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Articles 61 - 90 of 144
Full-Text Articles in Medical Pathology
Hyperglycemic Hyperosmolar State: A Diabetic Emergency, Rachel Fisher
Hyperglycemic Hyperosmolar State: A Diabetic Emergency, Rachel Fisher
Nursing Student Class Projects (Formerly MSN)
Hyperglycemic hyperosmolar state (HHS) is an acute complication associated with diabetes mellitus. HHS has been known by several other names in the past. These labels include Hyperosmolar Nonketotic Coma, Hyperosmolar Hyperglycemic Nonketotic Coma, and Hyperglycemic Hyperosmolar Nonketotic Syndrome (Hackel, 2014). HHS is characterized by severe hyperglycemia, profound dehydration, and is often accompanied by altered mental status. Less than 1% of diabetes-related admissions are due to HHS, but mortality rates are estimated to be 10% to 20% (Lenahan & Holloway, 2015). HHS typically affects the older adult population, with the average age of HHS patients being 60 years (Collopy, Kivlehan, & …
The Pathophysiology Of Sepsis, Rachel Hamilton
The Pathophysiology Of Sepsis, Rachel Hamilton
Nursing Student Class Projects (Formerly MSN)
Sepsis is still a leading cause of hospital admissions and often leads to death if not identified early and treated properly (Pilcher, Cooper & Bellomo, 2015). In the US there are approximately 200,000 deaths annually due to sepsis (Puskarich, Illich, & Jones, 2014). It is important for advance practice nurses to recognize risk factors for sepsis. By understanding the pathophysiology of sepsis nurse practitioners will be able to recognize early signs and symptoms of this inflammatory disease process and implement early medical management. Early medical treatment in septic patients is crucial to increase patient survival rates.
Congenital Cytomegalovirus (Cmv), Patty Fleming
Congenital Cytomegalovirus (Cmv), Patty Fleming
Nursing Student Class Projects (Formerly MSN)
Cytomegalovirus (CMV) is a common herpes virus infection that is usually harmless and belongs to a group of herpes viruses that includes the herpes simplex viruses, varicella-zoster virus (which causes chickenpox and shingles), and the Epstein-Barr virus (which causes infectious mononucleosis). Once CMV is in a person's body, it stays there throughout their life. (Centers for Disease Control and Prevention, 2010). CMV is shed in various bodily secretions, especially urine and saliva (Congenital Cytomegalovirus Foundation, 2014). According to the Centers for Disease Control and Prevention (CDC), the majority of otherwise healthy children and adults infected with CMV are asymptomatic while …
Hashimoto’S Disease: The Underactive Thyroid Disease, Patty Anderson
Hashimoto’S Disease: The Underactive Thyroid Disease, Patty Anderson
Nursing Student Class Projects (Formerly MSN)
The thyroid gland is part of the endocrine system and has a widespread function that controls multiple organ systems and processes. The main function of the thyroid gland is to produce and secrete two different thyroid hormones: triiodothyronine (T3) and thyroxine (T4), both of which help to meet the metabolic demands of the entire body. When the thyroid gland fails to produce T3/T4 hormones (primary gland failure) or is not activated successfully by the pituitary gland (by the release of thyroid stimulating hormone (TSH)), or hypothalamus, this results in low levels of circulating thyroid hormone. As low levels of the …
Sle And Pregnancy, Patricia Graham
Sle And Pregnancy, Patricia Graham
Nursing Student Class Projects (Formerly MSN)
Systemic lupus erythematosus (SLE) is a life-long, life-threatening autoimmune disease which can affect any organ in the body (Marks & Tullus, 2011). SLE disproportionately affects women in a ratio of 9:1 compared to men with most women being affected during child-bearing age (15-50 years) (Ferenkeh-Koroma, 2012). Pregnancy represents a challenge for the patient with SLE. Pregnant patients with SLE are considered high-risk for multiple medical and obstetric complications, as flares are related to increased irreversible organ damage (Ateka- Barrutia & Khamashta, 2013). Severe flares are also associated with poor fetal outcomes (Peart & Clowse, 2014). Successful pregnancies happen in 67% …
Effects Of Enhanced External Counter Pulsation Therapy On Patients With Angina, Valerie Jones
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 …
Understanding Bipolar Disorder, Tisha Perreira
Understanding Bipolar Disorder, Tisha Perreira
Nursing Student Class Projects (Formerly MSN)
According to McCance, Huether, and Brashers (2014), bipolar disorder is classified as bipolar I and bipolar II mood disorder. Bipolar I disorder, causes extreme mood swings of mania or hypomania (emotional highs) or emotional lows (depression). Manic disorder symptoms include: excessive risky activities, irritable mood, elevated mood, distractibility, excessive talking, inflated self-esteem, racing/crowded thoughts, decreased need for sleep, and increase in goal-directed activity. Symptoms of depression include: loss of interest/pleasure, weight gain or loss, fatigue/loss of energy, feeling of worthlessness or excessive guilt, depressed/irritable mood, recent thoughts of death/suicide, insomnia/or hypersomnia, poor concentration/indecisiveness, and psychomotor agitation. Bipolar II disorder has …
Rhabdomyolysis – Understanding The Mechanics, Tawnya Tucker
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 …
Paradoxical Vocal Fold Motion, Stephen Sherer
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 …
Implications Of Underlying Pathophysiology Of Osteomyelitis In Diabetics For Nursing Care, Danielle Spencer
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 …
The Pathology Of Heart Failure, Kevin Ahman
The Pathology Of Heart Failure, Kevin Ahman
Nursing Student Class Projects (Formerly MSN)
The topic I have chosen to research is heart failure. I have chosen this topic because I have treated many patients in the ICU with this condition, and find it an interesting pathology. Heart failure affects a significant portion of the patient population, and the rates are increasing. 5.1 million Americans ≥20 years of age have heart failure, projections show that by 2030, the prevalence of HF will increase 25% from 2013 estimates. At 40 years of age, the lifetime risk of developing HF for both men and women is 1 in 5. At 80 years of age, remaining lifetime …
Clostridium Difficile, Kristen Johnson
Clostridium Difficile, Kristen Johnson
Nursing Student Class Projects (Formerly MSN)
Clostridium difficile (CD) is an infectious disease that has a direct impact on our healthcare resources. “Clostridium difficile, an anaerobic, spore forming, toxin-forming, gram-positive bacillus, has become the leading cause of health care—associated infectious diarrhea (Walters & Zuckerbraun, 2014, p. 329).” I chose this topic because CD is a hypervirulent organism that is not only affecting hospitalized patients but is now emerging as a community acquired infection. Healthcare treatments and costs are on the rise due to persistent and recurrent CD infections. Understanding the pathogenesis, risk factors, diagnostic testing, and management strategies are important in reducing the spread of CD …
Post Traumatic Stress Disorder, Zachary Packard
Post Traumatic Stress Disorder, Zachary Packard
Nursing Student Class Projects (Formerly MSN)
Posttraumatic stress disorder (PTSD) can occur after witnessing or experiencing a terrifying event (Mayo Clinic, 2015). PTSD can manifest in a variety of symptoms including, nightmares, flashbacks, insomnia, irritability, and anger (Mayo Clinic, 2015). The extended combat engagement in Afghanistan and Iraq have caused many casualties for American service members, both physically and mentally. The Veterans Affairs (VA) stated that 476,515 people sought treatment for PTSD in 2011 alone (Veteran Affairs, 2014). The veterans returning home from combat require adequate services to support their transition to civilian life. Barriers may exist for those members with PTSD symptoms seeking treatment. The …
Takotsubo Cardiomyopathy, Angela J. Occidental
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 …
Investigating Duchenne’S Muscular Dystrophy, Ashley Beaujon
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). …
Acute Pancreatitis, Laura Skidmore
Acute Pancreatitis, Laura Skidmore
Nursing Student Class Projects (Formerly MSN)
Acute pancreatitis (AP) can be a singular incidence, a relapsing process or exacerbations of chronic pancreatitis. AP is a rapidly developing inflammatory disorder of the pancreas and can affect other organ systems. The process begins when pancreatic enzymes are activated prematurely and leak into surrounding tissue. The digestive process begins before reaching the intestines. AP is characterized clinically by abdominal pain and elevated levels of pancreatic enzymes in the blood. The pathogenesis is not fully understood however, a number of conditions are known to induce the disorder such as gallstones and chronic alcohol abuse (Schub & Kornusky, 2014)
Cardiac Tamponade, Ashley Miner
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 …
Myasthenia Gravis And Implications For The Certified Registered Nurse Anesthetist, Matthew Predick
Myasthenia Gravis And Implications For The Certified Registered Nurse Anesthetist, Matthew Predick
Nursing Student Class Projects (Formerly MSN)
In healthcare and, specifically anesthesia, there are many conditions that require various considerations by the prudent provider. An example of a condition requiring special attention is myasthenia gravis. Myasthenia gravis is an autoimmune disease in which skeletal muscle weakness and rapid fatigue result from destruction of nicotinic acetylcholine receptors [7]. Although the prevalence is not overwhelmingly high with most recent estimates of prevalence around 14 to 20 per 100,000 people in the United States [5] and 20 per 100,000 worldwide [9], inappropriate perioperative management of those with this ailment can result in serious consequences. Understanding the pathophysiology, various treatments (both …
Idiopathic Pulmonary Fibrosis: Understanding Has Led To Exciting Treatments, William Metz
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 …
Cervical Spinal Cord Injury, Melissa Schimmel
Cervical Spinal Cord Injury, Melissa Schimmel
Nursing Student Class Projects (Formerly MSN)
A spinal cord injury (SCI) can occur at any level of the spinal cord. A SCI involves an interruption between the brain and the body due to an injury or damage to the spinal cord (Sheppard Center, 2011, p1.). The location and extent of the injury is important because it will determine the severity and extent of dysfunction. The higher the injury is to the spinal cord, the more severe the loss of motor function (Sheppard Center, 2011, p.4). The spinal cord injuries are classified by based on the extent of injury, motor and sensory losses. The injury is considered …
Abdominal Aortic Aneurysm: A Silent Killer, Kristen Springer
Abdominal Aortic Aneurysm: A Silent Killer, Kristen Springer
Nursing Student Class Projects (Formerly MSN)
Rupture of an abdominal aortic aneurysm (AAA) is a significant cause of mortality in the United States. “Often asymptomatic, AAA is considered a silent killer because it frequently remains undiagnosed until the time of rupture or the patient’s death” (Gordon & Toursarkinssian, p. 242). As healthcare professionals, being aware of the pathophysiology, risk factors and symptoms influencing this disease is important in aiding early diagnosis and treatment, helping to reduce complications and mortality rates of those affected.
Pathophysiology And Treatment Of Life-Threatening Angioedema, Stephen J. Hoffman
Pathophysiology And Treatment Of Life-Threatening Angioedema, Stephen J. Hoffman
Nursing Student Class Projects (Formerly MSN)
Angioedema is a potentially lethal swelling of the interstitial space from extravasation of intravascular plasma (Wood, Choromanski, & Orlewicz, 2013). Angioedema may present in any medical setting with a broad range of severity. Angioedema is commonly seen in emergency departments and intensive care units. According to Barbara, Ronan, Maddox, & Warner (2013), “angioedema is of particular importance to anesthesiologists, as it may present at any point in the perioperative period and it may rapidly become life-threatening if it involves airway compromise” (p. 335). Anesthesia professionals may also respond to airway management emergencies throughout the hospital setting and may treat angioedema …
Preparedness Of Nurses For Malignant Hyperthermia, Melissa Flemming
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 …
The Importance Of Evaluation And Management Of Sepsis, Severe Sepsis, And Septic Shock, Katherine Herda
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). …
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, …
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 …
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 …
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 …