Ulcer
Many people say that an ulcer is caused by stress whereas scientific journals states that it is caused by bacteria. Actually, ulcer has traditionally been thought as a condition brought by stress as well as the consumption of coffee and spicy foods. Generally, an ulcer was believed to be a by-product of lifestyle factors like diet and stress. In the past few years, it has emerged that an ulcer is caused by a bacterial infection as stated in various scientific journals on ulcers. This change can be attributed to the fact that researchers determined that stomach acids like hydrochloric acid generates the formation of an ulcer. The determination that an ulcer is largely caused by bacterial infections raises concerns on whether bacteria survive the gastric juice and cause harm to an individual's body.

Gastric juice is primarily made of hydrochloric acid and pepsin, an enzyme that breaks down protein. Given its…...

Peptic Ulcer Disease: Pathophysiology
A peptic ulcer can be defined as "a focal mucosal defect with inflammatory cell infiltration and coagulation necrosis extending through the muscularis mucosae" (Halter, 1995, p. 2). Contrary to erosion, a peptic ulcer extends beyond the epithelial structures into that intestinal tract section that happens to be in constant contact with pepsin and acid-containing gastric juice (Halter, 1995). Peptic ulcers cause an imbalance between the gastro duodenal defense-influencing factors such as prostaglandin, bicarbonate and mucus, and those such as NSAID use, H. pylori, pepsin and gastric acid, which promote mucosal damage (Elsevier, 2012). If peptic ulcers keep recurring at the same site, the imbalance worsens, resulting in peptic ulcer disease (PUD).

Two types of peptic ulcers can be deduced from the explanation above; duodenal and gastric ulcers (Elsevier, 2012).

Gastric Ulcers: there are four major classifications of gastric ulcers: type I, type II, type III and type IV (Elsevier,…...

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References

Elsevier. (2012). Peptic Ulcer Disease. Clinical Key Elsevier. Retrieved from https://www.clinicalkey.com/topics/gastroenterology/peptic-ulcer-disease.html

Halter, F. (1995). Pathophysiology of Peptic Ulcer Disease. In D. Hollander & G. Tytgat (Eds.), Sucralfate: from Basic Science to the Bedside (Ch. 10). New York: Plenum Press.

UMMC. (2013). Peptic Ulcer. The University of Maryland Medical Center. Retrieved from  http://umm.edu/health/medical/ency/articles/peptic-ulcer

Peptic ulcer, often known as a peptic ulcer disease, is a painful condition of the abdomen resulting in mucosal erosion of the gastrointestinal tract usually by excessive acid (consult, 2007) these erosions can only be categorized as peptic ulcers if they are larger than 0.5cm in diameter. Peptic ulcers can be classified according to the location where they appear hence the ulcers occurring in the duodenum are known as duodenal ulcers, those occurring in the stomach are known as gastric ulcers and those in esophagus are known as esophageal ulcers. The causes of peptic ulcers majorly include special spiral bacteria known as Helicobacter pylori which produces excessive acid in the gastrointestinal tract and makes its mucosa eroded. Helicobacter pylori are responsible for at least 70-90% of peptic ulcers although only 40% of these cases are reported to the doctors. Another well-known cause of peptic ulcers is the excessive usage of…...

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Works Cited

A, S., & Muller-Lissner SA, V.E. (1981). "Predictors of duodenal ulcer healing and relapse. Journal of Gastroenterology, 81 (6): 1061 -- 1067.

consult, G. (2007, 08-26). perforated peptic ulcer. Retrieved 10-29, 2011, from GI consult:  http://www.emedmag.com/Default.aspx 

Kato, I., & Abraham M.Y. Nomura, G.N.-H. (1992). "A Prospective Study of Gastric and Duodenal Ulcer and Its Relation to Smoking, Alcohol, and Diet." American Journal of Epidemiology, 135 (5): 521 -- 530.

Kurata JH, H.B. (1984). Epidemiology of peptic ulcer disease. Clin Gastroenterol., 13(2):289-307.

Discussions 1
The mechanics of breathing are greatly compromised in each of the cases in the following manners: infant respiratory distress syndrome leads air sacs to collapse when air is expired and increases the energy needed to breathe; emphysema leads to air sacs becoming damaged and enlarged, which makes it difficult to breathe; and pulmonary fibrosis leads to air sacs becoming scarred, which makes it difficult to breathe.
The physiology that plays a vital role in the development of these diseases consists of the following: infant respiratory distress syndrome stems from a lack of surfactant in the lungs; premature birth is often one reason for this lack.[footnoteRef:2] The physiology of the development of emphysema can include the presence of chronic bronchitis which can lead to it; smoking, or exposure to harmful chemicals and irritants over time. For pulmonary fibrosis, the physiology includes exposure to silica dust, asbestos, coal dust, and long term exposure…...

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Bibliography

Cutter, Richard D. “Auditory nerve involvement after tetanus antitoxin: first reported case.” Journal of the American Medical Association 106, no. 12 (1936): 1006-1007.

Di Saverio, Salomone, Marco Bassi, Nazareno Smerieri, Michele Masetti, Francesco Ferrara, Carlo Fabbri, Luca Ansaloni et al. “Diagnosis and treatment of perforated or bleeding peptic ulcers: 2013 WSES position paper.” World Journal of Emergency Surgery 9, no. 1 (2014): 45.

Haberal, M., Abali, A. E. S., & Karakayali, H. “Fluid management in major burn injuries.” Indian Journal of Plastic Surgery: official publication of the Association of Plastic Surgeons of India, 43(Suppl) (2010): S29.

Jasani, Bonny, Nandkishor Kabra, and Ruchi Nanavati. “Surfactant replacement therapy beyond respiratory distress syndrome in neonates.” Indian Pediatrics 53, no. 3 (2016): 229-234.

Sgroi, Michael D., and Brian R. Smith. “Severe Epigastric Abdominal Pain.” In Surgery, pp. 493-499. Springer, New York, NY, 2015.

Pathophysiology of Gastric Acid Stimulation and Production
The human body produces gastric acid in the stomach, primarily to digest proteins (Anand, 2015; Huether & McCance, 2012). It is composed o hydrochloric acid and sodium chloride. It digests proteins through the action of digestive enzymes and allowing digestive enzymes break down the long chains of amino acids from digested proteins. The production of gastric acid us regulated by the autonomous nervous system and a number of hormones, and by positive regulators and negative feedback processes (Anand, Huether & McCance). But these structures and processes change when diseased conditions, like gastroesophageal relux disease or GED, peptic ulcer disease and gastritis, develop.

Summary

GED includes all the offshoots and by-products of acid reflux and other stomach irritants pushing up into the esophagus (Anand, 2015; Huether & McCance, 2012). The reflux is primarily caused by the failure of the anti-reflux barriers to perform their function. It becomes…...

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References

Anand, B.S. (2015). Peptic Ulcer Disease. Retrieved on July 22, 2015 from  http://www.emedicine.medscape.com/article/181753-overview 

Dach, J. (2015). Bioidentical hormones. Chapter 36 Heartburn, GE Reflux (GERD) ad Acid

Blocker Drugs. Retrieved on July 25, 2015 from  http://www.bioidenticalhormones101.com/Heartburn_Reflux_PPI_Drug.html 

Huether, S.E. & McCance, K. I. (2012). Understanding Pathophysiology. Laureate custom edition.. Philadelphia, PA: MosbyHiuHuntrHune

performing a clean and sterile technique wound dressing change.
The term sterile refers to being free from microorganisms, making the sterile technique method one that reduces exposure to microorganisms in a comprehensive way. Sterile wound dressing changes would mean meticulous hand washing, the use of sterile field, use of sterile gloves, and sterile instruments (Wound, Ostomy and Continence Nurses Society (Potter, et al., 2013; WOCN, 2012). The sterile techniques would be important in acute care and other settings in which patients may be at high risk for infection (WOCN, 2012).

The clean wound dressing change techniques imply methods that are sensible for reducing overall exposure to microorganisms or exposure to infections, but which do not count directly upon "sterile to sterile" rules (WOCN, 2012). Thus, meticulous hand washing and sterile environment are called for, but the process does not strictly deny contact between sterile instruments and non-sterile surfaces or products. While…...

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References

Lippincott Nursing Center (2008). Wound wise: Basic wound cleaning step-by-step. Nursing Made Incredibly Easy 6(5): 30-31.

Perry, A.G. & Potter, P.A. (2012). Nursing Interventions. 5th Edition. St. Louis: Elsevier.

Potter, P.A, et al. (2013). Fundamentals of Nursing. 8th Edition. St. Louis: Elsevier.

WOCN (2012). Clean vs. sterile dressing techniques for management of chronic wounds: a fact sheet. Retrieved online:  http://journals.lww.com/jwocnonline/Fulltext/2012/03001/Clean_vs__Sterile_Dressing_Techniques_for.7.aspx

Treatment for a Patient With a Duodenal Ulcer
Until relatively recently, stress and spicy foods were deemed to be the likely causes of ulcers. That has changed, however, with the discovery of the causal link between H. pylori and duodenal ulcers. "Infection with Helicobacter pylori (commonly just called H. pylori) is the cause in about 19 in 20 cases of duodenal ulcer" (Kenny 2012). For some people who are infected, the bacteria causes no symptoms while for others it causes a disruption of the mucus barrier and an increase in the amount of digestive acid in the lining of the stomach, resulting in inflammation and discomfort, ultimately cumulating in an ulcer (Kenny 2012).

This revelation about the causation of ulcers has caused a dramatic shift in how they are treated. Instead of prescribing surgery, a 4-8-week course of acid-suppressing medication is used. The intention is to allow the ulcer to heal. A…...

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References

DiMarino, M. (2014). Peptic ulcer disease. Merck Manual. Retrieved from:

 http://www.merckmanuals.com/professional/gastrointestinal_disorders/gastritis_and_peptic_ulcer_disease/peptic_ulcer_disease.html 

Kenny, T. (2012). Duodenal ulcer. Patient. Retrieved from:

 http://www.patient.co.uk/health/Duodenal-Ulcer.htm

Marshall and arren discovered that the organism was there in almost every patient with gastric ulcer and inflammation. Based on the results of their findings, they suggested that Helicobacter pylori are involved in the aetiology of these diseases. In fact, Helicobacter pylori cause over 90% of duodenal ulcers and about 80% of gastric ulcers. After this discovery, research has been deep.
This bacterium can be diagnosed by identification of the organism in biopsies, by antibody tests or by non-invasive breath test which recognizes bacterial production of an enzyme in the stomach. The use of antibiotics to eliminate Helicobacter pylori may lead to severe problems since bacteria and chronic inflammation of the stomach remains. Marshall, arren and other researchers showed that patients could be cured from peptic ulcer by eradication of the bacteria from the stomach. Due to Marshall and arren's discovery, peptic ulcer is no longer a chronic disabling disease…...

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Works Cited:

Claessen, Elin L. "How Stomach Ulcer Bacteria Survive in the Stomach." UNIVERSITY of GOTHENBURG. University of Gothenburg, Sweden, 1 Nov. 2007. Web. 10 Mar. 2010. .

"The Nobel Prize in Physiology or Medicine 2005." Nobelprize.org. Nobel Web, 3 Oct. 2005. Web. 10 Mar. 2010. .

United States. National Digestive Diseases Information Clearinghouse. Centers for Disease Control and Prevention. Viral Gastroenteritis. By Mary K. Estes and Robert Atmar. National Institute of Diabetes and Digestive and Kidney Diseases, Feb. 2006. Web. 10 Mar. 2010. .

United States. National Digestive Diseases Information Clearinghouse. National Digestive Diseases Information Clearinghouse. H. Pylori and Peptic Ulcer. National Institute of Diabetes and Digestive and Kidney Diseases, Oct. 2004. Web. 10 Mar. 2010. .

Otherwise, the resources are either short or unavailable. These situations tend to make gains in pressure ulcer care quickly vanish (Cuddigan et al.).
Lastly, national records on pressure ulcer rates have remained incomplete and unreliable (Cuddigan et al. 2001). Hospital discharge records do not all reflect or include pressure ulcer cases even if the patients reach Stage III or IV. In addition, these records are unable to recognize and tally the difference between pressure ulcers at different stages and complications already present on admission. It is still a fact that pressure ulcer rates in these databases remain lower than those gathered in clinical studies, indicating the inaccuracy of the databases. Yet valid and complete information from these national databases is needed to provide accurate feedback to providers. They form the basis for sound clinical, educational and public policy decisions for the future (Cuddigan et al.).

ibliography

Allman R.M. et al. (1995). Pressure…...

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Bibliography

Allman R.M. et al. (1995). Pressure Ulcer Risk Factors Among Hospitalized Patients with Activity Limitation. 5 pages. Hopkins Medicine. Retrieved on January 5, 2008 at  http://www.hopkinsmedicine.org/geriatrics/education/MedStudent/Geriatrics/SummerScholarsProgram/Section8.pdf 

Berman, K (2007). Pressure Ulcer. 1 web page. MedlinePlus: National Institute of Health

Collins, N (2002). Vitamin C and Pressure Ulcers. 4 pages. Advances in Skin and Wound Care: Springhouse Corporation

Cuddigan, J. et al. (2001). Pressure Ulcers in America: Prevalence, Incidence and Implications for the Future. 9 pages. Advances in Skin and Wound Care: Springhouse Corporation

The use of aspirin and other NSAIDs has not been eliminated by studies as possible causes of PUD. H. pylori infection generally occurred less among patients with complicated ulcer disease than in those with uncomplicated ulcer disease. Many studies point to aspirin or NSAIDs as the other identifiable risk or cause of PUD. PPI has been shown to reduce dyspeptic symptoms, which develop from NSAID use. In the past, lansoprazole was the only FDA-approved PPI. Recently, however, professors at the University Hospital, Queen's Medical Centre of Nottingham in the United Kingdom presented their findings on a comparison among PPIs. Their study was internationally-based with more than 500 patients. It showed that esomeprazole was superior to other PPIs in managing upper gastrointestinal symptoms of arthritic patients. It also enhanced their quality of life (Howden).
PUD is not only likely to remain a persistent condition (Howden, 2003). More cases of ulcers unconnected…...

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BIBLIOGRAPHY

Hansen, J.M.; Wildner-Christensen, M.; Hellas, J.; and Schaffalitzky de Muckadell, O.

B. (2008). Effects of a community screening for helicobacter pylori 103 (5): 1106-

1113 The American Journal of Gastroenterology: Blackwell Publishing. Retrieved on July 24, 2009 from  http://www.medscape.com/viewarticle/578729 

Howden, C.W. (2003). Peptic ulcer disease. Medscape Public Health & Prevention:

Pressure Ulcers/Case Study
Bedsores are also known as pressure ulcers. They are lesions that are primarily caused when soft tissues are pressed against bone for a long period of time, restricting blood flow to the area. These often occur when a patient is immobile or reclining in a recovery bed for a long period of time. They are common on the hips, elbows, knees, ankles and even the back of the head. Current research shows that they are exacerbated by other conditions like diabetes, perspiration, incontinence, infection, or medications that impair the circulatory system. Pressure ulcers are particularly serious in older patients -- particularly those in a wheel chair or in cases in which the patient does not move or exercise. Bedsores are often fatal, even when treated aggressively and are one of the leading causes of death from complications in many developed countries -- second only to adverse drug reactions…...

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REFERENCES

Coverage Information retrieved from  http://www.medicare.gov 

Medicare Nonpayment for Hospital Acquired Conditions. (2012). National Conference of State Legislatures. Retrieved from:  http://www.ncsl.org/issues-research/health/medicare-nonpayment-for-hospital-acquired-conditio.aspx 

Medicare Will Not Pay for Hospital Mistakes and Infections. (2007, August 20).

Medicalnewstoday. Retrieved from:  http://www.medicalnewstoday.com/articles/80074.php

Preventing Pressure Ulcers in Nursing Home Patients
With growing numbers of the American population joining the elderly ranks, there has been a corresponding increase in the number of residents of long-term care facilities including approximately 16,100 nursing homes in recent years (Palumbo & Mclaughlin, 2011). As a result, there has also been increased interest among clinicians concerning optimal turning and repositioning rates for immobile nursing home patients to reduce pressure ulcers (Miller & Ward, 2010). The need for improved care of pressure ulcers is great, and it has been estimated that the cost of each pressure ulcer incident ranges between $500 and $70,000 for a staggering total of $11 billion annually (Lilly & Estocada, 2014). Therefore, the question of interest for this study is whether turning and repositioning a patient more frequently (i.e., every 2 hours) reduces the risk of patients developing pressure ulcers compared with patient turned and repositioned less…...

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References

Lilly, D. & Estocada, N. (2014, December 1). Validation of the NE1 Wound Assessment Tool to improve staging of pressure ulcers on admission by registered nurses. Journal of Nursing Measurement, 22(3), 438-441.

Miller, L. L. & Ward, D. (2010, Spring). Evidence-based practices in nursing. Generations, 34(1), 72-77.

Palumbo, M. V. & Mclaughlin, V. (2011, Winter). Practical nurses' health and safety in nursing homes. Journal of Health and Human Services Administration, 34(3), 271-277.

Peterson, M. J. & Gravenstein, N. (2013, April). Patient repositioning and pressure ulcer risk-monitoring interface pressures of at-risk patients. Journal of Rehabilitation Research & Development, 50(4), 477-481.

Patient Turning Every Two Hours and Positioning Decreases the Development of New Pressure Ulcers
The objective of this study is to determine whether turning and positioning of a patient every two hours decreases in the development of new pressure ulcers. Toward this end, this study will conduct a review of the literature in this area of inquiry.

The work of ich, et al. (2011) entitled "Frequent Manual epositioning and Incident of Pressure Ulcers Among Fracture Patients" reports that frequent manual repositioning "is an established part of pressure ulcer (PU) prevention, but there is little evidence for its effectiveness." (p.1) The study reported by ich, et al. conducted an examination of the link between repositioning and incidence of pressure ulcers among elderly patients that were bedbound fracture patients. The study findings indicate that there was no link between patient repositioning and incidence of pressure ulcers. However, the work of Ostadabbas, et al.…...

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References

Baldwin, C. (nd) New Turning and Positioning System Facilitates Patient Repositioning to Aid in Pressure Ulcer Healing. Kindred Healthcare. Retrieved from:  http://www.sageproducts.com/documents/pdf/education/case_studies/sacral/21495.pdf 

National Institutes of Health, National Institute of Nursing Research, National Institute on Aging, et al. (2008) Pressure Ulcer Prevention: Turning for Ulcer Reduction (TURN) Clinical Trials Gov. Retrieved from:  http://clinicaltrials.gov/ct2/show/NCT00665535 

Prevention of Pressure Ulcers (2011) National Guideline Clearinghouse. Retrieved from:  http://www.guideline.gov/syntheses/printView.aspx?id=47794 

Rich, SE (2011) Frequent manual repositioning and incidence of pressure ulcers among bedbound elderly hip fracture patients. Wound Repair Regen, Jan 2011; 19(1): 10-18. Retrieved from:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059225/

Role of Staff Education in Pressure Ulcer Incidence in Long-Term Care Residents
Pressure ulcers (PUs), also known as bed sores, decubitus ulcers, or pressure sores, are formed where skin and tissue are squeezed between bone and an outside surface for long periods of time, often due to immobility ("Pressure Ulcer," 2002). The development of PUs is a common problem in long-term care of the elderly. A recent report by a national pressure ulcer organization estimates the prevalence of PUs in acute care at about 15%, with about a 7% incidence after admission (National Pressure Ulcer Advisory Panel, 2001).

Because PUs are so common, cause distress to the patient and their family, and can form the basis for litigation, it is important for the long-term medical care community to find ways to reduce their prevalence and incidence. Two commonly suggested solutions to the PU problem include identifying patients at risk using risk assessment…...

Pressure Ulcers in the Elderly During Hospital Stays
Pressure ulcers are potentially fatal skin lesions that develop especially in frail, elderly patients on bony or cartilaginous areas such as the sacrum, elbows, and ankles. Within acute care in the United States, the incidence of pressure ulcers lies between 0.4% and 38%. The incidence within long-term and home care is significantly lower while intensive care units report that 8% to 40% of ICU patients develop pressure ulcers during the hospital stay (Cuddigan, Berlowitz & Ayello, 2001). An epidemiological study of pressure ulcers reports that hospital-acquired pressure ulcers cost the U.S. $2.2 to $3.6 billion per year in 1999 (Vandenkerkhof, Friedberg & Harrison, 2011). These statistics carry important implications for guidelines of identification and treatment of pressure ulcers in the United States. In the complexity of the medical system, the application of Jean Watson's Theory of Nursing Caring and the developing role of…...

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References

Baumgarten, M., Margolis, D.J., Localio, A.R., Kagan, S.H., et al. (2006). Pressure Ulcers Among Elderly Patients Early in the Hospital Stay. The Journals of Gerontology, 61, 7, 749-754.

Baumgarten, M., Margolis, D.J. Localio, A.R., Kagan, S.H., Lowe, R.A., Kinosian, B., Abbuhl, S.B., Kavesh, W., Holmes, J.H., Ruffin, A., Mehari, T., et al. (2008). Extrinsic Risk Factors for Pressure Ulcers Early in the Hospital Stay: A Nested Case-Control Study. The Journals of Gerontology, 63, 4, 408-413.

Cara, C. (2003). Continuing Education: A Pragmatic View of Jean Watson's Caring Theory. International Journal of Human Caring, 7, 3, 51-61.

Clegg, A., Bradley, M., Smith, P., Kirk, Z. (2006). Developing the nurse's role in the care of older people. Nursing Older People, 18, 5, 26-30.

Implementing Evidence-Based Practice in Nursing Care

Evidence-based practice (EBP) is a systematic approach to healthcare that incorporates the best available research, clinical expertise, and patient values to deliver optimal patient outcomes. In nursing care, implementing EBP has proven instrumental in enhancing the quality and effectiveness of interventions.

Benefits of EBP in Patient Outcomes

Improved Patient Safety:

EBP guidelines reduce medication errors, hospital-acquired infections, and other adverse events by providing standardized protocols based on proven research.
Risk assessment tools and early warning systems help identify and intervene on potential complications early on.

Enhanced Treatment Efficacy:

EBP supports the use of therapies and interventions that have....

Proper nutrition and lifestyle choices play a critical role in maintaining the health of the digestive system. The digestive system is responsible for breaking down and absorbing nutrients from the food we eat, as well as eliminating waste from the body. When this system is not functioning properly, it can lead to a variety of digestive issues such as bloating, gas, diarrhea, constipation, and even more serious conditions like irritable bowel syndrome or inflammatory bowel disease. By making smart choices about what we eat and how we live, we can help support the health of our digestive system and prevent....

## The Impact of Proper Nutrition and Lifestyle Choices on Digestive Health

The digestive system plays a pivotal role in overall well-being, responsible for extracting nutrients from food and eliminating waste products. Maintaining a healthy digestive system is crucial for optimal physical and mental health. Proper nutrition and lifestyle choices can significantly impact the health of the digestive tract.

### Role of Nutrition in Digestive Health

Dietary Fiber: Fiber is an indigestible carbohydrate that promotes bowel regularity and prevents constipation. Soluble fiber, found in fruits, vegetables, and beans, absorbs water and forms a gel-like substance that slows digestion and helps regulate blood sugar....

How Radiology Specialists Harness Imaging Techniques for Accurate Diagnosis and Treatment

Radiology specialists, including radiologists and radiation oncologists, play a crucial role in modern healthcare by utilizing advanced imaging techniques to diagnose and treat medical conditions with precision. These techniques allow for non-invasive visualization of the body's internal structures, providing valuable information for accurate diagnosis and effective treatment planning.

Imaging Modalities

Radiology specialists utilize a range of imaging modalities to obtain detailed images of the body. These modalities include:

X-ray: Creates two-dimensional images of bones and some soft tissues.
Computed tomography (CT): Uses X-rays and sophisticated computer processing to generate cross-sectional images of....