Medical Sciences Commons^™

The Incidence Of Early Stage Postoperative Nausea And Vomiting Following The Use Of Nitrous Oxide And Prophylactic Antiemetic Therapy: Implications For Clinical Practice, James Sullivan

Doctoral Projects

Nitrous oxide (N₂O) is a volatile agent currently used during the induction and maintenance of general anesthesia. Since it’s discovery in 1786 by Dr. Priestly, it is the oldest volatile agent to find continued use in current practice (Kossick, 2014). In conjunction with its extensive history is the debate regarding its emetic properties. Numerous studies have investigated the effect of nitrous oxide to produce postoperative nausea and vomiting (PONV) with varying and often conflicting results. Generally speaking, nitrous oxide is theoretically an emetic and is believed to be associated with PONV (Tramer, Moore, & McQuay, 1996). This has …

The Effectiveness Of A Preoperative Multimodal Antiemetic Regimen On Reducing Early Postoperative Nausea And Vomiting In Total Joint Arthroplasty Patients, Jerry Mosley

Doctoral Projects

Postoperative nausea and vomiting (PONV) occurs frequently in all types of surgeries including after total joint orthopedic procedures. The resulting PONV can lead to many unwanted occurrences including immobilization, distress, and many serious adverse health complications. These unwanted occurrences may then lead to increased cost to the patient and healthcare facility. Administration of a preoperative multimodal regimen known to reduce PONV has the potential to reduce such unwanted anesthetic side effects influencing a reduction in overall healthcare cost. The purpose of this study is to determine the effectiveness of the preoperative kit which includes the administration of metoclopramide, famotidine, ondansetron, …

Restoring Digestive Health, Kristin M. Corbin, Dnp, Aprn, Fnp-C

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose: The purpose of this translational research project was to outline the healthcare problems associated with Functional Gastrointestinal Disorders and to explore the effectiveness of a gastrointestinal protocol utilized at Atlanta Center for Holistic and Integrative Medicine. The goal of this protocol is to restore digestive health with probiotics, digestive enzymes, and glutamine.

Background: Functional Gastrointestinal Disorders affect one in every four adults in the United States. These disorders encompass a variety of symptoms including diarrhea, constipation, cramping, abdominal pain, flatulence, reflux, and bloating without an identified physiological cause. There is currently no cure for Functional Gastrointestinal Disorders and treatment …

Herb-Drug Interaction Of Andrographolide On The Pharmacokinetics Of Carbamazepine In Rats, Elizabeth Aziz, Samuel Franklin, Ankit Pandav, Abigail Savino, Caleb Thompson, Caleb Vandyke, Ruth Choi, Elisha R. Injeti

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Objective: To determine if andrographolide (AND) impacts the pharmacokinetics of carbamazepine (CBZ).

Background: CBZ is an anticonvulsant medication that is metabolized in the liver by cytochrome P450 (CYP) enzymes. AND is an over-the-counter medication that is common in Eastern cultures to treat inflammation and is a CYP enzyme inhibitor. Because CBZ is metabolized in the liver by these specific CYP enzymes, coadministration of andrographolide and CBZ could result in a herb-drug interaction.

Methods: Sprague-Dawley rats (N=12) aged between 3 months and 6 months (250-350 g) will be split into control (N=6) and treatment (N=6) groups. The treatment group will receive …

Problem Solving Skill And Obesity In Children, Caitlin R. Spano

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract:

Introduction: Childhood obesity is a problem that leads to many serious health effects including early maturation, decreased quality of life and increased risk for cardiovascular disease. In 2012, over one third of children were considered obese (Childhood Obesity Facts 2015). Efforts have been made to reduce this number but they have not been fully successful (Nutrition Standards for School Meals 2015, Prevalence of Childhood obesity in the United States 2011-2012 2015). What other factors are causing kids to choose foods that lead to weight gain.

Literature Review: In research regarding psychological motivations of overeating, there has been a correlation …

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 …

Neurological, Nutritional And Cognitive Effects Of Environmental Lead Exposure In Infants And Children, Melissa Bianchi

Nursing Student Class Projects (Formerly MSN)

Environmental lead exposure is a pertinent public health risk that affects our rural population in Wyandot County, Ohio. Children exposed to lead hazards through toys, home remodeling and contaminated soil and water are at a greater risk for developing neurological, cognitive and behavioral issues than are children not exposed to lead (Cecil et al., 2011). Wyandot County parents are not adequately educated on the risks and consequences of elevated blood lead levels in their children. As a child advocate and director of the Women, Infant and Children program for Wyandot County there is an obligation to educate and inform parents …

Preparedness Of Nurses For Malignant Hyperthermia, Melissa Flemming

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is a potentially life threatening disorder that occurs following exposure to certain inhaled anesthetics such as halothane, isoflurane, sevoflurane, desflurane, enflurane, ether, and methoxyflurane alone or in combination with the depolarizing muscle relaxant, succinylcholine (Seifert,, Wahr, Pace, Cochrane, & Bagnola, 2014, p. 189). Patients experiencing malignant hyperthermia may progress to death if it is not recognized and treated early. Patient outcomes improve the earlier an intervention is given. Malignant hyperthermia is not a common condition and, therefore, nurses are frequently unfamiliar with the common signs, symptoms, and treatments. Malignant hyperthermia can occur in a variety of settings …

Neuroleptic Malignant Syndrome: A Pathophysicological Dilemma, Samantha Davis

Nursing Student Class Projects (Formerly MSN)

Neuroleptic malignant syndrome (NMS) is a rare disease occurring from an adverse reaction to anti-psychotic use. The diagnosis and predictability of the disease is extremely difficult as it mimics other syndromes (Margetić & Aukst-Margetić, 2010). The disease onset can occur when initiating medications, escalating doses, or adding an adjunctive anti-psychotic to the regimen. Although causing the unpredictability, the disease can occur at any dose (Paul, Michael, John, & Lenox, 2012). Further increasing the difficulty of diagnostics, signs and symptoms are very wide spread. The Diagnostic and Statistical Manual of Mental Disorders created a tool to assist in the clinical setting; …

Raynaud’S Phenomenon, Sarah Gasper

Nursing Student Class Projects (Formerly MSN)

Raynaud’s phenomenon (RP) is a widely prevalent clinical disorder commonly seen in outpatient settings. It is characterized by episodic vasospastic attacks of the digital arteries and arterioles that limit blood flow to the extremities, causing severe pain. Temperature changes and stress are the primary triggers that exacerbate this disease. The classic biphasic color changes of RP are pallor, cyanosis, and erythema and commonly affect the fingers and toes and more rarely, the nose, nipples, ears, lips, and penis. RP is divided into subcategories. Primary Raynaud’s phenomenon (PRP) is when no underlying medical disease exists and the condition happens spontaneously. It …

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).

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.

Takotsubo Cardiomyopathy, Angela J. Occidental

Nursing Student Class Projects (Formerly MSN)

Takotsubo cardiomyopathy is a rare, reversible form of cardiomyopathy. First cases of takotsubo cardiomyopathy were described in Japan, twenty years ago (Milinis, & Fisher, 2012). takotsubo cardiomyopathy is a transient left ventricular dysfunction, typically triggered by severe emotional or physical distress. Left ventricular ballooning is characteristic of Takotsubo syndrome. Images of this ballooning resemble a takotsubo vessel used in Japan for collecting octopus, thus the reason for the syndrome name (Pelliccia, et. al, 2014). In recent years, this cardiomyopathy has been described as “Broken heart syndrome” because severe emotional stress has been implicated as the cause of this cardiomyopathy in …

Chagas Disease: Immigrating Into The United States, Angela Metzger

Nursing Student Class Projects (Formerly MSN)

Chagas Disease is starting to make a profound entrance into our communities within the United States. The influx of the immigrant population is the principal cause of the accumulation in the number of reported cases. (Center for Disease Control and Prevention, 2014). The Trypanosoma cruzi is a parasite that causes Chagas disease. The triatomine blood sucking insect enjoys the mucosal membranes of their pray, both humans and animals. The most common regions of the penetrating bite are the conjunctiva of the eye or around the mouth. It is through the feces of the vector entering the inoculation site that initiates …

Exploring The Pathophysiological Concepts Of Ebola Virus, Andrew T. Wasson

Nursing Student Class Projects (Formerly MSN)

The Ebola virus is a member of the filoviridae family. Five distinctive species of ebolavirus have been identified, four of which are known to cause disease in humans (Martines, Ng, Greer, Rollin, and Zaki, 2014). The specific species known to cause disease in humans are Zaire, Sudan, Ivory Coast, and Bundibugyo (Bray & Chertow, 2014). Bah et al. (2015) report that the Zaire ebolavirus (EBOV) was the cause of the most recent West African outbreak and carries the highest human mortality rate among the five known species, with up to 90% of cases being fatal. Ebola is a filamentous, enveloped, …

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 …

Chikungunya Virus: More Than A Mosquito Bite, Abigail Shaw

Nursing Student Class Projects (Formerly MSN)

Chikungunya fever is a viral infection caused by the Chikungunya virus (CHIKV). Although seldom fatal, CHIKV causes high fevers, polyarthralgia, and rash. The mosquito-borne virus has spread rapidly in the last ten years, causing over three million cases of CHIKV worldwide (Powers, 2015). The recent outbreak initiated in Africa and the islands of the Indian Ocean in 2004 has quickly spread to Asia, Europe and the Americas (CDC, 2015). According to the CDC (2015), until 2014, cases in the United States had only been linked to foreign travel outside of the Americas. As the outbreak has grown, cases of local …

Identifying Acute Organ Dysfunction As A Marker Of Severe Sepsis, Daniell Mcsweeney

Nursing Student Class Projects (Formerly MSN)

The current definition of sepsis is suspected or documented infection plus at least one systemic manifestation of infection. Severe sepsis has been defined as sepsis plus evidence of organ dysfunction. Identifying acute organ dysfunction is a marker of severe sepsis. This topic was chosen after witnessing a number a patients fall into septic shock before severe sepsis was diagnosed and treatment initiated. Diagnosis of severe sepsis is important for specific protocol to be implemented in a timely fashion. The current differentiation between sepsis and severe sepsis is evidence of organ dysfunction. There are many examples of organ dysfunction that are …

Raising Awareness: Polycystic Kidney Disease, Dana Dendinger

Nursing Student Class Projects (Formerly MSN)

A young male patient was recently admitted to the intensive care unit at a local hospital with hypertensive urgency and acute renal failure of unknown etiology. A renal ultrasound showed polycystic kidneys and upon further investigation, it was discovered that the patient’s mother passed away last year from end stage renal failure related to polycystic kidney disease (PKD). The aforementioned case and the recent study into inherited disorders are what prompted further investigation into PKD. Liebau and Serra (2013) explain that “inherited cystic kidney diseases, autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD), are 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 …