...Congenital heart disease (CHD) is one of the most common birth defects found in children, with an incidence of approximately 9 in every 1000 live births worldwide (van der Linde et al., 2011). Children with complex congenital heart disease are living longer due to dramatic advances in medical procedures and surgical techniques, as well as the increase of pediatric heart transplant recipients, and the decrease in the death rates from CHD (Pillutla, Shetty, & Foster, 2008). Background Information Children with CHD have been noted to have increased rates of mental health comorbidities, which include depression and anxiety. Depression and mood disorders in this population have been positively correlated with lower physical and psychosocial quality...
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...Requiring Newborn Screening of Critical Congenital Heart Disease Date With the numerous technological advances that have occurred in today’s health care system, one would think newborn screening would be required in Maryland for the most common birth defect in the United States, critical congenital heart disease (CCHD), but only just this year has the state considered the requirement (Department of Legislative Services, Office of Information Systems [DLSOIS], 2011). Critical congenital heart disease, a disorder in which an infant’s heart or blood vessels near the heart develop abnormally before birth, affects approximately 8 out of every 1,000 infants each year in the US, amounting to around 36,000 infants (DLSOIS, 2011). CCHD is the leading cause of death among infants within the first year of life, amounting to nearly 40% of deaths, often due to the fact that a large number of infants with this disease go undetected (Martin, Bradshaw, & Wright, n.d.). Although some babies are diagnosed with congenital heart disease shortly before or after birth, many diagnoses are not made until days, weeks, or months later; sometimes not at all. Many benefits are associated with implementing CCHD screening, many treatment options are available for those diagnosed with CCHD, and a bill is being proposed to the State of Maryland’s General Assembly about including this screening in the Department of Health and Mental Hygiene’s Newborn Screening Program (DLSOIS, 2011). The benefits...
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...The heart is one of the most extraordinary and complex organ in the human body. It regulates our rich and poor oxygen levels. Poor oxygenated blood flows into the right atrium. While this occurs rich oxygenated blood flows through the right atrium. The heart delivers the rich oxygen blood. (It’s My Heart) But how does someone with heart disease heart and body different from an average person? If someone is born with Congenital Heart Disease, they may have been born with a mixture of both poor and rich oxygenated blood. However, after having a surgery to correct their specific defect, they have the same heart set up as someone without heart disease. (It’s My Heart) Unfortunately, after these surgeries they will still have complications such...
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...Birth defects, also known as congenital disorders, are conditions that exist before or at birth. 20% of these defects originate from heredity, but most of these disorders are caused by the poor life choices expecting mothers make. There are things moms may not consider that could put an infant in danger of congenital disorders. Some everyday activities contain underlying risks that can be detrimental over time. With that being said, most birth defects happen because of the carelessness of pregnant mothers by means of smoking, drinking, not eating correctly, and not taking care of themselves in various ways. Cigarettes There are many commercials on TV showing the negative effects cigarettes have on unborn babies. All cigarettes contain toxins,...
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...and spinal cord; which helps support the weight of the brain, and acts as a cushion for the brain and spinal cord. The cerebral spinal fluid in reabsorbed by fingerlike projections of the arachnoid called arachnoid villi at a simultaneous rate of production in order to maintain constant pressure. (AST page 1163-1166) An obstruction of this delicate flow of cerebral spinal fluid is known as non-communicating hydrocephalus while overproduction of cerebral spinal fluid is called communicating hydrocephalus. The improper absorption of cerebral spinal fluid by the arachnoid villi can also create high cerebral spinal fluid pressure within the cranial cavity. (Alexander page 540-541) Know causes of hydrocephalus in infants and children include congenital tumor, meningitis, hemorrhaging of the foramen of Monro, aqueduct of Sylvius, or exit canal of the forth ventricle. Hydrocephalus in adults is caused by obstructive tumors, meningitis, or hemorrhage. These conditions create an imbalance of cerebral spinal fluid levels and can result in high cranial pressure. Infants typically suffer from an enlarged head circumference and present large and distended scalp veins. Adults suffer from dementia, unsteady gait, and urinary incontinence as a result of chronic hydrocephalus. Those with acute hydrocephalus present with headache nausea, vomiting, drowsiness, and papilledema. (AST page 1163, Alexander page 541) The patient is placed in supine position with their head turned slightly. The surgeon...
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... Nova Southeastern University Newborn Screening for Congenital Heart Disease I represent the American Heart Association and this organization support Bill HB 81. The American Heart Association has been dedicated to the treatment and prevention of cardiovascular diseases of all age groups. Furthermore, our mission and goal is to" build healthier lives, free of cardiovascular disease, this is the single purpose that drives all we do and the need for our work is beyond question"(American Heart Association, n.d). Therefore, it is evident that this organization firmly support early screening, treatment and prevention of cardiovascular diseases. Congenital heart disease is the most common birth defect among newborns, affecting eight out of every one thousand newborn babies(Ewer et. al, 2011). It is also the leading cause of death among newborns within the first year of life. Early detection of congenital heart disease is crucial to newborn health and prevention of major problems later in child's life. Additionally, if detected early, congenital heart defects can be treated with surgical interventions or medication, depending on the severity. Pulse oximetry, a simple non invasive test and will be implemented as a screening tool for congenital heart disease(Kemper et. al, 2011). Bill HB 81 - Newborn Screening for Critical Congenital Heart Disease was sponsored by Cary Pigman(Republican, District 55) and Karen Caster Dentel(Democrat,...
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...The Aortic Arch When I was a little girl my mother would take me by the hand, tugging me towards our secret place. Together we would skip down the old yellow path, weeds tickling our feet. I still remember how her eyes would flash with laughter and the way her long blonde hair would sway from side to side as we made those trips to the garden. Together we would turn the soil, letting the buried earth meet the sky. We pressed seeds deep down and the garden flourished. A myriad of colours and scents pressed for attention; roses, lavender, lilies, daffodils, peonies, poppies, tulips. When we finished we would lie down on the rich ground together with the worms and ladybugs, birds and bees. “Do you hear it?” she would ask turning towards me. Pressing my ear to the dark earth I did; the steady pulse of the roots, the sighing sound of buds as they curl upwards towards the light. “Magic!” I’d say smiling. And she would smile back “Yes Sera, the magic of life.” It has been a long time since my mother and I spoke of magic. Our garden, withered, from years of neglect, the bed once filled with flowers now the home of weeds. Her hair is also long gone, the price paid for hope as she underwent chemotherapy for the cancer she thought she had beaten. She doesn’t laugh with me anymore either...only with them, in that room where I can never truly belong, where the failing body seems to create a bond stronger than family. I wish I was in that room too. School no longer held answers. People...
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...are important to address. Congenital heart disease is an abnormality in the structure of the heart that develops before birth (Pillitteri, 2014). Universal newborn pulse oximetry screening (NPOX) to detect critical congenital heart disease was added to the Recommended Uniform Screening Panel (RUSP) by the Health and Human Services Secretary in September 2011 (Studer, Smith, Lustik, & Carr, 2014). Two variables needed to promote the accuracy of pulse oximetry results in newborns are enhancing education efforts and electronic interpretation of data and quality controls. These variables are important because human errors in following the protocol and misinterpretation of the algorithm can lead to false negatives with serious consequences (Kumar, 2016). Continuing education for the medical staff will help keep the signs and symptoms of CCHD fresh in their minds and if further education is needed to help determine whether a newborn shows...
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...Diarrhea / ORT DEFINITION | SIGNS/SYMPTOMS | Most commonly due to acute infectious diarrhea (gastroenteritis) from a variety of causative organismsAntibiotics are a common cause of acute diarrhea! | Acute inflammation of the lining of the stomach and intestines caused by viruses, bacteria or their toxins or parasitesPresents commonly with diarrhea, abdominal cramps, and vomiting.CommunicabilityOften fecal-oral route (especially viruses)Food poisoning (especially bacteria)Day care centers, crowded living conditions, poor sanitation and cleanliness | DIAGNOSTIC TESTS | MAIN TREATMENT | Stool gram stain and culture (if bloody stools)Stool for Ova & Parasites (if hx suggestive)CBC – assess for anemia/infectionUrinalysis and urine culture (r/o UTI)Electrolytes | Oral rehydration therapy (ORT) is one of the major worldwide health advances of the last decade:Safer, less painful, and less costly than IV rehydrationOral rehydration solution enhances and promotes reabsorption of H2O and NaReduces vomiting, diarrhea, and duration of illnessORT GuidelinesDiarrhea w/o dehydrationMild dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet...
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...Physical activity recommendations for adolescents with repaired tetralogy of Fallot: review of the literature and guidelines for practitioners Adolescents living with congenital heart defects (CHDs) are a growing population in the United States. While in the 1960s and 1970s, the risk of dying after cardiac surgery was high at 30%, over the past few decades, this risk has decreased to approximately 5%, with the majority of children born with CHD living into adulthood (American Heart Association [AHA], 2006c; Jones, Willis, & Uzark, 2006). One of the most common CHDs is tetralogy of Fallot (TOF), occurring in 9% to 14% of the children born with a CHD and approximately 5 out of every 10,000 births (AHA, 2006a, b; National Heart Lung and Blood Institute [NHLBI], 2007). The need for primary care providers to manage the health of adolescents with TOF has developed as the population and lifespan of children born with TOF has increased. One of the most important roles of a primary care provider is to educate adolescents and their families to facilitate the achievement and maintenance of optimal health. This includes counseling adolescents, especially those living with TOF, of the importance of regular exercise and participation in sport activities as necessary factors for their physical, emotional, and social growth and development (Bar-Or & Rowland, 2004). Physical activity is also essential for the prevention of long-term cardiovascular and obesity-related health problems (AHA, 2006d)...
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...Arnold Palmer 10 Strategic Om Decisions Provide examples for each of the ten Operations Decisions that the OM will have to make for Arnold Palmer Hospital. 1. Design of goods and services * Arnold Palmer is able to develop custom products that require collaboration down to the third tier of the supply chain. * Arnold Palmer Hospital is the only hospital in the central Florida area with an emergency/trauma department dedicated to pediatric patients. The hospital’s Congenital Heart Institute (CHI), created by a partnership with Miami Children’s Hospital, is well known for its pediatric cardiovascular services. The Congenital Heart Institute combines a select group of cardiologists, cardiac anesthesiologists, cardiovascular surgeons, physicians, nurses, intensivists and technicians to diagnosis and offer treatment to infants and children with heart disease or congenital heart disorders. The CHI is the only pediatric cardiology center to offer real time web-based surgical outcome data. 2. Managing quality * Arnold Palmer supports efforts to make hospital comparison data as transparent and available to the public as possible. * Many quality measurements types to form the most complete picture of a hospital’s total quality of care before making a final decision are used, such as, AHCA, the Joint Commission, Hospital Compare and Patient Satisfaction Surveys. 3. Process and capacity design 35 planning teams study issues such as service, process, staffing and capacity...
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...Provide examples for each of the ten Operations Decisions that the OM will have to make for Arnold Palmer Hospital. 1. Design of goods and services * Arnold Palmer is able to develop custom products that require collaboration down to the third tier of the supply chain. * Arnold Palmer Hospital is the only hospital in the central Florida area with an emergency/trauma department dedicated to pediatric patients. The hospital’s Congenital Heart Institute (CHI), created by a partnership with Miami Children’s Hospital, is well known for its pediatric cardiovascular services. The Congenital Heart Institute combines a select group of cardiologists, cardiac anesthesiologists, cardiovascular surgeons, physicians, nurses, intensivists and technicians to diagnosis and offer treatment to infants and children with heart disease or congenital heart disorders. The CHI is the only pediatric cardiology center to offer real time web-based surgical outcome data. 2. Managing quality * Arnold Palmer supports efforts to make hospital comparison data as transparent and available to the public as possible. * Many quality measurements types to form the most complete picture of a hospital’s total quality of care before making a final decision are used, such as, AHCA, the Joint Commission, Hospital Compare and Patient Satisfaction Surveys. 3. Process and capacity design 35 planning teams study issues such as service, process, staffing and capacity design. 4. Location strategy ...
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...Three major health conditions that is widespread in the United States today: • Heart Disease • Kidney Disease • Cancer • Kidney disease is the 8th leading cause of death in the United States. • More than 20 million adults age 20 or older in the U.S. have kidney disease and most don't know it. • Diabetes and high blood pressure are the two leading causes of kidney disease. Kidney Disease High blood pressure, especially when left untreated, can damage kidneys and lead to chronic kidney disease. High Blood Pressure • The National Kidney Foundation (NKF) has divided chronic kidney disease into five stages to create a guideline to identify and treat each level of kidney disease. The first four stages focus on ways to preserve kidney function for as long as possible. While the final stage 5 which is kidney failure reviews treatment choices. Chronic Kidney Disease Kidney disease is on the rise. Affects more than 10 percent of people worldwide. Between 2000 and 2008 Kidney Disease has double in the Unites States with people over 65 years of age. Due to increasing rate of obesity and diabetes researchers are founding increasing kidney disease with 1 in 25 adults between the ages of 20 and 29. World Wide Killer “Cancer comes from the Greek word “karkinos”, meaning crab. This word also means any dangerous and spreading evil.” 100 diseases created by abnormal cell growth. Cancer cells: - Did not die, - DNA within...
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...INTRODUCTION Hypoplastic Left Heart Syndrome (HLHS) is a rare form of pediatric congenital heart defect that affects only 1% of all congenital cardiac disease. HLHS accounts for 23% of all cardiac deaths within the first week of life. HLHS exists under any or all of the following: “hypoplasia of the left ventricle, stenosis/atresia of the aortic valve, stenosis/atresia of the mitral valve, and varying degrees of hypoplasia of the ascending aorta and aortic arch” (Dadlani and Bradley 2011). Without surgical intervention, HLHS is uniformly a fatal condition. Research shows that before the use of these surgical interventions, nearly 90% of all patients diagnosed with HLHS died within the first 30 days of life. Advancements in both pediatric cardiac surgery as well and pediatric cardiology has significantly decreased the fatality rate in HLHS patients over the past decade. When looking at courses of treatment for HLHS there are four main approaches that are commonly used worldwide: The Norwood Palliation,...
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...CA Essay “Story of an Hour” Kate Chopin’s literary work has touched many reader with an open mind of what many women in the ninetieth century was going through as a woman with no freedom. One of the most commendable aspects of Kate Chopin’s short story “The story of an Hour” is the fact that the author is able to manipulate oppression, freedom and symbolism in a table that is extraordinary compact. SparkNotes Editors. “SparkNote on The Story of an Hour.” SparkNotes LLC. 2007. http://www.sparknotes.com/short-stories/the-story-of-an-hour/ (accessed September 29, 2013). In the story, Mrs. Louise Mallards was an oppressed wife of Brentley Mallard. She afflicted with a weak heart and good care was taken to give her the news of her husbands death from a railroad accident. Her sister Joseline told her in broken sentences about the loss of Mr. Mallard. Obviously, Mallard reacted to obvious grief and admits that her husband was kind and loving. She knew at the funeral she would "weep again when she saw the kind, tender hands folded in death; the face that had never looked save with love upon her, fixed and gray and dead". However, despite the love between each other, Brentley’s death was a release from oppression. She never described ways he oppressed her, but hinted that the marriages in general stifles both women and men. Also, she suggested that she oppressed him as much as he oppressed her. Mallard thoughts that was going...
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