Nursing Commons^™

Electronic - Cigarettes And Anesthesia Implications, Duane Robinson

Nursing Student Class Projects (Formerly MSN)

Electronic cigarettes (ECs) became available in the United States in 2007. They were originally marketed as a safer alternative to smoking (Arndt et al., 2020). The number of users has exceeded 14M people in the U.S. (Bulat et al., 2022). ECs are not as regulated as tobacco cigarettes. The levels of nicotine in the e-liquid vary significantly and the Federal Drug Administration (FDA) does not regulate the non-nicotine ingredients in e-liquid (Krishna et al., 2020). The vapor from ECs contains heavy metals, volatile hydrocarbons, and over 70 carcinogenic substances. Lung damage from EC use has created a new respiratory ailment, …

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 …

Safety Measures In The Epilepsy Monitoring Unit: An Organizational Assessment, Tina Yates

Doctor of Nursing Practice Scholarly Projects

Long-term video-electroencephalography (EEG) monitoring in the epilepsy monitoring unit (EMU) is an elective procedure and generally safe. Clinical experts determined the EMU protocols at a level-4 comprehensive epilepsy center were not followed correctly. The project is a retrospective chart audit incorporating Ray’s Bureaucratic Caring theoretical framework with Donabedian’s conceptual model. The project objective is to evaluate if safety measures protocols are implemented appropriately in the EMU and determine whether a need exists for quality improvements.

The project reviewed patients admitted to the EMU from September 2021 through November 2021 who developed a generalized tonic clonic (GTCs) seizure with electrographic epileptiform …

Evidence-Based Practice Guideline Development: Selection Of Local Anesthetics And The Additive Dexamethasone In Brachial Plexus Blocks, Alexandra Mcguire

Doctor of Nursing Practice Scholarly Projects

Brachial plexus blocks (BPB) are a type of regional anesthesia that inhibits the sensory and motor function of the upper extremity. The efficacy of a BPB depends on the type and dose of local anesthetics (LA), as well as the use of any additive agent. The selection of LA depends on the type, concentration, and volume of LA. Certain additives, such as dexamethasone, when added to BPB, were shown to increase motor and sensory block duration.

A chart audit conducted by the pharmacy and anesthesia departments revealed a significant variability of clinical practice in the use of LA and additives …

Evidenced-Based Practice Guideline Development: Selection Of Local Anesthetics And The Additive Dexamethasone In Brachial Plexus Blocks, Sabina Lamichhane Wagle

Doctor of Nursing Practice Scholarly Projects

Brachial plexus blocks (BPB) are a type of regional anesthesia that inhibits the sensory and motor function of the upper extremity. The efficacy of a BPB depends on the type and dose of local anesthetics (LA), as well as the use of any additive agent. The selection of LA depends on the type, concentration, and volume of LA. Certain additives, such as dexamethasone, when added to BPB, were shown to increase motor and sensory block duration.

A chart audit conducted by the pharmacy and anesthesia departments revealed a significant variability of clinical practice in the use of LA and additives …

Analysis Of Clinical Outcomes And Cost-Effectiveness Of Neuromuscular Blocking Drug Reversal In Patients With Obstructive Sleep Apnea, Samantha Kinglsey, Aaron "Mitch" Corn

Doctor of Nursing Practice Scholarly Projects

Non-depolarizing neuromuscular blockers are used during many surgical procedures to induce muscle relaxation for tracheal intubation and improve surgical conditions for surgeons. The use of these medications requires an agent to be given to fully reverse the effects of the neuromuscular blocking drug. Historically, neostigmine has widely been used as the primary reversal agent. However, sugammadex, a recently FDA approved drug, is also available for the reversal of common neuromuscular blocking drugs, rocuronium and vecuronium. In the literature, sugammadex is widely regarded as a clinically superior reversal agent. But its use is commonly limited to emergent situations due to the …

Malignant Hyperthermia, Brennon Pinion

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia is a rare but potentially fatal disorder that is triggered by the use of certain anesthetic medications. It is caused by a mutation in specific proteins in skeletal muscle that causes prolonged contraction, leading to a hypermetabolic state. This condition can have deadly effects like kidney failure, hemodynamic instability, and cardiac arrest. It is normally discovered during surgery and must be treated right away. The discovery of the treatment of Malignant Hyperthermia has dramatically decreased the fatality of the disorder, but treatment must be given immediately. For patients who develop Malignant Hyperthermia to have the highest chance of …

Myasthenia Gravis, Jonathan Garcia

Nursing Student Class Projects (Formerly MSN)

Poster Abstract

Jonathan C. Garcia

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology for the Advanced Practice Nurse

Dr. Deana Batross and Dr. Shivani Bhatnagar

July 29, 2022

Abstract

Myasthenia Gravis (MG) is a rare autoimmune neuromuscular disorder caused by the destruction or decreased availability of nicotinic acetylcholine receptors in the post-synaptic neuromuscular junction. Muscular weakness that worsens with activity and improves with rest is a hallmark of MG. MG patients are at increased risk for many postoperative and anesthesia-related complications. However, risk can be mitigated when providers thoroughly understand MG's pathophysiology and implications on the anesthetic plan. …

Perioperative Malignant Hyperthermia, Mitchell Mccorkle

Nursing Student Class Projects (Formerly MSN)

Abstract

Malignant Hyperthermia (MH) is a rare inherited disorder in which exposure to triggering agents such as volatile anesthetics or depolarizing neuromuscular blockers causes a hypermetabolic reaction leading to patient fatality. MH susceptible patients have a genetic mutation on the ryanodine one receptor (RYR1) in skeletal muscle, allowing uninhibited calcium release (Smith, Tranovich, & Ebraheim, 2018). Increases in free calcium result in an uncontrollable sustained muscle contraction through the excitation-contraction coupling of myosin and actin. Sustained muscle contraction rapidly consumes adenosine triphosphate stores and stimulates conversion to lactate producing anaerobic metabolism (Smith et al., 2018). Immediate recognition and treatment of …

Substance Use Disorder In The Crna, Bridget Hayes

Nursing Student Class Projects (Formerly MSN)

Substance use disorder (SUD) affects the anesthesia community disproportionally as compared to the general public (Rupprecht, 2022). It is estimated that SUD will affect 10%-15% of all anesthesia providers at some point in their careers (Rupprecht, 2022). One way that SUD affects the human body is the alteration of microRNAs, which are small segments of RNA that exist to regulate gene expression (Gowen et al., 2020). This poster will discuss how miRNAs change in the SUD-affected individual, anesthesia-specific risk factors, and signs and symptoms to identify when this disorder has affected someone else. Resources for help are available from the …

Cystic Fibrosis, India Hutchison

Nursing Student Class Projects (Formerly MSN)

Cystic fibrosis (CF) is a complex disease caused by an autosomal recessive gene mutation that results in the dysfunction of chloride transport proteins in epithelial tissues. The resultant highly viscous secretions can cause respiratory, gastrointestinal, endocrine, and reproductive complications. Although modern treatment has become more individually targeted and the average life expectancy has increased in recent years, no cure has been discovered. It affects over 80,000 people worldwide, with 30,000 affected individuals living in the United States alone. This poster aims to provide a brief overview of the pathophysiologic processes, treatment therapies, and nursing considerations for Cystic Fibrosis.

Chronic Obstructive Pulmonary Disease (Copd), Whitney R. Stant

Nursing Student Class Projects (Formerly MSN)

To make a safe anesthetic plan, a nurse anesthetist must evaluate a patient's medical history. Anesthesia providers will encounter patients with COPD requiring anesthesia. It is necessary that nurse anesthesia understands the pathophysiology and peri-operative considerations to provide safe care to COPD patients. The poster provided can be a tool to review the pathophysiology and nursing implementations of COPD. It provides information for the nurse anesthetist to apply to the perioperative setting to improve patients’ surgery outcomes. An anesthetist is always striving to provide quality anesthesia care to their patients. COPD patients require extra preparation to prevent complications from arising …

Type 2 Diabetes And A Plant Based Diet, Adrian Brown

Nursing Student Class Projects (Formerly MSN)

I was diagnosed as a Type II diabetic a few years ago when I was living in South Korea working as an English teacher. I, like many of the diabetics that I now take care of, said many of the same excuses that they tell me:

Patient: I heard that I might be pre-diabetic.

Nurse: You are on metformin and your morning glucose is in the 180s.

Patient: I’m not diabetic.

Nurse: You have peripheral neuropathy.

Patient: I watch what I eat. I’m ok.

Nurse: You have hypertension high cholesterol and don’t exercise.

I've said all over those things. But …

Ischemic Stroke, Brett Winner

Nursing Student Class Projects (Formerly MSN)

Cerebrovascular accident, or stroke, as it is referred to is a serious neurological event that affects almost 800,000 people in the United States annually, of which approximately 87% is ischemic in nature. Ischemic stroke is mostly caused by atherosclerotic plaques that develop due to endothelial injury in vessels that supply blood flow to the brain. An ischemic stroke can be the result of thrombi breaking off from vessels in the brain, emboli from outside the brain, or small vessel stenosis, all of which occlude a vessel within brain and cause tissue ischemia. When perfusion to portions of the brain is …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Hypertension, Bethany Stemen

Nursing Student Class Projects (Formerly MSN)

Hypertension is called the “silent killer” and can cause organ damage. This poster focuses on signs and symptoms of hypertension, along with the pathophysiology of hypertension. It also gives insight on how to manage and treat high blood pressure and ways to prevent hypertension. Knowledge is power and knowing the impact and ways to treat and prevent a problem is essential.

Acute Respiratory Distress Syndrome, Amanda Kleinfelder

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by damage in the lungs leading to persistent hypoxemia. The alveoli in the lungs become filled with fluid from damage to the pulmonary capillaries due to inflammatory mediators. The buildup of fluid in the lungs ultimately result in intubation of the patient and mechanical ventilation (Senapathi et al., 2020). ARDS has become more prevalent today with the 2020 Covid-19 pandemic affecting 200 countries resulting is 1.1 million deaths so far (Weiss et al., 2021). Multiple therapies exist for the management of ARDS including prone positioning, deep sedation, and mechanical ventilation …

Heart Failure, Meredith Louden

Nursing Student Class Projects (Formerly MSN)

Abstract

Background: Heart failure (HF) is the heart’s inability to maintain the blood flow needed by the body’s organs for perfusion. HF affects millions of adults worldwide annually and holds detrimental characteristics with its high hospitalization and mortality rates. As a result, healthcare systems spend exponentially more resources and money to take care of HF patients. An interactive poster is presented on HF to educate patients with HF, healthcare providers, and other related parties.

Methods: Research articles that focused on HF, including the following topics: pathophysiology, clinical signs and symptoms, treatment, complications, impact on healthcare, and etiology, were evaluated and …

Delirium, Angela Lee

Nursing Student Class Projects (Formerly MSN)

Delirium is a severe neurocognitive syndrome characterized by acute changes in consciousness and cognition (American Psychiatric Association, 2013; Wilson et al., 2020). The syndrome is found to be prevalent within the adult intensive care population resulting from various triggers and stressors in the critical care setting (Wilson et al., 2020). On average, the prevalence of delirium is 23%, but the incidence significantly increases to 50-70% in mechanically ventilated patients (Wilson et al., 2020). As a result of the extension of cognitive deficits, if left untreated, delirium may lead to long-term impairments in cognitive disfunction (Wilson et al., 2020). Current studies …

Current Management Of Acute Hyperglycemia: Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome, Cary Bedinghaus

Nursing Student Class Projects (Formerly MSN)

The purpose of this poster is to review and promulgate current best practices in management of the two forms of hyperglycemic crises: diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Reviews of literature showed large agreement on efficacious protocols in acute hyperglycemic treatment, while also noting wide prevalence of the disorder. Given the high human and financial cost of hyperglycemia, the dissemination of high quality, evidence-based interventions, to the widest possible audience participating in patient care, is imperative. This poster outlines signs and symptoms, basic pathophysiology, and implications for the treatment team with emphasis placed on areas of settled best …

Asthma Pathophysiology, Tyler Wolpert

Nursing Student Class Projects (Formerly MSN)

This poster will examine the pathophysiology of Asthma, explore signs and symptoms of the disease, and review different treatment modalities. The Doctorate of Nursing (DNP) prepared nurse should be able to identify signs and symptoms of the disease and be prepared to manage the disease from a medical standpoint, as well as with behavior modification. The economic burden of asthma on healthcare yearly is over $82 billion. It is pertinent that continued research is done in the field of asthma to reduce the economic impacts of the disease, as well as to help improve patient outcomes on people living with …

Effect Of Microbiome Alterations On The Progression & Treatment Of Nonalcoholic Fatty Liver Disease, Rachelle Virgin

Nursing Student Class Projects (Formerly MSN)

Nonalcoholic fatty liver disease (NAFLD) is the presence of hepatic steatosis that is not caused by alcohol consumption, viruses, or medications (Sivell, 2019). Fatty liver can become more inflamed and lead to nonalcoholic steatohepatitis (NASH) and possibly progress to cirrhosis and liver failure (Sheka et al., 2020). As rates of obesity and type 2 diabetes rise, healthcare providers can expect to see this disease more prevalently in practice. It can be difficult to provide timely healthcare because there are usually no signs or symptoms present with NAFLD (Mayo Clinic, 2020). This poster discusses the importance of recognizing comorbidities and risk …

Parkinson's Disease And Anesthesia, Anthony Brusadin

Nursing Student Class Projects (Formerly MSN)

Parkinson’s disease is one of the most common neurodegenerative disorders in the world and is rapidly growing. With the global population living longer there will be more people that develop Parkinson’s like the average person’s life expectancy increases. With no cure and only treatment and management of the symptoms, it is important for research to continue to find better treatment options and potentially a cure. In the world of anesthesia patients with Parkinson’s are more difficult to manage with sedation medication because of the lower dopamine levels the patient has. It is important to stay updated on how to prepare …

Cardiogenic Shock, Kourtney Crum

Nursing Student Class Projects (Formerly MSN)

Cardiogenic shock is a leading cause of mortality in critical care units globally, despite advances in research and medical management. This shock state is caused by an initial insult directly to the heart, including myocardial infarction, ventricular failure, or valve dysfunction. The purpose of this poster is to provide an overview of pathophysiology, signs and symptoms, clinical classifications, and management options for cardiogenic shock.

Sars-Cov-2 (Covid-19), Matthew Baker

Nursing Student Class Projects (Formerly MSN)

SARS-CoV-2 (COVID-19) emerged in the fall of 2019 and impacted millions of people worldwide deeming it a global pandemic. The virus primarily impacts the respiratory system, but has shown to affect other organ systems such as the kidneys, heart, and brain. Respiratory failure leading to Adult Respiratory Distress Syndrome (ARDS) associated with COVID-19 requires ventilatory support and possibly prone therapy to increase lung volumes and prevention of atelectasis. There are several treatment modalities for mild and severe cases of COVID-19 that range from antivirals to vaccine development. COVID-19 is a complex virus that can vary from mild to severe cases …

Malignant Hyperthermia, Emmanuel Mensah

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia is a rare but fatal disorder usually triggered using succinylcholine, a depolarizing muscle blocker, or other volatile anesthetics (Yang et al., 2020). MH is characterized by signs and symptoms including Hyperthermia, acidosis, tachycardia, hypercarbia, acidosis, etc. (Yang et al., 2020). When the signs and symptoms of MH are recognized, the provider should stop what he or she is doing and call for immediate help. When additional assistance arrives, the patient must receive Dantrolene. Dantrolene is a muscle relaxant that prevents the sarcoplasmic reticulum from releasing calcium. Additional interventions include cooling the patient using ice packs, treating electrolyte abnormalities, …

Alcohol Use Disorder (Aud) In The Elderly Population, Anthony Oguogho

Nursing Student Class Projects (Formerly MSN)

There is a substantial and growing population of elderly adults (65years and older) who misuse alcohol, and psychoactive prescription drugs. Evidence suggests that alcohol dependence and alcohol abuse which is now collectively known as alcohol use disorder (AUD) is common among 65years and older due to socioeconomic circumstances of aging. These socioeconomic circumstances include empty nest syndrome (when children grow up and move away), loss of friendships due to moves, health complications or death, deteriorating health conditions, traumatic events like a spouse’s illness or death, sadness after downsizing a home, and boredom from retirement or lack of socialization. ETOH is …

Chronic Obstructive Pulmonary Disease, Aaron Mcneilan

Nursing Student Class Projects (Formerly MSN)

The following poster presentation provides a brief overview of the disease process of Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the leading causes of disability and death worldwide, and its incidence does not appear to be declining. The most common factor causing COPD is cigarette smoking, which is modifiable. Other contributors are environmental air pollutants which some people may encounter depending on where they live or their occupation. This presentation is a culmination of information from different scholarly sources which discuss the symptoms, pathophysiology, causes, management, and prevention of COPD.

Polycystic Ovarian Syndrome: Pathophysiology And Chronic Health Implications, Makilah Witt

Nursing Student Class Projects (Formerly MSN)

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. If untreated, women suffer a myriad of secondary sequala and chronic diseases. The prevalence of PCOS is rising and greatly impacts patients' physical, mental, and emotional health, diminishes community health, and increases healthcare costs. However, many providers fail to properly diagnose patients, understand how this disease impacts women, or provide appropriate interventions to prevent chronic health problems. This paper outlines the pathophysiology of PCOS, identifies signs and symptoms, and provides recommendations for treatment and holistic patient care for the role of the Advance Practice Nurse.

Perioperative Management Of The Patient With Diabetes Mellitus, Alexa High

Nursing Student Class Projects (Formerly MSN)

Diabetes Mellitus is one of the most prevalent co-morbidities seen in hospitals today. As such, it is extremely important for healthcare providers to be well informed in order to care for their patients properly. This poster will adequately inform healthcare providers on key signs and symptoms, pathophysiology, diagnosis, and treatment for diabetes mellitus. This poster will also include significant information on how to care for the patient with diabetes mellitus during the perioperative period.