Medical Sciences Commons^™

Perioperative Risks Of The Patient With Heart Failure, Gabrielle Metoyer

Nursing Student Class Projects (Formerly MSN)

Perioperative Risks of the Patient with Heart Failure

Gabrielle Metoyer

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology

Dr. Deanna Batross and Dr. Shivani Bhatnagar

August 5, 2022

Abstract

According to the CDC (2020), heart failure occurs when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is an epidemic disease affecting 1-2% of the population worldwide (Schwinger, 2020). It is one of the leading causes of morbidity and mortality worldwide with an estimated 6.5 million adults with heart failure in the United States (Lo et al., 2021). Medical advances …

Malignant Hyperthermia For The Nurse Anesthetist, Victor Clark

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia (MH) is a rare, autosomal dominant skeletal muscle disorder that can have an insidious onset in susceptible patients exposed to the triggering agents succinylcholine, halothane, desflurane, sevoflurane, and isoflurane. MH can occur in patients who have received anesthesia with these agents in the past (Nagelhout & Plaus, 2018, p 775). Patients with a family history of MH or associated skeletal muscle disorder must be treated as MH-susceptible until proven otherwise. Failure to detect an MH crisis can lead to kidney failure, profound acidosis, coagulopathies, rhabdomyolysis, cardiac dysrhythmias, cardiovascular collapse, and death (Seifert et al., 2015). It is the …

Clostridium Difficile, Ryan Osborn

Nursing Student Class Projects (Formerly MSN)

Clostridium Difficile infection (CDI) is an antibiotic resistant bacterium that is widely recognized and currently noted to be the "most common and costly healthcare associated infection in the United States" (Abt, McKenney & Pamer, 2016). The topic of CDI is important to discuss, as this infection can attack all patient populations especially those following antibiotic treatment. A disruption in a person's intestinal microbiota is known to place them at higher risk for CDI (Abt, McKenney & Pamer, 2016). Becoming infected with this bacterium leads to symptoms of diarrhea, bloating, belly pain, and occasionally fevers. The growing prevalence, antibiotic resistance associated …

Malignant Hyperthermia, Aaron Roth

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia is a rare disease trait and can take place in a variety of settings. If not treated in a timely manner, the consequences will be dire. It is recommended that nurses and other healthcare personnel be properly educated on MH crises. By detecting the signs and symptoms associated with the disease, providers can efficiently remedy the crisis and save patient lives (Seifert, 2014). Since the discovery of dantrolene in 1975 and the advancement of genetics regarding MH, death rates dropped from about 80% to about 5% (Schneiderbanger et al., 2014). Today there is a MH group called the …

Complex Regional Pain Syndrome, Maria A. Hendrix

Nursing Student Class Projects (Formerly MSN)

Complex regional pain syndrome (CRPS) is a chronic and often disabling condition that is seen in many patients seeking pain management. The condition leaves patients in excruciating pain that is disproportionate to the inciting injury. In addition, patients with this pain disorder experience abnormal sensations such as cold and heat allodynia, hyperalgesia, edema, abnormal sudomotor activity and trophic changes (D. Lee et al., 2015). CRPS disproportionally affects four times as many women as men (Alexander, Peterlin, Perreault, Grothusen, & Schwartzman, 2012). There are two types of CRPS: type 1, often referred to as reflex sympathetic dystrophy (RSD), is not evident …

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 …

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 …

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 …

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 …

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 …

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, …

Thrombotic Thrombocytopenia Purpura, Ann Oliva

Nursing Student Class Projects (Formerly MSN)

Patients with Thrombotic Thrombocytopenia Purpura, or TTP, are often times seen in the emergency department and subsequently admitted to the inpatient or the critical care unit. The problems that TTP patients can present with vary greatly and astute nursing assessment plus knowledge of the pathophysiology behind the diagnosis is vital to deliver excellent nursing care. Thrombotic Thrombocytopenia Purpura or TTP is a rare but potentially fatal condition that occurs as result of decreased levels of ADAMTS-13, a cleaving protease for von Willebrand factor (vWF), which causes platelet aggregation and microvascular thrombi and subsequent end-organ damage, along with thrombocytopenia, hemolytic anemia, …

Investigating Duchenne’S Muscular Dystrophy, Ashley Beaujon

Nursing Student Class Projects (Formerly MSN)

Young boys usually present with disordered or delayed motor development, muscle weakness, and possible speech delays in early childhood (Ruiten et al, 2014). The first symptoms almost always show up prior to the age of six years. Parents may notice their young child with DMD having a hard time standing up, walking, or climbing stairs, and many will eventually need a wheelchair to get around (Brennan, 2014). Initial blood tests obtained are remarkable for an elevated creatine kinase (CK) and then diagnosis is typically confirmed with a genetic test showing a mutation in the dystrophin gene (Ruiten et al, 2014). …

Juvenile Myoclonic Epilepsy, April Britton

Nursing Student Class Projects (Formerly MSN)

Juvenile myoclonic epilepsy (JME) is one of the most common epilepsies of childhood (Korff, Nordli, & Eichler, 2014). JME typically occurs in otherwise healthy teenagers, and is characterized by one or more of the following seizure types: myoclonic jerks, generalized tonic clonic seizures, and absence seizures (Korff, Nordli, & Eichler, 2014). JME is thought to have genetically mediated factors (Park, Shahid, & Jammoul, 2015). JME is considered to be gender equal (Korff, Nordli, & Eichler, 2014). Most JME patients are diagnosed between 12 and 18 years of age (Korff, Nordli, & Eichler, 2014). Triggers linked to onset of seizure activity …

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 …

Cardiac Tamponade, Ashley Miner

Nursing Student Class Projects (Formerly MSN)

The topic the author chose to research is cardiac tamponade. Cardiac tamponade occurs when fluid builds up in the pericardial cavity, which is the cavity that surrounds the heart. Cardiac tamponade can occur due to various reasons, including myocardial infarctions, pericarditis, traumas, and placement of pacer wires. Palpitations, chest pain, and shortness of breath are common symptoms that occur with cardiac tamponade. Pericardiocentesis and a pericardial window are two interventions that are commonly used to treat cardiac tamponade. Cardiac tamponade is a medical emergency and without any intervention, may lead to cardiac arrest and possible death. The author chose cardiac …

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, …

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 …

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 …

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 …

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’ …

Pathological Jaundice, Dianna Contosta

Nursing Student Class Projects (Formerly MSN)

Neonatal jaundice is a common condition present in infants after birth. It is caused by elevated bilirubin in the blood. It can affect up to 84% of term infants and is one of the most common cause for hospital readmission for the neonatal department (Muchowski, 2014). It typically appears within 24 hours of life and is normally present in otherwise healthy newborns. Physiologic jaundice, also known as unconjugated bilirubin, is a normal process that happens in neonates because the hepatic system is not matured yet (Kirk, 2008). Majority of the time physiologic jaundice resolves on its own. Pathological jaundice, also …

Antithyroid Drug-Induced Agranulocytosis, Elizabeth Spears

Nursing Student Class Projects (Formerly MSN)

We live in a culture that is busy and constantly on the go. With little time to spare, often symptoms of an alteration in bodily function are pushed to the side and attribute to the stress of everyday life. With symptoms including nausea, fatigue, weight loss, nervousness, and irritability, one may be more inclined to disregard these symptoms, only to attribute them to effects of a busy lifestyle. The presentation of the previously listed symptoms can formulate a medical diagnosis of hyperthyroidism. According to the American Thyroid Association, 20 million Americans will develop some type of alteration in thyroid function …

Gout As A Significant Risk Factor For Cardiovascular Disease: A Case Study, Emily Leonhard

Nursing Student Class Projects (Formerly MSN)

Gout, an inflammatory arthritis caused by elevated serum uric acid levels, is emerging as a significant risk factor for cardiovascular disease (CVD). Recently, a nurse practitioner (NP) was caring for a patient who was suffering from a particularly severe gout attack while being treated in the ICU for new onset Atrial Fibrillation. The patient reported that he had never had an attack this severe before. He asked the NP if his history of gout could be related to his recent heart problems. The nurse practitioner, in order to answer the patient’s question, spent time researching the disease process of gout, …

Malignant Hyperthermia: A Clinical Crisis, Eric Reing

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia, though uncommon, is a serious and life threatening condition. Malignant hyperthermia is an autosomal dominant disorder that affects skeletal muscle. It can be caused by various general anesthetic agents like succinylcholine and several inhaled anesthetics. Malignant hyperthermia is a relevant topic to certified registered nurse anesthetists due to the potentially fatal result if not recognized and treated promptly. In understanding the pathophysiology, risk factors, signs and symptoms, epidemiology, and current treatments the health care provider can help to prevent complications due to this disorder (Nagelhout, 2014).

Malignant Hyperthermia, Hailey Jones

Nursing Student Class Projects (Formerly MSN)

According to the Malignant Hyperthermia Association of the United States (2015), “Malignant hyperthermia (MH) is a potentially fatal, inherited disorder usually associated with the administration of certain general anesthetics and/or the drug succinylcholine.” Malignant hyperthermia has been presented to me during hospital skills days over the past year due to the increased need for knowledge regarding this topic. I choose this topic because I find it interesting due to the fact that I could encounter this in the remainder of my days in the intensive care unit, but most importantly because I will be dealing with these drugs on a …

Acute Immune Thrombocytopenia Purpura, Erin Woodworth

Nursing Student Class Projects (Formerly MSN)

Immune thrombocytopenic purpura (ITP), formerly known as idiopathic thrombocytopenic purpura, is a relatively rare, but potentially life threatening autoimmune disorder that involves the destruction of platelets by autoantibodies. The resultant decreased platelet count leaves the patient at risk for excessive bruising and bleeding (Hunt, 2010). ITP can occur in both adults and children, and also occurs as an acute or chronic disorder. It is thought that the cause of acute ITP may differ from that of chronic ITP, however, the underlying disease processes that occur are very similar (Johnsen, 2012). Acute ITP, the most common form of the disease, most …

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 …

Nonimmune Hydrops Fetalis, Heather Walker

Nursing Student Class Projects (Formerly MSN)

Hydrops fetalis is an excessive accumulation of fluid within the fetal extravascular compartments and body cavities generally characterized by: •placental enlargement •ascites •pericardial effusions •pleural effusions (Bellini, 2014, p. 1082). Nonimmune hydrops fetalis (NIHF) develops as a result of one or more nonimmune factors, distinguishing it from immune hydrops fetalis that results from a maternal antigen-body fetal antigen-mediated red blood cell hemolysis (Randenberg, 2010, p. 281).