Medicine and Health Sciences Commons^™

Licorice Consumption Causing Hypokalemia And Lethal Dysrhythmias, Gina Grosscup

Nursing Student Class Projects (Formerly MSN)

This report describes a case in which approximately a two-month exposure of licorice root tea consumption containing glycyrrhizic acid (GA) produced generalized weakness, secondary hypertension, hyporeflexia and hypokalemia, leading to a reentry dysrhythmia of ventricular fibrillation. Although licorice root has been used for medicinal purposes dating back centuries the potential toxic side effects can be life threatening without early recognition. Most licorice candies in the western world contain artificial flavoring but the use of actual licorice root containing GA is common in many Middle-Eastern, Far Eastern and European countries. The purpose of this report is two-fold, first to describe the …

Basics Of Oncologic Type B Lactic Acidosis: Increased Awareness For Better Outcomes?, Erin E. Steiner

Nursing Student Class Projects (Formerly MSN)

The most common and best known form of lactic acidosis, Type A, presents in the environment of tissue hypoxia. The lesser known form, Type B, does not involve tissue hypoxia, is not well understood, and very often results in death. No randomized controlled trials (RCTs) comparing treatment modalities currently exist (Ruiz, Singh, & Hart, 2011). Increased recognition by medical and nursing disciplines may result in quicker diagnosis, opportunity to implement treatment, possibility for RCTs, and better outcomes.

Myasthenia Gravis: A Closer Look, Erin L. Ricker

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG) is a rare, chronic autoimmune disease that affects the neurotransmitter acetylcholine and the acetylcholine receptors at the neuromuscular junction (Mestecky, 2013). MG causes fluctuating skeletal muscle weakness and fatigue. According to the Myasthenia Gravis Foundation of America (MGFA) (2010), 20 per 100,000 patients are diagnosed with MG, although researchers believe several more patients are misdiagnosed or missed entirely. Several neurological disorders have similar clinical presentations to MG making it difficult for inexperienced practitioners to identify and properly diagnose patients. Patients are often misdiagnosed and delayed proper treatment for one to two years after initial presentation of symptoms …

Pathophysiology, Incidence And Implications In Intraductal Papillary Mucinous Neoplasia Of The Pancreas, Ericka Haverick

Nursing Student Class Projects (Formerly MSN)

Intraductal papillary mucinous neoplasms (IPMN) are uncommon tumors arising from the main pancreatic duct, branching pancreatic ducts, or both. The “overall incidence of invasive carcinoma associated with resected IPMN has been reported to be 20-40%” (Mohri et al., 2011). Due to their malignant potential, these lesions, along with mucinous cystic neoplasms (MCN), are considered more worrisome, and often require surgical resection (Gallucci, Langellotto, De Ritis, & Uomo, 2012). Even after removal of a primary lesion, patients remain under surveillance to monitor for recurrence, the rate of which is approximately 6 % (Gallucci et al., 2012), and patients with main duct …

Malignant Hyperthermia, Eric Weberding

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is an autosomal-dominant disorder that is inherited. The disturbance of calcium homeostasis associated with MH affects skeletal muscle (Schneiderbanger, Johannsen, Roewer, & Schuster, 2014). This hypermetabolic muscular disorder is triggered by exposure to depolarizing muscle relaxants such as succinylcholine or inhaled halogenated volatile anesthetics such as sevoflurane, halothane, desflurane, enflurane, and isoflurane (Stratman, Flynn, & Hatton, 2009). In susceptible individuals, this potentially lethal syndrome may cause hyperthermia, hypercapnia, muscular rigidity, hypoxemia, acidosis, tachycardia, and hyperkalemia (Schneiderbanger et al., 2014).

Hereditary Spherocytosis, Dolores Loeser

Nursing Student Class Projects (Formerly MSN)

Hereditary Spherocytosis (HS) is a hemolytic anemia where red blood cell membranes are spherical unlike common red blood cells, which are flat and round. In individuals with HS the spleen does not recognize these amorphous cells and destroys—rather filters—them them, making the individual anemic (MedlinePlus, 2013). HS is an autosomal dominant, or recessive autosomal inherited blood disease (Huq, Pietroni, Rahman & Alam, 2010) HS happens in 1 in 2,000 of the Caucasian population in or from Northern Europe (MedlinePlus, 2013). The proteins involved in HS are ankyrin-1, ά-spectrin, β-spectrin, band 3, and protein 4.2. Hyperbilirubinemia is a common symptoms in …

Global Burden Of Tuberculosis, Diana Moses

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is a major health concern not only in the United States, but in the entire world. TB is an airborne communicable infection which has affected human beings from immemorial times, evidenced by TB being found in the skeletal remains of ancient mummies (Gough & Kaufman, 2011). There are many patho physiological events in TB that concern the entire body, especially the respiratory and immunological systems. According to Knechel, TB prevalence is rising due to the increased number of patients infected with HIV, bacterial resistance to medications, increased international travel and immigration from countries with high prevalence of TB, …

Enterovirus: What Everyone Should Know, Debra Mccorkle

Nursing Student Class Projects (Formerly MSN)

Enterovirus is capturing the attention of everyone; but what is it, who is affected by it, and can it be treated and/or prevented? Like any virus the enterovirus has many different strains. The strain capturing everyone’s attention lately is human enterovirus 68 (HEV68). This strain was first detected in California in 1962 (Oberste et al., 2004). Most cases of HEV68 are mild and do not require medical attention, however some can become severe and may cause serious heart or brain infections according to the Center for Disease Control and Prevention (CDC) website (Updated September 8, 2014). HEV68 is a respiratory …

Hemophilia A: Pathophysiology And Treatment Strategies, Daniel Dinneen

Nursing Student Class Projects (Formerly MSN)

Hemophilia is a sex-linked recessive coagulation disorder that varies in severity. The implications and complications of hemophilia can be life threatening; pathology is usually diagnosed during childhood and adequate management is essential in maintaining health. Advanced practice nurses treat a variety of hemophilia patients in varying roles throughout the lifespan as hemostasis is a constant physiologic process. Thorough knowledge of the pathophysiology, signs/symptoms, and treatment modalities related to hemophilia is necessary to provide the highest level of comprehensive medical care to such patients. Hemophilia care is continued throughout the lifespan, and newer research indicates that current treatment modalities can initiate …

Early-Onset Familial Alzheimer Disease, Laura J. Murphy

Nursing Student Class Projects (Formerly MSN)

An Alzheimer’s diagnosis is an overwhelming and devastating diagnosis for both patients and families. Now imagine if this diagnosis was made at age 55. Instead of looking forward to retirement and grandchildren, these people are preparing for a debilitating disease that will rob them of their memory, cognitive and functional abilities. Early-onset familial Alzheimer’s disease (EOFAD) affects people before the age of 65. Although extremely rare, some exhibit symptoms as early as in their 30s. One of the things most frustrating about this disease is so little is known about its cause. That and the fact there is no cure. …

Sports Related Traumatic Brain Injuries, Ky Parrott

Nursing Student Class Projects (Formerly MSN)

Traumatic Brain Injuries (TBI) are the leading cause of long-term disability and injury death in the United States of America (Dash, Oh, Santiago, & Wade, 2012, p. 108). It is estimated that approximately 75% of all TBI’s are sports related. Recently, sports related TBI’s have received increased awareness due to the $765 million settlement between 18,000 retired football players who suffer from long-term concussive injuries and the National Football Association (NFL) (Mason, 2013, p. 267). Education regarding the pathophysiology of TBI’s is beneficial to understanding what changes the brain is enduring and why it is important to protect the brain, …

The Role Of Brain-Derived Neurotrophic Factor In Depression, Katie Mendez

Nursing Student Class Projects (Formerly MSN)

According to The World Health Organization, depression is the fourth leading cause of total disease burden and the leading cause of disability worldwide. In the United States, results from the National Health and Nutrition Examination Survey reflect a 16.2% lifetime depression prevalence. Symptoms of depression can range from mild to severe and can be episodic or chronic. Depression has a high rate of comorbidity with multiple chronic diseases and other mental health disorders, predominately anxiety. Unfortunately, few Americans diagnosed with depression actually receive sufficient treatment and symptom management. Previous research has shown that individuals are more likely to seek treatment …

Takotsubo Cardiomyopathy, Kari Patterson

Nursing Student Class Projects (Formerly MSN)

Term Takotsubo was introduced in 1991 to describe the shape of the left ventricle during an episode of cardiomyopathy. Takotsubo is a Japanese term for a narrow-necked fishing pot used to catch octopus. The left ventricle assumes the shape of the octopus pot during Takotsubo cardiomyopathy. Takotsubo cardiomyopathy is commonly known as Broken Heart Syndrome due to its association with an emotional stressor. Mimics acute coronary syndrome without coronary artery blockage/stenosis. Affects more women than men. Occurs mainly in postmenopausal women (women over the age of 50) Believe a hormonal effect on catecholamine release plays a role.

Tension Pneumocephalus, Nicole Liebner

Nursing Student Class Projects (Formerly MSN)

Pneumocephalus is defined as the presence of air within the cranial vault; tension pneumocephalus occurs when air within the cranial vault becomes trapped and causes a mass effect or increased pressure, damaging the brain (Patel, Idicula, Carrau, & Prevedello, 2013). Small amounts of air within the cranial vault can be reabsorbed or metabolized by the body over a few days without causing symptoms, however, in tension pneumocephalus the air cannot escape, causing extensive neurological symptoms (Webber-Jones ,2005). Thus, asymptomatic pneumocephalus can be a common finding following a cranial surgery, where as tension pneumocephalus is extremely rare (Webber-Jones, 2005). Markam (1967) …

Incretin Hormones And Their Effects In Type 2 Diabetes, Molly Getz

Nursing Student Class Projects (Formerly MSN)

Type 2 diabetes mellitus (T2DM) is a progressive disease characterized as having pancreatic β-cell dysfunction, insulin resistance and hyperglycemia (Stephens, 2010, p. 491). T2DM affected 29.1 million Americans or 9.3% of the population in 2012 and was the seventh leading cause of death in the United States in 2010 ("ADA Statistics," 2014), with many of these patients finding it difficult to achieve or maintain adequate glycemic control despite making lifestyle changes and pharmacologic interventions (Freeman, 2007). Disease management of T2DM requires a comprehensive plan including medication therapy, education and active involvement of the patient, with the goal of therapy to …

Cardiomems Heart Failure System: Keeping Patients Out Of The Hospital, Michelle Leyland

Nursing Student Class Projects (Formerly MSN)

It is well known that heart disease is the leading cause of death in the United States, with about 670,000 new diagnoses of congestive heart failure (CHF) each year (Suh et al., 2011). CHF results from a number of different causes, produces many different symptoms and occurs when the heart muscle cannot efficiently pump blood to the rest of the body (Suh et al., 2011). In the United States, heart failure (HF) and associated hospitalizations are leading contributors to high health care costs (Feltner et al., 2014). Up to one fourth of patients hospitalized with HF are readmitted within 30 …

Ebola: Protecting Healthcare Workers, Martha Mccoy

Nursing Student Class Projects (Formerly MSN)

Ebola is a hemorrhagic disease that has been seen throughout Liberia, but because of international travel it is spreading. Gilsdorf, Morgan and Leitmeyer (2012) researched air travel and reported that, “In 2010, 5.04 billion passengers arrived and departed from 1318 airports worldwide… and travel to and from Africa almost doubled between 1995 and 2005.” (p.1471). In the last few months there have been cases of Ebola reported in Spain and the United States linked to travel. These are recent developments because as of July, 2014 the Center for Disease Control and Prevention (CDC) reported “to date there are no cases …

Ebola Pandemic, Lurajean Cravens

Nursing Student Class Projects (Formerly MSN)

Ebolavirus, or Ebola Virus Disease (EVD), is of the filovirus family causing hemorrhagic fever first discovered in the African country of Zaire in 1976 (Turner, 2014; Hampton, 2014) and has gained global concern and attention since the recent epidemic outbreak in West Africa. There are five known species of Ebola: Zaire, Sudan, Ivory Coast, Bundibugyo and Reston, based on the region of origination. The Zaire species has been identified as the strain responsible for the current outbreak in West Africa, and has spread to Liberia, Sierra Leone, Nigeria and Senegal (Centers for Disease Control and Prevention,2014; Gostin, Lucey & Phelan, …

Steven-Johnson’S Syndrome/Toxic Epidermal Necrolysis, Lindsey Grant

Nursing Student Class Projects (Formerly MSN)

Steven-Johnson’s Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are both diseases mediated by hypersensitive immune reactions resulting in “full thickness epidermal necrosis” characterized by skin detachment. However, in SJS, there is only 10% skin surface area involvement whereas in TEN, over 30% of the skin becomes detached. TENS has a 50% mortality rate. (East-Innis & Thompson, 2013, p. 590) Why Chosen: SJS/TEN is a rare but extremely fatal disease. Initially, it is often mistaken as a simple allergic reaction to a new medication or environmental exposure because both cause truncal rashes and fevers. However, simple allergic reactions occur within days …

Pathophysiology Of Migraine, Tina Capers

Nursing Student Class Projects (Formerly MSN)

Migraine is a primary headache disorder and is ranked 19th among all diseases world-wide that cause disability (International Headache Society, 2013). There are more than 37 million Americans who experience migraine. Migraine is most commonly experienced by individuals between the ages of 15 and 55 and 70% to 80% of migraineurs have a family history of migraine (National Headache Foundation, 2014). Migraine is the most common headache disorder for which patients obtain medical care (Minen, Tanev, & Friedman, 2014, p. 1131). Estimated migraine healthcare costs in the United States are $19.6 billion annually (Da Silva & Tepper, 2012, p. 824). …

Chagas Disease: A Dangerous Kiss, Stephen Maynard

Nursing Student Class Projects (Formerly MSN)

Parasitic infections are a common occurrence worldwide and are often more common in low income countries. While these infections are associated with poor compromised communities outside the United States these diseases effect people within the United States and are more common than realized. One specific parasitic infection infects its human host causing Chagas disease. Chagas disease is an infection that occurs from the parasite T. cruzi and was named for the Brazilian physician Carlos Chagas who discovered the disease in 1909 (CDC, 2014). According to the Centers for Disease Control (CDC, 2014), Chagas disease has been targeted as a priority …

Spontaneous Coronary Artery Dissection Among Women, Stacy Hudepohl

Nursing Student Class Projects (Formerly MSN)

It has been noted that women often place their own health care on the bottom of their priority lists. Many times, they ignore simple pain and dismiss symptoms that may be troubling to health care providers. Health care providers especially to young women may dismiss complaints of chest pain as heartburn or anxiety. Changes seen in pregnancy and with menses can mimic some of these same complaints. As both an female professional in health care and as a patient it is very easy to get busy with the day and not recognize simple signs and symptoms that may lead to …

Idiopathic Pulmonary Fibrosis, Stacey Rosselot

Nursing Student Class Projects (Formerly MSN)

Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible lung disease, characterized by chronic inflammation and fibroproliferation of the parenchymal cells of the lung that lead to chronic respiratory failure and ultimately death (Kotsianidis et al., 2009). IPF is more prevalent in men than in women and risk for disease increases after age 60. IPF is the most common form of idiopathic interstitial pneumonia and it affects over 100,000 persons in the United States alone (Ding et al., 2011). Most of IPF cases are considered to be unpredictable and sporadic in nature, however approximately 15-20% of cases have a family history …

Necessity For Excellent Glycemic Control Before, During And After Cabg Surgery, Sheri Clouse

Nursing Student Class Projects (Formerly MSN)

A 72 year old male patient was admitted to the hospital presenting with sharp substernal pain and pressure to the left upper chest rated a “10” out of 10. Patient complained of chest pain even at rest which was relieved by a nitroglycerin infusion. Patient had established coronary artery disease as evidenced by five prior stent placements, with the last stent placement being in 2010. The patient also presented to the Emergency Room with a blood glucose level over 600 mg/dL and because of his complaints of chest pain, was transferred to a neighboring hospital facility to have a cardiac …

Review Of The Effectiveness Of Tissue Plasminogen Activator For The Treatment Of Plastic Bronchitis In Patients With Fontan Physiology, Ruth Ferroni

Nursing Student Class Projects (Formerly MSN)

Plastic bronchitis is a condition characterized by the formation of bronchial casts ranging from small to large obstructions of the pulmonary airways. Cast formation is intricate and resembles a plastic, rubbery model of the airway it obstructs. Its form was first described by Galen (A.D. 131-200). One of the patient populations at risk for developing this rare complication are those with single ventricle disease who are surgically corrected to Fontan physiology. It is a very abnormal type of circulation that is suspect in the development of plastic bronchitis. The cellular composition of plastic bronchitis differs from the casts seen in …

Ebola, A Deadly Viral Disease Affecting The West African Country Of Sierra Leone, Unisa Seisay

Nursing Student Class Projects (Formerly MSN)

Presently, there has been an outbreak of Ebola Virus Disease (EVD) in the West African countries of Sierra Leone, Liberia, Nigeria, Senegal and Guinea. The outbreak was first discovered in Guinea in March 21, 2014 and has spread to the neighboring countries. This has resulted in a lot of fatalities and is now considered a global public health concern (WHO, 2014).

Diagnosis, Pathophysiology, And Clinical Treatment Of A Patient With A Pheochromocytoma, Tricia L. Hale

Nursing Student Class Projects (Formerly MSN)

Hypertension is an extremely common diagnosis today. This condition can be caused by a multitude of factors, and can inversely cause numerous unfavorable processes in the body. One rare but significant source of hypertension is a tumor known as a pheochromocytoma, or PCC. This usually benign tumor is most often located on an adrenal gland, and can have a grave impact on the cardiovascular system. The tumor intermittently secretes an excess of the catecholamine norepinephrine, and if large enough, also secretes epinephrine [9]. These episodic bursts can cause extreme hypertension and tachycardia, leading to, at times fatal results. By understanding …

Enterococcus Faecalis Endocarditis: A Case Study, Torri Curtis

Nursing Student Class Projects (Formerly MSN)

Infectious endocarditis is an uncommon disease of the heart stemming from a bacterial or fungal infection on the endocardial surface of the heart or heart valve (Pierce, Calkins, & Thornton, 2012). From review of the literature, infective endocarditis is fairly uncommon and may be difficult to initially diagnose. Per Sabe, Shrestha, and Menon, occurrence of infective endocarditis (IE) is nearly 0.9-6.2 per 100,000 persons per year (2013). Several preexisting conditions such as aging, heart valve disease, implantable cardiac devices, a history of heart disease such as rheumatic fever, and invasive procedures can put a patient at higher risk for IE …

An In-Vitro Evaluation Of Mechanical And Esthetic Properties Of Orthodontic Sealants., Thyagaseely Sheela Premaraj, Nima Rohani, David Covey, Sundaralingam Premaraj, Yi Hua, Hidehiko Watanabe

Journal Articles: College of Dentistry

OBJECTIVE: To evaluate mechanical and esthetic Properties of two commercially available orthodontic sealants: Opal(®)Seal (OS) and L.E.D. Pro Seal (PS).

MATERIALS AND METHODS: Discs of each sealant were prepared to test the following properties: Micro hardness, wear resistance and color stability. Samples were randomly selected after the wear test for SEM imaging to analyze surface morphology.

RESULTS: OS was significantly harder than PS (P < 0.001). PS was significantly more wear resistant than OS (P < 0.05). PS showed a greater ∆E*ab (increased staining) when placed in wine or coffee showing a significant difference (P < 0.05). SEM showed particle size, shape and distribution were different for PS and OS reflecting the pattern seen on wear surfaces.

CONCLUSION: Both orthodontic sealants are beneficial for protecting enamel. However with better wear properties PS was superior in resisting mechanical stresses. OS was more color stable.

Agpt Registrar Satisfaction Survey 2014, Daniel Edwards, Jennifer Hong, Ali Radloff

Higher education research

The General Practice Education and Training Limited (GPET) Registrar Satisfaction Survey (RSS) is used for ensuring continuous improvement in the training of doctors in the Australian General Practice Training (AGPT) program. The RSS gauges the level of registrar satisfaction with the quality of their training, with training providers, and with career progression.