Crohn's Disease

By: Karlie Peters RN

Crohn’s “is a chronic inflammatory process in the gastrointestinal tract but with intermittent activation” (Crohn’s disease and IBS, 2007). Crohn’s is caused by an inflammation, which can cause “abdominal pain, severe diarrhea, and even malnutrition” (Mayo Clinic, 2009). The inflammation process can affect any aspect of the digestive system, but it is generally localized to the area of the distal parts, the ileum and colon. Crohn’s affects the deep layers of bowel tissue. “Crohn’s disease can be both painful and debilitating and sometimes may lead to life-threatening complications” (Mayo Clinic, 2009).

Signs and symptoms of Crohn’s include “diarrhea, abdominal pain and cramping, bloody stool, ulcers, reduced appetite and weight loss, fever, fatique, arthritis, eye inflammation, skin disorders, inflammation of the live or bile ducts, and even delayed growth or sexual development, in children” (Mayo Clinic, 2009).

Crohn’s disease has been linked to four components, they include “genetic predisposition to an increased intestinal permeability, an oropharyngeal bacterium that increases the mucosa; permeability of the small intestine with only a minimal inflammatory reaction, an adherent-invasive strain of Escherichia coli that penetrates the mucosa and causes an acute inflammatory reaction in the intestinal wall, and finally a secondary invasion of bacteria causing the chronic inflammatory characteristics” (Crohn’s disease and IBS, 2007).

Nurses can inform patients that the cause of Crohn’s disease is still unkown, but was previously thought of as being agitated from diet or stress. Researchers are now looking more towards a number of factors, “such as heredity and a malfunctioning immune system” (Mayo Clinic, 2009). Nurses can educate patients with the risk factors of Crohn’s disease. There are several risk factors and they include: “age, ethnicity, family history, cigarette smoking, where you live, isotretinoin (Accutane) use, and nonsteroidal anti-inflammatory drugs (NSAIDs)” (Mayo Clinic, 2009).

Teaching individuals that Crohn’s is diagnosed between in the ages of 20-30, with Caucasians having the highest risk, even those of Ashkenazi Jewish decent are even greater. Individuals whom have a close relative, like a parent or sibling, have a 1 in 5 risk. Cigarette smoking is “a determining factor for composition of the subgingival microflora” (Crohn’s disease and IBS, 2007). Lars Oble (2007) quoted that “a culture from the oral cavity of smokers showed an increased Gram-negative bacterial colonization.”

Once individuals get a general idea of the Crohn’s disease process, the individual should be identifying their own risk factors, for example, if an individual smokes, then cessation of smoking should be encouraged. Individuals should be seeking their primary physician if they are having signs and symptoms. Keeping a journal to write down all medications, a daily journal of food intake, along with personal information, such as major stresses or recent life changes, and making notes of bowel habits will help aid the physician in proper medical assistance. There are alternative medicines that include “herbal and nutritional supplements, probiotics, fish oil, and acupuncture” (Mayo Clinic, 2009). To feel in control of a disease, such as Crohn’s disease, then organizations, like Crohn’s and Colitis Foundation of America (CCFA) (888-MT-GUTPAIN) can help with providing information and accessing of support groups in the local areas.

Reference Page
Mayo Clinic. (1998-2009). Mayo Clinic. Retrieved from http://www.mayoclinic.com/ on
October, 6th 2009.
Olbe, L. (2008). Concept of Crohn's disease being conditioned by four main components,
and irritable bowel syndrome being an incomplete Crohn's disease. Scandinavian Journal of Gastroenterology, 43.

NOTE: This blog post reflects the work of Karlie Peters, 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.

DASH Diet and Hypertension

By: Debra Minnifield, RN

The “Dash Diet”, which stands for Dietary Approaches to Stop Hypertension, is credited with effectiveness in reducing blood pressure in African Americans and older adults. The focus of the DASH diet is to lower and control blood pressure. The use of this diet could reduce blood pressure by a few points in only two weeks and reduce it eight to fourteen points over time. Its other health benefits include protection against heart disease, stroke, osteoporosis and even diabetes. Use of the DASH diet may even potentiate the action of antihypertensive medications and decrease insulin resistance.

The Dash Diet formed the basis for the new SDA My Pyramid and is recommended by:

• The National Heart, Lung, and Blood Institute

• The American Heart Association

• The 2005 Dietary Guidelines for Americans

• US guidelines for treatment of high blood pressure

The DASH diet controlling portion sizes and consists of whole grains, low fat dairy products, fish poultry, legumes fruits, and vegetables. The diet is low in saturated fat, sodium, cholesterol and total fat. However, the diet is high in protein, magnesium, calcium and potassium. Red meat and sweets may be consumed in moderation.

As advocates, nurses can educate and empower clients to take control of their health by encouraging the use of the DASH diet. Nurses should perform thorough assessments and urge patients to make lifestyle modifications, such as engaging regularly in appropriate exercise, limiting their alcohol intake and avoiding tobacco.

References:

Hypertension in African Americans. Minority Nurse (2003).

www.mayoclinic.com,retrieved October 10,2009

Note: This blog post reflects the work of Debra Minnifield, 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.

Obesity in America

BY: Lora Hartman-Devine, RN

Obesity is a disease that affects millions of Americans and often is chronic in nature. Obesity can be caused by genetics, emotions, age, and medications. Obesity is commonly defined within the medical community as men with more that 25% fat and women with more than 30% are considered obese. According to the Center for Disease Control and Prevention, having a Body Mass Index (BMI) of greater than 25. Incorporation of using the BMI into nursing health assessments can help better treat our patients.
Many health risks are associated with the person that is overweight. Diabetes, coronary artery disease, hypertension and depression are a few of the prevalent diseases that occur due to obesity. The stress of trying to “fit in” within a society that equates beauty with thinness can be daunting to a person that is overweight leading to emotional and psychological problems in addition to the physical ailments.
Health care interventions should occur for those that are obese. Nurses, in conjunction with other healthcare professionals can work with patients in developing goals to reach a healthy weight. Nursing interventions can be customized to meet the needs of the patient through diet, exercise and counseling. Exploration of alternative means can be utilized to work towards the established goals as well. The nurse that is able to work with the patient towards developing a healthier eating lifestyle will help the patient avoid further medical problems. Nutritional counseling as well as simple exercises can be incorporated into care plans. Education and prevention are both key factors in dealing with obesity.
Education within communities is vital to help decrease the rate at which obesity is occurring. Communities that alliance with churches, schools and health organizations often offer education and prevention methods to overcome obesity and overeating. Referrals to these groups or agencies to clients that are overweight can greatly impact their attitude toward weight loss and influence the process. Nurses that are able to work together with community resources, and patient preference will help to reduce the number of Americans affected by this chronic disease.

References
1 .http://www.webmd.com/diet/understanding-obesity-2 2. 2.
2.http://www.emedicinehealth.com/obesity/page4_em.htm
3. Brown, I., Stride, C., Psarou, A., Brewins, L., & Thompson, J. (2007). Management of obesity in primary care: nurses' practices, beliefs and attitudes. Journal of Advanced Nursing, 59(4), 329-341.

NOTE: This blog post reflects the work of Lora Hartman-Devine, 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.

Raiding the Medicine Cabinet

By: Zondra Davis, RN

Drug addiction is characterized by compulsive use of a controlled substance for non-medical purposes despite deleterious effects from continued use. Physical dependence is manifested by painfully uncomfortable withdrawal symptoms after cessation of a drug. It is difficult for some to associate these outcomes with a curious teen raiding the medicine cabinet, but the epidemic of prescription drug abuse warrants our attention.

Vulnerable teens, ill-informed about the adverse consequences of prescription drug abuse have found themselves on the fast track to chronic illness as a result of prescription drug addiction. While illicit drug use has steadily declined among youth, prescription drug abuse has seen an astronomical increase! What can we do as healthcare providers to protect teens from reckless pleasure-seeking escapes in a pill bottle?
Assessing for and talking about substance abuse can be uncomfortable; nevertheless, it is an essential component that should occur at each healthcare contact for the developing adolescent. Substance abusers are more likely to engage in risky behaviors that result in sexually transmitted diseases-including HIV and to suffer from traumatic injuries that can disable for life. Depression and other mood and psychiatric disorders often accompany drug abuse.
Teens need to be educated about the lethality and morbidity that pervades substance abuse communities. Parents need to be aware of the signs of prescription drug abuse. Empirical data suggest that universal interventions have potential for public health impact by reducing many types of prescription drug abuse among adolescents and young adults (Spoth, Trudeau, Shin, & Redmond, 2008).

The fragility or resilience of familial relationships can be tested during the tumultuous teen years. The best nursing approach will be aimed at identifying teens at risk for substance abuse disorders so that preventative strategies can be employed. Positive communication and effective nursing education for parents and teens can avert the negative health outcomes linked to long term substance abuse disorders.

1. Spoth, R., Trudeau, L., Shin, C., & Redmond, C. (2008). Long-term effects of universal
preventative interventions on prescription drug misuse. Addiction. Jul; 103(7): 1160-8

NOTE: This blog post reflects the work of Zondra Davis, 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.

Hypertension Nursing Managment

By Jamie Brinton, RN

Hypertension is often referred to as the silent killer because there are frequently no symptoms associated with it, but it can lead to stroke, heart failure and heart attack. As nurses we help our patients decrease their risk of hypertension and manage hypertension through screening and education.

The first responsibilities of nurses for managing patients hypertension is to understand the disease itself. Primary hypertension is hypertension that has no identifiable cause, such as kidney failure or pregnancy. Most people who suffer from hypertension are suffering from primary hypertension. Even though there is not identifiable cause, there are several factors that may contribute to primary hypertension.

Hypertension occurs when the systemic vascular resistance is too high. Systemic vascular resistance, or SVR, is the amount the heart must work against to push the blood from the heart to the arteries.

Now that we understand the physiology of high blood pressure, we can look at what factors cause a high SVR. Obesity, stress, smoking, and caffiene use can lead to the release of epinephrine. Epinephrine increases the resistance, which in turn leads to an increased blood pressure. Obesity can also activate the renin-angiotension-aldosterone system. Angiotension II, is a potent vasoconstrictor, which also increases the resistance and therefore blood pressure. Genetics are a major risk factor for hypertension. It is believed that genetics effects angiotension and this increased hormone leads to the increased resistance in the body. Salt can cause an increased volume in the vascular system. This increase puts pressure on the ventricles making it harder to move the blood from the heart to the body. (Chummun, 2009)

As nurses we would not expect all of our patients to fully understand the causes of hypertension. However, it is important for nurses to understand the causes of the disease in order to fully answer patients questions.

The next step in managing hypertension for our patient's is education. Once a lifestyle assessment has been made, we can begin teaching. I would begin with telling patients at risk for hypertension the reasons it needs to be addressed. Hypertension can lead to other serious conditions such as heart failure, heart attacks and stroke. Furthermore, hypertension is associated with symptoms that effect quality of life such as fatigue, head aches, dizziness, sob, tinnitus, blurred vision, confusion and irregular heart beat. (Chummun,2009)

Next I would address their individual risk factors. Those who have a BMI greater than 25 can begin with weight loss. Programs such as weight watchers and seatle sutton promote portion control and making choices with lean protein, high in fiber and whole grains. I would give them a copy of a the updated food pyramid. Furthermore, teach them to look for food products that are approved by the American Heart Association. I know that at Jewel, they have heart tags next to price tags on items approved by the AHA. Increased physical activity will help patients loose weight, reduce stress, and lower cholesterol. All of these will help decrease their risk of hypertension. I would recommend inactive patients to set small achievable goals at first and gradually increase their activity as it become a permanat part of their lifestyle. As mentioned before excessive alcohol and caffiene intake can increase epinephrine levels and therefore increase blood pressure. Teach patients to limit these items and make sure they understand the effects of these on blood pressure. Stress is a part of life, but stress reduction is essential to prevent hypertension. Teach your patients stress reducing activities such as exercise, meditation, increased social support, aromatherapy, massage, baths and decreased worrying. Tell patients to put themselves on their to do list. Daily activities for stress reduction should be as important as work, school, and family.

Finally, it is important to make sure that patients know that by modifying the risk factors and taking an active role in the management of hypertension, shows a marked decrease in morbidity and mortality.

References:

Chummun, H. (2009). Hypertension - a contemporary approach to nursing care. British Journal of Nursing (BJN), 18(13), 784-789

NOTE: This blog post reflects the work of Jamie Brinton, 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.

Glaucoma

BY: Bisola A. Adeniran, RN



Glaucoma is a progressive disease of the optic nerve that can lead to loss of vision. It is usually due to increased intraocular pressure (IOP), but it can be due to to other causes. Open-angle glaucoma (or primary open-angle glaucoma (POAG) is one of the two main types of glaucoma, and it is common. The other type, angle-closure glaucoma is less common. Open-angle glaucoma affects all ages, but it occurs more often in people over 40. It is the second leading cause of blindness in the United States

Whose at Risk?
Family History of Glaucoma
Clients with Diabetes
Clients with Myopia (nearsightedness)
Previous eye injury
Regular, or long-term streoid use
African Americans (have a greater tendency)
Clients with low blood pressure
Restricted blood flow to the optic nerve

Normal eye blood pressure is maintained by a balance of fluid that flows into the front of the eye and then drains out. Thje angle of the eye where the iris and the cornea meet is where the fluid drains into the trabecular meshwork. If this drainage is obstructed it increases presuure on the optic nerve which can lead to vision loss.
Usually, there are no warning symptoms. Later stages of the disease include loss of peripheral vision in small areas, blurred vision, halos around lights, blind spots, and poor night vision. Frequent eye examinations help with screening and diagnosis of glaucoma. There is no cure for glaucoma but laser eye surgery may help improve the draining of the excess fluid. Eye drops that help to lower the pressure inside the eye are often prescribed.

Teaching
Since this is a silent eye killer of eyesight, patients often pay no attention to the symptoms. Nurses must emphasize and encourage early screening with eye examinations. The nurse can encourage clients to to inform their primary health care provider that if they symptoms of chronic glaucoma including: Any signs of eye infection, pain in the eye, redness of the eye and sudden vision changes.

References:
www. glaucomafoundation.org



NOTE: This blog post reflects the work of Bisola Adeniran, RN with 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.

Epilepsy

BY: Rosalind Anderson, RN

Several months ago my best friend bought a 42in LCD television for her mom. The television was quite the focal point in her mom’s small one bedroom apartment living room. Her mom’s nightly ritual included curling up on her recliner and watching her favorite late-night programs until she fell asleep. She usually would awaken in the middle of the night, turn off her television and go to bed. However a few months later her mother started to notice that she would wake up in front of the television with very bad headaches, dizziness and feeling disoriented. It wasn’t until she noticed a hole in her wall the morning following such an incident that she realized what had happened. My best friend’s mother suffers from epilepsy and had been suffering seizures. It wasn’t until she visited with her neurologist that the reason for her increase in seizures was known. Her neurologist identified the new television as the trigger for her increased seizure activity.
Epileptic seizures are the result of transient cerebral dysfunction caused by abnormal electrical activity in the brain presenting as sudden recurrent attacks of memory, sensory or psychic manifestations with or without loss of consciousness or generalized convulsions (Levenson, 2008). Some causes of seizures are genetic, brain disease, trauma, infection, febrile illness, electrolyte imbalances and eclampsia (Lawal, 2005). However approximately one third of adult epilepsy cases are idiopathic.
The standard medical treatment of epilepsy is with antiepileptic drugs (AEDs) (Lawal, 2005). However nonpharmacologic management such as surgery involving brain dissection or implantation of electrical devices may be used for those who do not respond to pharmacologic treatment (Kanceski et.al, 2005).
Despite use of AEDs or nonpharmacologic therapies, there are factors which may trigger seizures. These include emotional stress, insomnia, hormonal changes, alcohol/drug abuse, and photosensitivity. In photosensitivity, seizures are provoked by flickering light such as reflections from sunlight, flashing neon lights or watching television, as in this case. Sitting a few meters from the television would help to prevent these light-induced seizures (Lawal, 2005). However given the small dimensions of my friend’s mom’s living room, to the proportion of the visual area occupied by the television, this was not possible.
In additional to being knowledgeable of surgical and pharmacologic therapies and their side effects, and encouraging adherence to the treatment regimen, the nurse caring for the patient with epilepsy can assess for these triggers and teach the patient to do so also.
Unfortunately my friend had to trade in her mom’s television for a smaller one. After the switch, her mom did not experience any more seizures while watching television; and I got a good deal on a TV.

NOTE: This blog post reflects the work of Rosalind Anderson, 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.

Congestive Heart Failure

By Lynn Christain RN

According to the CDC, over five million people have heart failure in the United States, with 550 thousand new cases diagnosed each year. Over 287 thousand people will die this year as a result of congestive heart failure. The most common causes include coronary artery disease, hypertension, and diabetes.
Education of this group of individuals is vital in minimizing mortality and hospitalizations, as congestive heart failure is the most common admission diagnosis for the population using Medicare (CDC, 2009).

While and Kiek (2009), state that evidence supports that self-management programs have a positive affect on the quality of life and self care behaviors elicited by this group of individuals. In conjunction with this self-efficacy, nurse-directed patient education also plays a large role in management of this disease (2009).
As nurses, we must advocate for our patients psychological support network as many patients with CHF also have anxiety and depression. In addition, regular exercise, teaching about the patients medications and ensuring they have a clear understanding of why each medication is important is essential. Daily blood pressure and weight checks are important, as is keeping an accurate log. Identifying 1-2 pound weight gain in a 24 hour period or 3 pound weight gain in a week as warning sign and the primary health care provider should be notified. Other early warning signs that patients should be aware of are shortness of breath and difficulty lying in a flat position. All of these signs are vital to detecting fluid overload and may indicate the need for adjustment in the patient’s diuretics.
When educating a patient on their diet, emphasizing fresh fruits, meat and vegetables, and choosing foods low in salt, such as, poultry, legumes, milk, yogurt, pasta, rice and legumes, is important. Encourage patients to season with herbs, spices and fruit juices instead of salt. It is also important to teach patients to read labels and be able to identify the amount of sodium in less that 350 milligrams per serving. Another way to identify foods high in sodium is by locating the ingredients, if salt or sodium is listed in the first five ingredients, it is probably too high (UCSF, 2009).
Congestive heart failure is best managed by self-efficacy; patients must become their own advocates. In order for patients to transition into their own advocate, they must perceive their susceptibility to the disease as a serious illness and make educated choices regarding the modifiable factors that potentate the disease process such as diet, exercise, medication compliance, and follow up health visits. Often these modifiable factors are seen as barriers by CHF Patients. Education regarding how to change these modifiable factors will reduce the likelihood of exacerbations of CHF, thereby becoming more self sufficient in managing their own disease process.
It is important to acknowledge however, that each patient will differ in educational backgroupnd and cultural considerations must be made accordingly.

References
Centers for Disease Control and Prevention. Division for Heart Disease and Stroke Prevention. Retrieved from http://www.cdc.gov/dhdsp/library/fs_heart_failure.htm.

University of California. Diet and Congestive heart failure. Retrieved from http://www.ucsfhealth.org/adult/edu/dietAndHeartFailure/index.html.

While, A., & Kiek, F. (2009). Chronic heart failure: promoting quality of life. British Journal of Community Nursing, 14(2), 54-59.

Note: This blog post reflects the work of Lynn Christian 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.

Cardiovascular Epidemic

By: Ed Roska RN

In 2006, the American Heart Association (AHA) reported more than 80 million people have one or more cardiovascular disease. Heart disease claimed over 800,000 lives in 2005; 300,000 more than cancer, 5 times more than accidents and 80 times more than HIV. Heart disease is still the leading cause of death in the world. It is also the leading cause of disability. According to the Council of Disability Awareness (2008), 24 million Americans need on-going treatments, surgeries and medications that is costing our economy $1.3 trillion per year. This is just the direct cost of therapy. The indirect cost of heart disease is even greater to patients and their families. Loss of income because of surgeries and recovery can drastically affect the lives of family members.
One of the goals stated in the health people 2010 publication is increasing life expectancy and improving quality of life. Facts proved that cardiovascular diseases takes the most life and causes the most disability in patients and love ones. Hence, decreasing deaths and affected lives by cardiac disease will get us closer to achieving the goal of healthy people 2010.
A community health nurse work with a wide range of health care providers to ensure patients receive a full range of care. The main focus of a community health nurse is illness prevention and early interventions. Their goal is to avoid exacerbations and unnecessary hospitalization.
My goal for healthy people 2010 would be to increase education pertaining to heart care and decreasing death related to cardiac arrest. The objectives for these goals would be to reinforce the knowledge regarding the importance of activity, exercise and weight control, increase the communities’ knowledge about modifiable risk factors such as cholesterol, diabetes, high blood pressure and smoking and increasing the numbers of individuals capable of responding to a cardiac event.
The simplest and only answer to the epidemic that is cardiac disease is education. A community health nurse can provide this by working together with institutions like churches and health care facilities. Partnering with these institutions a nurse can develop educational programs and clinics that can provide community members a resource for their illness. A nurse cannot change a life-style of an individual but a nurse can change behaviors through education.

Note: This blog post reflects the work of Ed Roska, 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.

Epilepsy

By Karlie Peters, RN.

What is Epilepsy? “Epilepsy is a neurological condition, which affects the nervous system” (Epilepsy, 2009). Epilepsy and seizures affect people in many different ways. An individual is diagnosed with Epilepsy, when they have had two seizures without any cause from a medical condition. A community nurse can help a client “self-manage” their seizures by understanding the three parts of seizures. The three parts of seizures are the beginning, middle, and end.
If an individual is aware of the first part “the beginning”, which is considered a warning. Unfortunately some may not have warning signs. The middle stage has many different forms. People whom have warning signs, it may be a simple aura, turn into a complex partial seizures or convulsion. People without warnings, may have a seizure that continues into a complex partial seizure or a convulsion. People with epilepsy/seizures need to be informed of the end stage of this disease because this is when the individual transitions back into a normal state. One needs to be informed of the length this period of time last, which can be seconds to minutes, even hours, depending of the affected portion of the brain.
The community nurse can help stress the early (warning) signs of seizures to those who are in the early diagnosing stage, such as sensory/thought, emotional, and physical signs. The nurse should get the individual prepared with emergencies, treatment and safety matters.
One-way to “self manage” seizures is teamwork, whether healthcare team members, family and the individual. A seizure’s diary can help one keep tack of the types of seizures, meds, treatments, side effects, concerns, contacts information, prescription refills, and list medical appointments and take a copy to appointments. Having epilepsy/seizures can be scary, but if one is acknowledgeable about triggers they can minimize the number of attacks with the diary. Triggers are different for each individual person. Some triggers happen during sleep or while waking up, women may have seizures during parts of the menstrual cycle, or when under high stress. The community nurse can encourage the individual to seek support groups and take with family for support. One can also get involved with Blogs through websites such as http://www.epilepsy.com/ which provides information, community, and empowerment.

Note: This blog post reflects the work of Karlie Peters, 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.

The Benefits of Promoting Active Aging During the School Years

By: Zondra Davis, RN

Customizing community based nursing projects to promote physical activity in young children is an excellent way to get future Americans moving towards improved health.

Having a sedentary lifestyle is a significant risk factor for the development of cardiovascular disease, cancer, and cerebrovascular disease; the three leading causes of death in America (www.cdc.gov).

Physical inactivity diminishes life expectancy not only by predisposing to aging-related diseases but it also negatively influences the aging process itself. Astronomical morbidity rates can be linked to physically inactivate lifestyles. Individuals who get regular exercise enjoy lower rates of cardiovascular disease, type 2 diabetes, cancer, high blood pressure, obesity, and osteoporosis.

The prevalence of overweight children has tripled over the last 20 years (Clark, 2008). Our couch potato culture exacerbated by technology that requires much less activity to accomplish chores, homework, and entertainment has resulted in the swelling of the youngest waistlines. Many obese children, ravaged by depression and ill-health, threaten to be the first generation of Americans to have a lower life expectancy than their parents!

School nurses are in a unique position to promote physically active lifestyles throughout the school years to help youngsters ward off chronic illnesses associated with sedentary lifestyles. Children are impressionable and can reap the benefits of improved self-concept, stress management capacity, and physiological functioning that facilitates coping and optimal development across the lifespan. Comprehensive wellness education beginning in kindergarten can introduce age appropriate fun movement to children as they are taught to appreciate the benefits of lifelong fitness. Including daily fitness instruction into the school curriculum under the direction of conversant school nurses is a great way to develop children’s interest in exercise to ensure more than a good grade in gym; but a good deposit towards an improved quality of life.

School nurses can help to create a generation of Americans who have positive attitudes about aging, and who actively plan for healthy aging (Mcguire & Mefford, 2007).CitationsClark, M.J. (2008). Community health nursing advocacy for population health. 5th ed. Pearson Education, Inc. Upper Saddle River: NJMcGuire, SL., Mefford, L (2007) Growing up and growing older. Journal of School Nursing, 23 (2): 80-85.www.cdc.gov/nchs/FASTATS/deaths.htm. Retrieved July 23, 2009

Note: This blog post reflects the work of Zondra Davis 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.

Body Mass Index

By: Rosalind Anderson RN

The state of IL has implemented policies requiring mandatory physical exam including BMI screening upon entering 1st, 5th and 9th grades. However data indicates that annual screening may be preferable. Despite the intentions of state required BMI screening programs, screening lacking follow-up with a child who is identified as obese/overweight or at risk, is futile.

Parents may be motivated to take action after receiving their child’s BMI results, but their community might lack the appropriate medical care service, access to healthy and affordable food choices, safe locations for physical activity, or other resources needed to address the problem. BMI screening programs cannot help young people achieve a healthy weight if adequate school or community services do not exist for appropriate follow-up (Nihiser, A. et al, 2007).

Because BMI screening programs are not intended to diagnose weight status, schools should refer students who need follow-up to appropriate local medical care providers. Before initiating a screening program, schools should work with the local medical community to ensure that adequate diagnostic and treatment services are available, staffed by employees with appropriate training, and accessible to all students, including those with low family incomes or without insurance. Schools should also identify school- or community-based health promotion programs that encourage physical activity and healthy eating. School nurses should be educated, trained, and equipped with the appropriate resources to respond to parents requesting guidance. School nurses can be a valuable resource during the follow-up period because they can provide parents with a clear explanation of the results and health risks associated with obesity, develop an action plan for behavior change, and connect the family to medical care in the community (Nihiser, A. et al, 2007).

References

Nihiser, A., Lee, S., Weschler, H., McKenna, M., Odom, E., Reinhold, E., Thompson, D.,
Grummer-Strawn, L. (2007, Dec.). Body mass index measurement in schools.
Journal of School Health, 77(10), 651-674.

Note: This blog post reflects the work of Rosalind Anderson 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.

Abuse and Neglect Among Children

By Karlie Peters RN

Abuse can be defined as “put to a wrong or bad use; misapply, do wrong to; injure; violate; defile, and attack with contumelious language” (Webster’s Dictionary). Abuse can take on many forms, such as physical, sexual, and psychological abuse. Child abuse is not limited to a certain age, race, sex, socioeconomic background or religion. Years of child abuse can have a variety of adverse affects on those whom are victims, such as adult behavior problems, “prostitution, drug and alcohol abuse, and more unprotected sexual activity” (Dilorio, Hartwell, & Hansen, 2002). It is estimated that “700,000 to 4 million women and children are forced into the international sex trade every year in response to conditions of poverty, low social status women, lax border surveillance, and police collusion” (Clark, 389). Most of the sex workers in India are under the age of 18.
Primary health promotion interventions are based on the promotion and protection or prevention of the issue at hand. A community nurse can help educate the community and family members of any issues of a situation. Starting with the community, a community health nurse can round up all citizens with concern for abuse to get involved with identifying the problem, preventing the situation and to treat the victims of abuse and neglect. The first step of awareness is to spread the word. Monthly or weekly community meetings to discuss abuse can help citizens of the community be aware of the problem. Assemblies at schools, ranging from kindergarten to high school age and available counseling at schools may help children feel comfortable with seeking advice.
The National Foundation for Abused and Neglected Children (NFANC) can be considered as a secondary health promotion intervention. The NFANC reports over 30,000 cases of abuse and neglect in a year. They protect children under the age of 18 with the practices of a risk-oriented case management. The NFANC delivers services to those in need to reduce the risk of abuse.
Tertiary interventions involves coping and dealing with the long-term effects of abuse. The NFANC also helps families with preservation, which implies that they do not intervene when the situation is not in need of fixing. Therapy and counseling can help individuals deal with the long-term mental affects on a child. Long term affects can also include the separation of families, moving out of the children’s comfort zone, such as their home and school, and even withdrawal from social environments due to fear.

References

Clark, M.J. (2008). Community Health Nursing: Caring for Populations. (5th Ed.).
Upper Saddle River, New Jersey: Prentice Hall.

Note: This blog post reflects the work of Karlie Peters 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.

CHILDHOOD OBESITY

BY Abigail Ogunniyi RN

Obesity is an unhealthy accumulation of body fats. It is the most common nutritional disease in the United States of America. It occurs as a result of imbalance between food eaten and energy expanded. It can be caused by unhealthy eating, physical inactivity, genetic, hormonal, and medications. It is usually diagnosed by Body Mass Index (BMI) calculation.
Childhood obesity is a major public health issue, over the past four decades, obesity rates in the United States of America have more than quadrupled among children ages six years to eleven years, more than tripled among adolescents ages 12 years to 19 years and nearly tripled among children ages 2 years to five years. In 2000, for example 15.3% of children were obese compared to nearly 5.7% in 1980 (Clark, 2008). These increasing rates pose a serious health and economic threat to the nation. Being obese or overweight increases the risk of heart disease, type II diabetes and many other serious health conditions. Preventing obesity during childhood is critical as research shows that obese adolescents have up to an 80% chance of becoming obese adults.
To effectively address this problem, primary interventions includes teaching about the importance of healthy diet and physical activity. Advocating for healthy school meal programs as well as healthy diet in home settings; also advocating for increase in physical education time and providing schools with needed physical activity equipments.
Secondary intervention includes educating families/public regarding the consequences of childhood obesity including heart diseases, type II diabetes and other serious health conditions. Tertiary interventions includes referring obese children for counseling to improve self image if needed, promoting lifestyle changes consistent with weight management.

References

Clark, M.J. (2008). Community Health Nursing: Caring for Populations. (5th Ed.).
Upper Saddle River, New Jersey: Prentice Hall.

Note: This blog post reflects the work of Abigail Ogunniyi 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.

Child Abuse: How to Prevent Abuse

By: Patricia Thomas RN

The statistics are an eye opener an estimated 906,000 children are victims of abuse and neglect every year. Child abuse can occur in many different ways, the results are till the same. Sexual and phyisical abuse are prominantly found since it leaves physical and mental evidence behind. However emotional and abuse and neglect is just as common. Anyone under the age of 18 who's been abused or neglected by someone responsible for his/her care not just parents are victims of child abuse.There several complicated risks factors:

1.) History of child abuse, a personal history a learnedpattern from childhood.

2.) A limited ability to deal with stressors such ascaring for a child with disabillilties, caregiver financial, poor socilization, and relationship stress.

3.) Alcohol and drug abuse serious lapses in judgment.

4.) Domestic violence,frequently performed in the house will escalate to physical violence against the child as well. Abuse occurs in all socioeconomic level, however in poverty -stricken families it can occurs up to 20-25 times more likely experiencing maltreatment, according to the NIS-3. The NIS-3 found that race doesn't play a role in cases of abuse and neglect.

What does abuse look like?

Physical findings of abuse may include bruises, bite marks, burns, fractures,abdominal injuries, and hair loss. Sexual abuse may include lacerations or bruising of the hymen of the vagina and/or the anus.

You may be reluctant to interfere in someone's family , but you can make a huge difference in a child's life if you report the abuse, the earlier reported abuse children get help, the greater chance they have to heal from their abuse and not perpetuate the cycle. You may feel overwhelmed. The best help you can provide is calm, unconditional support and reassurance. The child is looking to you to provide support and help -don't let him or her down.

The primary phase is getting the child and family some help, couseling, anger management and parent training of which can make a tremendous difference in the life of the child's family especially if you can stop the abuse early.

The secondary phase is child protective services, getting the child completely out of danger to stop the abuse early. Stop It Now 1-888- PREVENT (1-888-773-8368) Please inform all children if they don't have a friend or family to turn to they can call child abuse hotline 1-800-4-A-CHILD for help, themselves if they feel reluctant to consult with you.The tertiary phase would include education, not learned skills neccessary for good parenting, education can greatly help caregivers who need information on raising children. Children need education as well to help protect for abuse. They need to know that is never their fault and never ok.

References

Clark, M.J. (2008). Community Health Nursing: Caring for Populations. (5th Ed.).
Upper Saddle River, New Jersey: Prentice Hall

Note: This blog post reflects the work of Patricia Thomas 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.

Teen Depression

By Ed Roska RN

The world health organization defines depression as a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. It is a known fact that depression can hinder one’s ability to have a productive life.

Depression is one of the leading causes Disability Adjusted Life Years (DALY) worldwide, DALY is the sum of years of productive life lost due to disability. According to Dr. Heinz of the NeuroResearch Clinics, depression is the 4th leading cause of Disability-Adjusted Life-Years; the World Health Organization also wrote that depression is expected to be the 2nd leading cause of DALYs in 2020 next to heart disease.

Mood swings are normal for teenager, sadness or withdrawal may be cause by hormonal changes or stress in school or conflict with parents. However persistent sadness that last for more than 1-2 weeks is an indication of depression. Some of the symptoms of depression may include:

· Decline in energy
· Noticeable changes in eating habits
· Poor concentration/poor performance in school
· Sleeping to much
· Alcohol abuse or smoking

Teen depression is different from adult depression. Teens tend to show more signs of anger and irritability instead of sadness. Unlike adults teens tend to spend more time with friends. Sometimes the only sign that indicate depression in teens is suicide or claims of wanting to die, which maybe then too late (Ellis-Christensen, 2003-2009).

Primary prevention for teen depression starts at home. Parents sometimes will have a hard time noticing signs of depression because teenagers have a tendency to have emotional ups and down. The best thing to do would be to talk and listen to the kids. Parents should be encouraging teens to be involved in activities and be involved in their activities. Most importantly parents should be role models. Risk factors for teen depression include alcoholic and abusive parents. Other primary preventions would include programs such as the Penn Resiliency Program and Coping with Stress courses. According to Gladstone and Beardslee (2009) these programs have been research and proven to be effective on teen with high risk factors for depression.
Secondary and tertiary prevention would involve hospitalization if the teen committed suicide, this would also involve medical and psychological therapy. The primary preventions mentioned above would be best initiated as well to prevent this from happening again.

If teens are showing signs of imminent suicide such as sadness and giving precious belongings call this hotline ASAP:
· 800-SUICIDE (784-2433) or 877-YOUTHLINE(968-8454)


References
Teen Depression (2005). Retrieved July 17, 2009, from http://www.teendepression.org/
Hinz, M. (2009). Depression epidemiology. Retrieved July 17, 2009, from http://www.neuroassist.com/depression-epidemiology.htm
Gladstone, T., Beardslee, W. (2009). The prevention of depression in children and adolescents: A review. Canadian Journal of Psychiatry. 54 (4), 212-220. Retrieved July 17, 2009 from EBSCO database GSU library.
Ellis-Christensen, T. (n.d.). How teenage depressions differ from adult depression? Retrieved July 17, 2009, from http://www.wisegeek.com/how-is-teenage-depression-different-from-adult-depression.htm
World Health Organization (n.d.). Depression. Retrieved July 17, 2009, from http://www.who.int/mental_health/management/depression/definition/en/

Note: This blog post reflects the work of Ed Roska 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.

What You Need to Know About the Pneumococcal Vaccine

By Heather Zelhart, RN

Too many times I have taken care of older patients who come into the hospital with a diagnosis of pneumonia who have not had a pneumoccoccal vaccine. If you have not had this vaccine, the following information may aid you in deciding if the pneumococcal vaccine will benefit you.

First, let’s start with a review of the pneumococcal disease. The disease is spread from person to person by droplets in the air. Many people carry the bacteria in their nose and throat without ever developing the disease. Symptoms of the disease can include an abrupt onset of fever, shaking, chills, or rigor, chest pain, cough, shortness of breath, rapid breathing and heart rate, and weakness. The fatality rate is 5-7 % and may be much higher in the elderly. Young children and the elderly (those of you 65 years of age and older) have the highest incidence of serious disease. Treatment for the pneumococcal disease is usually penicillin. However, resistance to penicillin and other antibiotics used to treat this disease has been on the rise. This increases the difficulty of treating this disease which makes PREVENTION THROUGH VACCINATION EVEN MORE IMPORTANT!

The vaccination currently recommended for the elderly and for high risk patients is called PPV, or the polysaccharide pneumococcal vaccine (that’s a mouthful!). The vaccine has been shown to provide approximately 60% protection against invasive disease in the elderly population. It is important to understand though PPV provides incomplete protection, especially in those with underlying high-risk conditions.

So, bottom line, if you are 65 years of age or older, and have not received the pneumococcal vaccine take charge of your health, and ASK YOUR PRIMARY HEALTH CARE PROVIDER ABOUT RECEIVING THE PPV TODAY! What do you have to lose?

References

Vila-Corcoles, A. (2007). Advances in Pneumococcal Vaccines: What are the
Advantages for the Elderly? Retrieved February 4, 2009, from
www.ncbi.nlm.nih.gov

Author unknown. (2007). Pneumococcal Vaccine Questions & Answers. Retrieved
February 4, 2009, from www.vaccineinformation.org

Notes: This blog post reflects the work of Heather Zelhart RN with minor editing by Shirley Comer RN and was completed as a class assignment. The icontent 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.

Colorectal Cancer Screening

By: DeAngela Newell RN

Colorectal cancer is the 3rd most common diagnosed cancer. As of 2005 colorectal cancer was diagnosed in approximately 150,000 people annually. Colorectal cancer occurs anywhere within the large intestines and usually develops from a polyp (abnormal growth). These abnormal cells will continue to grow and multiply. Death rate for colorectal cancer is 45% higher in African Americans than Caucasians related mostly to lack of screening and healthcare for this condition.

Signs and Symptoms of Colorectal Cancer:
· Changes in bowel movements (constipation/diarrhea)
· Stool that is long and thin “pencil like”
· Abdominal discomfort/bloating
· Unexplained fatigue/weight loss

Risk Factors:
· Increased age (over 50) increases with each decade of life.
· Occurs equally in both men and women. Women generally develop colon cancer while men are more prone to rectal cancer.
· Polyps-history of polyps
· Medical history: history of ulcerative colitis, crohn’s disease, uterine, ovarian and breast cancer
· High fat diet/ low fiber diet increases you risk.
· Lifestyle factors: smoking, not exercising and being overweight.

Prevention:
· Diet: high fiber diet including 5 servings of fruit/vegetables. Low fat diet
· Screening: Rectal exam yearly or per PHCP advise. Fecal occult blood testing and colonoscopy.

Treatment for colorectal cancer varies depending on your individual results and can be best managed and determined between you and your Primary Health Care Provider.

References

Mauk, K. (2006). Gerontological Nursing, Competencies for care: P. 382. Jones and Bartlett Publishers.
www.webmd.com
www.americancancersociety.com

Notes: This blog post reflects the work of DeAngela Newell 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.

Combating Coronary Artery Disease by Decreasing Cholesterol

By Lora Devine

Coronary artery disease (CAD) is a condition in which plaque builds up inside the coronary arteries. These arteries supply your heart muscle with oxygen-rich blood. This blood carries vital oxygen and nutrients needed by tissues and organs throughout the body. The heart itself is supplied with blood vessels called coronary arteries. When cholesterol levels rise above normal limits and stay high, some cholesterol is left behind in the arteries. In time, a hard waxy plaque builds in the arteries. This is called cholesterol reduces or blocks blood flow. Organs supplied by these arteries then become damaged because they cannot get the oxygen and nutrients they need. Sometimes bits of this hardened plaque breaks off and heads to the brain, this is called a Cerebrovascular Accident, also known as a stroke. When blood flow to the brain is blocked, a stroke occurs. When plaque completely blocks a coronary artery, a heart attack takes place. As we age our arteries can be more occluded from the foods we have eaten throughout our lifetime, putting the elderly at risk for heart attacks and stroke.
An important step in reducing the risk of having a heart attack or stoke is to manage cholesterol. A healthy lifestyle and being aware of risk factors can help you be proactive in your health management.

GET MOVING
Exercising is a great way to help you heart get a workout, as well decrease the odds of having a stroke. Exercising does not mean you have to run a marathon or have considerable speed or strength. Vigorous gardening, taking a walk with grandchildren, or exercising three to four time s a week. Staying moving for 30-40 minutes is beneficial to your heart health!

EAT RIGHT
Eating healthy can decrease your risk for stroke too. Think of the ”Fabulous Five” Fruits, Fiber, Folate, and Fish. Fruits, like apples and bananas. Fiber, found in vegetables and whole grains. Folate is found in spinach and broccoli. Fish, is high in Omega-3 Fatty acids like tuna and salmon help the heart. Decreasing sodium and saturated fats from your diet is a great start!

HAVE HOPE
Evaluate existing risk factors with HOPE! An easy way to remember some of the risks related to having a stroke is HOPE. Early evaluation of risk factors can help you and your healthcare provider make the necessary steps to monitor your health. Remembering to have HOPE can help evaluate if you are at risk for a heart attack or stroke. If you have one or more of the following risk factors contact your primary health care provider for further evaluation!

H -High blood pressure, High Cholesterol, High Blood Sugar, Heart Arrhythmias.
O -Obesity increases your risk of stroke and heart disease
P -Previous stroke or heart attack or family history
E -Engaging in drug use or heavy drinking


References

1. http://www.docguide.com/

2. http://www.healthline.com/

3. http://www.pennhealth.com/

Notes: This blog post reflects the work of Lora Devine 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.

Breath Right, Live Right; Smoking Cessation in the Elderly

By: Misty Fritz RN

Smoking cessation is a very personal experience. Approximately 13% of people age 65 and older smoke, which accounts for over 300,000 deaths per year. For you readers ages 65 and older it’s definitely time to take back your lives.

For the elderly population who think it’s too late, YOUR WRONG! Statics show that older adults who smoke have more success at quitting than younger smokers. Quitting now can greatly reduce your risk of myocardial infarctions, coronary heart disease, and lung cancer.

There are several treatment available such as: Nicotine gums or patches, prescribed medications, and counseling. There’s no one way that works for everyone. It takes will power and dedication from your end to succeed. So talk to your primary health care provider about different methods or treatments available and what might work best for you or your loved one.

So get up and get out with a plan. Take back your life, your taste buds, and ability to breathe and smell again. It won’t be easy, but if your up for the challenge make a plan, which can be your road map to success. What are you waiting for get ready, get support, and get started. GOOD LUCK!!!

References

Author unknown (2006) Smoking Cessation. Retreived Feb. 4th, 2009, from http://www.cms.hhh.gov.smoking/.

PubMed (2008) Predicators of Smoking Cessation Among Elderly. Retrieved feb. 4th, 2009, from www.ncbi.nih.gov./pubmed.

Notes: This blog post reflects the work of Misty Fritz 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.

A DASH to Stop Hypertension

By Krystle Banzuela

DASH stands for Dietary Approaches to Stop Hypertension. Hypertension is blood pressure greater than 140/90 mmHg. Studies have shown that following a DASH eating plan can prevent and control hypertension. It can lower the systolic blood pressure (SBP) 8-14 mmHg, lower weight and lower LDL or the bad cholesterol, which all together will reduce the risk of getting heart and renal diseases.
A DASH eating plan is low in saturated fat, cholesterol, and total fat. It emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products. It also includes whole grain products, fish, poultry, and nuts. It is reduced in lean red meat, sweets, added sugars, and sugar containing beverages. It is rich in potassium, magnesium and calcium, as well as protein and fiber. It contains less salt and sodium. 1500-2300 milligrams of sodium per day is recommended.
To make a DASH for life, start now and go slowly. Gradually increase the amount of fiber-rich foods you eat over several weeks to prevent bloating and diarrhea. Don’t stop taking prescribed blood pressure medications. Continue taking them and let your primary health care provider know that you are now eating the DASH way.

To learn and get more information, visit: http://www.nhlbi.nih.gov/hbp/prevent/h_eating/h_eating.htm.
To download the Guide to lowering blood pressure with DASH, visit: http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

References:

Mauk, K.L. (2006). Gerontological nursing: Competencies for care. Masachusetts: Jones and Bartlett Publishes.

National Heart, Lung, and Blood Institute. (n.d.). Your guide to lowering your blood pressure with DASH. Retrieved February 05, 2009, from http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

Smeltzer, S. C., Bare, B. G., Hinkle, J. L. & Cheever, K. H. (2008). Brunner & Suddarth’s textbook of medical-surgical nursing (11th ed., Vol. 2). Philadelphia: Lippincott Williams & Wilkins.

Notes: This blog post reflects the work of Krystle Banzuela RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The cont 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.

Healthy Living

Healthy Living as You Age

By: Zondra Davis, Rn.

An ounce of prevention is worth a pound of cure! Early detection and management of disease is worth its weight in gold! Effectively treating existing disease -PRICELESS! Individuals who have the privilege to enjoy a long, healthy life also have the responsibility LIVE WELL. The following steps are sure to add quality to your life.

Laugh often. If you feel a loss of pleasure and interest for 2 or more weeks, this is not normal aging. Ask your primary health care provider for a depression screening. You deserve to feel better.

Immunizations offer protection against influenza and pneumonia. Get your flu vaccine every year and the pneumonia vaccine once (repeat after five years if recommended by your primary health care provider).

Verify your medications and their side effects with each visit to your primary health care provider and keep an updated list with you.

Eat a balanced diet with daily exercise under the supervision of your primary health care provider. Regular exercise improves balance and strength, and is your best protection against falls.

Weigh-in with friends and family. Regular interaction within a positive social network improves well being.

Engage in diagnostic screening test to screen for cancer, hypertension, hearing, and vision problems. Talk to your primary health care provider about other screening test, early detection of disease improves treatment options.

Leisure that stimulates the mind provides recreation and has cognitive benefits. Puzzles, bingo, reading, writing, and nature walks are examples of activities that benefit well-being.

List important numbers and appointments, this helps you stay organized and keep important medical appointments. Live your best life!!!

References

1. Mauk, K.L. (2006). Gerontological nursing: Competencies for care. Masachusetts: Jones and Bartlett Publishes.

2. www.cdc.gov/ncipc/duip/spotlite/falls

3. www.cancer.gov/cancertopics/screening

4. www.cdc.gov/vaccines/

5. www.mentalhelp.net/

Notes: This blog post reflects the work of Zondra Davis 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.

By: Janella Schroeder RN

Natural Herbs and Vitamins Interact With Medications and Medical Conditions,
Elderly at Highest Risk

The concept of health promotion and primary disease prevention are growing trends in health care. With health awareness come more frequent doctor visits, more attention to lifestyle and diet choices and becoming more common is types of alternative medicine. Among the most common alternative medicine are natural herbal supplements and vitamins. The elderly have been quick to take part in this growing trend of “natural” medicine for varying reasons. Most are looking to supplement their diets and use herbs for health promotion and disease prevention. Unfortunately, some older adults turn to herbal supplements and vitamins due the high cost of prescription medication. Some are also looking for a more natural way to cure some aliment without going on another “medicine”.
It is extremely important to realize that herbal supplements and vitamins as natural as they may seem are still considered medication. The elderly are at higher risk for the side effect and drug interactions that herbal supplements and vitamins possess due to the increased multiple medications they are on and the decrease in kidney and liver function that comes with age. It is also vital that all consumers of herbal supplements and vitamins be aware that the evaluation of safeness and effectiveness of these substances is in the hands of the manufactures. The Food and Drug Administration (FDA) does not test the actual substances sold nor does it test the claims the manufactures of the supplements make.
There are many health benefits to supplements, but it is essential to discuss the supplement choice and dose with your doctor or pharmacist. Dosing can mean the difference between beneficial results and detrimental side effects and vitamin toxicity that are more common among elderly partakers. The some common supplements that can cause fatal vitamin toxicity in the elderly are vitamin D, vitamin A, and vitamin B6. So many herbal supplements and even plain vitamins can have detrimental interactions with prescription medications. One of the most common vitamin supplements taken is calcium which can interact with antibiotics, diuretics, thyroid medications and many more. It cannot be stressed enough that just because a medication is over the counter does not mean it does not come with side effects and potential interactions and your doctor still needs to know that you take it even though it is not a “medication”.
If your doctor is unwilling to work with you in finding the right supplements and vitamins to work for your symptoms and current medications, either find a doctor who will or visit a pharmacist. There are many great resources that offer nonbiased online information on all medications including vitamins and supplements. Most importantly the source discusses possible side effects and potential drug interactions.
Supplements and vitamins can have great benefits and most are considered safe however it is not safe to self-diagnosis and self-medicate, no matter what your age. Unfortunately with age comes more complications in taking these natural substances, so before you try them, please discuss them with a health care professional. Most importantly, consider every pill, cream, tea, or solution you ingest a medication and tell your doctor you are on it.


References

Drug Digest: http://www.drugdigest.org/wps/portal/ddigest

Beatty, E. (2007). Herbal Supplements and the Elderly. Retrieved 2 5, 2009, from Resources For Seniors: www.resourcesforseniors.com/pharm_essays/herbal%20supplements.doc

Mauk, K. (2006). Gerontological Nursing. Sudbury: Jones and Bartlett.

T. B. (2002). Vitamin toxicity. Retrieved 2 5, 2009, from Life Steps: http://www.lifesteps.com/gm/Atoz/ency/vitamin_toxicity.jsp

Notes: This blog post reflects the work of Janella Schroeder 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.