...Atrial Fibrillation And Nursing Considerations As a nurse one must provide holistic care. To better understand aspect of providing holistic nursing care one must have an in-depth understanding of primary body systems and their pathology. This paper will educate the prudent nurses who read it with detailed information about the specific cardiac pathology of atrial fibrillation. Written with a basic understanding of human heart function/structure as a prerequisite, this paper will first discuss key terms one must be familiar with before providing researched information explaining the pathophysiology of atrial fibrillation (AF). Next, it will discuss the etiology, clinical manifestations, common laboratory diagnostics, and interventions. Lastly, this paper continues by providing readers with nursing diagnoses and patient teachings associated with AF. Key Terms As a nurse one must become a scientist of sorts and must be familiar with technical nursing terminology. Atrial fibrillation, or AF, is a cardiac dysrhythmia in which “multiple rapid impulses from many atrial foci depolarize the atria in a totally disorganized manner at a rate of 350 to 600 times per minute” [ (Ignatavicius & Workman, 2010) ]. A dysrhythmia is a disorder of the heartbeat involving a disturbance in cardiac rhythm and an irregular heartbeat; whereas an arrhythmia is basically a fast or irregular heartbeat caused by a disorder in the heart's electrical system. Tachydysrhythmia is an abnormal...
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...COVER ARTICLE PRACTICAL THERAPEUTICS Acute Management of Atrial Fibrillation: Part I. Rate and Rhythm Control DANA E. KING, M.D., LORI M. DICKERSON, PHARM.D., and JONATHAN L. SACK, M.D. Medical University of South Carolina, Charleston, South Carolina Atrial fibrillation is the arrhythmia most commonly encountered in family practice. Serious complications can include congestive heart failure, myocardial infarction, and thromboembolism. Initial treatment is directed at controlling the ventricular rate, most often with a calcium channel blocker, a beta blocker, or digoxin. Medical or electrical cardioversion to restore sinus rhythm is the next step in patients who remain in atrial fibrillation. Heparin should be administered to hospitalized patients undergoing medical or electrical cardioversion. Anticoagulation with warfarin should be used for three weeks before elective cardioversion and continued for four weeks after cardioversion. The recommendations provided in this two-part article are consistent with guidelines published by the American Heart Association and the Agency for Healthcare Research and Quality. (Am Fam Physician 2002;66:249-56. Copyright© 2002 American Academy of Family Physicians.) I Members of various family practice departments develop articles for “Practical Therapeutics.” This article is one in a series coordinated by the Department of Family Medicine at the Medical University of South Carolina. Guest editor of the series is ...
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...Transforming an Electrophysiology Practice To Impact Timeliness of Care Studies of the U.S. healthcare system have indicated that timely access to appropriate providers improves the delivery, quality, and outcomes of care. Conversely, delayed or limited access contributes to patient/provider frustration, poorly coordinated care, unnecessary emergency room visits, and potential increases in the burden and cost of disease. A recent high-profile crisis in health care focused on prolonged and unfair wait times at Veterans Health Administration (VHA) facilities that led to potentially preventable morbidity and mortality. In response to this, the Institute of Medicine (IOM) was commissioned by the VA to understand experiences and opportunities throughout the nation related to the scheduling of and access to health care. In a very recent publication from October 2015, the IOM summarized their findings and established that inappropriate scheduling practices are a systemic problem across the entire nation and called for an end to arbitrary scheduling standards, for more transparency, more accountability, and for more attention to be paid to the “corrosive culture” that led to the manipulation of data in the system (1). The report also concludes that opportunities exist to implement enhanced practices and strategies. Appropriate Access To Care Within 48 Hours has been identified as one of the top priorities of the Spectrum Health System. To measure access, Spectrum Health uses...
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...Hebda via email to inform her that the instructions she gave me did not work. However, I did submitted the paper. I continue to search the internet on how to accomplish attaching a project document into a Word document. I tried converting the project document into a PDF file and that did not work for me. It is very frustrating for me, but with perseverance I shall overcome. Since I do not have Microsoft Project on my computer, it was difficult to see whether or not the project was displayed correctly after I saved it to my computer from the I-Lab. I emailed Dr. Hebda that I will be available for a webinar session with her on how to accomplish this task on Saturday. Course Outcomes 1, 3, and 4 are...
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...Family Health Promotion in Nursing Practice February 22, 2014 Family Health Promotion Health promotion is defined as the science and art of helping people improve their lifestyle to move toward a state of optimal health (Edelman & Mandle, 2010). The World Health Organization (WHO) believes health promotion allows health to be a resource and not the objective of living (WHO, 2012). This paper will review the purpose of health promotion as related to nursing practice, and how nursing roles and responsibilities have evolved in regards to health promotion and implementation on the prevention, management and long term maintenance and rehabilitation on Stroke patients, including preventing education to the public and communities, on a primary, secondary, and tertiary prevention level (Edelman & Mandle, 2010). A stroke is caused by the disruption of the blood supply to the brain, usually related to a blood vessel ruptures or blocked by a clot, as define by World Health Organization. The blockage of oxygen and nutrients to the brain’s tissues can cause permanent damage to the brain tissue. Warning signs of stroke are, sudden weakness or numbness of the face, arm or leg, most often on one side of the body. Other symptoms include: confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; walking, dizziness, loss of balance or coordination; severe headache with no known cause; fainting or unconsciousness. The effects of a stroke...
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...profession that involves skills and knowledge to provide optimum level of care. ADN versus BSN has been an issue of controversy for years. The primary focus of this paper will be discussing the differences in competencies of nurses educated in an ADN level to those educated in a BSN level. These differences include varying curriculum requirements, education content and patient outcomes. The first difference in ADN and BSN is the amount of education. The associate degree in nursing includes two years in the nursing program and can be obtained at a community or junior college. However, there are prerequisite courses required for entry into the nursing program, so ADN programs can be at least 3 years in length. Today, earning an ADN takes almost as long as earning a BSN (Orsolini-Hain & Waters, 2009). In contrast, baccalaureate degree in nursing includes four academic years of college at a four year university. Both degrees take the same NCLEX board exam for licensing and both degrees enter into the same position as a registered nurse, with similar wages and benefits. The second difference in ADN and BSN is the content and skills taught. Baccalaureate degree nursing includes all of the content of associate degree nursing, but also focuses on more in-depth studies of the physical and social sciences, nursing research, nursing leadership and management, community and public health nursing, and the humanities (Ridley, 2008). This more in-depth...
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...Community Interest Company: a Social Enterprise Organisation Project Report Health Needs Assessment: Stroke in South West and South East London Author: Version: Date: Client: Ref No: Dr John Hayward, Sarah Martin, Dr Michael Soljak Final Version 16.03.09 South West and South East London Cardiac and Stroke Network Boards P132 A Social Enterprise organisation and Community Interest Company Registered office: PO Box 1295, 20 Station Road, Gerrards Cross, Buckinghamshire, SL9 8EL English Company Number: 06480440 VAT Registration: 926 9466 78 www.phast.org.uk E&OE Final Project Report P132 Health Needs Assessment: Stroke in South West and South East London Public Health Action Support Team (PHAST) The Public Health Action Support Team (PHAST) is a Community Interest Company. This is a type of social enterprise that is committed to using its surpluses and assets for the public good. Social enterprises are social mission driven organisations which trade in goods or services for a social purpose.1 PHAST is based at Imperial College, London. It has over 60 experienced and expert public health professionals whose aim is to improve the health of the population and reduce inequalities. Many have worked at high level in the NHS, the Department of Health or in academia. Quality assurance and due diligence processes are in place to ensure all associates work to the highest standard. PHAST also has associates with economic, ethical and legal expertise. For further details see www.phast...
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...Vulnerable Population and Self-Awareness Paper NUR/440 – Health Assessment and Promotion For Vulnerable Population 12 December 2011 Vulnerable Populations and Self Awareness Introduction This paper is a study of the vulnerable population of the elderly in the United States and will discuss the mindfulness of this author’s personal biases, attitudes, and conceived stereotypes regarding this population. The patient chosen as an example for this paper is Norma James from the University of Phoenix “neighborhood”. Mrs James is a widow who’s vulnerability relating to health care will be compared with information gathered through research and applied to the elderly population and those with chronic illness. The vulnerabilities faced by Norma will be a realistic representation of the challenges associated with this population. Elderly Patients with Chronic Illness Despite the efforts of healthcare providers and various organizations across the United States to reduce or eliminate disparities within vulnerable healthcare populations, significant disparities continue to cause limited access to healthcare. This limitation poses risk to populations such as elderly and those living in poverty. The health domains of vulnerable populations can be divided into 3 categories: physical, psychological, and social. Those with physical needs include the elderly, chronically ill and disabled, chronic medical conditions include respiratory diseases, diabetes, hypertension, dyslipidemia...
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...Assessment and Diagnosis Student’s Name University Affiliation Introduction Lehigh County is one of the counties located in the Lehigh Valley and has a population of more than three hundred thousand. The large population ensures that there is a large field for making assessment of the health needs of the individuals in the County. The assessment in the county can be done using the demographic and the epidemiological data in the process of identifying the health risks. The population’s information can be collaboratively used in addressing the factors that affect the health of the community and the health problems that come over to the county. The paper uses the community assessment strategies to uncover the community health problems and make the identification of the components of the community health nursing of Lehigh County. Community overview The community of choice is Lehigh County which is located in the Lehigh Valley, the county houses a large number of families and therefore a number of health issues can be seen in the county. The health needs of the people living in the Lehigh County can therefore be discussed and the factors that influence the health of individuals, families, aggregates and even the communities. The assessment is done by the use of the demographic and the data for the spread and the control of diseases in the county (Raukar et al., 2014). Demographic data The detailed Lehigh Valley demographic report includes the population changes that has...
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...The Long Road to Direct Factor Xa Inhibitors: A History of Anticoagulation Marjorie Burnsworth Tacoma Community College July 24, 2014 Abstract This paper explores the history of the chemical research and development of anticoagulant medications over the years and how this has lead to the development of direct factor Xa inhibitors (fXa inhibitors). Since ancient doctors first used leeches to treat their patients, people have been aware of the properties of anticoagulants and anti-thrombolytics, but the development of Heparin almost 100 years ago signified the start of a century of chemical discovery and development in the field of anticoagulation that has peaked in the last 25 years. Following the development of Heparin, scientists next developed Vitamin K Antagonists (VKA's), such as Coumadin, which gave an oral option for anticoagulation but they were not without side effects. Nearly 30 years passed before chemists came up with the next step forward in anticoagulation, low-molecular-weight-heparin (LMWH). It was LMWH that first opened scientists eyes to factor Xa and the possibility of considering it as a possible target for future anticoagulation. In order to proceed with development, however, they had to look back to the past. Back to leeches and heparin, as these would prove hold the keys to the future development of direct factor Xa inhibitors. The Long Road to Direct Factor Xa Inhibitors: A History of Anticoagulation ...
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...assessment tools, Watson’s theory of human caring plays an important role in the integration of the mind, body, and spirit dimensions of each patient. This paper will state three assessment tools that evaluate a patient’s physical measures, describe each tool and the population for which it may be useful, and state data about each tool. Such data may include cost, length, ease in using the tool, for what population it is best designed, and the validity of the information. A description of how each tool enhances the assessment phase of the nursing process and affects the quality of health care delivered by the nurse will be discussed. Each of these tools will be applied to a chosen vulnerable population researched from the Vulnerable Population and Self-awareness paper. The vulnerable population I researched consisted of the elder population. Mrs. James was my subject. She is a 65-year-old widow who lives alone. She has become socially isolated with little to no support system. She has two sons who live out of state and very rarely keeps in contact with them. She does not work and has limited savings. Currently she relies on social security benefits for her income. She also does not drive and uses public transportation when needed. She has been diagnosed with type two diabetes, hypertension, and atrial fibrillation. “Watson defines the person as a being-in-the-world who holds three spheres of being—mind, body, and spirit—that are influenced by the concept of self and...
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...Acupuncture research in Cerebrovascular Accident induced hemiplegia. By Introduction to Cerebrovascular Accident and Hemiplegia Cerebrovascular Accident also known as stroke can broadly be described as an interruption of the blood supply to the brain. Without blood the brain cells are staved of oxygen, and can begin to die within minutes if the blood supply is completely cut off. It is this cellular death which has the greatest influence on the sequelae or after math of the stroke. Hemiplegia is the most common sequelae of stroke, this medical condition characterised by paralyses of one side of the body. It is similar to, but should not be confused with hemiparesis which is when one side of the body is weak but still mobile. While the leading cause of hemiplegia is a Cerebrovascular Accident, it is not the only cause, other neural conditions such as a unilateral pyramidal (UMN) lesion may also cause hemiplegia. It is difficult to discuss Hemiplegia without also discussing Stroke, similar to cause and effect, if stroke is the cause then hemiplegia is effect. A sudden stroke can be deadly, and how well someone recovers or if they recover depends largely on how fast they receive treatment. In Australia the most popular method for identifying stroke is the FAST test: * Face – Check their face. Has their mouth dropped? * Arms – Can they lift both arms? * Speech – Is their speech slurred? Do they understand you? * Time – Time is critical. If you see any of these...
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...Lorie Gage Richards: Motor Recovery and Neural Reorganization After Stroke Thomas Pearl SUNY Downstate ALWAYS JUSTIFY YOUR PAPER ….AS IN THE ALIGNMENT … NOT LEFT Over 750,000 strokes occur annually in the United States alone. The majority of those suffering a stroke have ongoing reductions in contralateral arm and hand functions that interfere with accomplishing goal oriented activities and vocational needs (Richards, Stewart, Woodbury, Senesac, & Cauraugh, 2008a). Knowing the best methods to promote motor recovery in arm and hand functioning is therefore critical in stroke rehabilitation. Lori Gage Richards, (PhD, OTR/L) is an active researcher and educator seeking to uncover which therapies drive neural reorganization after a stroke, and what are the most effective strategies leading to improvements is UE function. Richards is currently Associate Professor and Chair of the Occupational Therapy Department at the University of Utah. She was recently appointed editor-in-chief of the American Journal of Occupational Therapy and serves as Chair of the Nursing and Rehabilitation Committee-Stroke Council, of the American Heart Association. Additionally at the American Heart Association, she is a member of both the Leadership Council - Stroke Council and the Stroke Rehabilitation and Recovery Committee - Stroke Council. Her current professional affiliations include the American Occupational Therapy Association (AOTA), Society for Neuroscience, and the American Congress...
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...Heart Failure Western Governors University Pathopharmacological Foundations for Advanced Nursing Practice Heart Failure It is estimated that about five million people in the United States are living with heart failure with an overwhelming number of 550,000 newly diagnosed cases each year, costing the nation roughly $32 billion dollars per year (Centers for Disease Control and Prevention, 2016). Heart failure is a complex, pathophysiological condition in which the ventricles of the heart is weakened and unable to pump effectively to meet the body’s needs for nutrients or has lost adequate filling capacity. Clinical presentations of heart failure depends on which ventricles have failed to pump blood adequately; left ventricular failure, also known as congestive heart failure (CHF) is more common than right ventricular failure (McCance & Huether, 2014). The most common symptoms of heart failure are shortness of breath, fatigue, and peripheral edema. HF is not a disease, but rather a manifestation of a diseased heart. Large number of disorders can lead to heart failure, and with the aging population and many surviving primary cardiac events, it is no surprise that the most common reason for hospitalization in patients older than 65 years old is heart failure (McClintock, Mose, & Smith, 2014). Heart failure has become a major public health problem because it is the only cardiac condition that continues to increase in prevalence (McClintock, Mose, & Smith, 2014)...
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...In Pre-Hospital Cardiac Arrest Patients, How Does Hands-Only CPR Compared To Standard CPR, Affect Neurological Outcomes? Abstract Summary Out-of-hospital cardiac arrest is the leading cause of death in the U.S. Increasing bystander-initiated CPR through “hands-only” CPR and EMS dispatcher instructed “hands-only” CPR improves survival rates. Methods CINAHL, PubMed, and OvidMD were searched for the following key terms or combination thereof: “hands-only”; “compression-only”; chest compression-only”; “bystander”; “CPR”; “dispatcher”; and “neurological affect”. We initially restricted our search to peer-reviewed studies published in English between January 2004 and June 2014, but agreed by consensus to use a 2000 study located during a manual search of included study references. Results We identified nine Level II, III, and IV studies comparing “hands-only” CPR and “standard” CPR, published between 2000 and 2013, and occurring in the countries of Japan, London, Sweden and the U.S. All but one of the study results recommend that “hands-only” CPR is at least equal or superior to “standard” CPR. Conclusions Guidelines should be established to teach bystander “hands-only” CPR nationwide, to increase public awareness of the effectiveness of “hands-only” CPR and start to teach out-of-hospital “hands-only” CPR. Introduction Sudden cardiac arrest is the leading cause of death in the United States (Neumar, Barnhart, Berg, Chan, Geocadin, Luepker,… Nichol, 2011). According...
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