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2014

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Full-Text Articles in Nursing

Overcoming Barriers To Screening For Anal Intraepithelial Neoplasia For Persons Living With Hiv, Brandon Hastings Dec 2014

Overcoming Barriers To Screening For Anal Intraepithelial Neoplasia For Persons Living With Hiv, Brandon Hastings

Doctor of Nursing Practice (DNP) Projects

Screening has proven an effective strategy in the management of diseases that plague the population. This technique has proven to be most effective when screening is conducted with those who are most at risk for developing the targeted illness and when the frequency of screening follows set guidelines. Currently there are no nationally recognized screening guidelines for anal intraepithelial neoplasia (AIN). Screening for AIN stands to reduce overall incidence of anal squamous cell carcinoma through destruction of the dysplastic cells before they become cancerous. The goals of this project were to identify the patient population that stands to benefit the …

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Increasing Hpv Vaccination Rates Using Social Marketing Strategies, Sharon Wilson Catledge Dec 2014

Increasing Hpv Vaccination Rates Using Social Marketing Strategies, Sharon Wilson Catledge

Doctoral Projects

The human papillomavirus (HPV) is the most common sexually-transmitted infection (STI). Approximately 20 million Americans between the ages of 15 and 49 years currently have HPV with > 6.2 million new HPV infections estimated to occur each year. Yet, HPV vaccination rates remain relatively low. More than 40 strains of HPV are transmitted through genital contact during vaginal, anal, or oral sex and can infect males and females. In addition to causing genital warts, HPV is associated with cervical, vulvar, vaginal, anus, penile, and oropharyngeal cancers. In women, the most prominent type of cancer is cervical with > 12,000 diagnoses each year …

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Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents, Jennifer Mcguire Hitt Dec 2014

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents, Jennifer Mcguire Hitt

Theses and Dissertations (ETD)

Although the American Diabetes Association (ADA) adopted the use of the glycated hemoglobin (A1C) test as a method of diabetes and prediabetes diagnosis, the ADA has not developed firm guidelines concerning the use of the A1C test in children and adolescents, as research has not validated thresholds in this group. Diabetes and prediabetes are diseases influenced by multiple factors, including race and ethnicity, age, vitamin D deficiency, and body mass index (BMI). The purpose of this study was to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the A1C test compared to the gold …

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Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams Oct 2014

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

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Lymphedema: Pathophysiology, Diagnosis & Management, Bernadine Cruz Oct 2014

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.

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Therapeutic Hypothermia Following Cardiac Arrest, Cassandra Patrick Oct 2014

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 …

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Does Your Child Have Reflux Or Could There Be More To It Than That, Cody Elam Oct 2014

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). …

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Hemophilia A: Pathophysiology And Treatment Strategies, Daniel Dinneen Oct 2014

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 …

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Acute Respiratory Distress Syndrome, Brian Flowers Oct 2014

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 …

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Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency, Brian Albany Oct 2014

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 …

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Enterovirus: What Everyone Should Know, Debra Mccorkle Oct 2014

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 …

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Hereditary Spherocytosis, Dolores Loeser Oct 2014

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 …

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Global Burden Of Tuberculosis, Diana Moses Oct 2014

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, …

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The Mystery Of Transverse Myelitis: Can It Happen To You?, Jessica Castle Oct 2014

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, …

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Malignant Hyperthermia, Eric Weberding Oct 2014

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).

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Licorice Consumption Causing Hypokalemia And Lethal Dysrhythmias, Gina Grosscup Oct 2014

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 …

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Takotsubo Cardiomyopathy, Kari Patterson Oct 2014

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.

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Basics Of Oncologic Type B Lactic Acidosis: Increased Awareness For Better Outcomes?, Erin E. Steiner Oct 2014

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.

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Acute Respiratory Distress Syndrome, Jaqueline Yunker Oct 2014

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 …

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Pathophysiology, Incidence And Implications In Intraductal Papillary Mucinous Neoplasia Of The Pancreas, Ericka Haverick Oct 2014

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 …

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Craniocervical Arterial Dissection, Joseph Weisenberger Oct 2014

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.

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Myasthenia Gravis: A Closer Look, Erin L. Ricker Oct 2014

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 …

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Necrotizing Fasciitis, Holly Herron Oct 2014

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 …

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Necrotizing Fasciitis: The “Flesh Eating” Disease, John Neukam Oct 2014

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 …

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Enterovirus D68, Kimberly Meyers Oct 2014

Enterovirus D68, Kimberly Meyers

Nursing Student Class Projects (Formerly MSN)

Enterovirus D68 (EVD68) “belongs to the family Picornaviridae, genus Enterovirus, and species Human enterovirus D: (Kaida et al.,2011, para.2). It is a small nonenveloped RNA virus (Xiang et al., 2012). EVD68 “shares characteristics with rhinoviruses, such as infection of the respiratory tract and acid lability” (Lauinger et al., 2012). There is no specific treatment for EVD68. Since the infection is caused by a virus, antibiotics would be ineffective. There are no antiviral medications currently available to treat EVD68 (Herold, 2014). Treatment may include antipyretics, cough medicines, bronchodilators, oxygen, and mechanical ventilation if required.

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Acute Pancreatitis, Laura Payne Oct 2014

Acute Pancreatitis, Laura Payne

Nursing Student Class Projects (Formerly MSN)

Acute pancreatitis is a common diagnosis seen in intensive care units worldwide. The incidence of pancreatitis has increased over the last decade. It ranks third amongst the gastrointestinal diseases resulting in hospital admissions. The destructive complications of pancreatitis make it a life-threatening disease. If pancreatitis progresses to the severe form the mortality rate significantly increase from one percent to upwards of thirty percent. Pancreatitis is associated with high rates of morbidity, mortality, and prolonged hospital admissions(Goozen, Besselink, Santroort, & Bollen, 2013). An increased understanding of the pathophysiology of pancreatitis has changed the approach to treatment from early surgical treatment to …

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Ebola: Protecting Healthcare Workers, Martha Mccoy Oct 2014

Ebola: Protecting Healthcare Workers, Martha Mccoy

Nursing Student Class Projects (Formerly MSN)

Ebola is a hemorrhagic disease that has been seen throughout Liberia, but because of international travel it is spreading. Gilsdorf, Morgan and Leitmeyer (2012) researched air travel and reported that, “In 2010, 5.04 billion passengers arrived and departed from 1318 airports worldwide… and travel to and from Africa almost doubled between 1995 and 2005.” (p.1471). In the last few months there have been cases of Ebola reported in Spain and the United States linked to travel. These are recent developments because as of July, 2014 the Center for Disease Control and Prevention (CDC) reported “to date there are no cases …

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Atrial Fibrillation Post-Lung Lobectomy, Laura Adorni Oct 2014

Atrial Fibrillation Post-Lung Lobectomy, Laura Adorni

Nursing Student Class Projects (Formerly MSN)

According to the American Heart Association, atrial fibrillation affected 2.66 million individuals in the United States in 2010 and is expected to double by year 2050 (Sanoski, 2010, p. S11). Post-operative atrial fibrillation (POAF), a classification of atrial fibrillation (AF), can occur after thoracic surgery and is an ongoing source of morbidity and mortality (Imperatori et al., 2012). There is a 10-20% occurrence rate of POAF after non-cardiac surgery, such as a lung lobectomy, and a 40% incidence rate after a pneumonectomy (Omae & Kanmura, 2012, p. 429). Cardiovascular events such as heart failure, cerebral infarction, renal failure, and infection …

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Cerebral Venous Sinus Thrombosis (Cvst), Meghan N. Delong Oct 2014

Cerebral Venous Sinus Thrombosis (Cvst), Meghan N. Delong

Nursing Student Class Projects (Formerly MSN)

Cerebral venous sinus thrombosis (CVST) is an uncommon condition with incidence resulting in approximately 1-3 % of all strokes. Cerebral venous sinus thrombosis remains often unrecognized initially due to its vague manifestations of symptoms which range from isolated headaches to focal neurological signs and symptoms. CVST is slightly more common in women, particularly in the age group of 20 to 35, due to pregnancy, puerperium and oral contraceptive use (Stam, 2005).

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Steven-Johnson’S Syndrome/Toxic Epidermal Necrolysis, Lindsey Grant Oct 2014

Steven-Johnson’S Syndrome/Toxic Epidermal Necrolysis, Lindsey Grant

Nursing Student Class Projects (Formerly MSN)

Steven-Johnson’s Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are both diseases mediated by hypersensitive immune reactions resulting in “full thickness epidermal necrosis” characterized by skin detachment. However, in SJS, there is only 10% skin surface area involvement whereas in TEN, over 30% of the skin becomes detached. TENS has a 50% mortality rate. (East-Innis & Thompson, 2013, p. 590) Why Chosen: SJS/TEN is a rare but extremely fatal disease. Initially, it is often mistaken as a simple allergic reaction to a new medication or environmental exposure because both cause truncal rashes and fevers. However, simple allergic reactions occur within days …

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