Medicine and Health Sciences Commons^™

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Pectoralis Nerve Block Compared To Thoracic Paravertebral Nerve Block In The Mastectomy Patient: Evidence-Based Practice Recommendations, Eric Boyer

Doctor of Nursing Practice Scholarly Projects

Patients undergoing a mastectomy are at increased risk of becoming opioid dependent. Most patients undergoing a mastectomy are diagnosed with breast cancer, and the use of opioids is known to aid in cancer metastasizing due to the suppression of the body's natural killer cells. In addition, regional anesthesia, also known as a nerve block, has long provided a reduction in sensation by blocking the nerve pathway, thus numbing the feeling of pain in the operative area. The Pectoralis nerve block (PECS) and the Thoracic Paravertebral block (TPVB) are used in patients undergoing a mastectomy to help reduce the severity of …

Lung Cancer Screening In Primary Care, Ellen Macdonald

Masters Theses/Capstone Projects

A chart audit was completed in a central Ohio primary care office to evaluate the compliance of lung cancer screening according to guidelines set forth by the USPSTF.

Controlling High Blood Pressure, Heather M. Tatusko

Masters Theses/Capstone Projects

High blood pressure (HBP), also known as Hypertension (HTN), is a common diagnosis for primary care office visits in the United States; however, a persistent gap remains between the stated public health targets and achieved blood pressure (BP) control rates in the United States (US). In a small sample of patients with essential HTN (ICD 10: I10) receiving primary care at a mid-western Federally Qualified Health Center (FQHC), a chart audit tool revealed 10 out of 10 patients achieved BP control during the measurement period (defined as a BP reading <140/90). Quality improvement (QI) analysis revealed the bigger picture: Achieved BP control rates of patients does not reflect the 2017 American College of Cardiology/American Heart Association HBP guidelines. Additionally, the author found potential care gaps for patients in elevated BP (120-129/>80; n=34) and Stage 1 HTN (130-139/80-89; n=44) categories (who …

Perioperative Risks Of The Patient With Heart Failure, Gabrielle Metoyer

Nursing Student Class Projects (Formerly MSN)

Perioperative Risks of the Patient with Heart Failure

Gabrielle Metoyer

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology

Dr. Deanna Batross and Dr. Shivani Bhatnagar

August 5, 2022

Abstract

According to the CDC (2020), heart failure occurs when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is an epidemic disease affecting 1-2% of the population worldwide (Schwinger, 2020). It is one of the leading causes of morbidity and mortality worldwide with an estimated 6.5 million adults with heart failure in the United States (Lo et al., 2021). Medical advances …

Pathophysiology Of Aortic Stenosis, Melissa Lee

Nursing Student Class Projects (Formerly MSN)

Pathophysiology of Aortic Stenosis

Melissa J. Lee

Department of Nursing, Otterbein University

NURS 6810: Advanced Pathophysiology for the Advanced Practice Nurse

Dr. Deana Batross & Dr. Shivani Bhatnagar

July 29, 2022

Pathophysiology of Aortic Stenosis

Proper evaluation of co-morbidities is imperative for patient safety and successful outcomes for patients undergoing anesthesia. Aortic stenosis (AS) is one of the most complex diseases encountered in anesthesia, affecting five percent of older adults and ten percent of the 80-89-year-old-cohort (Joseph et al., 2017). The pathophysiological development of AS is the end result of an inflammatory process caused by endothelial damage from mechanical stress, …

Safety Measures In The Epilepsy Monitoring Unit: An Organizational Assessment, Tina Yates

Doctor of Nursing Practice Scholarly Projects

Long-term video-electroencephalography (EEG) monitoring in the epilepsy monitoring unit (EMU) is an elective procedure and generally safe. Clinical experts determined the EMU protocols at a level-4 comprehensive epilepsy center were not followed correctly. The project is a retrospective chart audit incorporating Ray’s Bureaucratic Caring theoretical framework with Donabedian’s conceptual model. The project objective is to evaluate if safety measures protocols are implemented appropriately in the EMU and determine whether a need exists for quality improvements.

The project reviewed patients admitted to the EMU from September 2021 through November 2021 who developed a generalized tonic clonic (GTCs) seizure with electrographic epileptiform …

Asthma Pathophysiology, Tyler Wolpert

Nursing Student Class Projects (Formerly MSN)

This poster will examine the pathophysiology of Asthma, explore signs and symptoms of the disease, and review different treatment modalities. The Doctorate of Nursing (DNP) prepared nurse should be able to identify signs and symptoms of the disease and be prepared to manage the disease from a medical standpoint, as well as with behavior modification. The economic burden of asthma on healthcare yearly is over $82 billion. It is pertinent that continued research is done in the field of asthma to reduce the economic impacts of the disease, as well as to help improve patient outcomes on people living with …

Malignant Hyperthermia, Joel Jackson

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is a hypermetabolic response to succinylcholine or inhaled volatile gases administered during anesthesia and is caused by an autosomal dominant mutation of RYR1 or CACNA1S genes which affect how calcium channels function. The uncontrolled, unopposed calcium release and excitation-contraction coupling results in sustained skeletal muscle contraction resulting in muscle rigidity, hyperthermia, hypercapnia, hypertension, and tachycardia among other less common clinical features. The sequelae of an MH crisis include renal failure, rhabdomyolysis, hyperkalemia, metabolic disturbance and left untreated will result in mortality. All clinicians involved in peri-operative care both in-hospital and out of hospital must be cognizant of …

Poster: Sars-Cov-2 Neuroinvasion, Heather M. Tatusko

Nursing Student Class Projects (Formerly MSN)

Over the last century, science and literature has reported neurological manifestations during various disease outbreaks as well as long-term sequelae following epidemics and pandemics. Some of the first neurological symptoms reported with Coronavirus Disease 2019 (COVID-19; caused by severe acute respiratory syndrome coronavirus 2 [SARS-Cov-2]) were anosmia and dysgeusia, suggesting SARS-CoV-2 penetrance of the central nervous system (CNS). To date, the definite clinical and pathological basis of CNS involvement of SARS-CoV-2 remains poorly understood, with the neurovirulence of SARS-CoV-2 and its neuroinvasive potential remaining largely unknown. The author’s poster will explore neurological manifestations of COVID-19 disease, the direct and indirect …

Cadaveric Endoscopic Gastrocnemius Recession Procedures To Identify Vital Anatomical Structures And Limit Intraoperative And Post-Operative Complications, Austin Combs

Undergraduate Distinction Papers

Gastrocnemius equinus contracture plays a role in a multitude of patient pathologies, conditions, and deformities seen in podiatric medicine (Barrett, 2011). Equinus deformity is associated with over 96% of the biomechanically-related foot and ankle pathologies including hallux valgus, metatarsalgia, capsulitis, pes planus, plantar fasciitis, tendonitis, and others (Deheer, 2015). These pathologies are linked with a decreased range of motion in the ankle joint specifically in dorsiflexion. Corrective approaches can be taken to reduce pathology if the patient presents prior to any major deformity. The aim of this study is to better define the location of the small saphenous vein and …

Malignant Hyperthermia For The Nurse Anesthetist, Victor Clark

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia (MH) is a rare, autosomal dominant skeletal muscle disorder that can have an insidious onset in susceptible patients exposed to the triggering agents succinylcholine, halothane, desflurane, sevoflurane, and isoflurane. MH can occur in patients who have received anesthesia with these agents in the past (Nagelhout & Plaus, 2018, p 775). Patients with a family history of MH or associated skeletal muscle disorder must be treated as MH-susceptible until proven otherwise. Failure to detect an MH crisis can lead to kidney failure, profound acidosis, coagulopathies, rhabdomyolysis, cardiac dysrhythmias, cardiovascular collapse, and death (Seifert et al., 2015). It is the …

Local Anesthesia Toxicity, Nicole Mccleery

Nursing Student Class Projects (Formerly MSN)

Local anesthesia (LA) provides a way to relieve temporary pain in a small part of the body and has been used for over 100 years (Fencl, 2015). LA also prevents the passage of surgical stimuli into the central nervous system (CNS) making a surgical procedure less painful for the patient (Noble, 2015). According to Noble, “altering the passage of stimuli from smaller diameter neurons in a confined area with lower drug dosages is called LA, such as the injection of LA around a surgical incision” (Noble, 2015, p.325). LA can be used in a variety of settings, such as in …

Synthesis Of Oxadeazoles With Electron Withdrawing Groups And The Analysis Of Product Yield With Bond Length, Elizabeth Ann Hall Peters

Undergraduate Honors Thesis Projects

2,5-disubstituted 1,3,4-oxadiazoles are a class of organic compound that are widely used and successful in pharmaceutical chemistry because they demonstrate strong biological activity. They are part of a larger class of compound called heterocycles, which make up most pharmaceutical drugs today. When synthesizing the compounds, higher yield means higher reactivity of the compound, and this is important for pharmaceuticals that need to have a strong biological activity. Per past studies, electron withdrawing groups on the compound allow higher, product yields. Along with electron withdrawing group addition, the bond length from electron withdrawing group and its corresponding carbon is analyzed to …

Clostridium Difficile, Ryan Osborn

Nursing Student Class Projects (Formerly MSN)

Clostridium Difficile infection (CDI) is an antibiotic resistant bacterium that is widely recognized and currently noted to be the "most common and costly healthcare associated infection in the United States" (Abt, McKenney & Pamer, 2016). The topic of CDI is important to discuss, as this infection can attack all patient populations especially those following antibiotic treatment. A disruption in a person's intestinal microbiota is known to place them at higher risk for CDI (Abt, McKenney & Pamer, 2016). Becoming infected with this bacterium leads to symptoms of diarrhea, bloating, belly pain, and occasionally fevers. The growing prevalence, antibiotic resistance associated …

Malignant Hyperthermia, Aaron Roth

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia is a rare disease trait and can take place in a variety of settings. If not treated in a timely manner, the consequences will be dire. It is recommended that nurses and other healthcare personnel be properly educated on MH crises. By detecting the signs and symptoms associated with the disease, providers can efficiently remedy the crisis and save patient lives (Seifert, 2014). Since the discovery of dantrolene in 1975 and the advancement of genetics regarding MH, death rates dropped from about 80% to about 5% (Schneiderbanger et al., 2014). Today there is a MH group called the …

Acute Respiratory Distress Syndrome, Jessica L. Kaufman

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is defined as lung failure with a ratio of partial pressure oxygen (PaO2) to fraction of inspired oxygen (FiO2) <100 (Michaels, Hill, Long, Young, Sperley, Shanks, & Morgan, 2013). ARDS is characterized by acute, widespread pulmonary inflammation due to infection (viral or bacterial), trauma, and/or inhaled toxins (Aokage, Palmer, Ichiba, & Takeda, 2015). Approximately 150,000 patients are diagnosed with ARDS each year in the U.S. with reported mortality rates varying from 20%-40% (Butt, Kurdowska, & Allen, 2016; Drahnak & Custer, 2015). The pathophysiology of acute respiratory syndrome is complex, and can result from a number of different insults. Acute respiratory distress syndrome is a life threatening condition that requires aggressive treatment with close monitoring. Successful treatment of ARDS requires expert knowledge from physicians, advanced practice nurses, bedside nurses, and respiratory therapists; all of whom must understand the complex underlying pathophysiology and critical nature of this condition.

Complex Regional Pain Syndrome, Maria A. Hendrix

Nursing Student Class Projects (Formerly MSN)

Complex regional pain syndrome (CRPS) is a chronic and often disabling condition that is seen in many patients seeking pain management. The condition leaves patients in excruciating pain that is disproportionate to the inciting injury. In addition, patients with this pain disorder experience abnormal sensations such as cold and heat allodynia, hyperalgesia, edema, abnormal sudomotor activity and trophic changes (D. Lee et al., 2015). CRPS disproportionally affects four times as many women as men (Alexander, Peterlin, Perreault, Grothusen, & Schwartzman, 2012). There are two types of CRPS: type 1, often referred to as reflex sympathetic dystrophy (RSD), is not evident …

Assessing Cultural Competence In Nursing Students At A Small Private Liberal Arts University, Mikah K. Barrueta Ms

Undergraduate Honors Thesis Projects

Appropriate care across cultures can occur only when patient, family, and community expectations are aligned with provider knowledge, attitude, and behavior (Doorenbos et al, 2005). Because nurses treat patients from all types of backgrounds, a culturally competent approach should and must be used when educating and training future nurses. The purpose of this study is to assess various cultural competence components of senior nursing students at a small Midwestern University. In order to assess this sample population, two peer-reviewed surveys were chosen; the Quality and Culture Quiz and the Affective Racial Attitudes subscale from the Quick Discrimination Index. Three more …

Myasthenia Gravis, Abbe R. Feaver

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease characterized by ocular, bulbar, facial, and skeletal muscle weakness due to a defect in the transmission of nerve to muscle impulses at the neuromuscular junction (Mestecky, 2013, p. 110). Approximately 14-20 in 100,000 people are diagnosed with myasthenia gravis in the United States (Leis, Moore, Kofler, Beric, De Visser, 2014, p. 112). Typically, diagnosis occurs in middle-aged adults with women generally acquiring the disease at a younger age than men (Mestecky, 2013, p. 110). MG has the potential to greatly affect the quality of life of a patient. Although the disease …

Neurocysticercosis, Abigail Hill

Nursing Student Class Projects (Formerly MSN)

Neurocysticercosis (NCC) is one of the most common parasitic infections of the central nervous system in humans and is the most serious clinical manifestation of cysticercosis. NCC is caused by the ingestion of the larval form of the pork tapeworm Taenia solium. NCC is endemic in low income developing countries where pigs are commonly raised, including the countries of Central America, South America, and parts of Africa and Asia. (Naddaf, Seeger, & Stafstrom, 2014). The parasite Taenia solium encysts in the brain and can express a broad range of symptoms including seizures, headache, hydrocephalus, encephalitis, stroke and mental health and …

Prevalence Of Sepsis In Pediatric Populations, Brittany Barnes

Nursing Student Class Projects (Formerly MSN)

Sepsis and more specifically septic shock in the pediatric population is a diagnosis that is full of complexities. There are instances where a neutropenic oncology patient observes a better outcome than a previously healthy patient who is suffering from the same pathogen related sepsis. Sepsis is the 10th leading cause of death according to the Center for Disease Control and Prevention, and each year between 20,000 and 42,000 children are diagnosed with severe sepsis (Riley & Wheeler, 2012). Even with significant advances in medical treatment, sepsis is still associated with high morbidity and mortality rates. A retrospective study of patient …

Marfan Syndrome In Athletes, Chelsey Hastings

Nursing Student Class Projects (Formerly MSN)

Genetic disorders are widely misunderstood in our society and can lead to early mortality. Marfan syndrome (MFS) is a genetic disorder that affects connective tissue (Harris, Croce, & Tian, 2014). Antoine Marfan, a French pediatrician, first described this disease in 1896 (Elshershari & Harris, 2014). MFS can manifest in several different organ systems. The cardiovascular complications of aortic dilation and dissection often account for the morbidity associated with this disease (Harris et al., 2014). Understanding the inheritance, pathophysiology, and treatment of MFS is important for the advanced practice nurse (APN). Prevalence of the disease is approximately two per 10,000 individuals, …

Granulomatosis With Polyangiitis (Wegner’S) : Often Mistaken For Tuberculosis, Dawn Palumbo

Nursing Student Class Projects (Formerly MSN)

The exact cause of GPA has yet to be identified. Dinić et al. (2013) defines GPA/WG as “anti-neutrophil cytoplasmic antibodies (ANCAs)- associated systemic vasculitis of unknown etiology” (p. 887). According to Alam, Dastider, Ahmed, and Rabbani (2012) both cellular and humoral immunity are thought to be involved in the pathogenesis of wegener’s granulomatosis. “ The initial pathologic lesion is granuloma believed to be caused by cellular immune process. The strong association on C-ANCA with this disease suggests the role of humoral immunity” (Alam et al., 2014, p. 98). Huang et al. (2013) suggest, “The main pathological features of limited Wegeners’ …

Basal Cell Carcinoma—A Preventable Disease, Jamie Weaver

Nursing Student Class Projects (Formerly MSN)

Basal cell carcinoma (BCC) is a nonmelanoma skin cancer. According to the Skin Cancer Foundation, “BCC is the most frequently occurring form of all skin cancers. More than one out of every three new cancers is a skin cancer, and the vast majority are BCC’s” (www.skincancer.org). Exposure to ultraviolet (UV) rays is one of the main risk factors in developing a BCC. People with a lighter skin tone are at a higher risk of developing a BCC than those with a darker skin tone.

Nash: Non-Alcoholic Steatohepatitis, Jennifer Heck

Nursing Student Class Projects (Formerly MSN)

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease which refers to the presence of hepatic steatosis without significant intake of alcohol. Non-alcoholic fatty liver disease develops in a variety of forms from reversible simple steatosis to non-alcoholic steatohepatitis (NASH), which if left unchecked can progress to liver fibrosis, cirrhosis and even develop into hepatocellular carcinoma (Mells et al., 2014). NAFLD is thought to be nonthreatening, but with progression over several years could lead to NASH. A strong link between obesity and NASH has been shown. In addition to obesity, insulin resistance (type II diabetes mellitus), and hyperlipidemia all …

Non-Valvular Atrial Fibrillation And Stroke: Novel Oral Anticoagulants Versus Vitamin K Antagonists, Kathryn A. Viglietta

Nursing Student Class Projects (Formerly MSN)

Atrial fibrillation (afib) is the most common sustained cardiac arrhythmia and second most common cardiovascular condition in adults in the United States (Zarraga & Kron, 2012). •2.2 million affected, increases risk of stroke 4 to 6 times (National Institute of Neurological Disorders and Stroke [NINDS], 2015). •Vitamin K antagonists (VKAs) have been mainstay of therapy for over 60 years (King, Holley& Moores, 2013). •Limitations with VKAs such as variability in response, need for frequent lab draws, food and drug interactions which decrease patients adherence and under prescribing by physicians (Halperin & Goyette, 2012). •Novel oral anticoagulants (NOACs) have been approved …

The Importance Of Evaluation And Management Of Sepsis, Severe Sepsis, And Septic Shock, Katherine Herda

Nursing Student Class Projects (Formerly MSN)

Sepsis is a life-threatening and complicated host response to the presence of infection that is affecting millions of individuals around the world each year (Dellinger et al., 2013, p. 583). According to Gray et al. (2013), sepsis is not only one of the primary causes of hospital admission but it is also a leading cause of morbidity and mortality worldwide (p. 397). Severe sepsis and septic shock are the more advanced and detrimental stages of sepsis, which are starting to increase in incidence and are killing one in four (and sometimes more) individuals infected (Dellinger et al., 2013, p. 583). …

Gout, Lorrie Listebarger

Nursing Student Class Projects (Formerly MSN)

Gout is a syndrome caused by an inflammatory response creating an over production of uric acid increasing uric acid levels in the blood and body fluids. Gout is defined as a disorder resulting from tissue deposition of MSU crystals (in joints, bursae, bone, and certain other soft tissues, such as ligaments, tendons and occasionally, skin) and/or crystallization of uric acid within the renal collecting system (tubules and renal pelvis) that typically occurs in acid urine” (Terkeltaub & Edwards, 2013, p. 20). Gout is among the oldest diseases affecting approximately 3.9% of adults in America (Terkeltaub & Edwards, 2013, p. xv). …

Diabetic Ketoacidosis, Mario Bianconi

Nursing Student Class Projects (Formerly MSN)

According to “Statistics About Diabetes” (2014), in 2012, 29.1 million Americans, or 9.3% of the population, had diabetes. Additionally, of the 29.1 million, 21 million of the population were diagnosed, and 8.1 million were undiagnosed. With such a high prevalence, it is imperative that the hospital nurse is aware not only how to treat diabetes, but also how to look for complications of diabetes. One of the severe complications of diabetes is Diabetic Ketoacidosis, or DKA. DKA occurs as a result of prolonged untreated diabetes. It is the result of the body not being able to produce, or use, insulin …