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Articles 1 - 30 of 60
Full-Text Articles in Medical Sciences
Protein Losing Enteropathy Following Fontan Palliation In The Single Ventricle Population, Alaina Dunkleberger
Protein Losing Enteropathy Following Fontan Palliation In The Single Ventricle Population, Alaina Dunkleberger
Nursing Student Class Projects (Formerly MSN)
Congenital heart defects requiring single ventricle palliation are a rare but life-threatening occurrence. There are multiple defects resulting in single ventricle physiology including defects in which the right or left ventricle within the heart is either undeveloped (hypoplastic left heart syndrome, hypoplastic right heart syndrome), or the valve to the main pulmonary artery did not form (pulmonary atresia). These defects prevent the heart from supplying adequate blood flow to the lungs or body. Single ventricle congenital heart defects are not easily treated surgically due to their complexity in nature. Single ventricle surgical palliation typically involves three open-heart surgeries including the …
Lymphedema: Pathophysiology, Diagnosis & Management, Bernadine Cruz
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
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
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). …
Malignant Hyperthermia, Chase Contri
Malignant Hyperthermia, Chase Contri
Nursing Student Class Projects (Formerly MSN)
Although very rare, occurring one out of every 100,000 anesthesia cases, malignant hyperthermia is a hypermetabolic disorder that anesthesia providers screen and interrogate patients prior to every case they are administering anesthesia. Many research studies about anesthesia induced malignant hyperthermia have explored new methods of testing for the genetic susceptibility for malignant hyperthermia and into hospital based protocols when a patient starts to show the signs and symptoms of the metabolic disorder. This new knowledge and understanding has decreased patient mortality of anesthesia induced malignant hyperthermia from eighty percent to five percent over the past three decades (Rosenberg et al, …
Angiotensin Converting Enzyme Related Angioedema, Andrea Sims
Angiotensin Converting Enzyme Related Angioedema, Andrea Sims
Nursing Student Class Projects (Formerly MSN)
A 54 year old female patient arrives to the emergency department (ED) via squad complaining that 2 days ago her lips were tingling and her face felt a little swollen but it subsided. Today she woke up with her tongue protruding out of her mouth, her lips, face and eyes are swollen. She does not present with itching or urticaria. Squad personnel established an IV, gave her intravenous (IV) Benadryl 50 mg, and 0.3 mg subcutaneous epinephrine without any change in her condition. The emergency medical service (EMS) also applied oxygen at 2 liters per minute (lpm). She denies taking …
Hemophilia A: Pathophysiology And Treatment Strategies, Daniel Dinneen
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 …
Effects Of Edmr On Veterans With Ptsd, Beth Abele
Effects Of Edmr On Veterans With Ptsd, Beth Abele
Nursing Student Class Projects (Formerly MSN)
Of all the mental health disorders, the most commonly diagnosed among Iraqi and Afghanistan wars is Posttraumatic stress disorder (PTSD) (Hellmuth et al., 2012). Veterans who are suffering the effects of PTSD are treated every day in VA Medical Centers across the country, as well as in private sector hospitals. Many of these men and women are battling with drug addictions and alcohol abuse in attempts to self medicate (Murdoch et al., 2010). According to nationally represented study by Murdoch and colleagues (2010), one fifth of individuals who have been diagnosed with PTSD use drugs, alcohol or both to treat …
Malignant Hyperthermia, Devin Poncsak
Malignant Hyperthermia, Devin Poncsak
Nursing Student Class Projects (Formerly MSN)
A crisis of malignant hyperthermia is a medical emergency, and must be treated immediately with a coordinated, multidisciplinary team response in order to give the patient the highest chance for a successful recovery (Dirksen, Van Wicklin, Mashman, Neiderer, & Merritt, 2013). Malignant hyperthermia is defined by Bandschapp & Girard (2012), as “a disturbance of the skeletal muscle calcium homeostasis, triggered by volatile anaesthetics and depolarizing muscle relaxants.” Once a vulnerable patient is exposed to one of these triggering agents, a pathologic hypermetabolic response ensues, and the patient has a rapid increase in oxygen consumption and expired carbon dioxide, hyperthermia, acidosis, …
Acute Respiratory Distress Syndrome, Brian Flowers
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
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
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 …
Early Onset Alzheimer’S Disease In Individuals With Down Syndrome: Explored Theories Of Pathophysiology, Amanda Pack
Early Onset Alzheimer’S Disease In Individuals With Down Syndrome: Explored Theories Of Pathophysiology, Amanda Pack
Nursing Student Class Projects (Formerly MSN)
This presentation is a focus on some of the theories of the pathophysiology of early-onset Alzheimer’s Disease (AD) in individuals with Down Syndrome (DS). Down Syndrome, a genetic condition where an individual has a partial or full extra chromosome 21, is the most common chromosomal condition in the United States (National Down Syndrome Society (NDSS), 2012). Average life expectancy for individuals with DS has vastly increased in the last thirty years from age 25 to age 60 (NDSS, 2012). The extra chromosome genetically makes individuals with DS predisposed to certain conditions, including early onset dementia and AD, therefore as their …
Brain Death Determination, Bethani Knipfer
Brain Death Determination, Bethani Knipfer
Nursing Student Class Projects (Formerly MSN)
Patient MR was a seventeen year old female involved in a motor vehicle collision which resulted in a traumatic brain injury leading to declaration of brain death. The pathophysiology behind the traumatic brain injury, the concept and use of a brain tissue monitoring device, and the tests used in the declaration of brain death will be explored. When brain death is determined, the patient has the opportunity to become an organ donor. Thousands of people are waiting for organs to become available. This is a huge healthcare concern that may be decreased if the general public is more educated regarding …
Hereditary Spherocytosis, Dolores Loeser
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
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
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
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
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 …
The Role Of Brain-Derived Neurotrophic Factor In Depression, Katie Mendez
The Role Of Brain-Derived Neurotrophic Factor In Depression, Katie Mendez
Nursing Student Class Projects (Formerly MSN)
According to The World Health Organization, depression is the fourth leading cause of total disease burden and the leading cause of disability worldwide. In the United States, results from the National Health and Nutrition Examination Survey reflect a 16.2% lifetime depression prevalence. Symptoms of depression can range from mild to severe and can be episodic or chronic. Depression has a high rate of comorbidity with multiple chronic diseases and other mental health disorders, predominately anxiety. Unfortunately, few Americans diagnosed with depression actually receive sufficient treatment and symptom management. Previous research has shown that individuals are more likely to seek treatment …
Takotsubo Cardiomyopathy, Kari Patterson
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
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
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
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
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.
The Pathophysiology Of Tumor Lysis Syndrome In Oncology Patients, Jessica Richardson
The Pathophysiology Of Tumor Lysis Syndrome In Oncology Patients, Jessica Richardson
Nursing Student Class Projects (Formerly MSN)
Patients with oncological conditions are at an increased risk of developing a wide variety of complications from chemotherapy that they would not otherwise be exposed too. One such life threatening complication is tumor lysis syndrome, which is an oncology emergency that frequently lands patients in the intensive care unit. Tumor lysis syndrome (TLS) occurs most frequently after the initiation of chemotherapy or other chemotoxic drugs during the patients’ treatment course [8]. It causes faster than normal tumor cell breakdown and release of intracellular contents into the general circulation. [8]. This leads to a very predictable development of electrolyte imbalances to …
Myasthenia Gravis: A Closer Look, Erin L. Ricker
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 …
Multimodal Therapy For Postoperative Pain Management, Karen Lynch
Multimodal Therapy For Postoperative Pain Management, Karen Lynch
Nursing Student Class Projects (Formerly MSN)
Multimodal therapy works best to control postoperative pain safely. Multimodal pain treatment involves the use of two or more classes of analgesics to target different pain mechanisms. Why? Data is present that supports that health care systems are still under treating pain in the postoperative patient. Unrelieved pain has harmful effects to multi ple body systems. There is still a need to provide education to providers, nurses and patients to promote best practice in pain management approaches regarding multimodal therapy. Opiate analgesics still remain the most commonly used treatment for pain following surgery. Using this singular analgesic modality could put …
Necrotizing Fasciitis, Holly Herron
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
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 …