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.
Monday, July 28, 2008
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.
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.)
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
- Retrieved July 21, 2008 from http://www.yourtotalhealth.village.com /html
- 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.
Monday, June 23, 2008
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.
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.
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.
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.
Tuesday, April 22, 2008
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.
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.
Subscribe to:
Posts (Atom)
Posts
