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Full-Text Articles in Medical Sciences

Sepsis & Emergency Management, Sharon Herndon Jul 2015

Sepsis & Emergency Management, Sharon Herndon

Nursing Student Class Projects (Formerly MSN)

Sepsis is a potentially life-threatening complication of an infection and a leading cause of death in the United States (Cawcutt & Peters, 2014). Sepsis is a systemic inflammatory response syndrome (SIRS) to invading microorganisms. Sagy, Al-Qaquu, and Kim (2013) define sepsis in three categories. “Sepsis” would be defined as the presence of infection along with other general systemic signs and symptoms. “Severe Sepsis” would be defined as sepsis complicated by at least one organ dysfunction, and “Septic Shock” would be defined as severe sepsis with acute circulatory failure that may be characterized by persistent arterial hypotension unexplained by other causes. …


Paradoxical Vocal Fold Motion, Stephen Sherer Jul 2015

Paradoxical Vocal Fold Motion, Stephen Sherer

Nursing Student Class Projects (Formerly MSN)

Paradoxical vocal fold motion (PVFM), otherwise known as vocal cord dysfunction (VCD) is an abnormal degree the vocal folds adduct upon inspiration causing airflow narrowing. This restriction can cause severe dyspnea and can be misdiagnosed as asthma. The cause of the abnormality related to PVFM has not been directly recognized, but multiple factors or triggers are associated. It is this lack of clarity and association with asthma, exercise, extubation, stress, and gastric reflux that I take interest in this pathology. I have a personal connection with exercise induced asthma. In addition, my sister in-law was recently diagnosed with VCD who …


Polycystic Ovarian Syndrome, Tameka Todd Jul 2015

Polycystic Ovarian Syndrome, Tameka Todd

Nursing Student Class Projects (Formerly MSN)

The main goal of this project was to educate peers on the pathophysiology of a disease or disorder of choice. The topic to be discussed is Polycystic Ovarian Syndrome (PCOS). This topic was chosen based on personal interest in women’s health issues. PCOS is a metabolic disease affecting 5-10 percent of women of childbearing age (Morgan, 2013). Characteristics of PCOS include enlarged ovaries consisting of multiple small cysts surrounding the outer ovary, with unknown cause (Morgan, 2013). Leading to the ovaries producing an increased amount of androgen (male hormones) (Morgan, 2013).


Rhabdomyolysis – Understanding The Mechanics, Tawnya Tucker Jul 2015

Rhabdomyolysis – Understanding The Mechanics, Tawnya Tucker

Nursing Student Class Projects (Formerly MSN)

As a hospital healthcare provider on a Medical/Surgical Unit the probability of examining and treating a patient diagnosed with rhabdomyolysis is scarce. Knowing the mechanics of the disease will assist the provider in evaluating and treating the patient. Awareness of the pathophysiology of the disease is vital in accurately diagnosing and treating the disease. The role of the advanced practice nurse is fundamental in distinguishing possible causes of the phenomenon by recognizing signs and symptoms that occur with the disease. Completing a thorough physical exam on the patient and obtaining special lab tests will assist in identifying the ailment. Treating …


Multiple Sclerosis And The Implications Of Anesthesia, Timothy B. Maiden Jul 2015

Multiple Sclerosis And The Implications Of Anesthesia, Timothy B. Maiden

Nursing Student Class Projects (Formerly MSN)

Multiple Sclerosis (MS) is an autoimmune process characterized by inflammation and demyelination of axons in the brain and spinal cord (Schneider, 2005). According to Maclean (2010), MS is one of the most common debilitating neurological disorders in young adults. My intent of this research project is to explain the pathophysiological process and become familiar with the implications of anesthesia related to MS. This research will enable me to prepare a safe, individualized anesthetic plan, taking all essential precautions when caring for a patient with multiple sclerosis.


Effects Of Enhanced External Counter Pulsation Therapy On Patients With Angina, Valerie Jones Jul 2015

Effects Of Enhanced External Counter Pulsation Therapy On Patients With Angina, Valerie Jones

Nursing Student Class Projects (Formerly MSN)

According to the literature, coronary heart disease (CHD) is responsible for 370,000 deaths annually in the United States (Centers for Disease Control and Prevention [CDC], 2015). A symptom commonly associated with CHD is angina (US Department of Health & Human Services, National Institute of Health, National Heart, Lung, and Blood Institute [NIH], 2011). An estimated 300,000 to 900,000 patients in the United States have refractory angina pectoris (RAP), with nearly 100,00 new cases diagnosed yearly (Manchanda, Aggarwal, Aggarwal, & Soran, 2011). Kones describes refractory angina as continued angina class III/IV, in the nonsurgical candidate, with objective evidence of ischemia despite …


Idiopathic Pulmonary Fibrosis: Understanding Has Led To Exciting Treatments, William Metz Jul 2015

Idiopathic Pulmonary Fibrosis: Understanding Has Led To Exciting Treatments, William Metz

Nursing Student Class Projects (Formerly MSN)

Pulmonary fibrosis can be described as an excessive amounts of fibrous connective lung tissue in the lung. Idiopathic pulmonary fibrosis(IPF) is the most common form of interstitial lung disease(ILD). When an obvious cause cannot be determined, a diagnosis of Idiopathic pulmonary fibrosis is made. The mean survival for patients is approximately 3-5 years from time of diagnosis. IPF is found primarily in men over 50 years of age, with a history of cigarette smoking with concurrent environmental and occupational inhalation exposures(Leslie, 2011, p. 592). Pulmonary fibrosis has been identified by early pathologists at the beginning of the last century. During …


Lymphedema: Pathophysiology, Diagnosis & Management, Bernadine Cruz Oct 2014

Lymphedema: Pathophysiology, Diagnosis & Management, Bernadine Cruz

Nursing Student Class Projects (Formerly MSN)

Lymphedema is a disfiguring condition whose hallmark is progressive, increasing swelling which occurs as a result of the accumulation of protein rich fluid in interstitial spaces. Those individuals who are affected suffer from either primary lymphedema or secondary lymphedema; the pathophysiology of both conditions is similar. Lymphedema can be a chronic, acute, or transient alteration, which can eventually lead to keratinization of the skin. An increase in the incidence of lymphedema has also been observed with increase in levels of obesity.


Therapeutic Hypothermia Following Cardiac Arrest, Cassandra Patrick Oct 2014

Therapeutic Hypothermia Following Cardiac Arrest, Cassandra Patrick

Nursing Student Class Projects (Formerly MSN)

According to the Sudden Cardiac Arrest Foundation (2014), each year, 424,000 people in the U.S. (more than 1,000/day) experience EMS-assessed out-of-hospital non-traumatic sudden cardiac arrest. This is roughly equivalent to the number of people who die from Alzheimers’ disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer and suicides combined (Sudden Cardiac Arrest Foundation, 2014). It is estimated that the likelihood of surviving an out-of-hospital cardiac arrest (OHCA) to hospital discharge can be as low as 6% to 8% (Williams, Calder, Cocchi & Donnino, 2013). Additionally an estimated 200,000 hospitalized …


Does Your Child Have Reflux Or Could There Be More To It Than That, Cody Elam Oct 2014

Does Your Child Have Reflux Or Could There Be More To It Than That, Cody Elam

Nursing Student Class Projects (Formerly MSN)

Eosinophilic esophagitis (EE) is differentiated from Gastroesophageal Reflux Disease (GERD) by endoscopic and histopathologic examination. The hallmark of EE is eosinophilic infiltration of the esophagus. EE has been defined as “a clinicopathologic entity, combining clinical data on (1) relevant symptoms (distinct in the pediatric or adult populations with mostly food impaction and dysphagia in adults and feeding intolerance, failure to thrive, and GERD symptoms in children); (2) esophageal biopsies with adequate histologic findings in the esophageal biopsies (>15 eosinophils/high power field [HPF]); and (3) exclusion of other diseases with overlapping features, especially GERD” (Genevay, Rubbia-Brandt, & Rougemont, 2010, p.816). …


Hemophilia A: Pathophysiology And Treatment Strategies, Daniel Dinneen Oct 2014

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 …


Acute Respiratory Distress Syndrome, Brian Flowers Oct 2014

Acute Respiratory Distress Syndrome, Brian Flowers

Nursing Student Class Projects (Formerly MSN)

In healthcare, there are many interesting and intriguing conditions that are vital to understand from both a clinical and a pathophysiological standpoint. Comprehending and knowing how to treat these conditions effectively, ultimately leads to the best care and patient outcomes. As a current critical care nurse and future advanced practice nurse, it was important to select a research topic of interest to explore that would benefit a high risk group of patients. Based on this precedent, acute respiratory distress syndrome (ARDS) was chosen. As a critical care nurse, exposure to respiratory conditions and mechanical ventilation management is something nurses are …


Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency, Brian Albany Oct 2014

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 …


Enterovirus: What Everyone Should Know, Debra Mccorkle Oct 2014

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 …


Hereditary Spherocytosis, Dolores Loeser Oct 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 Oct 2014

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, …


The Mystery Of Transverse Myelitis: Can It Happen To You?, Jessica Castle Oct 2014

The Mystery Of Transverse Myelitis: Can It Happen To You?, Jessica Castle

Nursing Student Class Projects (Formerly MSN)

Imagine a day like any other, as a healthy performs daily tasks without any particular difficulty. Then, the first fall happens. After standing and recovering, two more falls occur; however, despite all physical effort, standing proves to be a complete impossibility. Imagine the fear. What is going on? This unexplainable scenario happened to an 81 woman diagnosed with idiopathic transverse myelitis (TM) in May 2011, leaving her permanently paralyzed below the mysteriously appearing T9 lesion. This woman had only a personal history of asthma and breast cancer, and nothing significant in her family history. After 60 days of lumbar punctures, …


Malignant Hyperthermia, Eric Weberding Oct 2014

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).


Licorice Consumption Causing Hypokalemia And Lethal Dysrhythmias, Gina Grosscup Oct 2014

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 …


Takotsubo Cardiomyopathy, Kari Patterson Oct 2014

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.


Basics Of Oncologic Type B Lactic Acidosis: Increased Awareness For Better Outcomes?, Erin E. Steiner Oct 2014

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.


Acute Respiratory Distress Syndrome, Jaqueline Yunker Oct 2014

Acute Respiratory Distress Syndrome, Jaqueline Yunker

Nursing Student Class Projects (Formerly MSN)

Acute Respiratory Distress Syndrome is an inflammatory response resulting from injury to the alveolar-­‐capillary membrane. This injury is caused by a systemic inflammatory response that involves either direct trauma to the lung cells, such as a pneumonia, or indirect, such as sepsis. The inflammatory response that is triggered results in leaky alveolar-­‐capillary beds and infiltration of the lungs (Villar, 2011). This is very common with approximately 150,000 cases annually in the United States and a very high mortality rate of 60,000 deaths per year (Pipeling & Fan, 2010). Despite the high mortality rate, 15-­‐35%, there is no set of guidelines …


Pathophysiology, Incidence And Implications In Intraductal Papillary Mucinous Neoplasia Of The Pancreas, Ericka Haverick Oct 2014

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 …


Craniocervical Arterial Dissection, Joseph Weisenberger Oct 2014

Craniocervical Arterial Dissection, Joseph Weisenberger

Nursing Student Class Projects (Formerly MSN)

The annual incidence for spontaneous carotid artery dissection (CAD) ranges from 2 to 3/100,000 patients and is even lower for a spontaneous vertebral artery dissection (VAD). Furthermore, there is only a .08% - .04% chance for the incidence of a traumatic dissection (TD), of the entire trauma population (Mortazvi, Verma, Tubbs, Harrigan, 2011). However, despite these low levels, CAD/VADs pose a serious threat to a patient’s plan of care if not identified and treated early.


Myasthenia Gravis: A Closer Look, Erin L. Ricker Oct 2014

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 …


Necrotizing Fasciitis, Holly Herron Oct 2014

Necrotizing Fasciitis, Holly Herron

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis also known as necrotizing soft tissue infections (NSTIs) is a rare life-threatening infection that involves the skin and soft tissue. A rapid and accurate diagnosis of NSTIs must be identified by healthcare providers to diminish morbidity and mortality. NSTIs are characterized by progressive necrosis of subcutaneous tissue and fascia involving large areas of tissue (Lin, Chang, Lai, Lin, & Chen, 2013). Hippocrates (500 BC) described necrotizing fasciitis as “diffuse erysipelas caused by trivial accidents [where] flesh, sinews, and bones fell away in large quantities, [leading to] death in many cases” (Lancerotto, Tocco, Salmaso, Vindigni & Bassetto, 2012). In …


Necrotizing Fasciitis: The “Flesh Eating” Disease, John Neukam Oct 2014

Necrotizing Fasciitis: The “Flesh Eating” Disease, John Neukam

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis, often referred to as the “flesh-eating disease”, is a rare bacterial infection with an extremely high mortality rate with symptoms that begin subtle but can quickly ravish the human body.1 While the prevalence of this disease is relatively low, evidence of this disease can be traced back as far as the 5th century BC where it was initially described by Hippocrates.2 It wasn’t until 1952 however that Dr. Bob Wilson termed the disease “necrotizing fasciitis”.3 The rapid progression of this disease and the acute deterioration it causes in a patient is extremely intriguing. This “flesh-eating disease” can present …


Enterovirus D68, Kimberly Meyers Oct 2014

Enterovirus D68, Kimberly Meyers

Nursing Student Class Projects (Formerly MSN)

Enterovirus D68 (EVD68) “belongs to the family Picornaviridae, genus Enterovirus, and species Human enterovirus D: (Kaida et al.,2011, para.2). It is a small nonenveloped RNA virus (Xiang et al., 2012). EVD68 “shares characteristics with rhinoviruses, such as infection of the respiratory tract and acid lability” (Lauinger et al., 2012). There is no specific treatment for EVD68. Since the infection is caused by a virus, antibiotics would be ineffective. There are no antiviral medications currently available to treat EVD68 (Herold, 2014). Treatment may include antipyretics, cough medicines, bronchodilators, oxygen, and mechanical ventilation if required.


Acute Pancreatitis, Laura Payne Oct 2014

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 …


Ebola: Protecting Healthcare Workers, Martha Mccoy Oct 2014

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 …