Endocrine System Diseases Commons^™

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 …

Maggot Therapy For Treating Diabetic Foot Ulcers, Amber Nikolaus

Nursing Student Class Projects (Formerly MSN)

Diabetes mellitus, Type 1 and Type 2, are associated with numerous debilitating consequences. One of the most common and serious complication is diabetic foot ulcers (DFU) (Baltzis, Elftheriadou, and Veves, 2014, p.817). DFUs are “caused by loss of glycemic control, peripheral neuropathy, peripheral vascular disease, and immunosuppression” and account for greater than 80,000 amputations per year in the United States (Aumiller & Dollahite, 2015, p.28). Approximately 15% of people with diabetes have diabetic foot ulcers (Aumiller & Dollahite, 2015, p.28) and studies demonstrate that 45% to 55% of patients presenting with neuropathic and ischemic diabetic foot ulcers will die within …

Insulin Resistance Due To Obesity, Chasity Crist

Nursing Student Class Projects (Formerly MSN)

Diabetes is defined as a common metabolic disorder where hyperglycemia or elevated glucose levels are prevalent (Shah & Vella, 2014). The most common form of diabetes is type two diabetes (T2DM) and effects around 9.3% of the population in the United States (Cornell, 2015, p. 631). The pathophysiology of this disease includes involvement from the pancreas, liver, skeletal muscle, adipose tissue, gastrointestinal tract, brain, and kidneys. Hyperglycemia is high blood sugar levels that effects multiple organs (Rymaszewski & Breakwell, 2013). Protocols are developed to allow nurses to identify and treat hyper/hypoglycemia. Patient education is a direct impact of the long …

Type Ii Diabetes And Its Treatment, Gregory Mountain

Nursing Student Class Projects (Formerly MSN)

Approximately 28.9 million Americans have been diagnosed with type II diabetes (Jia-Haur Hu, Lin, Miller, Nguyen, & Nguyen, 2014). It is a disease that can cause or potentiate numerous comorbidities that negatively affects multiple body systems if left untreated (Jia-Haur Hu, et al., 2014). In 2012, the total estimated cost for treatment of type II diabetes in America was an astronomical $245 billion (Jia-Haur Hu, et al., 2014). Type II diabetes is a result of many cellular processes that lead to insulin resistance resulting in increased blood glucose levels (Jia-Haur Hu, et al., 2014). Treatments for type II diabetes include …

Autoimmune Thyroiditis: A Look Into Hashimoto’S Disease, Jessica Hannan

Nursing Student Class Projects (Formerly MSN)

Thyroid disease is a general term utilized to describe a variety of conditions affecting the thyroid gland, including hypothyroidism, the deficient production of thyroid hormone; hyperthyroidism, the excess production of thyroid hormone; and goiter, the physiologic swelling of the thyroid gland (Cihakova, 2001; Warren, 2014). Primary hypothyroidism is the most prevalent thyroid disease in the United States, most frequently occurring as a result of chronic autoimmune thyroiditis, specifically Hashimoto’s Disease (Warren, 2014). Hashimoto’s disease (HD), also known as Hashimoto’s thyroiditis and human autoimmune thyroiditis, was named after Hakaru Hashimoto, a Japanese medical scientist who first described the condition in 1912 …

Diabetic Gastroparesis, Noreen Burris Welch

Nursing Student Class Projects (Formerly MSN)

According to the 2014 Centers for Disease Control (CDC) 9.3% of the United States Population have diabetes (National diabetes statistics report, “2014, p.1). One of the complications of diabetes is gastroparesis. Gastroparesis is “a delay in the emptying of ingested food in the absence of mechanical obstruction of the stomach or duodenum ‘’ (Koch & Calles-Escandon, 2015, p. 40). Mortality in the diabetic patient with gastroparesis is higher than the diabetic patient without gastroparesis (Koch & Calles-Escandon, 2015). Patients with either type 1 diabetes (T1DM) or type 2 diabetes (T2DM) may experience he clinical symptoms of early satiety, prolonged fullness, …

Hyperglycemic Hyperosmolar State: A Diabetic Emergency, Rachel Fisher

Nursing Student Class Projects (Formerly MSN)

Hyperglycemic hyperosmolar state (HHS) is an acute complication associated with diabetes mellitus. HHS has been known by several other names in the past. These labels include Hyperosmolar Nonketotic Coma, Hyperosmolar Hyperglycemic Nonketotic Coma, and Hyperglycemic Hyperosmolar Nonketotic Syndrome (Hackel, 2014). HHS is characterized by severe hyperglycemia, profound dehydration, and is often accompanied by altered mental status. Less than 1% of diabetes-related admissions are due to HHS, but mortality rates are estimated to be 10% to 20% (Lenahan & Holloway, 2015). HHS typically affects the older adult population, with the average age of HHS patients being 60 years (Collopy, Kivlehan, & …

Hashimoto’S Disease: The Underactive Thyroid Disease, Patty Anderson

Nursing Student Class Projects (Formerly MSN)

The thyroid gland is part of the endocrine system and has a widespread function that controls multiple organ systems and processes. The main function of the thyroid gland is to produce and secrete two different thyroid hormones: triiodothyronine (T3) and thyroxine (T4), both of which help to meet the metabolic demands of the entire body. When the thyroid gland fails to produce T3/T4 hormones (primary gland failure) or is not activated successfully by the pituitary gland (by the release of thyroid stimulating hormone (TSH)), or hypothalamus, this results in low levels of circulating thyroid hormone. As low levels of the …

Implications Of Underlying Pathophysiology Of Osteomyelitis In Diabetics For Nursing Care, Danielle Spencer

Nursing Student Class Projects (Formerly MSN)

Osteomyelitis is an infection of the bone caused by either bacteria, fungi, parasites, viruses or mycobacteria (McCance, et. al., 2014). The infection can enter bone either through an outside source or through the blood from a blood borne infection (McCance, et. al., 2014). The most common bacteria involved with osteomyelitis is Staphylococcus aureus (Hatzenbuehler & Pulling, 2011, p. 1027). Recently, at Dublin Methodist Hospital there has been an increase in the number of osteomyelitis cases in chronic uncontrolled diabetic patients requiring below the knee amputations. Two of the cases specifically were linked to chronic diabetic foot ulcers. Each of these …

In-Patient Self-Management Diabetes Education, Amy Matthews

Master's Projects and Capstones

The diabetes program strives to provide diabetes self-management education to the in-patient with diabetes. The specific aim is to improve and standardize diabetes education for the inpatient with diabetes by June 2015. The microsystem is a medical surgical unit for patients 18 years and older who present with diabetes as either a primary diagnosis or secondary diagnosis. Fifty percent of the diabetes patients on this unit are ages 65-89 years old, twenty nine percent are ages 50-64. The unit has 32 beds and is filled to capacity ninety five percent of the time. The fishbone diagram revealed our microsystem lacked …

Using Technology To Improve Diabetes Self-Management Within A Federally Qualified Community Health Center, Lisa Diane Morgan

Doctoral Projects

The Patient Centered Medical Home (PCMH) concept places the patient and family at the center of healthcare. The patient becomes actively involved in their own care. One aspect of PCMH is managing care and increasing chronic disease self-management. Diabetes, a chronic disease, is a leading diagnosis among the patients served by the federally qualified community health center (FQCHC). The prevalence of diabetes in Mississippi in 2012 was 12.3%. The purpose of this DNP Capstone project was to implement a pilot study to increase diabetes self-management knowledge. The program utilized the current technology of text messaging to send biweekly supportive and …

Efficacy Of Behavioral Interventions In African-Americans With Type Ii Diabetes: A Comparative Effectiveness Analysis, Tangela Nicole Hales

Dissertations

Context: The efficiency and effectiveness of the healthcare system are prime foci for nursing research.

Objective:The purpose of this study was to review and critically appraise the current state of the evidence in the treatment of African American adults with type II diabetes. To address this objective, a systematic review was undertaken that investigated the comparative effectiveness of behavioral interventions in improving glycemic control.

Methods: Robust methodological approaches to comparative effectiveness research (CER) serve to improve the transparency, consistency, and scientific rigor of the research. The methods for this systematic review of literature followed those recommended in the Agency …

Diabetes Distress: Transforming A Practice, Goff M. Jeannie

Doctor of Nursing Practice Scholarly Projects

Diabetes mellitus affects millions of people in the United States, placing them at risk for other disease related complications. This makes the management of diabetes and the prevention of complications an important challenge. The psychological aspect of diabetes care may present a barrier to patients that inhibit them from achieving optimal self-care.

Diabetes distress (DD) is the psychological aspect of diabetes that is specific to the emotional distress caused from living a chronic disease. DD has been linked to poorer self-management behaviors which makes it a significant problem that should be taken into consideration for effective management of the diabetic …

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents, Jennifer Mcguire Hitt

Theses and Dissertations (ETD)

Although the American Diabetes Association (ADA) adopted the use of the glycated hemoglobin (A1C) test as a method of diabetes and prediabetes diagnosis, the ADA has not developed firm guidelines concerning the use of the A1C test in children and adolescents, as research has not validated thresholds in this group. Diabetes and prediabetes are diseases influenced by multiple factors, including race and ethnicity, age, vitamin D deficiency, and body mass index (BMI). The purpose of this study was to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the A1C test compared to the gold …

Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency, Brian Albany

Nursing Student Class Projects (Formerly MSN)

Diabetic ketoacidosis (DKA) serves as one the leading causes of mortality in diabetic patients [14]. The mortality has decreased over the past several decades due to the rapid recognition of the disease state and the improvement of management of DKA [14]. Despite a decline in mortality rates over the past twenty years from 7.96% to 0.67%, errors in management of the disease state are associated with significant morbidity and mortality [2]. Utilization of DKA protocols in the acute care setting have allowed congruency in care and delivery of effective lifesaving treatment. Despite advances in standardized DKA protocols, there still remains …

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 …

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 …

Literary Research On Alport Syndrome, Shailendra Jain

Nursing Student Class Projects (Formerly MSN)

Alport syndrome is rare genetic disorder of the glomerulus in the kidneys that can be X-linked, Autosomal recessive, or Autosomal dominant in nature. Clinical manifestation includes hearing loss, hematuria, proteinuria, and hypertension (Cheungpasitporn, Kaewpoowat, Suksaranjit, Kittanamongkolchai, Srivali, Ungprasert, & Rangan, 2012). It is most common disease in males. A 24-hour urine specimen is usually obtained to check for proteinuria and elevated creatinine, which indicate acute renal failure (Cosgrove, 2012). A renal biopsy and ultrasounds is used to confirm the diagnosis of Alport Syndrome. Patients that are diagnosed with such disease require dialysis and referral to an ophthalmology and audiology. The …

Acute Pancreatitis, Laura Payne

Nursing Student Class Projects (Formerly MSN)

Acute pancreatitis is a common diagnosis seen in intensive care units worldwide. The incidence of pancreatitis has increased over the last decade. It ranks third amongst the gastrointestinal diseases resulting in hospital admissions. The destructive complications of pancreatitis make it a life-threatening disease. If pancreatitis progresses to the severe form the mortality rate significantly increase from one percent to upwards of thirty percent. Pancreatitis is associated with high rates of morbidity, mortality, and prolonged hospital admissions(Goozen, Besselink, Santroort, & Bollen, 2013). An increased understanding of the pathophysiology of pancreatitis has changed the approach to treatment from early surgical treatment to …

Diabetes Care Management In The Cancer Center: Challenging Current Models Of Care To Optimize Outcomes For A Complex Population, Cara Habeck Rn, Cde, Joyce Najarian Msn, Rn, Cde, Gregory R. Harper Md, Phd, Gretchen Perilli Md, Janelle M. Sharma Dnp, Crnp, Melissa Kratz Rn, Msn, Aocn, Patricia Shearburn Rn, Msn, Aocn, Cathy A. Coyne Phd, Mph, Hope Kincaid Mph, Cph, Roya Hamadani Mph

Patient Care Services / Nursing

No abstract provided.

Endoscopic Pancreatic Pseudo-Cyst Drainage, Judith Dorsam Rn

Patient Care Services / Nursing

No abstract provided.

Practitioners' Use Of Clinical Practice Guidelines: An Evidence-Based Approach, Sondra Michelle Phipps Santana

UNF Graduate Theses and Dissertations

Pre-diabetes is a serious health problem in the United States. Distinguished by plasma glucose levels that are above the normal threshold, patients with pre-diabetes are 10 times more likely to develop type 2 diabetes. Patients with pre-diabetes suffer the same complications as patients with diabetes including diabetic retinopathy, nephropathy, and microalbuminuria.

There is considerable evidence to support the idea that early identification and aggressive treatment of pre-diabetes has the potential to delay disease progression. The American Diabetes Association’s clinical practice guideline recommends management of with lifestyle modification and metformin for patients who are at risk for developing type 2 diabetes. …

Metabolic Syndrome, Inflammation, Heart Rate Variability, And Fitness In Obese African American Youth, Belinda J. Fleming

Theses and Dissertations (ETD)

Purpose. The purposes of this dissertation were to (1) explore the relationships among fitness, heart rate variability (HRV), inflammation and components of the Metabolic Syndrome in obese African American youth participating in a supervised weight management program, (2) examine the effect of change in severity of obesity on these variables, and (3) identify predictors of weight loss.

Method. This study consisted of a post-hoc analysis of existing pre and post-intervention data obtained from 50 African-American youth (70% female, aged 7-18 years). Anthropometric assessment of height, weight, waist circumference, systolic blood pressure, body mass index, body mass index percentile …

Associations Among Health Literacy Levels And Health Outcomes In Pregnant Women With Pregestational And Gestational Diabetes In An Urban Setting, Rosemary Ann Mclaughlin

Theses and Dissertations (ETD)

Purpose/Objectives: Poor health literacy is a problem for over 45% of American adults and is associated with a variety of adverse health outcomes. Low health literacy has been associated with poor prenatal care utilization and a higher likelihood of poorer glycemic control. Poor glycemic control can lead to poor birth outcomes for both the mother and infant. Health literacy levels of pregnant women with diabetes can influence these outcomes and need to be known early in the pregnancy. Interventions can influence tighter glycemic control and lessen the impact of diabetes for the mother and infant. Therefore, the purpose of this …

Gastric Myoelectrical Activity In Patients With Diabetes, Sandra Luberata Holmes

Theses and Dissertations (ETD)

This descriptive, correlational study investigated the associations among gastric myoelectrical activity (GMA), upper gastrointestinal (GI) symptoms, and glucose control. The study also attempted to determine whether any relationship existed between upper GI symptoms, glucose control, age, or length of diagnosis and pattern of GMA identified using electrogastrography (EGG). A total of 25 persons participated in the study. The sample was comprised of 7 healthy controls, 5 patients diagnosed with type 1 diabetes, and 13 patients diagnosed with type 2 diabetes. Electrogastrography was performed for 30 minutes in the fasting state and continued at 30-minute intervals for a total of 1-1/2 …

Presentation And Symptom Predictors Of Coronary Heart Disease In Patients With And Without Diabetes, Marjorie Funk, Janice B. Naum, Kerry A. Milner, Deborah Chyun

Nursing Faculty Publications

The aims of this prospective, observational study were to compare: (1) symptom presentation of coronary heart disease (CHD) between patients with and without diabetes and (2) symptom predictors of CHD in patients with and without diabetes. We directly observed 528 patients with symptoms suggestive of CHD as they presented to the ED of a 900-bed cardiac referral center in the northeastern United States. There were no significant differences in symptom presentation of CHD between patients with and without diabetes, although patients with diabetes were slightly more likely to present with shortness of breath (P =.056). Patients with diabetes reported …

Measurement Of Autonomic Function In Renal Disease And Diabetes, Ann King Cashion

Theses and Dissertations (ETD)

Renal disease and diabetes lead to dysautonomia resulting in consequences ranging from gastroparesis to sudden death. New technologies to detect dysautonomia, such as 24-hr heart rate variability, are being evaluated and compared to traditional evoked tests. These advances have, however, lead to a lack of standardization in testing batteries, procedures, and reporting formats. This series of 3 studies psychometrically assessed measures of autonomic function (AF) and explored relationships among objective and subjective measures in healthy adults and uremic patients. Participants underwent evoked tests that included change in heart rate with deep breathing and Valsalva. In addition, measures of 24-hr HRV …