Depression and Women

By Tyonna Gilbert
Depression is a mood disorder that is very common in women. It affects your social life, your personal relationships, careers, and sense of self-worth. Most don’t get the help that they need due to the stigma that it carries. The symptoms of depression varies from person to person, the intensity of symptoms depends on how severe the depression is. Without proper treatment the symptoms can last from weeks, months, or years. Signs and symptoms of depression include:
~Feelings of guilt, hopelessness and worthlessness
~Suicidal thoughts or recurrent thoughts of death
~Sleep disturbances
~Loss of appetite
~Weight changes
~Lack of energy and fatigue
~Difficulty concentrating
Causes of depression in women are related to several factors such as biological, psychological, and social factors. Hormonal fluctuations during the menstrual cycle, pregnancy, and after childbirth can contribute to depression. Women often suffer from role strain which causes conflicting and overwhelming responsibilities in their lives. Sexual and physical abuse contributes to depression in women.
The first step in receiving treatment is to visit a doctor. Certain medications and some medical conditions can cause the same symptoms as depression. A physical examination, interview, and lab test can rule out these possibilities. Once the medical condition is rule out, the doctor can conduct a psychological evaluation or make a referral to a mental healthcare professional.
The most commonly used treatments for depression are psychotherapy and antidepressant medication, or a combination of the two. Which treatment is used depends on the nature and severity of the depression. Psychotherapy is supportive counseling which addresses the hopelessness of depression. Cognitive therapy focus on changing negative ways of thinking and behaving that contribute to depression. Interpersonal therapy helps deals with stressful relationships and how to manage them.
Medication doesn’t cure the depression; it helps you feel better by controlling the symptoms.
The medication used for depression is called antidepressants, which regulates the mood. The medication must be taken for at least three to four weeks before a therapeutic effect occurs. Medication needs to be taken even if you are feeling better, to prevent a relapse of depression.
You can maintain a normal life if you follow the treatment regimen that was prescribe to you by a mental healthcare provider.

www.psychologyinfo.com/depression/women.htm
www.helpguide.org/mental/depression_women.htm
www.nimh.nih.gov/health/publications/depression

Note: This material was created by Tyonna Gilbert RN with minor editing by Shirley Comer Rn. The content is indented as information only. Please consult your primary health care provider before beginning or changing your healthcare regimen.

When is Chubby no Longer Cute?

By: Janella Schroeder RN

Everyone loves a chubby baby…the chubbier they are, the cuter and more “healthy” they seem; but when does “chubby” become unhealthy? As cute as a chubby child may seem, it is a very startling fact that the number of children and adolescents that are considered overweight or obese has more than doubled in children aged 2-11 and tripled in adolescents ages 12-19 over the last 20 years (Center for Disease Control, 2009).

Today there is much concern over “labeling” children or causing self esteem issues, so many unhealthy weight problems dealing with children are left untouched by parents and schools. It is imperative to realize though that ignoring the problem in childhood can lead to a life full of health and emotional problems that can be detrimental. It has been shown that overweight children are almost twice as likely to be overweight as an adult and that overweight children can develop “adult” diseases like high blood pressure, diabetes, high cholesterol, sleep apnea and heart disease. The effects of being overweight are not only physical however, the emotional stress of being overweight in childhood can lead to depression, low self esteem, and can even hamper academic success (Center for Disease Control, 2009).

To put it plain and simple, being overweight is caused by an imbalance of calories eaten vs. calories burned through normal body function and everyday activity. The important issue to focus on though is what has changed in the last 20 years leading to this imbalance. There has become an overabundance of fast food and non-nutritional “junk” food consumed by children and adults alike. The increasing oversized portions served at restaurants and at home can be detrimental to a child’s weight and health. There is also a lack of physical activity both at home and school. There is an increasing lack of funding for physical education classes and sports and at home there is more time spent on sedentary activities such as TV, video games, and computer. One of the most damaging effects on a child’s weight is the lack of guidance and education on healthy lifestyle choices by both schools and parents.

So how can all this start to be reversed? The schools needs to start providing healthy and balanced lunch choices, daily physical activity for children and adolescents, and most importantly educate children on balanced eating, making healthy choices, and exercise. Some very useful information can be found at: http://www.mypyramid.gov/Kids/ and http://www.keepkidshealthy.com/welcome/TreatmentGuides/exercise.html. At home parents can start by including children in meal planning, shopping, and preparation, keeping healthy snacks in house in place of junk food, paying attention to portion sizes (not just the child’s, but theirs too…children learn by watching) and most of all encourage children to “Get up and play and hour a day” (Healthier US).

References:

Be A Player Get Up And Play An Hour A Day. (n.d.). Retrieved Feb. 22, 2010, from Healthier US: http://www.healthierus.gov/video.html

Childhood Overweight and Obesity. (2009, October). Retrieved Feb 22, 2010, from Centers for Disease Control and Prevention : http://www.cdc.gov/obesity/childhood/index.html

NOTE: This blog post reflects the work of Janella Schroeder, 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.

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.