Nurses Know! - Addressing Childhood Obesity

By: Ruth Young RN

Obesity is a growing concern in our community that is affecting children at alarming rates. According to the CDC, more than half of the adults in the U.S. are overweight, and the number of overweight children and teens has doubled in the past decade. An estimated 17% of children and adolescents age 2-19 are overweight. (National Health and Nutrition Examination Survey)
The cause of obesity may be genetically linked or lifestyle behaviors and this may put you at risk for developing other medical conditions such as diabetes, high cholesterol and cardiovascular disease. (CDC) Other problems that may also develop are depression, anxiety, low self-esteem & poor body image.
With the help of the parents and the Community Health Nurse, this problem can be managed successfully with diet modifications, an exercise regimen, and maybe counseling for some individuals.
First there is a need to assess the family’s willingness to change; secondly we need to focus on healthy behaviors, its not just about losing weight. Education on fresh fruits and vegetable consumption, incorporation of 3 balanced meals a day, limiting highly processed foods, and comparison shopping may be beneficial for those families who aren’t able to buy healthy foods due to the cost.
The nurse needs to place an emphasis on getting the children back to being active instead of watching television, playing video games, and surfing the internet. The parents need to be educated on providing physical activity for their children which helps keep them healthy.

References
http://www.cdc.gov/nchs/about/major/nhanes/DataAccomp.htm http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight/overwght_child_03.htm

Note: This blog post reflects the work of Ruth Young RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Congestive Heart Failure

By: Michael Lane RN
Congestive Heart Failure (CHF) is a condition that impairs the pumping of the heart (Lewis, Heitkemper, and Dirksen 2004). The heart is unable to pump enough blood to meet the body’s needs. Any number of underlying heart conditions can lead to heart failure (http://www.mayoclinic.com). Its called “congestive” from the fact that one or both of the heart's lower chambers fail. This failure causes blood to back up into,or congests, the liver, abdomen, lower extremities, and lungs, causing symptoms such as shortness of breath, fatigue, and leg swelling (www.mayoclinic.com).
Currently over 5 million people in the United States have CHF. It is the most rapidly increasing form of Cardiovascular Disease. The American heart association estimates that close to 500,000 new cases are diagnosed a year. CHF increases with advancing age. Approximately 1 in 100 older adults have some form of CHF. The incidence is the same in both women and men. The annual cost of the disease exceeds $57 billion dollars (Lewis, Heitkemper, and Dirksen 2004).
The care is multi-faceted and the community nurse is essential in educating this community. Lifestyle changes are critical brcause CHF is a progressive disease. Transplants are a possible option for younger sufferers of CHF but are not often offered to most older adults with CHF. The key is slowing the progression of the disease and improving the overall heart function. Some people can live for years with CHF if managed properly.
Severe cases will require closer monitoring. The use of oxygen and BiPap machines to aid in breathing and combating dypsnea and apnea while sleeping will help improve quality of life. Medication therapy is essential to keep heart working efficiently and keep fluids from accumulating. Diet and weight management is critical to the patient. Salt and water must be measured on a daily basis. Abstinence from smoking and alcohol consumption should be strictly adhered to. Daily weights should be done to detect complications of fluid retention early.
Patient teaching should include the family and support structure. Everyone needs to know that this disease is progressive and requires strict guidelines to ensure medication is taken properly. Patients needs to be aware of early signs of exacerbations and side affects of medicines.
Patients must learn the importance of frequent blood test and doctor visits. Encourage patients to write down questions so they can remembered them when calling the doctor. Home health and counseling should be in place for monitoring and psychological problems stemming from the disease.
Prognosis is good with proper management. The future holds promise with things like ventricular devices, balloon pumps, and new medications in research as we speak management will become much easier

Note: This blog post reflects the work of Michael Lane RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Protecting Children from lead poisoning

By Tracey Jackson RN

Keeping children safe from lead poisoning requires attention from everyone in a child's life. Lead is harmful to children because if they get enough of it in their bodies, it can limit their physical development; cause irreversible neurological damage as well as renal disease; cardiovascular effects and reproductive toxicity.
Childhood lead poisoning can be addressed by the community health nurse in the home. Community health nurse (CHN) works with the family to identify possible sources of contamination and to educate families on ways to reduce the risk of lead contamination. In cases where the child's blood lead level is 10 micrograms per deciliter or greater, a CHN contacts the family either by phone or letter to provide education to prevent further lead poisoning. In cases where the blood lead level is 20 micrograms per deciliter or greater, a CHN and a Registered Environmental Health Specialist visit the home of the child to provide education to prevent further poisoning and to attempt to identify the source of the lead poisoning.
The CHN helps client to self manage their disease process by decreasing exposure to lead. From January through June 2008, there have been more than 50 recalls of over a million products due to high lead content. The vast majority of these recalled products are children's products (http://service.mattel.com/us/recall/39054_IVR.asp?prod=).
CHN role is to ensure abatement of the lead source and provide education to the family and patient.To prevent further hospitalization of lead poisoning the plan of care consists of prescribing treatment of chelating therapy which reduce existing blood lead levels. Reducing the hazards lead poisioning requires both individual actions and public policy regulations. CDC’s Childhood Lead Poisoning Prevention Program is committed to the Healthy People 2010 (http://www.healthypeople.gov/) goal of eliminating elevated blood lead levels in children by 2010.

Note: This blog post reflects the work of Tracey Jackson RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Preventing seizure related injuries

By Stacy Hall RN

According to the Epilepsy Foundation (2005) each year approximately 300,000 people experience a first convulsion. More than one third of them (120,000) are children under eighteen years of age, and 75,000 to 100,000 are children under five years of age who experience febrile seizures. Many of those who experience a first seizure however go on to develop chronic seizure disorder without any known cause (Clark 410).
Caring for children and adolescent with seizure disorder can be quite a scary situation when you don’t know what is going on with your child. A seizure is a sudden change in consciousness or behavior caused by abnormal brain activity. It also involves assisting them to cope with the perceived or real stigma attached to the disease as well as encouraging compliance with medical therapy (http://www.yourtotalhealth.village.com/). Medication is highly effective in the treatment of epilepsy, with approximately 70% of those treated remaining seizure-free for 5 or more years, at which time three fourths of them can discontinue medication without a return of a seizures. With Adolescent the need is different than with children, with adolescent in particular may need to be referred for counseling if their condition contributes to a poor self image or difficulty with interpersonal interactions especially in school setting. Under certain circumstance anyone can experience a seizure, but a seizure can occur at any age although children are at greater risk for seizure than any other age groups. There are different medical conditions that may produce a seizure such as (Diabetes and etc).
The community health nurse can educate them about the inadvisability of swimming alone or help adolescent cope with their inability to obtain a drivers license. Both the children and parents may need to be helped to cope with the fear and uncertainty caused by uncontrolled seizures. School nurse in particular, may be in a position to educate others about seizures disorder and advocate for fair treatment of those affected, and also medication management. Educate on keeping an emergency kit for seizure disorder with them at all times, educate on the pre seizure activity to family and client, and Safety measure such as (helmet wearing for protection of head, and etc.)

References

1. Retrieved July 21, 2008 from http://www.yourtotalhealth.village.com /html
2. Clark, J.M., (2008) Community Health Nurse Meeting the Health Needs of Children and Adolescent (pp. 410) Pearson Education, Inc., New Jersey.

Note: This blog post reflects the work of Stacey Hall RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Preventing Lead Poisoning

By Tracy Jackson RN.

Childhood lead poisoning
Lead is a toxin that is harmful to young children. Primary prevention for lead awareness is education, which include risk assessment. Healthy People 2010 have established the goal of elimating lead poisoning by 2010 (Healthy People, 2008). Lead poisoning has been linked to autism and cognitive delayed development. Pregnant women or any women who are planning a pregnancy should know the facts surrounding lead poisoning (Safe babies, 2008). Lead awareness information should be included in that new mother’s visit, which should include patient teaching information to prevent expose to lead.
Risk assessments are surveys used to establish your child’s level of exposure to lead (EPA, 2008). The first question usually starts with your home—how old is it? Was the house built before 1974? In the State of Illinois, each local health department has a lead prevention program whereas funds are allocated for lead awareness. Other successful events are health fairs, block parties, run, walk and bike for lead prevention that are held in many communities around the State of Illinois (IDPH, 2008).
Secondary prevention emphasis screening used to identify potential exposure to lead poisoning. The screening is easy to remember, every child starting at birth until 6 years old must receive a yearly screening. The toxic number to remember is 10mcg. Anything over 10mcg will requires treatment according to EPA (EPA, 2008) Starting today, families with young children from birth to 6 years old should not allow shoes that are worn in the public to enter your home. Place a shoe rack at the front door and kindly request all guests to remove their shoes when entering your home. The earth soil carries an enough lead to cause potential harm to all young children (EPA, 2008).
Tertiary prevention for lead awareness consists of treatment. The first line of treatment is to reduce exposure and incorporate foods that are high in calcium and iron into the diet (Safe babies, 2008). Treatment for lead poisoning is a chelating agent which is an oral drug that binds to lead and mercury, and is given every eight hours for five days and then every twelve hours for two more weeks (APA, 2008).

Reference:
AAP parenting corner: Q&A lead screening. Retrieved June 20, 2008, from American Academy of Pediatrics Web site: http://www.aap.org.
Illinois childhood lead poisoning prevention program. Retrieved June 20, 2008, from Illinois Department of Public Health Web site: http://idph.state.il.us/.
Lead awareness program. Retrieved June 20, 2008, from The United States Environmental Protection Agency Web site: http://www.epa.gov.

Written by Tracy Jackson RN with minor editing by Shirley Comer RN.

Nurses Know! - Facts about Violence against Women

By: Gertrude Ajaere RN.

VIOLENCE AND ABUSE OF WOMEN.
Violence against women affects approximately 2 to 4 million women each year. Violence is the major cause of injuries to all women between the ages of 15 and 44 years. Violence has become a major health issue. The extent of abuse of women is not known. It is underreported in part because of threats, fear, and feelings of guilt. Mounting evidence is showing that abuse of women may be the most common form of family violence during the prenatal period. An estimated 10% to 50% of women in the world experiences assault by their male partner (Mary Jo Clark 2008).

Every woman is at risk, and most women experience more than one episode of violence. According to the American medical Association, some group of women are at higher risk for abuse, such as women who are single, separated, divorced, btween the ages of 17 and 28 years, those who abuse alcohol or drugs, pregnant women and women that has jealous partners. The most dangerous time for abused women is when they leave abusive relationships (Delorey & Wolf, 2002).

Different types of abuse exist including, slapping, shoving, kicking, assault with a weapon, restraining, and hitting. Some women suffer emotional abuse in the form of isolation, deprivation, intimidation, humiliation and critism. Of course sexual abuse is reported frequently in many clinics and hospitals, such as forced sexual act and sexual degradation.

Nurses working in the community can identify women who are experiencing any form of abuse using their skills in the area of assessment, therapeutic communication, and help in counseling, advocating for them, making referrals to promote the wellbeing and minimize the effects of violence and abuse (Mary Jo Clark 2008). The nurse needs to develop an awareness of how a woman’s cultural belief affects her response to abuse to avoid going against her wish and to advocate for her appropriately. Implementation of primary intervention will aid in decreasing the occurrence women abuse, by identifying abused women and increasing an awareness of the problem of violence and abuse at community level. Secondary intervention includes assessing the abused women and implementing an appropriate plan of care. The nurse also needs to implement tertiary care that includes referral and provision of continuous support to them. ReferencesMary Jo Clark (2008). Community health nursing, p 435-436.Delorey, C., & Wolf, K (2002). Sexual violence & Older Women, p 173-179.

Written by Gertrude Ajaere RN with minor editing by Shirley Comer RN.

Nurses Know! - Cervical Cancer Facts

By Ruth Young RN.

Cervical Cancer
What is cervical cancer? According to the National Cancer Institute it is cancer that forms in the tissues of the cervix which is the organ that connects the uterus to the vagina. This topic is of interest to me because Cervical Cancer is one that is preventable and treatable if detected early on, but there are many who are still unaware of how it is caused. This disease is caused by many factors, but the most common cause is an infection called Human Papillomavirus (HPV).
There are over 100 strains of this virus and of the 100 strains; about 60 are those which causes warts on hands and feet. The other 40 affect the mucosal area, such as the anal and genital area. While most women’s bodies would be able to rid them of HPV, some aren’t able to, and it may develop into Cancer. This is why it of great importance to have an annual pap smear performed if you’re sexually active. According to the American Cancer Society some other risks factors for HPV are:
1. Immunosuppression (ex. HIV ,STD's)
2. Family history
3. Smoker
4. Lower socioeconomic status
5. Multiple pregnancies
Cervical cancer is usually slow growing and may not present any symptoms, but can be found with regular Papanicolaou smear exams (Pap smear). During the pap smear exam, some of the cells are scrapped from the cervix and sent off to the lab to be examined under the microscope, where they’re looking for any cell changes. According to the National Cancer Institute some signs and symptoms are moderate pain during intercourse, vaginal bleeding, pelvic pain and unusual vaginal discharge.
Primary prevention would include abstinence, education on barrier contraceptive methods (Clark, 452), and vaccination. For secondary prevention, screening such as Pap smear and HPV tests which would help detect if one is at risk for cervical cancer, and early detection is key. The HPV tests looks for the virus that can cause these abnormal cell changes. (CDC) Tertiary prevention should focus on prevention of recurrence of the disease through re-infection.

Written by Ruth Young RN with minor editing by Shirley Comer RN.

Nurses Know! - Complimentary and Alternative Treatments

By: Rosalind Anderson RN
Complementary and alternative medicine (CAM) is the use of practices and products that are not considered part of conventional medicine in the United States. Biological therapies include herbs, vitamins, foods including dietary supplements and other natural substances (Pepa). With the increase of infomercials which boasts the benefits of these products, use of alternative medicine is on the rise.

This is especially important when assessing the medication history of elder patients. Although many herbal supplements are safe when used as recommended, the concern is that many elder patients may not tell their nurse, practitioners or physicians they are taking these medications (Pepa). Often times the reason for this is that elders feel that the supplements are not medications because they are “natural”. However the astute nurse should realize that these “all natural” supplements may have deleterious effects when combined with prescribed medications and address natural supplements or home remedies in the medication history assessment of their patient. Common prescription drugs taken by elders such as blood thinners, blood pressure medication, cyclosporins, digoxin, hypoglycemic agents, and antidepressants should not be taken with herbal supplements (Pepa).

The increased use of CAM by the elderly mandates that nurses maintain thorough communication and be knowledgeable about these supplements in order to provide proper care for the patient.


Reference:
Pepa, C. (2006). Alternative health modalities. In Mauk, K. (Eds.), Gerontological nursing: Competencies for care (pp 683-700). Sudbury, MA: Jones and Bartlett Publishers.

Nurses Know! - Recognizing Depression in Older Adults

By: Lisa Whitney RN
Loss is painful whether it is a loss of independence, mobility, health, career, or someone you love. Grieving over these losses is normal, even if the feelings of sadness last for weeks or months. Losing all hope and joy, however, is not normal. It’s depression.
Untreated depression poses serious risks for older adults, including illness, alcohol and prescription drug abuse, a higher mortality rate, and even suicide.
Recognizing depression in the elderly can be difficult, since many people believe it is a normal part of the aging process. As we age, it is normal to experience sadness when facing changes in capabilities, or sorrow at the loss of loved ones, however, we also continue to feel happiness, joy, contentment, and other positive emotions.
It’s important to watch for the warning signs of depression and seek professional help when you recognize it.
Signs and symptoms of depression:

• Unexplained or aggravated aches and pains
• Hopelessness
• Helplessness Anxiety and worries
• Loss of feeling of pleasure
• Slowed movement Irritability
• Memory problems
• Lack of interest in personal care (skipping meals, forgetting medications, neglecting personal hygiene)

Depression in the elderly has underlying causes and treatment is complex in that it involves consideration of the role of current disease, memory changes, various medications, and the status of the patient's support systems. Optimum results are achieved with a management approach that incorporates a system of collaborative care.

References

Ashok, R., & Md. (2004, June 1). Depression in the elderly. In Symposium on geriatric psychiatry (Postgraduate Medicine). Retrieved February 9, 2008, from The Practical Peer Reviewed for Primary Care Physicans: www.postgradmed.com.

Notes: This blog post reflects the work of Lisa Whitney RN with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Hearing Loss

By: Debbie Minniefield RN

CAN YOU HEAR ME NOW?

Many elderly people have hearing problems and it only gets worse as they get older. Hearing loss affects some 2 million older adults over 70, by estimate. That statistic makes it one of the most chronic health conditions affecting older adults today. In one study, more than 90% of adults were found to have some degree of hearing loss. Despite this, more than 36% of them reportedly never even had their hearing tested. (Archives of Otolaryngology Head and Neck Surgery)Four out of five who could benefit from wearing hearing aids, do not use them.

Many avoid going to their doctor with their hearing problems, are unaware of their deteriorating hearing, or see it as a sign of growing old and feel embarrassed.

Hearing Loss is seldom Assessed

Untreated hearing loss in the elderly is common and often results in depression and social isolation. Effective treatment could dramatically improve their hearing. Yet, according to a major study published by the Journal of the American Medical Association, in 2003, fewer than 10% of primary care physicians screen elderly patients for hearing loss. So, ask to have a hearing test whenever you see your doctor. JAMA strongly recommends that hearing screenings become as consistent a focus of health examinations taking blood pressures or vision screenings. At the same time, it is imperative that the elderly themselves ,their relatives, colleagues and friends be aware of the need to look for signs of hearing loss and ask that it be properly diagnosed and treated.

References

Journal of the American Medical Association, April 2003.

http://www.webmd.com/

http://www.righthealth.com/

http://www.hear-it.org.com/

Notes: This blog post reflects the work of Debbie Minniefield RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Smoking and the Older Adult

Smoking Cessation in Older Adults

By: Keturah Mayhorn



Most elderly people, who use tobacco, didn’t start recently. In fact, many have been smoking for years, sometimes even decades, making cessation a hard battle to win. Despite it’s documented relationship with cardiovascular diseases and illnesses, such as cancer, so many older Americans have yet to kick the habit. There isn’t a particular number of cigarettes that causes illness and disease, for some people it could one and for others thousands.

Financial Considerations

It is not uncommon for elderly patients to be on fixed income forcing them to perform a balancing act between food, medication, and other necessities of life. With tobacco’s recent tax increase, uncomfortable adjustments will have to made to some already impossibly tight budgets. Unfortunately, many smoking adults will always make room in their bugets for tobacco.

Why Quitting is recommended no matter what your age

“There is good data to support that smoking cessation lowers the risk for heart disease, stroke, and lung disease” (Mauk, 2006). According to the American Lung Association, benefits begin within only 20 minutes of quitting and continue for by the hour. They include: decreased heart rate and blood pressure, normal blood levels of oxygen, enhanced smell and taste, improved circulation, easier walking, and improved lung function (all within 3 months).

Effective interventions

“The USPSTF found evidence that screening, brief behavioral counseling, and pharmacotherapy are effective in helping clients to quit smoking and remain smoke-free after one year” (Mauk, 2006). It’s never to late to quit paying for tobacco and all of its bad effects, and start living healthier lives.



References

American Lung Association (2007). Smoking Cessation Support.Retrieved February 7, 2008, from web site:http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=33568



Mauk, K. (2006). Gerontological Nursing Competencies for Care. Massachusetts: Jones and Bartlett




Notes: This blog post reflects the work of Keturah Mayhorn RN (pictured above) with editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Preventing Heart Disease

by: Charissa Hurt RN

According to the American Heart Association (AHA), cardiovascular diseases rank as America’s No. 1 killer. Heart Disease claims the lives of 41.4 percent of the more than 2.3 million Americans who die each year. Over 83% of people who die from the disease tend to be over 65 years (Mauk, 2006).

Coronary Artery Disease (CAD) is the end result of narrowing and hardening of the arteries associated with fatty plaque buildup and fibrin formation within the heart.

Risk factors include:

• heredity
• race
• increased age
• obesity
• high sodium and cholesterol intake
• sedentary lifestyle. (Mauk, 2006).

CAD can cause angina (chest pain), heart attack, heart failure, high blood pressure and arrhythmias (irregular heart beat).

What can be done to prevent CAD?

Genetics, race and increased age are unavoidable risk factor to developing CAD; however we can make lifestyle modifications to prevent the disease from progressing.

1. Eat a low fat, low sodium, fiber rich diet.
2. Maintain a healthy lifestyle by stop smoking
3. Regular exercise at least every day of the week, such as walking
4. If overweight, try losing a few pounds can make a significant difference
5. Get routine blood pressure screenings
6. If diabetic, controlling blood sugar reduces cardiac risk (Wikipedia, 2008).

CAD is becoming a growing problem in America. Making lifestyle changes can drastically reduce our risk.


References

American Heart Association. 2008.

retrieved Feb. 8 2008

Coronary Artery Disease. Wikipedia the Free Encyclopedia. Feb. 7 2008

retrieved Feb. 8 2008

Mauk, K. L. (2006). Gerontology Nursing: Competencies for care. Sudbury, Massachusetts: Jones and Bartlett

Notes: This blog post reflects the work of Carla Hurt RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Recognizing Elder Abuse

By: Carla Jenkins RN

What is Elder Abuse?

Have you or someone you know been a victim of elder abuse? Do you know what elder abuse is? Do you know where to report suspicions of elder abuse?

Elder abuse is often defined as a single or repeated act, or as a lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.

How big of a problem is Elder Abuse?

It is estimated that only 1 in 10 cases of elder abuse are actually reported. Every year an estimated 2.1 million older Americans are victims of physical, psychological, or other forms of abuse and neglect.

Where should Elder Abuse be Reported?

In almost all states, reporting of elder abuse is mandatory. It should be reported to the Adult Protective Service Agency, Department of Aging or other state mandated agencies. Abuse occurring in nursing homes and assisted living facilities should be reported to the Ombudsman program.

Types of Elder Abuse

There are several types of abuse of older people that are universally recognized as being elder abuse and include:

• Physical

• Psychological

• Financial

• Sexual

• Neglect

Once the report is made, ascertain if the person is in immediate danger, law enforcement may be needed. Ensure that there is a safety plan. Elderly persons referred for suspected abuse are at increased risk of injury due to retaliation.

References

http://www.dmoz.org/Society/Issues/Violence_and_Abuse/Elder/

http://www.en.wikipedia.org/wiki/Elder_abuse

http://www.karisable.com/elderabuse.htm

Mauk, K.L. Gerontological Nursing Competencies for Care.(2006). Salisbury,Mass. Jones and Bartlett.

Notes: This blog post reflects the work of Carla Jenkins RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Should I get a flu vaccine?

By: Lisa Dempsey RN

Many people are aware of the importance of young children receiving vaccines to prevent common childhood illnesses, but what about the older population? As well as very young children, the elderly more susceptible to illness. Annual vaccination against influenza is recommended for all adults 65 years of age or older (Mauk, 2006).

More than 90% of deaths from influenza occur in persons over 65 years of age (Mauk, 2006). In an average year, influenza causes 36,000 deaths and more than 200,000 hospitalizations in the United States.(mostly among those aged 65 years and older)(CDC). Influenza vaccines are available beginning every September until the end of December. The Centers for Disease Control recommend receiving the vaccine in October or November because influenza activity in the United States generally peaks between late December and early March(CDC).

There are a few "cons" to receiving the Influenza vaccine. There may be some mild side effects such as soreness to the injection site and a low grade fever for a few days after the injection(CDC). Influenza viruses change year after year, so it is necessary to get a "flu shot" every year. It is also possible that even after receiving the vaccine that a person may still get Influenza. That is because illness may be caused by a strain not protected by the vaccine.

There are certain people who should NOT get the Influenza vaccine. Those persons who are allergic to eggs or chicken, and those who have ever had Guillian Barre Disease. In such cases, the Influenza vaccine is CONTRAINDICATED(CDC).

Although there are "cons" to receiving the Influenza vaccine, the benefits greatly outweigh the risks. Get the Influenza vaccine every year and protect your health.

References

Mauk, K.L. Gerontological Nursing Competencies for Care.(2006). Salisbury,Mass. Jones and Bartlett.

Notes: This blog post reflects the work of Lisa Dempsey RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Improve your health with physical activity

By: Lynn Christian RN

Unfortunately, the lack of physical activity in our senior population has become a significant, yet preventable risk factor that has been proven to attribute to an increase in the number of elderly deaths. It is estimated that two-thirds of adults between the ages of 65-75 are considered to be inactive (Mauk, 2006).

Society seems to have the impression that exercise after fifty is no longer important, however, that can not be further from the truth. Scientific evidence supports that moderate physical activity is instrumental to decreasing mortality, heart disease, colon cancer, diabetes and hypertension in our elderly population. In addition moderate activity, which is considered 30 minutes of walking weekly, and 2 days of strengthening, will also prevent obesity, reduce depression and falls, and increase one's quality of life (Mauk, 2006).

So, how do you get started? First talk to your physician or nurse to be evaluated for your current level of activity and identify barriers that you may find are keeping you from getting started. Your health care professional will help to find simple, yet effective solutions to these issues. Included in these concerns may be safety, pain, fatigue, immobility, and impaired sensory function (Mauk, 2006).

Set realistic goals, wear comfortable loose, yet some what fitted clothing and wear safe fitted shoes. Start slowly, walking is a great place to start, and you can gradually increase your intensity. Also incorporate some strengthening and resistance exercises a couple of days each week. Remember to stretch for about 5 minutes before and after to "warm up" and "cool down". If you are have a cold, flu or other illness, wait to exercise until you have recovered and then resume your routine slowly. Recruiting a friend will not only provide some companionship, but will most likely keep you on task as well ("exercise", n.d.). There is a web site linked below to help you get started and provides some simple exercises that you may incorporate into your new exercise program.
http://familydoctor.org/online/famdocen/home/seniors/staying/754.html
An exercise program empowers you to make a positive impact on your own health, as well as improve your quality of life allowing continuing indepencence.

References

Mauk, K. (2006). Gerontological Nursing Competencies for Care. Massachusetts: Jones and Bartlett
Exercise for the Elderly (n.d.). Retrieved February 7,2007 fromhttp://familydoctor.org/online/famdocen/home/seniors/staying/754.html

Notes: This blog post reflects the work of Lynn Christian RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Screening for Colo-rectal Cancer

By: Rosalind Anderson RN

Colorectal is the third most common cancer in the United States (Mauk, 382). It is the second leading cause of death in the United States (Menon, 2003). Early detection can lead to decreased mortality and morbidity.
Survival of colorectal cancer is directly related to the stage at diagnosis. If the disease is localized (not spread) there is a 5 year survival rate of 90% for colon cancer and %80 for rectal cancer (Menon, 2003).
Polyps are precancerous lesions in the colon and can take 7 to 12 years to turn cancerous. For this reason early detection is critical (Menon, 2003).
Colonoscopy takes a picture of the colon and involves introducing flexible tube into the retum through the colon. This is usually done under sedation(ACS). Risks include perforation, bleeding and risks associated with sedation (Mauk, 382). However colonoscopy is the most sensitive of screening methods, and colon polyps can be easily removed during the colonoscopy, resulting in the prevention of that polyp from turning into cancer(Torpy, 2006).
Despite promising prognosis as a result of early polyp detection and/or stage diagnois, only 37% of colorectal cancer is diagnosed at an early stage (Menon, 2003).
The American Cancer Society recommends that beginning at age 50, men and women of average risk get screened. The adage an ounce of prevention is worth a pound of cure has never been so relevant.
References
American Cancer Society (ACS). How is Colorectal Cancer Found. Retrieved 2/7/2008
Mauk, K. (2006). Gerontological Nursing Competencies for Care. Massachusetts: Jones and Bartlett
Menon, U., Champion, V., Larkin, G., Zollinger, T., Gerde, P. Vernon, S. (2003). Beliefs associated with fecal occult blood test and colonoscopy use at worksite colon cancer screening program. Journal of Occupational and Environmental Medicine, 45(8), 891-8.
Torpy, J. (2006) Colon cancer screening. Journal of the American Medical Association, 295(10), 1208.

Notes: This blog post reflects the work of Rosalind Anderson RN (minor editing by Shirley Comer RN) and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Fall Prevention in Older Adults

By: Candice Williamson RN


Fall Prevention in Older Adults
Have you or anyone you know ever fallen? Falls are the leading cause of unintentional injury and death in older adults in this country (Mauk 2006).
The risk of falling increases with age and is greater for women than for men. Although no single risk factor causes all falls, the greater the number of risk factors an individual is exposed to, the greater the probability of a fall and the more likely the results of the fall will threaten the person’s independence.


Five key risk factors of falls among older adults include:
1. Osteoporosis
2. Lack of physical activity
3. Impaired vision
4. Medications
5. Environmental hazards

Many of these risk factors are preventable. A lack of knowledge about these risk factors, and how to prevent them, contributes to falls. Balance and strengthening exercises, home safety modifications, and eliminating high-risk medications have been the focus of fall-risk prevention strategies.


Prevention tips for the five key risk factors listed above include:
1. Eat or drink sufficient calcium
2. Regular exercise designed to increase muscle and bone strength, such as walking or swimming.
3. Have regular checkups by an opthamologist and make sure eyewear is clean.
4. Know the common side effects of medications taken, remove all out-of-date medications, have your primary health care provider review all current medications, and limit alcohol intake as it may interact with medications.
5. Keep walk areas clear of clutter, avoid throw rugs, add non skid mats to bathtubs, and keep all commonly used items within easy reach.

References
Mauk, Kristen L. (2006). Gerontological Nursing: Competencies for care. Sudbury, MA: Jones and Bartlett Publishers.

Notes: This blog post reflects the work of Candice Williamson RN (pictured above) with minor editing by Shirley Comer RN, and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.