Medicine and Health Sciences Commons^™

The Pathophysiology Of Heart Failure, Amber C. Tieu

Nursing Student Class Projects (Formerly MSN)

Abstract

The purpose of this presentation was to discuss the pathophysiology of heart failure. Topics covered included disease prevalence and common signs and symptoms. The pathophysiology of heart failure is further discussed identifying how heart failure is classified and how each compensatory mechanism of heart failure leads to further disease progression. Implications for nursing care are discussed including goals of treatment, medication regimens, and patient education on disease management.

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 …

Post-Operative Nausea And Vomiting, Casey Schmiesing

Nursing Student Class Projects (Formerly MSN)

Post-operative nausea and vomiting (PONV) is any nausea or vomiting that follows immediately after and up to 48 hours post surgery. PONV is common complaint from patients and has many serious consequences to the patient and hospital. There are several risk factors that make a patient more susceptible to experiencing PONV. Using a multimodal approach to work on all receptors involved with the vomiting reflex will help decrease the chances of the patient getting PONV. There are several implications for anesthesia providers to decrease PONV with their patients.

Angioedema: Adverse Reaction From Ace-Inhibitors, Jennifer L. Hawkins

Nursing Student Class Projects (Formerly MSN)

Angiotensin-converting enzyme inhibitor (ACEI) medications are one of the leading causes of angioedema in the United States, also known as ACEI-RA (Chan & Soliman, 2015). ACEI medications are frequently prescribed to help manage diseases, such as hypertension and congestive heart failure, and include, but are not limited to lisinopril and enalapril, with lisinopril being the most commonly prescribed at this time (Chan & Soliman, 2015). In addition, ACEIs are used to help prevent myocardial infarction, diabetic neuropathy, and a cerebrovascular accident (Chua, Ignaszewski, & Schwenger, 2011). There are several risk factors for developing ACEI-RA, with African-American females being the greatest …

Time Lost Is Brain Lost: Impact Of Ischemic Stroke, Paula Severns

Nursing Student Class Projects (Formerly MSN)

Stroke is the leading cause of functional impairment and the fourth leading cause of death in the United States. Annually 795,000 stokes occur with mean annual lifetime cost estimated at $140,000 per person. Approximately every 40 seconds a stroke occurs while every four minutes a stroke death occurs. Stroke is the broad term often used to describe a neurological emergency, of either ischemic or hemorrhagic etiology, affecting blood flow to the brain. Although approximately 90% of strokes are ischemic in nature, both are medical emergencies requiring time sensitive medical intervention. Decreasing modifiable risk factors, public education and recognition, along with …

Guillain-Barre Syndrome, Tyler B. Skelton

Nursing Student Class Projects (Formerly MSN)

Guillain-Barre Syndrome consists of a group of neuropathic conditions characterized by progressive weakness and diminished or absent myotatic reflexes. The estimated annual incidence in the United States is 1.65 to1.79 per 100,000 persons (Walling & Dickson, 2013). Understanding how this condition progresses and the affects it has on a patient will assistant in providing optimal patient care as a future nurse anesthetist. As stated by Turakhia, P., Barrick, B., and Berman, J. (2013) “the anesthetic implications for the various comorbidities are varied and can be profound” (p.1). An individual who suffers from Guillain-Barre is a patient who certainly requires critical …

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.

Progressive Multifocal Leukoencephalopathy In Multiple Sclerosis, Lauren R. Jackson

Nursing Student Class Projects (Formerly MSN)

Progressive multifocal leukoencephalopathy (PML) is a rare and debilitating disease caused by the JC virus and results in demyelination of oligodendrocytes and glial cell lysis. The virus is able to cross the blood brain barrier, leading to plaque development on the brain and neurological problems. (Gorelik et al., 2011). PML develops in individuals who have an immune disorder and who have been treated with immunomodulatory medications, including patients with Multiple Sclerosis (MS). There is no cure for PML and 30-50% of patients who develop the disease die within the first few months of diagnosis. The JC virus is thought to …

Infective Endocarditis Related To Iv Drug Abuse, Jasmine D. Branch

Nursing Student Class Projects (Formerly MSN)

Drug abuse in the United States continues to rise. In 2014, the U.S. had the highest rate of deaths due to drug overdose (Centers for Disease Control and Prevention, 2015). There are several health conditions that are associated with drug abuse. Intravenous drug abuse (IVDA) is a common route used, which often works fast and causes an “immediate high”. IVDA often involves the injection of illegal drugs into an individuals veins. The needles are often shared or re-used, exposing individuals to infectious diseases. One common complication of IVDA is infective endocarditis (IE). IE can occur when bacteria enters the bloodstream …

Neurohormonal Activation In Cardiorenal Syndrome, Eric J. Glasstetter

Nursing Student Class Projects (Formerly MSN)

Cardiac and renal functioning are highly related as each system is interdependent on the other, and subsequently, dysfunction of one system can potentiate the development of dysfunction of the other, a conditioned referred to as Cardiorenal Syndrome, or CRS. (Scully & Goldsmith, 2013). In CRS, heart failure and renal failure exist together. Heart failure is the result of decreased heart efficiency and results in hemodynamic and neurohormonal changes (Nicholson, 2014). A decrease in cardiac function and cause dysfunction of other body systems, including the renal system, and at the same time, impaired renal functioning can result in increased fluid retention …

Systemic Lupus Erythematosus And Cardiovascular Disease, Jayme York

Nursing Student Class Projects (Formerly MSN)

Systemic lupus erythematosus (SLE) is a challenging auto-immune disorder that incurs sporadic flares, remissions, and relapses (Robinson & Currie, 2011, p. 629). This auto-immune process is caused by the lack of tolerance to self-antigens within the adaptive immune system and can involve multiple organ systems, including the brain, heart and kidneys (Chen, Wu, Wang, Li, 2015, p. 1). SLE, also referred to as lupus, is a disease that affects women more often than men, especially during their childbearing years (Robinson & Currie, 2011, p. 631).

Over the past 3 decades, the five-year survival rate for patients suffering from Lupus have …

Calcific Aortic Stenosis, Michelle L. Rapach

Nursing Student Class Projects (Formerly MSN)

Degenerative calcific aortic stenosis is a progressive disease that becomes more severe with age and is a direct result of an active inflammatory process. The life expectancy of the United States’ population is increasing and with it, the incidence of aortic stenosis has increased over the past several decades. Surgical data suggests an rise in prevalence of the disease by over 25% over the past ten years (Bonow & Greenland, 2015). Advanced Practice Nurses (APNs) are more fequently encountering patients of an advanced age and recent technologic advancements have created more treatment options for aortic stenosis. APNs should be aware …

Japanese Octopus Traps & Broken Hearts: Takotsubo Cardiomyopathy, Chase A. Smith

Nursing Student Class Projects (Formerly MSN)

This academic poster provides a brief overview of Takotsubo Cardiomyopathy (TTC), it’s pathophysiology, and implications for nursing care. TTC is a non-ischemic cardiomyopathy that typically presents acutely in a very similar fashion to an acute myocardial infarction (Reeder & Prasad, 2015). Interestingly the disease primarily afflicts females (90% of cases) and is often triggered by an intense emotional or physical stressor (Minhas, Hughey & Kolas, 2014). Despite the acute onset and symptoms, the majority of cases are benign and resolve with conservative heart failure treatment (Scantlebury & Prasad, 2014) though a small percentage of cases can develop profound shock, resulting …

Amyotrophic Lateral Sclerosis, Emily Stitzel

Nursing Student Class Projects (Formerly MSN)

Amyotrophic Lateral Sclerosis (ALS) is a terminal neurodegenerative disorder affecting an individual’s motor neurons. With a high prevalence affecting people in the United States of America, the progressive disease affects the lives of many. Once a patient is diagnosed, a short survival rate is to be expected. Importance for healthcare workers should be to focus on proper diagnosis, therapeutic communication, and palliative care. The pathophysiology is still under investigation; however, there have been breakthroughs regarding genetic alterations within the Cu/Zn superoxide dismutase gene (SOD1) and a large repeat on the C9ORF72 gene. By examining the signs and symptoms, doing the …

Kawasaki Disease In Pediatric Patients, Cassandra F. Krinn

Nursing Student Class Projects (Formerly MSN)

Kawasaki Disease (KD) is an idiopathic, multi system disorder that is characterized by vasculitis of the arteries, capillaries, and veins. It typically affects children 5 years old or younger and is predominately seen in male children of Japanese decent. The inflammation of the blood vessels seen makes Kawasaki disease the leading cause of acquired heart disease in children, with 20% of those affected developing coronary artery aneurysms, cardiac arrhythmias, and heart failure. Diagnosis is based on criteria including presence of fever for 5 days, bilateral conjunctivitis, erythema of the lips and oral mucosa, changes in extremities, rash, and cervical lymphadenopathy. …

Congenital Syphilis, Natalie T. Bennett

Nursing Student Class Projects (Formerly MSN)

Despite available prevention and treatment measures, congenital syphilis is on the rise again in the United States (Su et al, 2016). Congenital syphilis is caused by maternal infection during pregnancy with the bacteria Treponema pallidum, which is then transmitted to the fetus. Complications include miscarriage, fetal and neonatal death, premature birth, and other anomalies in the newborn. The leading factor in congenital syphilis infection is limited or no prenatal care (Dobson, 2016). If the syphilis-infected mother is treated during pregnancy, infection of the fetus can be prevented (Su et al, 2016). Nurses and health care providers need to be …

Gram-Negative Bacteria And Sepsis, Christine D. Ridge

Nursing Student Class Projects (Formerly MSN)

Today’s medical world encompasses an environment in which gram-negative bacteria that once were defeated with common antibiotics, have now become resistant. Gram-negative bacteria like Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter, and Acinetobacter are pathogens that are an emerging threat causing sepsis due to multidrug-resistance (Pop-Vicas & Opal, 2014, p.189). The multidrug-resistance mechanisms of gram-negative bacteria coupled with a patient population commonly seen in hospital settings, that consist of immunocompromised adults due to advancing age, comorbidities (e.g. AIDS, history of transplants, diabetes, and chemotherapy), and immunotherapies, create an environment for advanced infection or sepsis to take place.

Complications of multidrug-resistant gram-negative bacteria …

Acute Respiratory Distress Syndrome, Jessica A. Bernhard

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a severe respiratory ailment that is a chief cause of mortality for patients in the Intensive Care Unit (ICU) (Gibbons, 2015). ARDS involves the rapid development of respiratory failure resulting from various diseases or injuries to the lungs. Because it includes both short and long term complications, early detection of ARDS is beneficial to prevent its devastating course. Often, these patients have various diseases and injuries which make it difficult to determine the appropriate therapy. Most therapies aim to enhance oxygenation. Some of the interventions include low tidal volume mechanical ventilation and placing the …

Pulmonary Fibrosis, Coreena Wells

Nursing Student Class Projects (Formerly MSN)

Pulmonary fibrosis is a lung disorder characterized by development of a fibrotic pathway following injury and inflammation. Initial injury can be caused by environmental, biologic, or chemical irritants. Many times the cause is unknown. Lung fibrosis leads to difficult ventilation and perfusion and subsequent hypoxemia. Current research shows an increase in inflammatory mediators which stimulate ECM deposition.

Guillain-Barré- Adding Insult To Injury, Casey M. Hudnall

Nursing Student Class Projects (Formerly MSN)

a poster project about Guillain-Barré syndrome (GBS) which is described as an acute peripheral neuropathy causing limb asthenia, or weakness, that progresses over a short period of time.

Diabetic Retinopathy, Tara L. Smith

Nursing Student Class Projects (Formerly MSN)

This poster is intended to cultivate a better understanding of diabetic retinopathy, the pathological process of the disease, signs and symptoms, and nursing implications related to the disease.

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 …

Portal Hypertension, Kristi Loomis

Nursing Student Class Projects (Formerly MSN)

Chronic liver disease plagues the body with many significant complications. One of the more commonly identified complications is portal hypertension (PHT). Without intervention the elevated pressures in PHT will lead to extensive complications, and eventually death

Assessment Of Air Force Providers’ Adherence To Overweight And Obesity Guidelines, Dale Harrell

Doctor of Nursing Practice Scholarly Projects

Despite the existence of obesity treatment guidelines, Air Force healthcare providers may offer suboptimal weight management. The purpose of this quality improvement project is to assess adherence by healthcare practitioners with adult overweight and obesity guidelines before and after an educational session on the optimal management of the overweight or obese patient. Overweight or obese adults treated in Military Treatment Facilities (MTF) may not be properly identified and controlled, as providers may not be adhering to the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for the management of obesity.

Increasing Colorectal Cancer Screening Rates In A Rural Health Clinic Through Practice Change, Kirsten S. Johanson

Doctor of Nursing Practice Scholarly Projects

Colorectal cancer (CRC) is the third leading cause of cancer deaths in the United States (Siegel, DeSantis, & Jemal, 2014). The United States Preventative Services Task Force (2008) “recommends screening for CRC using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years” to decrease CRC rates (p. 627). In May 2015, CRC screening rates were 70.65% at the Monroe Clinic-Durand Primary Care branch (D. Dubs, personal communication, May 18, 2015). Increasing CRC screening rates in the Monroe Clinic-Primary Care branch office could decrease CRC rates and deaths in the …

Early Sport Specialization: Overuse Injury And Burnout, Jessica J. Mcclelland

Masters Theses/Capstone Projects

There are an increasing number of opportunities for today’s youth to participate in year-round sport organizations that promote early sport specialization before the age of fifteen. Early sport specialization is linked to a higher rate of overuse injury of frequently used muscle groups. The physical, mental, and psychological demands of early sport specialization increase likelihood of burnout and cessation of sport participation. Early sport generalization allows physiological and psychological rest and recovery in youth athletes that lead to decreased injury rates and less burnout with more individuals continuing to participate in competitive sports throughout the collegiate years. The purpose of …

The Nurse Executive Role In Implementing Evidence Based Practice (Ebp) At The Point Of Care, Kimberly Ann Malcolm Mrs.

Doctor of Nursing Practice Scholarly Projects

Scientific knowledge is available to guide point of care practice. Due to reported barriers, however, implementation of evidence-based care is not the norm. Current literature supports that knowledge and beliefs about evidence-based practice are related to the extent nurses engage in evidence-based practice. Additionally, current literature describes the positive effects nurse administrators can have on employment of evidence-based practice. The focus of this student nurse executive’s DNP scholarly project, therefore, was to improve use of evidence-based practice by nurses at the point of care using an evidence-based practice benchmark (at the rural Midwestern hospital where employed), specifically beta-blocker administration by …

Factors Influencing Participation In Screening Mammography Among Rural Women, Kelly Colliver

Doctor of Nursing Practice Scholarly Projects

Rural residents at all income levels are significantly less likely than urban residents to participate in cancer screenings. Furthermore, rural women face common significant barriers to mammography, including: knowledge deficit, lack of primary care provider, no health insurance, fear, decreased access, transportation issues and financial constraints. The purpose of this project is to investigate factors influencing participation in screening mammography among rural women in Adams and Highland counties. Both of these Southern Ohio counties have lower than average rates of screening mammography. For this project, a non-experimental, cross-sectional design was utilized. Data was collected using a survey, based on the …

Nursing Perception Of Psychogenic Nonepileptic Spells: Improving Patient Outcomes, Amanda J. Cramer

Doctor of Nursing Practice Scholarly Projects

Patients with psychogenic nonepileptic spells (PNES) have generally poor outcomes and many fail to engage in evidence-based treatments (Thompson et al., 2013). Negative healthcare provider perceptions have been implicated as a barrier to patient engagement in treatment recommendations for PNES (Whitehead, Kandler, & Reuber, 2013; Worsely et al., 2011). Illness perception of these patients has been evaluated from the perspective of physicians in multiple settings but perceptions by nurses are not well studied despite the close interactions that nurses have with these patients.

This project used Pender’s health promotion model to collect information about the nursing experience with patients with …

Enhancing Interest And Knowledge Of How To Start A Nurse Practitioner-Led Clinic, Kami S. Campbell

Doctor of Nursing Practice Scholarly Projects

Theoretical and methodological contributions of nursing entrepreneurship and starting an independent practice within the Nurse Practitioner arena are sparse in American clinical prospectuses. The American health care system is in need of enhancement to better serve the healthcare needs of all people so there has never been a greater opportunity for NP entrepreneurial thinking and implementation of new initiatives (Marshall, 2011). Information regarding NP-led clinics is limited and NPs need to be educated on elements of successful independent healthcare ventures. The purpose of this project was to enhance interest and knowledge of starting a NP-led clinic.

A review of the …