1998). Professionalism, respiratory care practice and physician acceptance of a respiratory consult service. Vol 43 # 7, Respiratory Care: American Association
of Respiratory Care. Retrieved on November 23, 2012 from http://aarc.org/daz/rcjournal/rcjournal/x.RCJOURNAL.COM02.21.07/content
Kollef, M.H., et al. (2000). The effect of respiratory therapist-initiative treatment protocols on patient outcomes and resource utilization. Vol 117, Chest: Clinical
Investigations in Critical Care. Retrieved on November 23, 2012 from http://journal.publication.chestnet.org
Marelich, G.P., et al. (2000). Protocol weaning of mechanical ventilation…… [Read More]
In addition, small frequent feeds, and a large amount of fluid is provided to maintain the nutritional needs of the patient and prevent dehydration. The r suctioning of secretions proves necessary in preventing aspiration of secretions. The loss of voluntary muscle's activity increases the risks of accumulation of secretions hence, the need for regular suctioning. Bulbar involvement often results in communication complications such as dysarthria and muscle paralysis of the muscles of the face, throat, and tongue. As such, it requires the provision of management strategies such as augmentative and alternative communication (AAC) techniques and other forms of speech therapy that improves the communication abilities of patients with ALS. Pseudobulbar effects that often accompany those brought by the frontotemporal lobe degeneration often require the administration of antidepressants. The antidepressants manage mood disorder that presents through disproportionate crying, and inappropriate response to the external stimuli. Maximizing patients' comfort and…… [Read More]
Attorneys, however, note that the suits are reflective of an increase in negligent doctors, who are hard pressed to serve a larger and more demanding patient load. Medical care is more costly and it is true that doctors fail to establish bedside relationships with their patients. Others point out that problems lie at the door of the insurance industry and management of hospitals (Committee, p. 1).
Because we discovered the problem in time, Mr. Jones was able to apologize and explain to the patients affected concerning the true nature of his outbursts. They did not have to pay for their treatment and none of them brought lawsuits against Mr. Jones or the hospital. We retained Mr. Jones, but advised him to notify the management if it appeared that there might be future outbursts. It is true that hospitals are much more diligent today because of risk management practices. Because of…… [Read More]
assist you in one or more of the following areas of your current (or past) job?
espiratory care is a highly technical profession, so critical thinking skills are very useful in being able to troubleshoot equipment, locate and correct technical problems (Mishoe, 2003). Critical thinking is very useful to the respiratory therapy profession because the position requires the evaluation of information for problem solving which is crucial to operating complex equipment and diagnosing unknown problems in patients who often require immediate care to breathe and survive.
Critical thinking in communication is crucial for the respiratory therapist to gather and provide information through verbal and nonverbal communication with nurses, physicians, patients, patients' families, other respiratory therapists, and other clinicians (Mishoe, 2003). Gathering appropriate and sufficient information to analyze, evaluate, and make judgments in clinical practice depends on effective communication (Mishoe, 2003). There is a tremendous amount of skill…… [Read More]
Healthcare Practices in Nursing Today
Over the last 50 years, health care systems all over the world have experienced rapid and significant changes. Some of these changes have been the result of innovative developments in medical science and technology that have greatly benefited patients, prolonging and saving the lives of millions. Some of these changes, however, have had the unfortunate result of limiting patient access to prescribed treatment and diminishing the overall quality of care.
Significant challenges are being faced in health care as systems restructure and reinvent themselves in a difficult and often painful effort to make more efficient use of their available resources (ICN, 2001). Since health care is such a labor-intensive industry, the stresses on these systems inexorably trickle down to affect those employed by the system. Nurses, who are the most highly trained caregivers who have ongoing, regular patient contact, stand at the very heart of…… [Read More]
health profession that I am considering is respiratory therapist. Respiratory therapists care for patients who have trouble breathing; for example, from a chronic respiratory disease, such as asthma or emphysema. They also provide emergency care to patients suffering from heart attacks, stroke, drowning, or shock (OOH)
O-Net online lists basic tasks of a RT as the following:
Assess, treat, and care for patients with breathing disorders. Assume primary responsibility for all respiratory care modalities, including the supervision of respiratory therapy technicians. Initiate and conduct therapeutic procedures; maintain patient records; and select, assemble, check, and operate equipment
What we have here then is a combination of patient skills with rigorous attention to order and organization as well as to details. The RT has to be self -- disciplined and enjoy working according to rules. he has to be responsible and able to follow orders. ome administrative and leadership capacity is required…… [Read More]
I believe that my education and my professional experience in management genres, in healthcare -- including working as a nursing assistant and in homecare environments -- and in business have prepared me well for a career in nursing. After reviewing my qualifications and my skill set -- revealing that I have a history of competent, dependable involvement in worthy vocations -- and the extent of my career interests, I believe it will be clear that I am well positioned for a career as a practical nurse.
Reasons that justify my Goal of becoming a Practical Nurse
First of all, I am very familiar with a number of pivotal aspects of medicine and healthcare and have worked extensively in the industry. I have an Associate Degree in Respiratory Therapy (1992) from the California College of Health Sciences through St. Joseph's Hospital in Minot, North Dakota. As a respiratory therapist at…… [Read More]
All these professionals work together in order to establish a
rehabilitation plan that works best for each individual. The component
members of the team are subject to change in accordance with each
individual's needs and requirements. Also, the center holds
The Palm Gardens Center does not use volunteers in its activity. The
reason behind this choice relies on the fact that this center is a for
profit organization. All the individuals employed here are paid. Most of
them work full time, but there are also part time employees.
In management's opinion, it is not a good idea to use volunteers,
because people that are not financially motivated tend to not perform their
tasks as good as they are supposed to. Basically, if one wants something
done properly, the activity in cause must be remunerated in accordance.
The Palm Gardens Center is very involved in the life of the…… [Read More]
It would be impractical, for example, to expect Cardiac Medicine, Billing Services, Supply, and Maintenance functions to be supervised by the same individuals. In essence, the many services and functions provided by modern hospitals are so different from one another that they are actually completely distinct operations, each with its own organizational substructure and supervisory hierarchy.
The Hierarchical Nature of Hospital Administration
Generally, the various different areas of hospital services and functions all use a hierarchical supervisory structure. Within medical departments, senior attending physicians supervise residents based on professional seniority and experience. The same is true within nursing services. Other non-medical service areas such as administration and billing function much more similarly to general business offices. Usually, they are headed by a director or supervisor who performs the same role as supervisors responsible for administrating general business offices. Finally, departments such as supply and maintenance operate within a hierarchical structure…… [Read More]
This included meeting the concerns of being able to properly care for patients while implementing the program.
In addition, I was able to finds creative ways to solve problems by having meetings and expressing concerns. I was able to show creativity through the development of workshops to aid the nurses. I was also able to encourage the development of the skills of the junior nurses through workshops and granting them hands-on experiences with nurses under the watchful eye of more experienced professionals. I was able to find ways of making people aware of the program.
Another important aspect of the role I played as responder involved participating in planned changes. I was involved at every facet of the plan to implement the campaign at our facility. Initially I was involved in the meetings and played an instrumental role in developing a plan that would provide a sound platform for the…… [Read More]
The term health care refers to the inter-related system of care provided to persons during illness. In most of the cases, healthcare begins with the family doctor who refers patient to specialists if needed or directly order further diagnostic testing. Community health clinics perform the same procedure as a family doctor, but alongside with that, clinics also provide insight into patterns of health or illness seen within the community. Hospital just form one part of the healthcare community, as are mostly visited when a patient's condition is more acute and requires intervention by the hospitals high-end staff, since more can be done for him in a hospital rather than in a clinic where he is just an out-patient.
Clinics of various types provide very specific services, such as "pain management clinics" these clinics are targeted for towards people suffering from pain conditions. ehabilitation services also form a needed part…… [Read More]
The progressive care unit (PCU) is a practice setting in which the researcher’s health care team is often failing to meet quality care objectives according to patient reporting on the hospital consumer assessment of healthcare providers and systems (HCAHPS). Opportunities for growth in quality care based on the HCAHPS of the PCU include topic areas related to patient inclusion as well as communication skills of the members of the healthcare team. Patient perception of quality is that the healthcare team in the PCU is unable to explain the care process in a way that the patient and family members feel comfortable with or that allows them to understand the care that is being provided to them. The researcher has first-hand experience with this challenge in the PCU and has heard first-hand from patients there that the care seems disjointed, that continuity is lacking, and how problematic it is for…… [Read More]
In an acute care setting, such Veterans Affairs, this objective is executed by educating patients about how to maintain a healthy diet and lifestyle after the leave the facility, while in a long-term care setting-such as Cobble Hill-this objective is executed on a daily basis by providing nutritious meals for elderly residents. And finally, in an ambulatory, out-patient care setting-such as Atlantic -- the clinical nutritionist works to support patients in maintaining a diet that addresses their personal healthcare needs, while still living independently within a larger community. Perhaps the most significant similarity between facilities is the notion of nutrition as merely one component of a comprehensive care program; hence the necessity of a clinical nutritional to work in conjunction with a full medical, administrative, and social support staff. The apparent goal of such an approach is to promote multiple aspects of health and well-being among patients, regardless setting or…… [Read More]
Participative Management: analysis and literature review of a 1930's theory -- Does it still have relevance 21st century management
What are the strengths and weaknesses of this theory?
One of the strengths of the theory of participative management is that it enables organizations to eliminate unneccaary and costly layers of managerial bureaucracy. Through deploying the concept of team leadership and work teams, it can empower employees to make immediate, practical decisions rather than relying upon management. Thus, it creates a leaner managerial structure and a greater sense of loyalty to the organization when employees can be responsible for everything from hiring, firing, corrective action, budgeting, education and performance appraisals. Work teams are encouraged, with participative management, to "set goals that are congruent with those of the organization and develop goal implementation strategies." (Warner, 1998)
ut particpatory management is not beloved by all management theorists. "The author of a book published…… [Read More]
high-performance work practices benefit the nursing profession -- and moreover, how are high-performance work practices beneficial to the patient receiving care from the nurse? This paper delves into the concept of high-performance efforts in the nursing workplace.
Severe nursing shortages and the urgent concerns as to the quality of care resulting from these shortages has led to the increased implementation of high-performance work practices (HPPs), according to assistant sociology professor Janette Dill and colleagues in the peer-reviewed journal Health Care Management Review. And it should be noted that the study that Dill and colleagues conducted relates not to nurses per se, but to the career development that HPP offers for "unlicensed frontline healthcare workers." These workers are nursing assistants, mental health counselors, "patient care technicians" and "respiratory therapy technicians" (Dill, 319).
hile they are not licensed as RNs, these workers make up 50% of the healthcare workforce (six million of…… [Read More]
Arterial Blood Gas Samples
Instructions for the Sampling of Arterial Blood for Blood Gas Analysis
This document provides the procedure for the drawing of arterial blood from human patients for use in the analysis of blood gasses.
This document is intended to provide proper and safe steps in the procedure used by respiratory therapists, phlebotomists, nurses and doctors for the procurement of human blood from extremity arteries for subsequent analysis of blood gases (Browning 1989).
This document covers recommended clinical practice for the sampling of arterial blood (Bruck1985). Because the nature of this procedure uses human clinical subjects and a biohazardous substance, human blood, significant explanation of safety and best clinical practice are covered in the information. Topics covered include:
Clinical Practice Guidelines
I. Safety Guidelines
Blood is considered a toxic and/or pathogenic substance;…… [Read More]
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…… [Read More]
business plan for a unique business opportunity- a sleep lab. This paper investigates the unique business needs of this business as well as the challenges of engaging the surrounding community, its employees as well as clients on the health benefits of sleep as well as the necessity for the identification as well as treatment of various sleep disorders. The safety needs of the participant are also taken into consideration and well as the setup and running costs.
A sleep disorder is noted by Al Ghamdi (2009) to be a medical disorder of a person's sleep patterns and is a serious condition that affects an individual's normal mental, physical as well as emotional functions. Most sleep disorders can effectively be diagnosed and treated in a sleep lab or center via a common test referred to as polysomnogram (Patil,2010).
Sleeps disorders as a source of public health concern
Sleep is also being…… [Read More]
According to the text by Sanders (2011), the Venturi Mask is likely to be the most appropriate assistive device in this process. Sanders indicates that this particular apparatus is "advised for patients who rely on hypoxic respiratory drive. This includes, for example, patients with COPD. The main benefit of the Venturi Mask is that it allows precise regulation of the FiO2. It also permits the paramedic to titrate oxygen for the patient with COPD so as not to exceed the patient's hypoxic drive while allowing enrichment of supplemental oxygen." (Sanders, p. 422)
In addition the Venturi Mask which can help to normalize pulmonary activity, the patient is also experiencing a productive cough with thick yellow sputum. The presence of excessive mucus is also likely contributing to Mr. Hay's airway blockages. This would be an appropriate place to use the Yankeur sucker in order to help remove fluids that might be…… [Read More]
Gaps occur in various situations. They can be in lesson plans or healthcare. When it comes to the MICU, practice gaps happen. To implement a quality improvement proposal one needs to see what works and how to use it to meet the needs of the proposal. Early Progressive Mobility in a Medical Intensive Care Unit has shown to be helpful in meeting the medical goals of patients. In this proposal, evidence as well as strategies will show how important it is for patients to gain mobility early on in recovery and the problems these kinds of programs face.
The MICU or ICU is for patients who are very ill. When in the ICU, it's been demonstrated patients acquire weakness from the acute onset of neuromuscular/functional impairment caused by unknown factors other than their critically ill condition. This weakness impairs ventialtor wearing and functional mobility. (AACN PEAL, n.d.,…… [Read More]
Extracorporeal Membrane Oxygenation is a procedure that allows for the oxygenation of a patient through the use of an external machine. Oxygen is required in order to keep a body healthy and alive. The definition of oxygenation is the amount of oxygen in the bloodstream of a patient. If the oxygen level drops below 90% a condition called hypoxemia occurs. Hypoxemia can be very serious and if not addressed within a short period of time can be fatal. Hypoxemia is diagnosed through cyanosis (the skin turning blue). Patients being treated with the EMCO procedure are usually longer-term patients (3-10 days) as compared to the short-term patients who receive a standard cadriopulmonary bypass which is a support that usually only lasts for a number of hours (not days).
According to odriguez-Cruz et al. The purpose of the ECMO is "to allow time for intrinsic recovery of the lungs and…… [Read More]
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…… [Read More]
, 2010). egardless of the cause, infant SV is linked to "significantly more symptoms of wheezing disorder and clinical allergy than controls and were more likely to be sensitized to common inhaled allergens" (Todd et al., 2010). The number of studies and the number of subjects is still small, but the correlations have been consistently large enough to suggest that a serious bout of SV-bronchiolitis in infancy is linked to later lung problems such as asthma, wheezing, and atopy. Therefore, M.C.'s parents should be educated about the possibility that M.C. may experience breathing problems in later life, and told to advise her primary care physician of her SV diagnosis and hospitalization.
Caiulo, V.A., Gargani, L., Caiulo, S., Fisicaro, A., Moramarco, F., Latini, G., & Picano, E.
(2011). Lung ultrasound in bronchiolitis: Comparison with chest x-ray. Eur J. Pediatr, 170, 1427-1433.
Healthwise. (2012). Bronchiolitis- topic overview. etrieved March 9, 2013…… [Read More]
For example, Dr. Gutierrez took me around to the different departments and allowed me to meet and talk with Dustin Bowman, one of his patients. He is 23-year-old, was in the U.S. Air Force and just transferred to Haley Hospital about a week ago. He had a Cervical 1 injury, and his left lung was deflated, which completely affected his entire body. He needs a great deal of respiratory care. With this patient and others that Dr. Gutierrez told me about during my observations at the hospital, I clearly came to see how respiratory therapist must know the patient's entire medical condition to fully provide effective treatment.
Respiratory therapists have to be knowledgeable and skillful about cardiopulmonary therapy, but beyond this, they must have the necessary understanding about human physiology, anatomy, and body chemistry to best understand the holistic condition of their patients. For example, to evaluate patients, the respiratory…… [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]
Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…… [Read More]
Multisystem Failure in a Geriatric Patient
Multisystem Failure in a Geriatric
eflect on your analysis of the geriatric patient in multisystem failure by doing the following:
Explain key immediate assessments you should make that would help assess the patient's homeostasis, oxygenation, and level of pain.
There are various diagnoses undertaken in assessing the patient's homeostasis, oxygenation, and level of pain. The immediate objective that nurses prioritize on is checking the patient's vital symptoms. Vital symptoms form the baseline of the assessment by providing significant information that illustrates whether the most essential organs function as required.
The assessment may involve checking the health status of the patient in the laboratory (Kane, 2004). In the laboratory, there is an assessment of the patient's capillary tube, urine test and blood pressure. When there is simultaneous malfunctioning of the body organs, nurses refer to this condition as multiple organ dysfunction (MODs).
Multiple organ dysfunction…… [Read More]
GLAXOSMITHKLINE (GSK) - SUCCESSFUL INTENAL INNOVATION ead case study answer 4 questions . Do write a report. 1. Based GSK's past performance, critical implementation issues GSK internal innovation? Justify answer.
GlaxoSmithKline (GSK) -- Successful Internal Innovation
Critical implementation issues for GSK with regards to internal innovation
Implementation processes are complex endeavors which need to be thoroughly assessed and carefully decided upon. This is true in any situation and in the case of virtually all economic agents, but while this necessity is valid, it is to be differently approached and resolved across companies. In other words, the dimensions of a strategy to be implemented are sensitive to a wide array of organizational and situational particularities, including, among other things:
The size of the economic agent
The availability of resources (capitals, labor force, commodities and technologies)
The intellectual capitals possessed and the ability to gain, transfer and capitalize on knowledge
The access…… [Read More]
The authors state: "The amphetamines occasioned dose-related increases in d- amphetamine-appropriate responding, whereas hydromorphone did not. Amphetamines also occasioned dose-related increases in reports of the drug being most like "speed," whereas hydromorphone did not. However, both amphetamines and hydromorphone occasioned dose-related increases in reports of drug liking and in three scales of the ARCI. Thus, some self-report measures were well correlated with responding on the drug-appropriate lever and some were not. Lamb and Henningfield (1994) suggest that self-reports are complexly controlled by both the private event and the subject's history of experience with the drug. Some of the self-reports they observed (e.g., feels like speed) are probably occasioned by a relatively narrow range of stimuli because in the subject's experience with drug administration, these reports have been more selectively reinforced by the verbal community relative to other reports (e.g., drug liking). They also suggest that these results imply…… [Read More]
Cognitive Behavioural Therapy Techniques
For Treating Sedative, Hypnotic or Anxiolytic use disorder
Sedative-Hypnotic are a Class of Medications that Includes Barbiturates.
Sedative hypnotic refers to the medication such as benzodiazepines, barbiturates and nonbenzodiazepine. All these are medications used to treat insomnia. They are referred to as Z drugs because the members consist of zaleplon, the eszopiclone and zolpiden all of which contain letter Z. Benzodiazepines are the most prescribed drugs across the globe. They are used to treat anxiety, disorder, insomnia and panic disorders. The drugs are used to treat disorders even though they are hazardous, and expose the user to other conditions such as physical dependence misuse, overdose as well as abuse (Levounis, Herron & American Psychiatric Association, 2014). When the individuals become dependent, they suffer from anxiolytic, hypnotic or sedative; a condition where one becomes dependent on the substances that cause a calming effect. They may also suffer…… [Read More]
Healing Touch Annotated Bib
Bardia, A., et.al. (2006). Efficacy of Complementary and Alternative Medicine Therapies in elieving Cancer Pain: A Systematic eview. Journal of Clinical Oncology. 24 (34): 457-64.
Anecdotal evidence abounds regarding the use of complementary and alternative medicine therapies when dealing with issues of pain. One of the clear issues is that there is a lack of rigorous and well-developed scholarly literature on the subject. In this study, 18 trials were reviewed totaling 1,499 patients. Seven trials reported significant benefits using CAM, seven reported intermediate or short-term benefits, and four studies reported no benefits. The researchers conclude that there are a number of variables and a number of types of CAM, all which require more methodologically sound studies in order to determine actual efficacy of individual interventions.
Jones, T., Glover, L. (2012). Exploring the Psychological Processes Underlying Touch:
Lessons From the Alexander Technique. Clinical Psychology and Psychotherapy. EPub:…… [Read More]
CUBAN CASE STUDY Mrs. Demetilla Hernandez a 63-year- Cuban woman seeks consultation Liberty health-maintenance organization (HMO) clinic weakness, lethargy, fatigue experienced 2 months. A week ago, cooking dinner daughter, Mariana's house, momentarily lost balance slipped kitchen floor.
CUBAN CASE STUDY
As a health-care provider, what are the typical Cuban communication patterns you need to be aware of in dealing with Mrs. Hernandez?
Latino families are often multigenerational in their composition. As the grandmother, Mrs. Hernandez assumes control over the family meals. This is a very important part of her identity. ather than communicating directly, food is love and emotions and feelings are communicated through food.
Q2. Describe the traditional Cuban food patterns. How would you assist Mrs. Hernandez
in developing a plan for a 1500-calorie diet and regular exercise?
People who have grown up in poor, food-insecure settings often develop patterns of eating high-calorie, high-carbohydrate comfort foods and many Latino…… [Read More]
Swallowing Difficulty and Speech Difficulty on Quality of Life in Patients with PEG Tubes vs. Those on NGT Feeding Systems
Stroke can effect neurological functioning and can have an effect on the patient's ability to talk and swallow. This condition can lead to severe malnutrition A decision is often made to feed the patient using a tube feeding method. Many studies have been performed to measure the clinical outcomes of these procedures, but few have focused on the effects of the patient's quality of life after receiving these interventions. This study will measure the effects of having a PEG tube inserted on the patient's quality of life as it relates to their ability to communicate and swallow. Two research questions will be answered: "Does a PEG procedure have an effect on the patient's ability to communicate their wishes and improve there satisfaction with the quality of their life in regards…… [Read More]
Walking: Slow down your walking to a regular pace for 5 minutes.
If needed utilize heat or ice therapy to knees after walk.
Stretching: Sit down on the floor and reach for your toes. Hold this position for 1 minute and do not bounce. Next, sit with your legs crisscrossed, place your arms out to the sides and rotate your center slowly from side to side. Finally, stand up and face the wall. Slow begin walking your feet away from the wall until you feel a stretch in your calves.
Walking: Walk at a regular pace for 5 minutes.
Increase your pace for 8 minutes.
Frequency: Once per day
Intensity: Your heart rate should be at 80 bpm during the fast-paced walking. If you find that it is becoming hard to breath, then slow down to a normal pace until your breathing is back under control.
Walking: Slow down…… [Read More]
Studies suggest that more computerized order entry of medications helps reduce errors by limiting interpretation errors due to handwriting (Meadows, 2003). Thus more order entry is involving computers to protect patients. A culture that supports safety and safe practices has also been adopted to provide nursing staff and patients information about drug therapy and medication to ensure that everyone is aware of the need for safe practices when utilizing and dispensing medications.
Describe the strategies used to ensure nursing practice is performed within legal requirements and ethical frameworks
Nurses now "live and work in a world where there is no single reality but many coexisting realities among which they must choose" (Johnston, 1999:1). Given that through more and more nurses are forced to make legal and ethical decisions and take steps that will determine the best processes to adopt to ensure that moral and legal processes are adopted and followed.…… [Read More]
A way to better distribute the information that is being taught in the classrooms is also through the community so that the changes are also effecting the parents to the students, as a change on their part as well would be helpful in the battle against obesity. It would be useful to initially target pamphlets, an informational booth or table at grocery stores, where the foundation of the problem lies. It would be effective if information is given before families go grocery shopping so they are more conscious of the items that they are purchasing. Furthermore, information should also be initially presented on TVs, in newspapers and magazines and other mediums that would likely be used in the more low-key and sedentary setting in order to galvanize individuals to get outside. Once outside, in order to sustain the physical activity, it would be nice to have water and juice at…… [Read More]
working with a diverse population of Native Americans, Hispanics, and other individuals in the prison systems and public clinics of this country, I have come to two, crucial conclusions. Firstly, that the currently cost-strapped environment of the national health care system cries out for innovative financial and sociological solutions. Secondly, I believe I require further education in the field of public health to accomplish my goals in seeking to remedy the systemic abuses I have personally witnessed in my own, current capacity as a physician's assistant. These two crucial reasons combine and fuse in my desire to pursue a PhD at Walden in the field of public health.
"Physician, heal thyself," goes the famous quotation -- and indeed, I have sought to heal my own gaps of knowledge through continually educating myself in the technical innovations of the medical field and of the current state of public health in America.…… [Read More]
Pharmaceutical industries have to operate in an environment that is highly competitive and subject to a wide variety of internal and external constraints. In recent times, there has been an increasing trend to reduce the cost of operation while competing with other companies that manufacture products that treat similar afflictions and ailments. The complexities in drug research and development and regulations have created an industry that is subject to intense pressure to perform. The amount of capital investment investments required to get a drug from conception, through clinical trials and into the market is enormous. The already high-strung pharmaceutical industry is increasingly investing greater amounts of resources in search of the next "blockbuster" drug that can help them gain market position and profits. Laws, regulations and patents are important to the industry while spending billions of dollars in ensuring the copyright of their products.
It is the intention of this…… [Read More]
In addition, the classic version of problem-based learning "requires students to collaborate, formulate learning issues by determining factors that may contribute to the cause or solution of a problem, identify relevant content, and generate hypotheses. Most problem-based learning models also contain student reflection components as a means of self-evaluation" (Knowlton & Sharp, 2003, pp. 5-6).
Although the positive effects of using a problem-based learning approach have been documented in a number of studies, the findings of other studies have indicated that problem-based learning may not compare favorably with more traditional teaching methods with regards to student's knowledge base, technical skills, or the resources expended; however, Dadd (2009) suggests that the benefits of using a problem-based learning approach justify the additional resources this method requires. Moreover, Simons et al. (2004) report that students using a problem-based learning approach "tend to develop more positive attitudes toward learning than students in more traditional…… [Read More]
The dexamethasone group showed meaningful improvements in several variables. After 48 hours, the women who received dexamethasone has a significantly reduced mean arterial pressure at 115 mm Hg v 94 m Hg, P < 0.05 and mean asparatate aminotransferase level at 100 IU/1 v 50 IU/1; P < 0.05. Their urine output also improved at 60 ml/h v 40 ml/h; P < 0.05 and a mean platelet count at 115-000 v 70 000; P < 0.05. The researchers concluded that their findings supported a high dose corticosteroid treatment of women with the HELLP syndrome. Although three control patients showed infectious complications, there were no statistically significant differences in morbidity.
As part of nursing and medical management, dexamethasone is often given to women with this condition and are between 24 and 34 weeks' gestation at risk of pre-term delivery to accelerate the maturation of fetal lungs (Matchaba and Moodley 2005). While…… [Read More]
Knowles stated "The richest resources for learning reside in the adult learners themselves" (p. 66). n instructional strategy like gaming may help to facilitate tapping into the adult learner's experience. Through collaboration during the play of a game, learners may discuss prior experiences to aid in discovery of the correct answer. Gaming activities also permit peer feedback to be given to students based on their previous experiences. The millennial student desires immediate feedback and integrates their experiences into their learning (Tapscott, 1998). gain, through group discussion and collaboration, learners share previous experiences with others to confirm or not the correct answer.
By not tapping into the experience of adult learners, negative effects may result (Knowles, 2005). The adult learner identifies their experiences as who they are. In other words, their experiences help to define them as a person. dult learners, who perceive their experiences as being ignored or devalued, perceive…… [Read More]
Healthcare for Mentally Impaired Patients
Probing what information is available about the current status of placement or accommodation and level of personal healthcare available to mentally impaired and emotionally disturbed individuals, it is clear that the analysis is as diverse as there are different mental illnesses. While statistics on managed care treatment for people with severe and disabling mental illnesses are sparse, it is evident that the financial responsibility to care for and house these patients is enormous.
According to Dr. David Satcher, the Surgeon General (1999), approximately 20% of the U.S. adult population has a mental illness. He says, "These illnesses include anxiety disorders, mood disorders, anorexia nervosa, and severe cognitive impairment. More serious mental illnesses include ipolar disorder and schizophrenia. Mental illness accounts for 15% of overall burden of disease -- more than malignant cancer and respiratory diseases -- and as far back as 1996 the direct cost…… [Read More]
g., teachers of young children, day-care employees, and residents and staff in institutional settings).
Persons who live or work in environments in which varicella transmission can occur (e.g., college students, inmates and staff of correctional institutions, and military personnel).
Nonpregnant women of childbearing age. Vaccination of women who are not pregnant -- but who may become pregnant in the future -- will reduce the risk for VZV transmission to the fetus.
Interpretation of elative History:
18-month female with fever, diffuse rash
Prime demographic for varicella infection)
Child is irritable but alert
Good sign, since toxicity would be an issue with this child. A good level of consciousness is useful in assessing the level of illness but can change quickly in the pediatric population)
Her heart rate is 180 beats per minute
She is tachycardic, but most likely due to the fever and irritability. The child is not described as tachypneic)…… [Read More]
Gulf War Syndrome (GWS), is a representation of several medical and psychological complaints, which are affecting several men and women who had participated in the Gulf War which took place in 1991. These ailments are muscular pain, skin rash; sleep disturbances peripheral numbness, memory loss, fatigue, respiratory illness, headaches, fever, spasms, low blood pressure and dizziness. The Depleted uranium could be considered partly as a factor responsible for the Gulf War Syndrome. The depleted uranium produced long-term health problems in people who had contacts with its usage. It was in the Gulf war that the Depleted uranium weapons were used for the first time. There have been studies conducted by scientists regarding whether depleted uranium affects the physical health of individuals. As a result they are of the opinion that many veterans of the Gulf War are affected in terms of health problems by the depleted uranium. Even though several…… [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]
ENEFITS, ARRIERS, CHALLENGES
ackground and Origin
Progressive mobility refers to a series of planned and sequential movements aimed at bringing the patient back to his or her baseline (Vollman, 2010). It consists of positioning and mobility techniques. A meta-analysis of 39 randomized trials was conducted to examine the effect of bed rest on 15 different medical conditions and procedures. Four short-term medical conditions were identified for critically ill patients. ut the major and long-term complication was the reduced quality of life after discharge on account of lost physical functions during their stay at the ICU. Another study conducted among survivors of acute respiratory conditions found that they lost 18% of their body weight and suffered much functional limitations from muscle wasting and fatigue. The more than 5 million who get confined at the ICU must come to terms with both the short- and long-term complications of immobility or prolonged…… [Read More]