A blood test is the most commonly used test to help determine if one is infected with HIV virus (Felman, 2018). Most of the blood tests that are available cannot however detect HIV virus immediately it is contracted. This is because the virus takes time to grow once inside the body and so it can take up to six months before a positive result is detected (Felman, 2018). The best test to help an early detection of HIV virus is the antibody combination screening test, which can diagnose HIV in two to four weeks after exposure. The test checks for certain protein that s normally formed in response to HIV infection. Once an individual has been diagnosed with HIV virus, they are put on antiretroviral therapy (ART) (Felman, 2018). This is where one is given HIV medications to help lower the viral load by controlling the growth of the virus and also fighting infections. These medications cannot however cure HIV; they just simply help strengthen the immune systems of the people infected with HIV helping them live longer and healthier (Felman, 2018). They also lower the one’s chances of transmitting the HIV virus to other people.
Trichomoniasis is diagnosed through a pelvic exam and a urethra swab (Guy & Jewel, 2016). The vaginal discharge collected is evaluated under a microscope to confirm the presence of the parasite. Trichomoniasis greatly increases the risk of one acquiring or even spreading other STDs like HIV. Trichomoniasis is treated with antibiotics such as metronidazole or tinidazole which are all taken orally (Guy & Jewel, 2016). One can get re-infected again after getting treated if one continues to have sex with infected partners.
Herpes is normally diagnosed through a physical exam and laboratory tests including blood test and polymerase chain reaction (PCR) test (Boskey, 2019). These tests help to detect the presence of herpes simplex virus (HSV) antibodies either in the blood or in the DNA. There is no cure for Herpes, but its symptoms can be treated using antiviral medications like Zovirax and Valtrex (Boskey, 2019). These medications help the sores to heal much faster and help reduce the harshness of the recurring symptom outbreak. They also help to minimize the chances of herpes being transmitted to other people.
Human Papillomavirus (HPV) is diagnosed through the use of Pap test which produces abnormal results if one is infected (Gabbey et al., 2019). There is no cure or treatment for HPV virus, there are only treatments for the conditions that it causes which include, cancer and genital warts. There are vaccines that can be taken to help prevent one from getting HPV; the vaccines are given in multiple doses. Children who are aged between 9 and 14 receive two doses and anyone above 15 gets 3 doses (Gabbey et al., 2019).
Syphilis is normally diagnosed through a simple blood test and a physical examination to detect any sores on the body (Lori, 2017). Any person can be infected if they have directed contact with the sores of an infected person. The infection can be passed on from a mother to a baby during pregnancy and it is hence very important for pregnant women to get tested for the virus. Syphilis is normally treated through the use of antibiotics the most common one being Penicillin (Lori, 2017). If it is not treated, syphilis can spread to the rest of the body causing brain damage, loos of sight and hearing and also serious damage to the heart and other vital organs (Lori, 2017).
References
Boskey, E. (2019, May 04). An Overview of Herpes. Retrieved from
Marijuana legalization is the current debate in the political landscape and a topic in which controversialists are raising different viewpoints. The purpose of selecting this topic is to analyze this issue and understand why the topic has become a hot-button issue. Different authors have done their own research and found that there are two groups of people; those who are for the legalization of marijuana as a natural treatment and those who are against marijuana legalization as it is associated with negative health effects. Some authors have conducted proper research on the issue and the sources will present the powerful arguments, and help us understand whether marijuana is good for medical use and whether it is associated with physical and psychological harm.
Larkin (2018) assert that advocates argue that marijuana is not harmful but rather it is associated with medical benefits such as pain relief, increase appetite, treats sleep disturbances, among other benefits. Supporters argue that it is not possible for the criminal justice system to prohibit marijuana use in that and the attempt to implement measure will waste the scarce resources and cause a disproportionate effect. Note that individuals live in a free society where they have the freedom to live as they wish. Therefore, since society has legalized the consumption of alcohol and tobacco, it should also legalize marijuana (Larkin, 2018). On the other hand, defenders such as the Food and Drug Administration (FDA), medical organizations, and other agents argue that marijuana is associated with health effects and there is no valuable evidence for medical benefits. They argue that the legalization of marijuana will lead to a thriving black market (illegal sale). Note that if marijuana is legalized, it should have a well-organized marketplace that offers safe and high-quality products. However, the high taxes will hinder users from buying legal products and thus they will opt to buy the products from the black market (Larkin, 2018). The authors state that both the advocates and defenders' argument have not prevailed due to the current political debate that focuses on the lack of a standardized form of agriculture, and lack of evidence that supports marijuana (Larkin, 2018). However, despite these problems, some States have permitted marijuana, while others have decriminalized. The article concludes that this is a controversial issue that needs more inquiry and evaluates both recreational marijuana law and medicine law to understand the intersections.
Pascula & Smart (2017) assert that the federal law is against the use of marijuana but currently, there are marijuana policies that have been implemented by some States whereas others have decriminalized marijuana. This means that there are diverse policies across populations due to various factors such as budget constraints, preferences for risk, and more. The authors assert that the heterogeneous policies in different States have affected marijuana liberalization policies (Pacula & Smart, 2017). Therefore, the article recommends that future research should examine the policies variation and this will help understand the policy which has potential benefits and the policy which has potential harms.
According to Bull et al (2017) Marijuana prevalence is high in that some States have legalized marijuana for medicinal use. However, scientific reports show that marijuana affects adolescents' brain development and neurocognitive performance. The authors used a qualitative methodical approach and found that the attitude toward marijuana use among young adults has changed. Today, young adult believe that marijuana is not harmful and thus, the potential for consumption is high (Bull et al, 2017). It is easier to access marijuana since there are marijuana ‘edibles' which resemble sugary snacks. Other adolescents believe that marijuana use either through smoking or edibles is harmful and it is associated with addictive outcomes (Bull et al, 2017). The author recommends that the policymakers responsible for marijuana legalization or decriminalization should focus on the consumers' perceptions and attitudes. By having the right information, the policymakers and medical personnel will develop an effective decision-making strategy either to legalize marijuana or make it illegal.
According to Nikkine (2017), there are different arguments in marijuana debate in that some argue that legalization will bring more harm than good whereas other argue that legalization will increase public revenue in terms of income tax. Marijuana, and other products like alcohol, and practices like gambling are termed as ‘addiction surplus' which means that people are addicted to these behaviors and as a result, the behaviors general financial surpluses (Nikkine, 2017). The authors argue that since some States have legalized marijuana use, other States will find it difficult to prevent marijuana use. States which have not legalized marijuana will be guided by the premise that marijuana will generate revenue like gambling. However, the government should understand that the main purpose of legalization or decriminalization should be to maximize individual well-being (Nikkine, 2017). However, the idea of generating tax revenue will through excise taxation cause more harm than good since users will have the freedom to use other addictive products.
Caspar & Joukov (2018) adds that legalization of marijuana will bring additional dangers in that users especially adolescents will be at risk of developing schizophrenia. Schizophrenia is a brain disease and the condition is likely to worsen if the patient is using marijuana. Therefore, marijuana regulation will decrease the emergence of the condition (Caspar & Joukov, 2018). The authors recommend that the federal government should restrict adolescents who have schizophrenia and those who have not developed the condition from using marijuana. When making legalization policies, it is important to consider marijuana effects on schizophrenia and put age limits to reduce the risk factors.
Conclusion
The debate on marijuana legalization has evolved rapidly. Supporters argue that legalizing marijuana will reduce harm, generate revenue, promote consumer safety, and bring medical benefits. However, defenders argue that marijuana is associated with dangers and risks, and there is no evidence that marijuana is good for medical purposes. However, to address the issue, the policymakers should understand the users' perception and awareness will enable the policymakers to create an education program to educate the users and help them make informed decisions.
References
Larkin Jr, P. J. (2018). Introduction to a Debate: Marijuana: Legalize, Decriminalize, or Leave
the Status Quo in Place. Berkeley J. Crim. L., 23, 73.
Pacula, R. L., & Smart, R. (2017). Medical marijuana and marijuana legalization. Annual review
of clinical psychology, 13, 397-419.
Nikkinen, J. (2017). The legalization of dangerous consumption: a comparison of cannabis and
gambling policies in three US states. Addiction Research & Theory, 25(6), 476–484.
https://doi.org/10.1080/16066359.2017.1366455
Bull, K., Lang, D., Mariani, A., & Griffiths, M. A. (2017). Marijuana Edibles: Exploring the
Impact of Decriminalization and Legalization of Marijuana on Young Consumers’
Consumption. Society for Marketing Advances Proceedings, 246–247. Retrieved
from http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=128442279&site=ehost-live
Caspar, S. M., & Joukov, A. M. (2018). The Implications of Marijuana Legalization on the
Prevalence and Severity of Schizophrenia. Health Matrix: Journal of Law-Medicine, 28,
175–200. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=129525671&site=ehost-live
Overweight and obese are a matter of concern since they cause chronic diseases to both children and adult. Recent research and studies have confirmed that social and environmental factors contribute to overweight and obesity Physical activities can promote good health and help one lose weight but it is also important to focus on a healthy diet such as fruits and vegetable, whole grains, among other healthy diete. The research paper finds that the reason as to why overweight and obesity are public health threats is that westernization and urbanization have brought lifestyle changes. Today, people have shifted from healthy diets to unhealthy diets or in other words, people like consuming food high in fat and sugar. They have reduced the consumption of traditional diets such as food high in carbohydrates and fiber. As a result, an unhealthy diet has increased the rate of obesity and has also increased the prevalence of diabetes, high blood pressure, coronary heart diseases, gall bladder disease, cancer, among other diseases. It is also important to understand that the direct and indirect health costs for obesity account for a higher percentage. Direct health costs occur from diseases such as cardiovascular diseases and indirect healthy cost occur from premature mortality, workdays lost, among other factors. Recent research and studies have found that people who are overweight and obese can manage weight through various methods but the recommended methods are physical activity and a low-calorie diet. The main point is that the overweight population need lifestyle modification and this research paper focus on losing weight through dieting. Lifestyle modifications which entail the consumption of healthy food are effective in helping overweight and obese individuals achieve weight loss.
There is a higher risk in obesity prevalence in the world's population though the prevalence varies within countries. For example, U.S prevalence increased from 12% to 20% over the past 30 years. In the UK, the prevalence increased from 7% to 16% in a span of 15 years (Swinbur et al, 2004). Other countries like Asia, China, New Zealand, and the Netherlands have also experienced the obesity epidemic over time in different patterns. An important point to note is that obesity is common in both high and low-income countries. In developing countries, people who have a higher social-economic status have higher cases of obesity. In high-income countries, people whose social-economic status is lower have higher cases of obesity (Swinbur et al, 2004). In both countries, middle-aged women have higher cases of obesity compared to men. Carlisle & Hanlon (2014) add that the level of obesity in the UK is very high and in response to this issue, the UK governments have developed interventions that would help individuals, and the entire population. However, the big challenge is that there is a lack of scientific knowledge toward behavior change and healthy weight maintenance. The authors assert that the issue of obesity needs a multi-disciplinary approach so that there can be positive changes.
Nutrition plays a critical role in the human body by supporting good health. Note that good health and fitness will not only be attained from engaging in physical activity but individuals should consume a healthy diet rich in nutrients. Ismail et al (2018) assert that overweight obesity is caused by an energy imbalance. In other words, the intake of high-fat food and failure to engage in physical activity cause this adverse condition. Unless individuals achieve weight loss through physical activity and a healthy diet, they will continue to suffer from obesity-related morbidities such as cardiovascular diseases. Ismael at el (2018) conducted qualitative research and participants were individuals whose BMI was 8 kg/m2 and above. A formal group discussion was used and participants presented their perception of weight loss using dieting method. The result showed that the majority of the participants dieting contributed to overweight and obesity. They testified that they engaged in physical exercise like cycling but they did not reduce weight. The reason as to why they did not achieve their goals is because they had misconceptions of dieting to reduce weight as majority thought that weight is cut through skipping meals, reducing food intake, among other methods (Ismail et al, 2018). This report shows that a high number of overweight population is trying to lose weight but their attempt leads to overweight and obesity since they do not have the right strategies for weight reduction. However, the research shows that dietary strategies are associated with weight loss but the right intervention should entail the provision of weight loss strategies so that the overweight population can achieve positive outcomes (Ismail et al, 2018). Note that individuals have a misunderstanding on the dieting and for this reason, there should be an intervention program that will bring long-term change and help the individuals gain the appropriate concepts.
Lee et al (2014) assert that dairy products such as calcium reduce the risk of obesity. The authors used qualitative research to gain knowledge related to health behaviors of the Korean population and after an extensive interview with the participants, the results showed that participants who consumed dairy products such as milk and yogurt reduced the risk of obesity. The article concludes that the consumption of low-fat milk may prevent people from being overweight whereas high-fat milk increases the chances of being overweight. Thus, it is advisable to consume dairy products in a small amount in order to achieve positive results. Bleich & Wolfson (2015) also reviews the weight loss strategies used by individuals to lose weight and assert that since the federal movement mandates the food industry to provide labeling on the packaged foods, the consumer now uses the nutrition labels to make food choices. They believe that food with nutrition labels are healthier and when making food choices, they have different buying behaviors since some consumer purchase food with high calories whereas others purchase food with fewer calories (Bleich & Wolfson, 2015). This means that individuals who are working on their weight are guided by food labels and this strategy may bring negative results in that adults are influenced by the commercial programs to consume packaged food and thus they lack self-directed efforts. Focusing on intervention, Bleich & Wolfson (2015) propose that there should be an educational program that should focus on obesity. Individuals especially those who have a higher risk of being obese should learn more about the food nutritional information so that consumers can make healthy choices while making the purchase. Note that not all consumers understand the information in the packaged food especially the calorie information and this means that they may end up adding weight rather than losing weight.
Pinho et al (2013) provides intervention for obesity and assert that obesity is an epidemic and a serious issue that affect the public health. To prevent and treat overweight and obese patients, the primary care staffs should be at the forefront. For them to effectively offer quality primary care, they should have adequate knowledge and ability. Note that their primary role is to provide the obese children and adults with guidance and assistance so that they lead a healthy lifestyle. They should provide them with dietary counseling but they cannot be in a position to do so unless they receive appropriate training, use effective tools, work in an organized system, and work together with qualified dieticians (Pinho et al, 2013). Thus, the authors recommend that in order to help patients manage and prevent obesity, the primary care practitioners should not only evaluate obesity but they also train patients on how to live a healthier life. It is also important to understand that primary care practitioners need tools to assess obesity and overweight but the tools are scarce. However, the care providers should adhere to the available studies and training programs so that they can gain knowledge of nutritional counseling. Aboueid, Bourgeault & Giroux (2018) also put an emphasis on the role of primary care practitioners. The authors assert that patients who are overweight and obese need primary care. Thus, primary care practitioners should provide multicomponent interventions or rather interventions related to diet and exercise. There should be individualized medical nutrition so that patients can receive nutritional counseling and knowledge on how to manage weight (Aboueid, Bourgeault & Giroux, 2018). However, many patients do not receive nutritional counseling due to a shortage of registered dietitians. To address this issue, there should be multidisciplinary clinics so that health care practitioners such as dietitians may provide special health care to patients with chronic diseases. The multidisciplinary initiates such as the Family Health Teams and Community Health Centers should work toward a common goal of providing nutritional care.
Grondhuis & Aman (2014) also supports the individualized medical nutrition by asserting that in order to help overweight and obese adults and children reduce weight, they should be assessed individually. If an individual would not engage in the program on his or her own, the caregiver should act as the role model and help the patients reduce weight. The care provider should help the patients on behavior modification and dietary adjustment as a result, the patents will work hard to accomplish the goals. Carlisle & Hanlon, (2014) adds that elevated weight contributes to morbidity and mortality. In addition, elevated weight reduce life expectancy and bring health problems to both adults and children. Obesity can cause illnesses such as asthma, sleep apnoea, orthopedic complications, fatty liver disease, hypertension, coronary heart disease, type 2 diabetes, among other illnesses. Therefore, apart from the above intervention options, other options include pharmacotherapy which can be used to patients with severe health complications.
Another important thing to note concerning weight loss is that the aging process is affected by various factors such as poor nutrition. For example, during aging, the aging cells require cell replacement and the lost cells can be replaced by adequate nutrition that is; vitamins and minerals (Chernoff, 2016). A healthy diet is made of nutrient-rich foods, vegetables, plenty of fluid, and fruits. Thus, it is important to consume essential nutrients in order to stay free from acute and chronic illnesses. Klinkmann & Vienken (2008) introduced the concept of ‘health is wealth' and ‘wealth is health' and asserts that current demographic analysis has reported an increase in life expectancy in the world. The world is also experiencing a healthy economy in that the GDPs is high and the population of the elderly generation is high. The reason as to why life expectancy has increased is the improvement in hygiene and nutrition. Thus, to maintain these options, there should be an improvement of the public programs to maintain the good health status of the working and elderly population.
Conclusion
Today, people have shifted to unhealthy personal behaviors which have contributed to overweight and obesity. Overweight and obesity have affected both developing and developed nations and thus it has become a global epidemic. Almost all nations are experiencing the risk of co-morbidities such as insulin resistance, hypertension, coronary heart disease, among other chronic diseases. The paper has conducted research on how lifestyle modification can reduce overweight and obese and it has found that there are various lifestyle modification method and one them is nutrition. Various authors have recommended that people should make healthy choices such as consumption of fruits and vegetables to reduce the risk of cardiovascular diseases and other illnesses. In addition, authors have proposed that the government should protect the public by ensuring that the primary care practitioners have adequate training on healthy nutrition so that they can have the ability to help the patients change behaviors and live a better life.
References
Ismail, T. A. T., Jalil, R. A., Wan Rosli Wan Ishak, N. F. H., Nik, W. S. W., Mohamed, H. J. J., Mohd, N.
H., ... & Hassim, T. F. T. (2018). Understanding Dieting and Previous Weight Loss Attempts
among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at
Work Program. Korean journal of family medicine, 39(1), 15.
Swinburn, B. A., Caterson, I., Seidell, J. C., & James, W. P. T. (2004). Diet, nutrition and the prevention of
excess weight gain and obesity. Public health nutrition, 7(1a), 123-146.
Lee, H.-J., Cho, J., Lee, H.-S. H., Kim, C., & Cho, E. (2014). Intakes of Dairy Products and Calcium and
Obesity in Korean Adults: Korean National Health and Nutrition Examination Surveys (KNHANES)
Sobriety is the state of being sober from any drug of choice. A patient’s journey to sobriety is not an easy one. Overcoming addiction can be hard but it all comes down to one’s ability to stay sober and maintain the recovery. Being sober do not simply mean saying no to the drug of choice but also changing and reevaluating a lot of things in one’s life. Things would be much easier if there was an easy way to maintain recovery and handle the difficulties arising along the way even after completing treatment but there is no easy way. Often with the help of treatment such as therapy patients are taken through the process of being sober and how to maintain that sobriety.
Boredom has been termed as one of the sobriety killers, therefore, one way of maintaining sobriety is by finding something productive to occupy oneself with in order to occupy the previous time that was used while abusing the substance that led to addiction. When a person who is struggling to remain sober finds themselves in a bored and in an inactive situation, they can start to reminisce on the past days while they had “fun” when using the substance, they are trying to stay away from. This would potentially make them reconsider reusing the which would lead to a relapse (Laudet, Savage, & Mahmood, 2002). In order to kill the boredom, it is advisable for one to pick a new hobby.
In addition to the formal or informal treatment such as the 12-step groups some psychological factors are important in helping a patient maintain sobriety. Several forms of motivation that stand out among cognitive variables have also produced good results and enabled patients to stay sober and example is if the persistence use of the substance will result to the patient losing a friend or a family member then the patient is likely to remain sober in order to keep their dear ones. The support of friends and family also helps in maintain sobriety (Laudet, Savage, & Mahmood, 2002). Recovery from addiction is a lifelong process.
The road to recovery does not always end with rehab treatment. After leaving rehab people are faced by the excitement of living a substance free life and the constant fear or relapsing back. Life after rehab can be hard and the constant support of peer counselors is very much needed, the follow up programs that are initiated after one leaves rehab help one to maintain sobriety after going back to their normal lives (Laudet, Savage, & Mahmood, 2002). Effective intervention is a way that is used to maintain sobriety too. Intervention are planned meeting that are directed towards someone with an addiction in order to enable change as they undergo recovery or maintain sobriety. Effective intervention meeting involves people that are important to the person so that they can be able to discuss the impact of addiction to the targeted person in a way that is direct and non-judgmental. Mostly, interventions involve a lot of planning and fore thoughts since the topic on addiction is sensitive and easily provokes the emotion of the targeted person (Abuse, S., US, M. H. S. A., & Office of the Surgeon General US, 2016).
Follow up support plays an important role in helping one maintain sobriety while on the road to recovery. Rehab can be termed as the beginning of recovery and to maintain sobriety it is important for a person to not only go through rehab but also to have people who will offer support to them after leaving rehab. It is much easier for addicts who receive help from friends and family to adjust to life away from rehab. Follow ups by one’s loved ones can be done by accepting them without judgment, creating a substance free environment for them in order to avoid substances that would lead to relapse. Actively listening to the concerns voiced by them and encouraging them to join a support group where they can share their experiences and listen to how other people are progressing on their road to recovery (Pagano, Zeltner, Jaber, Post, Zywiak, & Stout, 2009).
In order to improve addiction treatment in the future it is recommendable to increase the span of treatment which today it is virtually all short term while the disease of addiction has remained to be a lifelong threat since the chances of relapsing even after maintain sobriety for a long time are still very high (Robert, 2016). The future of addiction treatment depends on the adaptation of long-term recovery treatments that will give medical participants a chance to evaluate and asses the effectiveness of the addiction treatments being used.
Conclusion
The road to recovery is lifelong. For one to maintain sobriety it is important for them to avoid boredom which would likely lead to them reminiscing about the past days while they had fun abusing the substance and this would only lead to a relapse. Rehab treatment is the begin of the road to recovery and it is necessary that any addict willing to recover from any substance abuse to first start with rehab. Follow up support is very vital after one leaves rehab. Mostly, follow up support is offered by family and friend. Effective interventions are also necessary when it comes to maintain sobriety. The future of addiction treatment lies on the use of long-term addiction treatment.
References
Abuse, S., US, M. H. S. A., & Office of the Surgeon General (US. (2016). Early Intervention, Treatment, and Management of Substance Use Disorders.
Laudet, A. B., Savage, R., & Mahmood, D. (2002). Pathways to long-term recovery: A preliminary investigation. Journal of Psychoactive Drugs, 34(3), 305-311.
Pagano, M. E., Zeltner, B. B., Jaber, J., Post, S. G., Zywiak, W. H., & Stout, R. L. (2009). Helping others and long-term sobriety: Who should I help to stay sober? Alcoholism Treatment Quarterly, 27(1), 38-50.
Acute care nursing is a type of nursing service that is administered to patient actively for a short period. It involves short term treatment of life-threatening injuries, routine health problems, illness, acute exacerbation of chronic diseases, and recovery from surgery. The main aim of acute care nursing is to improve and restore the health of the patient, and it is practiced in various areas including emergency care, trauma care, critical care, acute psychiatric care, acute care surgery, and rehabilitative care. The setting in which the care is provided is closely associated with the possibility of patient declining without warning. Therefore, the role of a nurse is to provide rapid intervention to injuries, and illnesses that are time-sensitive to prevent death or disability that may result and thus restore the health of the patient to the optimal, and better health status.
This paper will describe a case scenario of a patient who is admitted to the emergency care room and then identify two core acute care nursing concepts from it. It will describe the fluid loss and subsequent fluid replacement under ‘F,’ meaning fluid and management of wound under ‘E,’ representing exposure both in the A-G algorithm. The paper introduces the case scenario and describes the previous management of the workplace system.
In addition, the paper also describes the strength and weaknesses of the nursing interventions that are carried out by the nurses while comparing with the best practice guidelines in place with a critique of nursing care against the evidence-based practice.
Case scenario
A 45-year-old male client working in a chemical laboratory was brought to the health facility by an ambulance with a history of chemical spillage (Trifluoroacetic acid) while working. On assessment, the Total Body Surface Area (TBSA) was at 45% and a degree of burns between 2nd and 3rd degree. The regions of the body affected include; anterior upper both limbs, anterior trunk, and anterior both lower limb. The patient has a medical history of type-I diabetes mellitus, which has lasted for the past 30 years and well-controlled until three months ago. The client also has a history of hypertension and GABG surgery done six years ago.
On triage examination, there is a facial grimace, and the patient reports severe pain on the chest, abdomen, and anterior upper and lower limbs which he rates 10, in the scale of 0-10 with 0 being no pain and 10 being the worst pain he had ever experienced n his life. The patient also looked nervous during the process. The patient vital signs were taken and found to have a blood pressure 90/50mmHg, heart rate of 120 beats per minutes, the temperature of 39.6°C, respiratory rate of 25breaths/minute and oxygen saturation of 93%. The vitals, therefore, showed the presence of tachycardia, hypovolemia due to fluid loss, hyperthermia, tachypnea, and low oxygen saturation. The initial laboratory investigations, including baseline, HB, hematocrit, electrolytes, blood glucose, and urine analysis, were done.
During the examination, the A-G algorithm had also been checked according to the policies of the hospital, and therefore, oxygen 6ml was administered by a mask to improve on the oxygen saturation level. There were no signs of paralysis or weakness noted in the patient. All the patient clothes that were contaminated by chemical were removed and the area flooded with cold and running water for 20 minutes. The patient was also put on intravenous (IV) fluid (Ringer's lactate solution) to restore the fluid volume deficit based on the Modified Parklands resuscitation protocol for adults. The glucose levels for the patients were also checked and found to be 300mmol/l. The pain was effectively managed with Morphine IV 15ml and 50 mg IV ketamine.
In addition, after the initial management in the emergency department, the patient was attended by a surgeon to examine the wounds according to the policies of the hospital, and later the wound was closed with a biosynthetic dressing. The patient was then taken to the burns unit in the hospital after dressing care, insertion of a urinary catheter, and a central venous line for close monitoring.
The case scenario is complicated due to the multiple health conditions affecting the client and also the complex care needs that the client requires. The patient suffered from disease co-morbidities due to the loss of the fluids and presence of the burns, which thus had a significant impact on his health. Additionally, the patient also sufferers from diabetes mellitus, which have a high effect on the wound healing process, thus making the condition to be considered as complex. Presence of hypervolemia affects the levels of ketones in the body, predisposing the patient to diabetic ketoacidosis. The wounds will thus heal slowly and poorly and might also be infected.
Concepts
Fluid loss
Fluid balance is one of the critical aspects that need to be maintained to maintain the homeostasis of an organism, and it is controlled through behavioral and osmoregulation. Individuals with severe burns widely experience fluid volume deficit due to fluid loss, and thus, it is one of the most crucial factors to note during the admission of the burns patients. Presence of extensive burns results in fluid extravasation and hypovolemia, and thus, there is a need for fluid replacement within the first 1-2 days after the burns incident. Fluid resuscitation has been considered as one of the essential factors in the management of burns. This is because it restores the amount of fluid loss and aid in the prevention of dehydration.
However, controversies are present on the type of fluid to be used for fluid management within the first 24 hours following the burns injury. The amount of fluids to be administered to the patients of burns depends on the TBSA, which, according to the case scenario, the rule of nine was used in determining the surface area of the injuries. However, according to last et al. (2015), the most accurate method to use in calculating the total body burn is Schema for estimation of body surface area in adults because it is more specific and provides the exact amount of fluid that the client needs.
Furthermore, burns injuries which are less than 15% are not associated with a significant shift in body fluids and thus, the client can be resuscitated with oral fluids except burn injuries that occur in the face, the genitalia, children, the elderly and the hands. In the cases of burns with the surface area of more than 20%, the route of choice for rehydration is intravascular, and in the cases where the peripheral intravenous access cannot be found, central venous catheterization must be done and used to deliver the fluids.
The “Modified Parkland” formula is the most commonly applied formula in calculation of the number of fluids required in the resuscitation of the patient. The formula calculates the amount of fluid based on the percentage of the injury. In the case scenario of the patient described above, the amount of fluid was calculated based on the formula;
Total ml = 4ml* weight in kg* % TBSA
After the administration of the fluid calculated above for the first eight hours following the burn injury, the fluid is reduced to half the total calculated fluid needed for the best clinical practice based on the Agency for clinical Innovation 2014. The fluid administered to the client in the case scenario is Ringer's lactate. However, according to Bedi et al. (2019, it is not the best fluid to be used in maintenance due to its low levels of sodium and potassium, 130 mEq/L and 4 mEq/L respectively. This is due to the daily body electrolytes requirements. Ringers lactate also does not have any glucose content in it, which would have provided the body with calories. Therefore, normal daily saline needs to be added to the daily maintenance dose with ringers lactate to act as a replacement for the evaporative losses that result after burns. In the case above, it is clear that the intervention that was made had a weakness in restoring the level of the electrolyte of the client and also to aid in the provision of enough calories.
The use of opioid medication should be under close consideration, for example, in the case of morphine and ketamine drugs, because of the effect on the cardiovascular system. Opioids are associated with decreasing the blood pressure of an individual. The comparison emphasized that the fluid requirements in the patient should be correlated with the opioid dosage and therefore, the fluid creep was as a result of an increase in the usage of narcotics in the initial management of burns.
The shift in the fluid after burn injury is mainly considered to be rapid during the first 24-72 hours, and thus, determination of serum electrolytes, hematocrit, osmolality, glucose, calcium, and albumin are important in adding in determination of the suitable method for fluid restoration. The ratios for the fluid intake and output are taken hourly as a method of tracking the individual fluid requirements. Urine output is the most significant indicator, and it is done every hour.
Also, patients with significant burn injuries should be carefully and monitored with continuous electrocardiography, frequent vital signs recording and monitoring for positive patient outcome. In addition, acute renal failure has been found previously with severe burn injuries. Its first form is claimed to occur within the first few hours after the injury, and it has been related closely to low fluid volume with low cardiac output and systematic constriction of veins occurring during resuscitation. Fortunately, this form of acute renal failure has become less prevalent due to the presence of well controlled fluid resuscitation that is done during the initial phase of the management of burns.
Wound management
Burns injuries are common in Australia and New Zealand, and it affects at least one person in 100 people. The injuries from heat, electricity, chemicals, radiation, and also from cold result to the development of wounds. Burns are usually classified by depth into partial thickness, superficial, and full-thickness burns (all of the dermis is destroyed, it may also extend to include the subcutaneous, neuromuscular, muscular or skeletal structures).
According to the agency for clinical innovation, the burn area is flooded with cool running water and not cold unless there are contraindications such as significantly extensive burns, hypothermia, and presence of multiple traumas. This is the hospital policy concerning the best clinical practice for the management of burns wound. Cold water is associated with increased tissues damage and increasing the severity of hypothermia. However, it contributes to the reduction of pain and also edema of the wound
The ideal wound dressing will provide the perfect microenvironment to facilitate the healing process of the injuries. Wound healing process occurs well in an environment that maintains the temperature of the wound its moisture level, allows for respiration, permits epithelial migration, and prevents the entry of bacteria into the wound. The rate of healing of the wounds depends on the layers of the skin that were damaged from the injury; superficial burns heal faster than those involving the deeper layers of the skin.
In addition, biosynthetic dressing in comparison with silver sulfadiazine cream may be more effective in speeding the healing process of the partial-thickness burns. The frequency for changing the burn wound dressings have to be regular for most of the dressings done. In addition to dressing, the deep wounds are cleansed, and debridement is done as standard care before it is then covered. After that, the wound dressing is done daily together with pain management to prevent unnecessary discomfort that that can be felt by the client during the routine care delivery, this is usually done for patients who have 1st and 2nd-degree burns.
The type of dressing that was used for the patient in the case scenario is biosynthetic and contained the biosynthetic contents, Eiratex®, which contains biosynthetic cellulose (BC) having same structure like the collagen. Studies concerning its use for drug delivery, biomedical purposes, wound healing, and tissue engineering, and it is not the ideal one due to the fact that exudate and other fluids draining from the wound can be trapped in the interspace that lies between the burn wound and the membrane. The materials stuck in the interspace might cause infection of the wounds and thus slow the process of healing, especially for the patient because of the diabetes mellitus. Wound examination was done every day by nurses on duty and every two days by attending doctor until the wounds were healed entirely. Proper wound dressing type is vital and depends on the nature of the injury such as the size, depth, frequency of dressing, and status of the wound bed.
According to Jull et al. (2015), there is evidence suggesting that honey dressing contributes to the healing of the partial thickness burns faster than the conventional dressing. It is good to note that burn wound undergo various changes especially in the first 48 hours and for this reason, there is a need for the caregivers in the health care team to performs wound assessment before making the necessary decision on the type of dressing method to choose or the need for surgery.
Conclusion
In conclusion, injuries resulting from burns are usually severe, and therefore, there is a need for more effective interventions to improve the healing process and prevention complication that results from poor management. Burns have been closely associated with a fluid volume deficit, and this means that the amount of fluid in the body is significantly reduced and therefore, there will also be a reduction in the cardiac output which might then result to hypotension and more complications. Thus there is a need for close monitoring to prevent developments of complications. Individuals who have significant burns injuries with delays in fluid resuscitation should also be investigated for the possibility of acute renal failure.
In addition, fluid resuscitation is essential. However, the amount of fluid infusion should be calculated using the most accurate formula depending on the policies of the hospital frequently; this means that before a patient is infused with any intravenous fluid, it should be calculated to avoid the issues of fluid overload through an infusion. It will also help in monitoring the functionality of the kidneys.
Furthermore, the wound resulting from burns injury needs to be adequately managed to enhance the healing process. The practice of ideal dressing depending on the nature of the burns wound is necessary because it means, the wound will achieve the essential environment that promotes the healing process such as the absence of environmental bacteria, maintained wound temperature and moisture. There is also a need to access the wound frequently because this will aid in making decisions on the intervention that can be made to hasten the healing process.
However, there is a need for more research to be done on the existing methods and also to come up with better ways to improve the current interventions in order to improve the quality of care delivered to the clients, for example, ways to reduce wound infection resulting from dressing methods.
Health promotion is the act of enabling individuals to improve and have more control over their health. The united states have a diverse group of individuals from various ethnicity and races. About 36% of the population belongs to the ethnic and racial minority group based on the census done in 2010. All the races and the ethnic group have different health concerns, and this can be due to the diversity that exists in genetics, access to health care, cultural factors, and environmental factors. However, infant mortality has significantly improved, and most Americans live a healthier life with a longer lifespan. This paper will be based on African American’s health status.
Describe the Ethnic Minority Group Selected and their Current Health Status of this Group. How do Race and Ethnicity Influence Health for This Group
African American is one of the largest ethnic minority group that accounts for about 12.7% of the total population in the United States. Analysis that was done recently has indicated that most of the health conditions that African Americans have or die of are those that are found in the older white Americans. The differences in the conditions or the deaths that are experienced by African Americans are seen between the ages of 20-40 years. There are some of the terms that were found to be higher in black Americans than the whites, for example, cancers, asthma, pneumonia, heart conditions, and influenza.
However, most of the individuals in the ethnic group report inability to afford the health services and therefore, they are unable to go for screening services which then results in too late diagnoses of health problems and delayed treatment of the conditions. For this ethnic group, there is a high possibility to find individuals with serious health complications and thus more suffering resulting from disease comorbidities, this might also result in death. There is also a close association to retain between the African American and low levels of participation in health promotions for example dieting and exercising; this contributes significantly to the generally reduced levels of health among individuals in the ethnic group as compared to the whites.
The Health Disparities That Exist for African Americans and the Nutritional Challenges for This Group
According to Healthy People 2020, health disparities are defined as a health difference that has a close association with economic, social, and environmental disadvantages. Individuals who have challenges in accessing better health care needs based on their ethnic group, age, gender, socio-economic status, religion, mental health; sensory, cognitive or physical disabilities are adversely affected by health disparities. Geographic location and other factors that contribute to exclusion. In 2015, the private insurance coverage for the African American was at 54.4% as compared with the whites at 75.8%. On the other hand, 43.6% of the blacks and 32.7% of the whites relied on Medicaid. However, 11.0% of the blacks were uninsured compared to 6.3 among the whites
African Americans have cultural, economic, political, racial struggles, and despite all this, they can maintain a strong sense of their culture, shown by their kind of food. The typical diet that is commonly consumed by African Americans is meat, yams, potatoes, and rice. The main nutritional challenges among this ethnic group are the high consumption of vegetables than meat and thus low levels of proteins.
The Barriers to Health for This Group Resulting From Culture, Socioeconomic, Education, and Sociopolitical Factors.
Barriers to health have a significant impact on the well-being and the health of African Americans. Unhealthy behaviors and lifestyle such as cigarettes smoking, inadequate exercising, and obesity have been closely associated with this ethnic group due to the low social, economic status. It is not common among those in high socio-economic status. The African American has a low level of education, and they have poor knowledge of susceptibility to diseases and the impact it has on their lives. They also have inadequate disease preventive measures as well as adherence to treatments. Individuals in this ethnic group have a high rate of unemployment and low-income status, which then limits them to have better access to health care services because of the high cost of health services. Other barriers affecting this ethnic group is poor access to healthy diet and discrimination from the social support systems and some of the health care staff.
Health Promotion Activities That are Often Practiced by African Americans
The most common health promotional activities that are practiced by this group are walking, biking, swimming, and change of diets. Improvements in the quality of life are always necessary to promote individual well-being, and due to this, African Americans have conducted educational services to support the need for healthy and safe habits, for example, eating, and avoidance of smoking and regular exercising. Routine vaccination is also being carried out to reduce the cases of infectious diseases. The changes are significantly thought to be due to social developments programs and participation of the African Americans in policy making as well as an economic investment in education.
One Approach Using the Three Levels of Health Promotion Prevention (primary, secondary, and tertiary) That is Likely to be the Most Effective in a Care Plan Given the Unique Needs of African Americans and why it Might be the Most Effective Choice.
For this minority group, the most critical health promotion prevention is tertiary prevention because of its ability to maintain the disease process. The most effective way to reduce the health issues among this group is to have regular doctor visits, proper diet, adherence to treatment, exercise, education on health issues and their health status, availability of sound support system and involvement in the decision making. People in the ethnic group can be involved in annual physical activities, which are well organized and must include other services such as monitoring for blood pressure. Those who get diagnosed with hypertension are closely monitored in collaboration with health home care team to initiate lifestyle changes such as a reduction in consumption of sodium and checking of weight together with the use of medication to ensure that it is in control. By doing this, it can reduce the risk significantly for getting strokes.
Cultural Beliefs or Practices Must be Considered When Creating a Care Plan and Cultural Theory, or Model Would be Best to Support Culturally Competent Health Promotion for This Population
A care plan needs to be culturally sensitive as well as addressing the needs of the people from the ethnic group. Individuals from the African American ethnic group’s values family and therefore, the care that is provided by the health care team should involve the family members of the client to improve on the patient outcome. Family-centered care is critical when caring for people from African American ethnicity. The family-centered care is a theory which sometimes is referred to as patient-family-centered care, and it involves a partnership between the health care team and the family of the client. The family provides support to the client, and they are also involved in the decision making of the client when the need is necessary where the client cannot be able to make informed decisions. Other roles of the family members are to provide care during the illness an also aid in teachings concerning self-care and wellness behaviors. They also play a crucial role in health-promoting activities including ensuring the clients adhere to medication or treatments that are recommended by the health care team
References
Healthy People 2020. (n.d.). Retrieved June 10, 2019, from https://www.healthypeople.gov/
Minority Health and Health Equity - CDC. (n.d.). Retrieved June 10, 2019, from http://www.cdc.gov/minorityhealth/index.html
Office of Minority Health. (n.d.). Retrieved June 10, 2019, from https://minorityhealth.hhs.gov/
Programs. (n.d.). Retrieved June 10, 2019, from http://www.samhsa.gov/specific-populations/racial-ethnic-minority
Racial and Ethnic Approaches to Community Health (REACH) | At A Glance Reports | Publications |Chronic Disease Prevention and Health Promotion | CDC. (n.d.). Retrieved June 10, 2019, from http://www.cdc.gov/chronicdisease/resources/publications/aag/reach.htm
The diagnostic process is very important in providing patients with quality care. Health care professionals should collaborate with the patients and the family in the diagnostic process in order to arrive at an accurate diagnosis. Diagnosis should be a team-based activity so that all individuals can participate in bringing an accurate diagnosis. The importance of a team-based approach is that the professionals who have different backgrounds and skills will work together in assessing and evaluating patient care (Balogh et al, 2015). Thus, interdependent collaboration and shared decision-making will improve service provision, promote team innovation, and more importantly enhance patient satisfaction. In the case study, the health care professionals need to evaluate the condition of the patients and consider factors such as age, symptoms, the activities, the medication that the patient has taken to manage the pain, the period in which the patient has lived with the illness, among other factors. Generally, the diagnostic research will assist the clinicians to come up with a correct and accurate diagnosis.
Considering the circumstances and the preliminary workup, Ms. A is suffering from nutritional anemias and in specific, Iron Deficiency Anemia (IDA). Anemia is a condition in which the body has low hemoglobin (Hb) due to iron deficiency (Ramakrishnan, 2000). Other micronutrients deficiencies such as vitamin A, folic acid, Vitamin-12, and riboflavin can also contribute to anemia. In Ms. A's case, chances are that she is suffering from iron deficiency anemia and this condition has occurred due to heavy bleeding. During her menstrual cycle, she loses vital iron minerals which are required for growth. The reason as to why she experiences low levels of energy and feel lightheaded is because she has suffered from menorrhagia and dysmenorrhea or heavy loss of blood. Fatigue, weakness, shortness of breath, and lightheadedness are major signs and symptoms of iron deficiency (Ramakrishnan, 2000). These symptoms are an indication that Ms. A has iron deficiency and she does not produce enough hemoglobin that carried oxygenated blood.
Approach to care
After establishing the diagnosis process using interrelated individuals and arriving at the accurate and timely diagnosis, the clinicians should use an integrated approach which means that they should coordinate with the patient and the family in order to attain better health outcomes (Kulkarni, 2014). In addition, an integrated approach involves the coordination between primary health professionals with a nutritionist to improve healthcare.
Treatment plan
The treatment plan should start with oral iron therapy. Ms. A should receive a dosage for 120mg for three months and as a result, she will increase the level of hemoglobin (Short & Domagalski, 2013). The patient should expect side effects such as epigastria discomfort, constipation, and others. To manage the side effects, the patient should take the medication with meals. The patients should go for a check-up for blood counts to evaluate whether the hematocrit level is normal.
A method for providing education to the patient and the family
Patient and family education is an important way to help them become responsible and take a proactive role in the condition. The education will also help the patient and the family make informed decisions on care. The health care professional should start with assessing the learning needs, consider cultural values and language skills (Short & Domagalski, 2013). Methods or providing education includes the use of technology, and select the best learning style. The health care professional should inform the patient and the family about the condition, the administrated medication, and ensure that they understand the care.
A teaching plan
A teaching plan should with teaching the patient and the family about anemia, and the treatment, and the side effects (Short & Domagalski, 2013). Second, the adviser should create a food plan for the patient. The clinician should advise the patient to take food rich in iron such as leafy green vegetables, and nuts, and reduce the intake of tea and coffee. Third, the teaching plan should talk about anemia prevention.
References
Ramakrishnan Usha. (2000). Nutritional Anemias: Modern Nutrition. CRC Press
Balogh, E. P., Miller, B. T., Ball, J. R., & National Academies of Sciences, Engineering, and Medicine.
(2015). Diagnostic Team Members and Tasks: Improving Patient Engagement and Health Care
Professional Education and Training in Diagnosis. In Improving Diagnosis in Health Care.
National Academies Press (US).
Kulkarni, A. V. (2014). Integrative Approach for Health Care: Time to Review and Change the
Paradigms. Journal of Ayurveda and integrative medicine, 5(2), 71.
Short, M. W., & Domagalski, J. E. (2013). Iron deficiency anemia: evaluation and management. American
Though Asthma cannot be cured, it can be controlled and understanding the effective control treatment is important for patients. The most effective asthma treatment needs routine tracking of the symptoms and frequent measuring of how the patient’s lungs are working (Castro & Kraft, 2008). Good management of asthma treatment is important in helping to maintain long-term asthma control, helps ensure prevention of asthma attacks and avoids long-term problems for the patient. It is important to understand that every type of asthma is dissimilar, the patient and the physician therefore need to construct an asthma management strategy that best works with the patient’s asthma (Castro & Kraft, 2008). This strategy should have details on the asthma triggers and the directions on how medications should be taken.
Two kinds of medicines for asthma exist; there are the long term regulators and the quick relievers (Stewart, 2016). It is important to understand the differences between these two types of medications and the role that they play in helping manage asthma because they can be confusing.
The long-term controllers
These are the medicines that help to prevent and control asthma symptoms. The medications can be taken every day or not depending on the intensity of the asthma. They include;
Inhaled corticosteroids
This type of medicine helps prevent and also reduce the swelling of the airway, by reducing mucus in the lungs (Stewart, 2016). The medicine is normally given through an inhaler or a nebulizer. They are so far the most operative long term control asthma drugs available. Some of the possible side effects include; cough, oral thrush, skin thinning, and growth delay in pre-pubertal children (Stewart, 2016).
Oral corticosteroids
This are regularly used to help achieve control of poorly managed tenacious asthma or when an individual is initiating long term treatment. The prescription is used for a few days, roughly 3 to 10 days (Asthma and Allergy Foundation of America, 2015). The drug helps to hinder late reaction to allergen and it decreases lung sensitivity. It helps to hinder manufacture of cytokine, the bond protein stimulation as well as stirring cell relocation and stimulation at the cellular level (Asthma and Allergy Foundation of America, 2015).
Some of the side effects include; the short terms one that are reversible are; irregularities in sugar breakdown, augmented need to eat, fluid retaining, weight gain, high blood pressure (Stewart, 2016). The long term side effects comprise; growth subdual, dermal weakening, diabetes, muscle faintness and weakened human function. It is always important for doctors to consider co-existing conditions which could be worsened by the systemic corticosteroids for example tuberculosis, hypertension, varicella and peptic ulcers among others (Asthma and Allergy Foundation of America, 2015).
Leukotriene modifiers
This type of medicine can be reflected as a substitute treatment to low amounts of inhaled corticosteroids for kids who have a minor but tenacious asthma (Stewart, 2016). The medicine blocks synthesis of all leukotrienes at the cellular level. The medication is available in pill form that ought to be taken an hour afore or two hours after mealtimes for optimum effects (Stewart, 2016). One of the possible side effects to this medicine is the elevation of liver enzymes.
Long acting beta2 agonists
This is normally taken collectively with anti-inflammatory medicines for long-term regulation of the asthma attacks. It is not advisable to use it on its own and also must never be used to treat acute attacks. The medication is used to improve the asthma attacks and lessen the necessity for using quick relief drugs (Stewart, 2016). Some of the possible side effects include; augmented heart rates, tremor and hypokalaemia
Quick-Relief medicines
These sorts of drugs are taken to help relieve the asthma symptoms like wheezing, coughing, shortness of breath within minutes when they occur (Asthma and Allergy Foundation of America, 2015). The medicines act very fast in helping to diminish the tight muscles round the airways allowing air to flow over them. These drugs are only used when one has asthma attacks and should not be used more than 3 days a week because they do not have a long-term effect (Asthma and Allergy Foundation of America, 2015). They include;
Short acting beta agonists, they are breathed in and work swiftly to release the asthma attacks. They are the major choice for speedy release of an asthma attack (Stewart, 2016).
Anticholinergics, they are inhaled and act much slower as compared to short acting beta agonists. They help open the lungs by soothing the muscles round the lungs and they also help lessen the production of mucus (Stewart, 2016).
Combination quick relief medicines, they comprise equally an anticholinergic and a short acting beta agonist. The mixture is presented either as an inhaler or a nebulizer (Stewart, 2016).
Step wise approach treatment for asthma patients
This is a therapy approach where the dose, number and frequency of medication administration for the asthma patients, is augmented as essential and reduced when conceivable to help attain as well as uphold control of the asthma (Khalid, 2015). The approach has 6 steps where every step has its recommended therapy as well as an alternative therapy that is normally used when the patient cannot tolerate the recommended therapy. The dosage of treatment starts from the lowest dosage to the highest (Khalid, 2015). There are two general approaches to this therapy; there is step up of step down therapy. Step up basically comprises beginning treatment at a short dose and evaluating symptom control every two to four weeks and aggregating the concentration of therapy as desirable if regulation is not attained. Step down therapy begins with the patients getting the maximum dose regimen and the concentration is condensed as regulation is attained (Khalid, 2015).
The stepwise method is an important therapy to help manage asthma for the health care providers. Once a patient has been started on the appropriate step and has received education on the triggers, the environment controls and the symptoms; it becomes very easy to manage asthma and prevent recurrent attacks. This approach has greatly improved therapy for asthma.
References
Asthma and Allergy Foundation of America. (2015). Retrieved from
Global health plays a crucial role in reducing poverty and promoting global security. However, there are many health challenges affecting the globe including climate change, and communicable and non-communicable diseases (Daniels et al 2014). Today, one significant problem that affects global health is non-communicable diseases and in specific cancer. Cancer is one of the global health crisis affecting low-and-middle-income countries (LMCs) Daniels et al 2014). The research finds these countries experience a high level of poverty. People living in these areas have less income, they do not access quality care, and the developing countries do not have effective prevention and treatment tools. In addition to inadequate resources, the political, social and economic status is poor and this affects the standard of living Daniels et al 2014). People in these counties face lifestyle challenges such as consumption of alcohol, excessive use of legal and illegal drugs, consumption of unhealthy food and drink, and inactivity.
The most common types of cancer in LMCs are breast cancer, and lung cancer which occurs due to cigarette smoking (McCraken & Phillips, 2017). Men and women also suffer from stomach cancer, liver cancer, and cervix cancer. In every year, the total cases of cancer are 11 million and 6 million comes from LMCs (McCraken & Phillips, 2017). Cancer in these countries is neglected and resources are insufficient making it hard to address the public health issues. People from LMCs are disadvantaged in that they are exposed to risk factors and extra dangers and they cannot avoid them due to poor access to healthcare. In the past, people believed that cancer affects people in the Western world but today, cancer is ‘globalizing'. In the 1970s, the cancer cases were only 15% but in 2007, the cancer cases were 72%. (McCraken & Phillips, 2017). The research indicated that by 2020, the poorest nations will experience 60% of cancer cases and if the recent trends continue, the total cancer cases will be 23.6million by 2030 (McCraken & Phillips, 2017). Thus, cancer is a real crisis, and the cancer caseloads in LMCs are increasing due to inaccessibility, and unavailability of quality care and technology.
Solutions
Given that the affected population is people living in LMCs, the solutions or preventive measures should start with implementing effective cancer control measures in the countries (Institute of Medicine et al, 2007). The national government should solve the cancer crisis in developing countries by allocating resources. The U.S can make a tremendous difference and prevent cancer by providing technical assistance and curative care strategies. The LMCs should be provided with population-based strategies to address poor nutrition and physical inactivity (Institute of Medicine et al, 2007). The national governments should also collaborate in implementing tobacco control interventions and develop cancer plans and programs. Non-government organizations, private sectors, and other interests groups should also develop national cancer plans and come up with common goals toward ending preventing cancer in LMCs (Institute of Medicine et al, 2007). The national government should also ensure the availability of resources and infrastructure to asset health care professionals in performing testing and providing treatment.
Nursing's role
Nurses should also engage in cancer control activities to reduce cancer in LMCs. Since cancer shares risks factors, health professionals should provide control measures such as vaccinations for HBV and HBP to prevent liver cancer (Institute of Medicine et al, 2007). Health professions should also control cancer such as cervical cancer through screening and provide psychosocial support to help the patients deal with psychological impacts.
References
Daniels, M. E., Donilon, T. E., Bollyky, T. J., & Council on Foreign Relations,. (2014). The
emerging global health crisis: Non-communicable diseases in low- and middle-income
countries.
McCraken Kevin.,& Phillips R. David. (2017). Global Health: An Introduction to Current and
Future Trends. Taylor & Francis,
Institute of Medicine et al. (2007). Cancer Control Opportunities in Low- and Middle-Income
Three strengths of behavior therapy are; it uses behavioral techniques and relies on the problematic thoughts in order to help the clients change their thinking and behaviors. Secondly, behavioral therapy is scientifically and empirically based or in other words, behavioral therapy is an approach that is tested and well-established scientifically (Scott, 2009). This means that it does not rely on vague clinical theories but it relies on empirical research. Third, its focus on ethical accountability or in other words, the counselors adhere to codes and regulations.
One limitation of behavioral therapy is that it does not pay attention to emotions or feelings. Behavioral practitioners ignore clients' emotions yet emotions or self-consciousness would help in behavioral responses (Scott, 2009). By ignoring emotions, it means that the approach treats symptoms to reinforce behaviors and ignores the cause of the problem.
Three concepts associated with behavioral therapy include collaborative empiricism- this is an element whose role is to build a collaborative therapeutic relationship with the client. The latter is allowed to define problems, and the therapists provide solutions to the problems. The second concept is problem-oriented- this is an element that focuses on problems and difficulties or rather the current state of mind. The therapists and the client creates goals toward solving the problems (Scott, 2009). Another concept is classical conditioning- this term is used to imply that neutral stimulus and unconditioned stimulus develop a conditioned response.
One technique in behavioral therapy is the Community Reinforcement Approach (CRA) - this involves the weakening of reinforcement that influence negative behave and strengthening the reinforcement for positive behaviors (Scott, 2009). It provides alternative activities such as job clubs and social activities, among other environments where the client can have fun.
This approach is effective in people of all age but it best fits children aged 3 to 12 years. This is because children suffer from negative behaviors and this therapy is effective in influencing desirable behaviors and discouraging maladaptive behaviors.
Cognitive Therapy
Three strengths of cognitive therapy are; it focuses on inward actions and thought processes. Secondly, by looking at inward actions, it controls the mind and improves the outward behaviors (Rupke et al, 2006). Third, the approach has long-lasting effects in that the client can use the skills to solve other problems in the future.
One limitation of cognitive therapy is that it only focuses on cognitive processes and ignores other factors that may affect human behaviors such as genes, biological structures, and more (Rupke et al, 2006). These factors may affect the thought processes and failure to address these factors makes the approach ineffective.
Three concepts of cognitive therapy are; rational emotive behavior therapy- this means that irrational thinking leads to emotional disorders. Thus, the approach helps the patient change negative thinking and develop positive thinking. The second concept is dialectical behavior therapy-this means that the client is responsible for bringing positive changes through techniques such as mindfulness, distress tolerance, and emotional regulation (Rupke et al, 2006). The third conceit is rational living therapy-this means that the therapist should use persuasive techniques to encourage the patient to change negative feelings.
One technique from cognitive therapy is cognitive restructuring-this means that the therapist helps the client change the dysfunctional thought patterns and as a result, the negative mood state which affects the emotions and behavior will be eliminated (Rupke et al, 2006). The client will develop a positive way of thinking and recover from depression and anxiety.
Cognitive therapy works well in adolescents with depression. Adolescents with negative thoughts and negative moods will overcome the thoughts and manage the condition.
References
Scott J. Michael. (2009). Simply Effective Cognitive Behaviour Therapy: A Practitioner's Guide. Routledge
Rupke J. Stuart, M.D., Blecke David, M.S.W., & Renfrow Marjorie, M.D. (2006). Cognitive Therapy for Depression. Am Fam Physician, 73(1), 83-86.
As a medical professional, it is important to ensure that medical terms are spelled correctly and that the correct abbreviations are used because such information is used by the patient when purchasing medication or on follow-ups (Bernstein, 2004). Since patients are attended to by more than one practitioner, using the correct abbreviations ensures that patients understand what they are being treated for and what medicine to buy when they leave the health facility. If wrong abbreviations are used, the patient may end up buying wrong pills or get misdiagnosed by other doctors during follow-ups especially if treated by another doctor.
The wrong abbreviations and spellings could have serious consequences for both the patient and the caregivers. On the side of the patient, wrong abbreviations may mislead the patient into thinking that these suffer a serious condition even when this may not be the case. When wrong abbreviations translate to serious ailments, patients are forced to unnecessarily deal with the trauma associated with such diseases (Connor & Stanford, 2014). On the side of the caregivers, wrong spellings and abbreviations could result in lawsuits especially if they result in the patient being misdiagnosed. Since the patient is under the care of medical professionals, they have the right to take legal action if misled by the mistakes made by caregivers when writing down abbreviations or due to spelling mistakes.
In order to avoid making spelling mistakes or using the wrong abbreviations, medical professionals must take it upon themselves to learn the proper spelling and abbreviations for the medical terms they use. Since the terms may differ depending on location or type of institution, it is the caregiver’s responsibility to ensure that they learn the appropriate terms before using them with patients. Lastly, medical professionals should go over any written information before presenting it to patients so that they can identify any mistakes and rectify them before presenting it to the patients
References
Berntsen, K. J. (2004). The patient's guide to preventing medical errors. Westport, Conn: Praeger.
Stanford, C. C., & Connor, V. J. (2014). Ethics for health professionals. Burlington, MA: Jones & Bartlett Learning.
Osteomyelitis is a severe pyogenic infection that affects the bones and their surrounding tissues. It results in inflammation, necrosis, and inflammation and formation of a new bone. The condition is in two categories, which is; according to severity (acute, subacute, and chronic) and according to the route of entry (hematogenous and exogenous) (Murillo et al., 2014). The most common cause of the condition is Staphylococcus aureus. Other causes include Coliform organisms, Pseudomonas, Hemophilus influenza, and salmonella. The risk factors for the disease are diabetes, prior spleen removal, intravenous drug administration, and trauma
Normal anatomy and physiology of the bones
The skeleton of adult human being has a total of 213 bones, with sesamoid bones not included. All of the bones undergo constant modeling as the individual grows to adapt to the changes in the biochemical forces and also changes to remove old and damaged bones and replace it with new and stronger ones (Tortora & Derrickson, 2017). Bones are generally in four categories, which are short bones, flat bones, long bones, and irregular bones.
The human skeleton serves several functions such as providing structural support to the body, protection of the internal structures and organs, permission of movement and locomotions through the provision of levers for the muscles. The bones also work to ensure the maintenance of homeostasis and acid-base balance as well as serving as a reservoir of growth factors and cytokines. The bones also provide the environment for hematopoiesis, which occurs within the bone marrow (Tortora & Derrickson, 2017).
Mechanism of Pathophysiology
Bacteria enter the bone through metaphyseal capillaries and are contained by the epiphyseal growth plate — an acute pyogenic inflammatory response results. There is increased capillary permeability that allow plasma protein and cells of acute inflammation to the bone tissue. A combination of leukocyte migration, edema with microvascular obstruction leads to increased pressure in the bone. These combine with the bacterial growth causes necrosis of bone, and secondary infection follows (Roy et al., 2012). As the disease proceeds to the chronic stage, Organisms start spreading through Haversian and Volkmann canals. The infection extends laterally and, as pressure builds, perforates the bony cortex, lifts the periosteum, and spreads subperiosteally, Ischemic necrosis of the underlying bone and secondary infection of the damaged bone result. The periosteum itself responds by laying down new bone—the involucrum. Pus that is sub-periosteal is under pressure, this perforates through the involucrum forming holes called cloacae, then through soft tissue to the skin (Roy et al., 2012). Part of the cortex without the periosteum which becomes necrotic is the sequestrum. In the hip and the shoulder; the synovial capsule reaches beyond the epiphyseal plate. Infection no longer limited by the growth plate may spread to the joint (Zardo & Kutschka, 2016). In infants younger than one year of age, metaphyseal capillaries perforate the epiphyseal growth plate, and infection may spread to the epiphysis. Consequently, septic arthritis and the destruction of epiphyseal growth are common in this age group, however, treatment with antibiotics or surgical procedure in the early course of the condition, will resolve the situation and prevent the development of complications.
Therefore, the condition undergoes five stages, which include, inflammation, suppuration, sequestrum, involucrum, and finally, resolution or progression to complications. This condition interferes with the normal functions of the body because it results in pain, malaise, chills, and inflammation (Zardo & Kutschka, 2016). The functioning of the human skeleton to provide support and also aid in locomotion and movement are greatly affected, thus interfering with the individual life.
Prevention
It involves primary and secondary prevention, and this is mainly focused on minimizing the risk factors for the condition. Individuals at risk, for example, those with diabetes mellitus are advised to mitigate foot trauma and prevent the development of foot ulcers (Griffon, 2016). They should be monitored for the development of ischemia with the involvement of the multidisciplinary team to improve the outcomes. Education on foot care such as daily cleaning and moisturizing to prevent skin breakage is vital because it may provide a route of entry to microorganisms. Secondary prevention involves the preventable physician measures, for example, surgical debridement, reducing the bacterial load, muscle-flap, wound irrigation, avoiding the internal fixing of contaminated bone, and provision of antibiotics (Griffon, 2016).
Treatment
Medical management
The main aim is to control or to stop the spread of the infection. Prescription of antibiotics with general supportive measures such as the provision of a diet high in proteins and proteins, hydration, and correction of anemia is provided (Griffon, 2016). Pharmacologic therapy can be an administration of penicillins, tetracyclines, cephalosporins, or aminoglycosides.
Surgical management
Surgical debridement is indicated for infections which do not respond to antibiotic treatment. The infected bone is surgically exposed, and the purulent and necrotic material is removed, and then the area is removed with sterile saline then intravenous antibiotic therapy is continued (Griffon, 2016).
Clinical relevance
Infection of the long bones with acute pain and signs of sepsis. It results in localized pain and drainage that might be described by the patients as pulsating that intensifies with movement (Griffon, 2016). Those with chronic osteomyelitis present with a non-healing ulcer that overlies the affected bone, with a sinus that drains pus.
Conclusion
Osteomyelitis is an infection of the bones that affect both infants and adults. It is mainly associated with bacteria which can spread from one point to another through the bloodstream. It is predisposed by trauma and also diabetes mellitus however, it can be prevented through proper foot care and avoidance of injury. Treatment can be through surgical intervention or administration of antibiotics.
References
Griffon, D. (2016). Osteomyelitis. Complications in Small Animal Surgery, 28-33.
Roy, M., Somerson, J. S., Kerr, K. G., & Conroy, J. L. (2012). Pathophysiology and pathogenesis of osteomyelitis. In Osteomyelitis. IntechOpen.
Tortora, G. J., & Derrickson, B. (2017). Principles of anatomy & physiology. John Wiley & Sons, Incorporated.
Zardo, P., & Kutschka, I. (2016). Pathophysiology of sternal osteomyelitis. In Deep Sternal Wound Infections (pp. 13-16). Springer, Berlin, Heidelberg.
Theory-based interventions have been advocated to guide nursing practice. Unfortunately, it has been hard for the theories to be practised clinically. Theory of integral nursing brings significant benefits, which aid in the management of pain. Pain is one of the symptoms which is commonly experienced by individuals with various health problems. According to Tracy & DiNapoli (2012), healing is one concept that is central to the theory of integral nursing. In theory, healing involves planned pain management, which engages the client and the health care team. The theory provides an excellent opportunity for the nurses to provide care to the client by offering a suitable environment for the healing process (Tracy & DiNapoli, 2012). It will, therefore, ensure that quality care is provided to the clients in the management of pain.
However, the theory is still considered to be new to most of the nurses, thus posing challenges in understanding and its application. There is also less administrative support to aid in developments of theory-based interventions. Due to this, it becomes a challenge to put theories into practice, and this is also promoted by the numerous facilities which are task-oriented and putting less focus on the theories. Furthermore, the prevalence of the theory will require many nurses to be involved in trial and error levels to understand it better (Tracy & DiNapoli, 2012).
Essentials are vital for a nurse-undertaking master’s education to equip them with valuable skills and knowledge in their roles of promoting health and care. One of the crucial areas is in technologies in healthcare, and another is informatics. Skills and knowledge gained from this areas are vital for a nurse who wants to do Masters of Science on Nursing, this is because various changes are occurring in the healthcare system due to the changes in technology. The technologies in the healthcare system have improved the quality of care provided to the patients, and therefore, it is necessary for the nurses to have good knowledge to deliver excellent care.
References
Tracy, S. M., & DiNapoli, P. P. (2012). Exploring the theory of integral nursing with implications for pain management practice. International Journal of Human Caring, 16(1), 26-33.
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