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2020

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Articles 871 - 900 of 2469

Full-Text Articles in Nursing

Sugammadex Versus Neostigmine In Reducing Postoperative Adverse Effects In The Pediatric Population, Robert Vieto Jr. Jul 2020

Sugammadex Versus Neostigmine In Reducing Postoperative Adverse Effects In The Pediatric Population, Robert Vieto Jr.

Nurse Anesthesia Student Capstones

Neostigmine and sugammadex are two medications used to reverse the neuromuscular blockade caused by nondepolarizing aminosteroidal neuromuscular blocking agents. Research has shown an association between the use of acetylcholinesterase inhibitors, such as neostigmine, and residual neuromuscular blockade in pediatric patients. Sugammadex has been shown to reduce residual neuromuscular blockade in adults without adverse effects, but minimal research has been performed on the effects of sugammadex in the pediatric population. Therefore, the objective of the present study is to compare sugammadex and neostigmine to determine if using sugammadex instead of neostigmine reduces postoperative adverse effects in the pediatric population. A systematic, …

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Basic Airway Management For Non-Anesthesia Operating Room Personnel: Education Implementation, Dylan Ouellette Jul 2020

Basic Airway Management For Non-Anesthesia Operating Room Personnel: Education Implementation, Dylan Ouellette

Nurse Anesthesia Student Capstones

A review of basic airway management for non-anesthesia personnel is presented. Included is a literature review of 20 articles surrounding the most current literature on preoperative airway assessment, cricoid pressure, video laryngoscopy, adjuncts for airway management, and airway management education for non-anesthesia health-care personnel. Following the review, an in-service style education presentation was developed and implemented at two sites in Maine. A pre- and post-test evaluation of the participants demonstrated an overall increase in test scores of 22%.

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Anesthetic Implications Of Intraarterial Chemotherapy For Retinoblastoma: A Literature Review, Marguerite Mullin Jul 2020

Anesthetic Implications Of Intraarterial Chemotherapy For Retinoblastoma: A Literature Review, Marguerite Mullin

Nurse Anesthesia Student Capstones

Retinoblastoma (RB) is a rare pediatric cancer commonly diagnosed in patients at a very young age. New therapies for this disease are emerging that involve some degree of sedation, requiring anesthesia providers to be involved in their care. Intraarterial chemotherapy (IAC) is one of these new exciting treatment options and requires general anesthesia. Multiple studies and case reports have reported a sudden decrease in pulmonary compliance during IAC for RB and attribute this response to the trigemino-cardiac reflex (TCR). Once this event occurs, patients experience associated hypoxemia, hypotension, bradycardia, and cardiovascular collapse. A systematic literature review was aimed at educating …

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Exparel Versus Bupivacaine: Outcomes, Advantages, And Costs, Jessica Duraney Jul 2020

Exparel Versus Bupivacaine: Outcomes, Advantages, And Costs, Jessica Duraney

Nurse Anesthesia Student Research Posters

Research poster comparing two local anesthetics, bupivacaine and Exparel (liposomal bupivacaine). The use of these drugs in various regional techniques, specifically for total knee arthroplasty (TKA) and abdominal surgeries, is discussed. Research shows that adequate pain control is associated with increased patient satisfaction, faster rehabilitation, mobilization, reduced hospital stays, and ultimately decreased hospital costs. Due to the many disadvantages of opioids, such as ileus, nausea, vomiting, respiratory depression, tolerance, and physical dependence, there has been a push for opioid-sparing and multimodal analgesia perioperatively.

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Early Initiation Of Therapeutic Hypothermia In The Emergency Department., Taylor Purnsley Jul 2020

Early Initiation Of Therapeutic Hypothermia In The Emergency Department., Taylor Purnsley

Doctor of Nursing Practice Papers

Therapeutic hypothermia (TH) is a treatment initiated by critical care providers for the management of cardiac arrest. It has been shown to lower the body temperature, reduce the inflammatory response, and suppress many of the pathways leading to delayed cell death. The American Heart Association (AHA) has strongly recommended to initiate cooling within 4-6 hours after return of spontaneous circulation (ROSC); however, despite the recommendation, the use of TH in emergency departments (ED) is not routine and it is commonly delayed. The purpose of this project was to evaluate the impact of an educational intervention on the timing of initiation …

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Improving The Rates Of Smoking History Documentation In The Electronic Medical Record., Megan Mccleese Vitellaro Jul 2020

Improving The Rates Of Smoking History Documentation In The Electronic Medical Record., Megan Mccleese Vitellaro

Doctor of Nursing Practice Papers

Lung cancer is the leading cause of cancer related deaths in the United States, and Kentucky leads the nation in lung cancer deaths. Lung cancer care also contributes billions of dollars a year to the cost of health care in this country. The U.S. Preventive Services Task Force (USPSTF) recommends low-dose computed tomography (LDCT) for lung cancer screening with a grade B recommendation, which is a covered service under the Centers for Medicare and Medicaid Services (CMS) guidelines. In order to qualify, patients must have an appropriately documented smoking history. A primary care office was identified within a major healthcare …

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The Impact Of Estimated Weight Versus Accurate Weight On Ischemic Stroke Patients With Tpa., Vanessa Johnson Jul 2020

The Impact Of Estimated Weight Versus Accurate Weight On Ischemic Stroke Patients With Tpa., Vanessa Johnson

Doctor of Nursing Practice Papers

Purpose: The gold standard of treatment for an ischemic stroke is the administration of weight based tPA within 4.5 hours of patient last neurological known well. The aim of this project was to improve accuracy of tPA dosing and decrease complications, improving outcomes for the stroke patient population. Method: This project implemented a new system, allowing every stroke patient to be accurately weighed when arriving to the hospital. AIS patients from a historical group were compared to patients receiving tPA within the first 3 months following an in-service, evaluating prospectively to determine if estimated or measured weights were used for …

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Malignant Hyperthermia For The Nurse Anesthetist, Victor Clark Jul 2020

Malignant Hyperthermia For The Nurse Anesthetist, Victor Clark

Nursing Student Class Projects (Formerly MSN)

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

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Infective Endocarditis, Lauren Verdow Jul 2020

Infective Endocarditis, Lauren Verdow

Nursing Student Class Projects (Formerly MSN)

Infective Endocarditis (IE) is a relatively rare disease but is well known to intensive care units and has a disturbingly high mortality rate despite advancements in medicine. IE is a condition characterized by damage to the endothelial lining of the heart, which can lead to vegetation growth on cardiac valves. IE can lead to a multitude of complications, such as pulmonary embolism or stroke. Patient education and prevention are crucial to reducing mortality and improving patient outcomes. Healthcare providers must be diligent in their measures to prevent pathogen entry into open areas, such as central access devices and wounds. They …

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Malignant Hyperthermia, Kathryn Hernandez Jul 2020

Malignant Hyperthermia, Kathryn Hernandez

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is a condition in which the body goes into a hypermetabolic state affecting skeletal muscle in response to receiving inhaled anesthetics or the neuromuscular blocking agent, succinylcholine. MH is an autosomal dominant disorder that is most closely related to a defect in the ryanodine receptor. The defective receptor causes a rapid increase of intracellular calcium causing hyperthermia, tachycardia, tachypnea, hypercapnia, increased oxygen consumption, acidosis, hyperkalemia, muscle rigidity, and rhabdomyolysis. With the complexity of this disorder and its unique pathophysiological process it is crucial that all parts of the surgical team, especially anesthesia providers, understand how to treat …

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Understanding Covid-19, William Carson Ii Jul 2020

Understanding Covid-19, William Carson Ii

Nursing Student Class Projects (Formerly MSN)

The SARS-CoV-2 outbreak has changed the lives of many. To combat the disease referred to as COVID- 19, anesthesia providers must be educated on specific topics. Understanding of a brief history of previous strands of the disease details the need for measures to reduce healthcare providers exposure. As patients present to the operating room (OR), viral and antibody testing combined provides identification and prognosis of the disease with infected patients who can transmit the disease. Anesthesia providers encounter transmission entry points frequently increasing possibility of exposure. The disease process of COVID-19 can lead to progression of complications necessitating interventions from …

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Irritable Bowel Syndrome, Katherine Stillman Jul 2020

Irritable Bowel Syndrome, Katherine Stillman

Nursing Student Class Projects (Formerly MSN)

Past understanding of the pathophysiology of irritable bowel syndrome (IBS) presents this chronic condition as a functional gastrointestinal disorder related to psychological causes. While no structural abnormalities are present in IBS, this poorly understood condition of persistent abdominal pain and altered bowel habits can be debilitating, contributing to a decreased quality of life. Current research has uncovered new evidence, that for many patients, symptoms may actually originate in the gut. An altered gut microbiome is now accepted as playing a central role in the development of the disorder. This poster summarizes the current pathophysiological concepts of IBS, including the role …

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Acute Kidney Injury, Mary Boadu Jul 2020

Acute Kidney Injury, Mary Boadu

Nursing Student Class Projects (Formerly MSN)

This poster presents up to date information regarding acute kidney injury (AKI) which often presents in patients in the intensive care unit (ICU). Most patients may not have identifiable symptoms therefore, advanced practice clinicians are charged with a great responsibility to diagnose, treat and follow-up with such patients. It is pertinent that clinicians recognize AKI early in an effort to prevent adverse consequences as seen in the progression of AKI to chronic kidney disease (CKD).

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Alzheimer’S Disease, Brandi Herman Jul 2020

Alzheimer’S Disease, Brandi Herman

Nursing Student Class Projects (Formerly MSN)

Alzheimer’s disease is a cause of dementia that affects older adults worldwide. There is a greater understanding of the disease but the cause remains unknown. Alzheimer’s disease affects the brain ultimately leading to cognitive decline. Although there are modifiable risk factors that could potentially decrease the risk of Alzheimer’s there is no definitive treatment. As numbers increase of Alzheimer’s patients in the United States, updated research and clinical trials are needed to find a cure. Education on managing Alzheimer’s patients along with treating their symptoms is essential.

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Medication Adherence And The Schizophrenic Patient, Vennessa Downs Jul 2020

Medication Adherence And The Schizophrenic Patient, Vennessa Downs

Nursing Student Class Projects (Formerly MSN)

Medication adherence and patients diagnosed with schizophrenia is an ongoing issue for both health care practitioners and the patient. This a concern because patients with schizophrenia may experience severe adverse reactions from delayed care, withdrawal symptoms and cognitive impairment. Psychiatric medications have side effects that induces sickness, this may explain the reluctance of patients not wanting to continue psychiatric medication therapy. The lack of medication adherence in psychiatric patients leads to a disturbed quality of life; inducing clinical depression, anxiety, psychosis and the use of physical and chemical restraints in the hospital. Patients with schizophrenia that have a good insight …

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Aortic Stenosis, Christina Lower Jul 2020

Aortic Stenosis, Christina Lower

Nursing Student Class Projects (Formerly MSN)

Aortic Stenosis is the progressive and permanent narrowing of the aortic valve that is located between the left ventricle and the aorta. The pathophysiology is endothelial damage to the valve resulting in lipid penetration, calcific changesand valve stiffness.Major risk factors for aortic stenosis are natural aging>60 years(atherosclerotic changes in vasculature) and male gender.In the early phases of aortic stenosis, the body compensatesvia hypertrophy of the left ventricle to accommodateforthe increased pressure gradient. Progression is typically over years to decades untildecreased outflow of blood leads toinadequate perfusion to major organsystems including the heart itself. Patientsdo not typically have symptoms until …

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Sepsis: Early Identification Of Sepsis, Natasha Asante Jul 2020

Sepsis: Early Identification Of Sepsis, Natasha Asante

Nursing Student Class Projects (Formerly MSN)

Sepsis is a life threatening emergency and it is the body’s extreme response to an infection (CDC, 2019). Sepsis continues to be a problem for all medical institutions globally due to its high mortality rate. Sepsis can be caused by any pathogen and may arise from pneumonia, urinary tract infections and infections in the skin or soft tissue (Nagalingam, 2018). As sepsis progresses, it can lead to organ dysfunction, tissue damage and death. The progression of sepsis can be categorized in 3 stages, that is Systemic Inflammatory Response Syndrome (SIRS), severe sepsis and septic shock. Septic shock is the most …

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The Importance Of Understanding Pheochromocytomas, Aaron Corn Jul 2020

The Importance Of Understanding Pheochromocytomas, Aaron Corn

Nursing Student Class Projects (Formerly MSN)

Pheochromocytomas are endocrine tumors that originate from the adrenal medulla. These tumors secrete endogenous catecholamines that elicit significant hemodynamic effects. If left untreated, these tumors can cause chronic, permanent damage to organs and possibly lead to death. The clinical triad of symptoms include headache, heart palpitations and diaphoresis. The generalized symptoms that pheochromocytomas cause combined with their rarity make them a difficult illness to identify. Early management of these tumors is paramount. Symptoms are managed with alpha-adrenergic blockers until surgical intervention can be performed. Surgical intervention is the only curative treatment. It is important to note that there are pertinent …

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Improving Peripheral Intravenous Maintenance Compliance To Decrease Intravenous Infiltration In A Pediatric Icu., Miranda Jones Jul 2020

Improving Peripheral Intravenous Maintenance Compliance To Decrease Intravenous Infiltration In A Pediatric Icu., Miranda Jones

Doctor of Nursing Practice Papers

Purpose: Intravenous (IV) infiltration is recognized as the most frequent complication of IV therapy (Thigpen, 2007). Pediatric patients are at an increased risk due to small and weaker blood vessels, immature skin, lack of subdermal fat, and constant movement (Odom & Lowe, 2018). In 2018, the pediatric intensive care unit (PICU) in a Kentucky children’s hospital reported 229 IV infiltrations, that which included over 10% of the PICU population. As a result, a quality improvement (QI) project was developed to identify and correct barriers to compliance, knowledge gaps, and target specific behaviors that may contribute to IV infiltration in the …

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Evaluation Of A Blood Pressure Education Program On Knowledge And Self-Efficacy In Patient Care Associates ., Casey Prestigiacomo Jul 2020

Evaluation Of A Blood Pressure Education Program On Knowledge And Self-Efficacy In Patient Care Associates ., Casey Prestigiacomo

Doctor of Nursing Practice Papers

The American College of Cardiology (ACC) and American Heart Association (AHA) revealed common errors made by healthcare professionals when measuring blood pressure (BP) in adult inpatients. These errors include using incorrectly sized cuffs, improper cuff placement, and inappropriate patient positioning. Inconsistent cuff sizes and position lead to underestimated and overestimated results, directly impacting patient care and outcomes. Additionally, the ACC/AHA identified patient position and talking during assessments as factors that directly impact the accuracy of the results. At Norton Healthcare facilities, a majority of BPs are obtained by patient care associates (PCAs). The purpose of this quality improvement project was …

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Implementation Of A Wellness Program For Emergency Department Medical Professionals., Madeleine Chesney Jul 2020

Implementation Of A Wellness Program For Emergency Department Medical Professionals., Madeleine Chesney

Doctor of Nursing Practice Papers

Background: Current data from the ANA HealthyNurse Survey 2018-2019 states that 70 percent of nurses that were surveyed report putting the health, safety, and wellness of their patients before their own. Additionally, in a study conducted between 2011 and 2017 of over 5,000 physicians less than 50 percent stated that they had enough time for their personal and family life. This data supports the urgent need to focus on the promotion of self-care and wellness for medical professionals. Objective: The purpose of this quality improvement project was to provide an opportunity for emergency department medical professionals to work toward improving …

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Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith Jul 2020

Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith

Doctor of Nursing Practice Papers

Background: Early referral and implementation of palliative best-practices in patients with chronic diseases and at the end-of-life (EOL) significantly decreases patient symptom burden, increases quality-of-life, contributes to patient and family satisfaction with care, and reduces healthcare costs. Nurses in long-term care (LTC) are poised to help identify patients appropriate for referral, to provide quality palliative and EOL care, but lack adequate knowledge. Objectives: To determine if a short one-on-one or two-on-one palliative and hospice educational offering can improve (a) knowledge of best-practice palliative and hospice care symptom management techniques (b) the ability of nurses to identify patients appropriate for hospice …

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Improving Delirium Management And Compliance On A Trauma/Surgical Universal Unit., Ardis Roederer Jul 2020

Improving Delirium Management And Compliance On A Trauma/Surgical Universal Unit., Ardis Roederer

Doctor of Nursing Practice Papers

Background: Delirium is an acute, reversible syndrome that may cause cognitive impairment, disorientation, perceptual disturbances, attention discrepancies, and fluctuating psychomotor activities. Health professionals may not recognize, treat, or prevent delirium. More than seven million hospitalized adults, with an estimated cost of $164 billion annually, suffer from delirium each year. Consequently, delirium commonly affects 15 to 37% of the older adult population, yet less than 5% of delirium cases are documented in the electronic medical records of older adult patients. Early detection, intervention, and compliance with best practices are critical for the reduction of hospitalized delirium incidence. Aim: This project aimed …

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Expansion Of A Food Insecurity Scale In Primary Care., Andrea Gibson Jul 2020

Expansion Of A Food Insecurity Scale In Primary Care., Andrea Gibson

Doctor of Nursing Practice Papers

As a household-level economic and social condition defined by limited or uncertain access to inadequate food, food insecurity serves as a health threat. Food security impacts health by increasing the risk of cardiovascular disease, type 2 diabetes, stroke, and several cancers (WHO, 2005). Expansion of the two-item food insecurity screening to a six-item short-form (USDA 6- SF) screening in primary care has the potential to identify and categorize households into three categories of food security, high/marginal, low, or very low. By differentiating food insecurity categories, clients received more appropriate referrals to services aimed at improving food security. During a recent …

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Hepatitis A Educational Program In Food Service Workers., Katherine Barker Jul 2020

Hepatitis A Educational Program In Food Service Workers., Katherine Barker

Doctor of Nursing Practice Papers

Louisville, KY was affected by a significant outbreak of Hepatitis A in 2017-2018. Kentucky consisted of one-third of the national deaths. The outbreak influenced not only human mortality but had an economic impact on the food service industry. Many restaurants were affected, and some were forced to close due to Hepatitis A outbreaks. To address this issues, a two-step educational process was designed for management to gain understanding of hepatitis A content. The first step was to survey staff (kitchen staff, waiters/waitress, busier, etc.) to determine the compliance rate and variables that influence the compliance rate for vaccination of Hepatitis …

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Effects Of Bariatric Surgery On Metabolic Insulin Resistance, Tricia Brown Jul 2020

Effects Of Bariatric Surgery On Metabolic Insulin Resistance, Tricia Brown

Nursing Student Class Projects (Formerly MSN)

Diabetes and Obesity are major diseases that affect Americans today. This project looks at insulin resistance independent of weight loss in diabetic patients who have had undergone bariatric surgery. Bariatric surgery changes the structure of the stomach and the digestive process. A metabolic change has been noted in patients immediately after surgery. Studies have shown that bariatric surgery can cause a remission of diabetes. A change in insulin resistance is noted immediately after surgery. A specific pathologic process is still unclear, and more research is needed. This project explores different theories of metabolic changes in the human body after bariatric …

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Neuroblastoma, Cydney Keene Jul 2020

Neuroblastoma, Cydney Keene

Nursing Student Class Projects (Formerly MSN)

In the pediatric population, Neuroblastoma is the most common solid malignant tumor, beginning in utero along the sympathetic nervous system. The maturation of neural crest cells determines if an immature cell does not mature, a solid malignant mass can form. Various articles and journals conduct studies and compare statistics in supporting the development and pathophysiology of Neuroblastoma in children. Dependent upon the tumor site and presence of metastasis, with interventions and early detection, the cancer cells will be targeted for removal.

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Trauma Informed Care (Tic): Caring For Victims Of Trauma, Deanna Smith Jul 2020

Trauma Informed Care (Tic): Caring For Victims Of Trauma, Deanna Smith

Nursing Student Class Projects (Formerly MSN)

This poster discusses the use of trauma-informed care (TIC) in care settings to address health needs of patients who have experienced traumatic events. Complex trauma, childhood trauma, and post-traumatic stress disorder (PTSD) can cause long term impacts on health of patients including physical, behavioral, and cognitive manifestations. This poster explores health implications of trauma, how they can present in healthcare settings, and how the use of trauma-informed care can alleviate the burden on healthcare settings and improve patient outcomes by preventing further re-traumatization. The use of the TIC approach is applicable to all care modalities and settings, including primary and …

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Wound Healing, Emily Schmitter Jul 2020

Wound Healing, Emily Schmitter

Nursing Student Class Projects (Formerly MSN)

The topic being presented is wound healing. Wound healing is a pathological process that occurs in three phases: inflammation, proliferation and new tissue formation, and remodeling and maturation. Several factors can affect wound healing such as nutrition status, increased age and health status. Wound healing is relevant to advanced practiced nursing because APNs participate in prevention, assessment, and treatment of wounds. The APN is responsible for teaching diabetic patients about the importance of proper nutrition. The APN must also be able to identify a hard-to-heal wound. And the APN must know how to prevent infection and induce healing in hard-to-heal …

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Acute Respiratory Distress Syndrome, Caroline Bedinghaus Jul 2020

Acute Respiratory Distress Syndrome, Caroline Bedinghaus

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a complex disease discussed in the following poster. ARDS is an inflammatory disease with a high mortality rate, making it a topic of high interest. Numerous different diseases can initiate ARDS, but not everyone who develops one of those diseases goes into ARDS. The inflammatory response within the lungs causes refractory hypoxemia and shunting. Treatments available for ARDS is mechanical ventilation with smaller tidal volumes, prone positioning, and neuromuscular blocking agents. Nurses caring for these critically ill patients must have an understanding of the overall picture of ARDS, while continuously assessing for possible complications …

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