...Cardiac Death VS Brain Death Brain death indicates that a person is dead, not because unconsciousness is attributable to the brain, but because the brain function is a necessary prerequisite to maintaining the vital function of the organism. The perception of the onset of death in the case of brain death is different to that in the case of cardiac death, when the body changes almost instantly to the state associated with dead people: breathing stops, the body cools off and the color of the skin pales. If, on the other hand, the deceased person has been declared brain-dead, the body will still feel warm, and the skin will be its normal colour. Although the relatives have reliable medical information that death has set in, they have to overcome the mental barrier that is deep-rooted in human nature: that as long as the heart is beating and there is breathing, there is life, and thus hope. Furthermore, although specific bodily states can be cited that involve the onset of death in specialist medical terms, people have different views of what it means to be dead, and how body and soul belong together. Being dead is not just a concept in medical science, but also an existential concept, and recognition of the brain death criterion is largely dependent on emotional and experiential aspects. Sudden cardiac death (SCD) is a sudden, unexpected death caused by loss of heart function (sudden cardiac arrest). Sudden cardiac death is the largest cause of natural death in the United States...
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...University HLT322 10/25/09 Abstract With anything that is done in the medical field there will be ethical issues that surround it. Since we are only on this earth for so long then death becomes one of those issues that we must face. With the new advancements in technology death can become complicated. Also since we have other issues such as euthanasia involved things will only get even more complicated. Euthanasia, definition of death, living will decisions, and ethical issues surrounding these subjects will be discussed. End of Life Decisions No one living on this earth will live forever. It comes a point in time when we all must go. Our bodies are not made that way and they start to break down. Once deterioration happens or if a person comes into physical contact that causes the body too much trauma then death occurs. In the past twenty years four concepts of death have emerged, traditional, whole-brain, higher-brain, and personhood. Each one of these versions of death has ethical issues surrounding them and complicate important end of life decisions. Ethical issues surrounding when a person is dying is euthanasia and end of life decisions such has a person being on life support or having a feeding tube. Euthanasia is define as “The act or practice of killing or permitting the death of hopelessly sick or injured individuals (as persons or domestic animals) in a relatively painless way for reasons of mercy” (n.d. Merriam-Webster). There are different types of euthanasia...
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...show that newly uncovered risk factors in heart disease may help doctors and patients to recognize those who might be at higher risk of dying from heart incidents, and encourage them to pay close attention to maintaining their hearts healthy. The author’s evidence was supported from a report in the British Medical Journal's Health. The research was conducted by a team of physicians from the Wake Forest Baptist Medical Center One notable source from Wake Forest Baptist Medical Center is a physician named Dr. Elsayed Z. Soliman. The doctor’s input was instrumental in holding my attention and further solidified the article’s authentication. Dr. Elsayed Z. Soliman explained “Identifying specific predictors that separate the risk of sudden cardiac death from that of non-fatal or not immediately fatal heart attacks would be the first step to address this problem, which was the basis for our study” (Time Magazine healthland,2011) He included other useful information such as risk factors that include ethnicity, blood pressure, body mass index (BMI) and an ECG report. These risk factors could be signals for other unseen factors like lifestyle, access to health care, health insurance and chronic illness. Dr. Elsayed Z. Soliman presented sufficient information to understand the concepts of heart disease risk factors. The author’s position and argument was easily understood and it was a stimulating read. In addition, while there were some areas the author could have elaborated on it...
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...the legal health record in complete. Understanding the HIPAA privacy rules and regulations for organ and tissue transplantation will help the HIM professional when needing to receive or disclose health information. These laws are set in order to protect physicians, patients, families, as well as the health care facility. Principles of ethical decision making have an impact on choices patients and their families make regarding this sensitive subject. These important principles are autonomy, beneficence, non-malfeasance, and justice (McWay, 2010, p. 93-96). They key bioethical issues surrounding organ transplantation can be divided into three areas, death, recovery and donation, and organ allocation as they parallel principles of ethical decision making. The freedom to make decisions for oneself before the time of death...
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...Final Exam Study Guide Important to Know the function of anterior and posterior pituitary gland. Anterior Pituitary Gland: (Adenohypophysis) The anterior pituitary gland regulates several physiological processes including stress, growth, reproduction and lactation (Adrenal, liver, bone, thryroid and gonads). -It is regulated by negative feedback and the hypothalamus. Major hormones: ACTH: Stimulates the adrenal cortex. TSH: Thyroid stimulating hormone, promotes secretion of thyroid hormone. FSH: Follicle-stimulating hormone, promotes growth of reproductive system. LH: Luteinizing hormone. Promotes sex hormone production GH: Growth hormone, promotes growth, lipid and carbohydrate metabolism. PRL: Prolactin, Milk production and progesterone/estrogen. -Hormones are secreted from the hypothalamus to the A. Pituitary so these hormones can be released. Posterior Pituitary Gland: Mainly axons extended from the hypothalamus. These axons contain and release neurohypophysial hormones oxytocin and vasopressin. Oxytocin: Targets the uterus, and mammary glands causing contractions and lactation. Vasopressin (ADH): Antidiuretic hormone, arginine vasopressin, argipressin. Stimulates water retention absorbs it back into blood causing raises blood pressure by contracting arterioles, and inducing male aggression. Very Important to know and understand Diabetic Ketoacidosis Pathophysiology: -In DKA, the lack of insulin prevents glucose from being utilized by the tissues...
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...what you will select for a yearlong beverage contract from these three choices water, Gatorade, and Powerade. The role of water in our body are giving cell life, where water is a carrier, distributing essential nutrients to cells as minerals, vitamins, and glucose. It also has chemical and metabolic reactions as it removes waste products including toxins that the organ cells reject and removes through urine and feces. Water is a transport of nutrients in the biochemical break down of what we eat. H2O regulates body temperature, it has a large heat capacity which helps limit changes in body temperature in a warm or cold environment. The elimination of water is an effective lubricant around joints and acts as a shock absorber for eyes, brain, and spinal cord. The goal of drinking fluids during exercise is to prevent dehydration and maintain performance. Fluids preferably with carbohydrates and electrolytes, should be consumed in small amounts every 15 to 20 minutes during exercise. Water and electrolytes serve very important roles in the functioning of the body and sweating can lead to excessive losses of both critical nutrients if not properly replaced. Dehydration and electrolyte imbalances can adversely impact health and exercise performance. The magnitude of fluid and sweat losses during exercise depends on the intensity of the exercise, environment conditions, and the type of clothing worn during the exercise. To avoid excessive fluid and electrolyte losses, a person...
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...independent of the effect of aldosterone on sodium transport. The nongenomic effects of aldosterone to increase fibrosis, collagen deposition, inflammation, and remodeling of the heart and blood vessels, however, are markedly increased in the presence of high sodium intake. The genomic effect of aldosterone increases renal sodium transport, but the administration of large doses of aldosterone to normal individuals does not cause edema, relating to the phenomenon of "aldosterone escape"; however, in edematous disorders including cardiac failure, cirrhosis, and nephrotic syndrome, impaired aldosterone escape leads to renal sodium retention and edema formation. There is now considerable evidence for the nongenomic effects of aldosterone in several important diseases. Thus, low dosages of mineralocorticoid antagonists, with little or no effect on urinary sodium excretion, have been shown to afford a beneficial effect on morbidity and mortality in patients with advanced cardiac failure and after acute myocardial infarction. Three-drug-resistant hypertension has also been found to respond to spironolactone in modest dosages. The combination of an angiotensin converting enzyme inhibitor (ACEI) with spironolactone to treat such resistant hypertension may be more effective than adding an angiotensin receptor blocker to an ACEI. The role of spironolactone has also been shown to decrease albuminuria in chronic kidney disease including diabetic nephropathy in the presence of maximal dosages of ACEI...
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...increase surface area so they are the actual sites of gas exchange Smaller animals tend to have single circulatory systems – 1 pump Larger animals have double circulation – 2 pumps MEMORIZE THE ORDER OF BLOOD FLOW!!! Blood cells are mainly made of plasma Know the mechanism of blood clotting Thrombin makes more of itself to make fibrinogen to make fibrin Lymphocytes become B or T cells while myeloid make WBC and RBC Atherosclerosis is caused by build up of plaque LDL goes to tissues HDL leave the tissue to go to liver HDL is the good cholesterol LDL is bad bc it takes it to the tissue Hypertension is high blood pressure inflammation plays a role in atherosclerosis heart attack is the death of cardiac tissue and blockage from coronary arteries stoke is the death of brain resulting from a blockage of arteries in the heart angina pectoris is the...
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...Even though chloral hydrate is used all the time in infants, chloral hydrate has many dangerous side effects when used in infants and children. Medical Research states that chloral hydrate has adverse side effects and clinical data shows it can even cause death. Aidan Janssens was born on December 23, 2009 and had some minor birth defects, none of which were life threatening. Because of these defects, doctors wanted to perform an MRI (magnetic resource imaging) on him on the second day of his life. They sedated him with chloral hydrate for the procedure he was to undergo. The procedure went well, but when Aidan woke up from the procedure, he immediately experienced unrelenting obstructive apnea. His episodes of apnea required Aidan to be manually stimulated, so he would start breathing on his own. These episodes continually worsened, and the need for him to be manually bagged (a bagged placed over his nose and mouth that is manually pumped to give him air) were required. The onset of these episodes would continually worsen and become more frequent with each passing day. The doctors had a conference with Aidan’s parents requesting they sign a DNR (do not resuscitate) order for Aidan and told Aidan’s parents that they could not continually bag Aidan. Aidan’s parents refused and requested that they be able to bring Aidan home. Aidan lived at home for 4 days and ultimately on the 38th day of his life, he passed away from unrelenting obstructive apnea, bradycardia and cyanosis...
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...firing too rapidly. TREATMENT is BB or CCB to ↓ HR and BP * PAC (Premature Atrial Contraction): impulse travels across atria via abnormal pathway, creating a disturbed P wave. Contraction originates from ectopic focus in atrium other than the SA node. Caffeine and diet pills predispose people to these but they don’t adversely affect health. TREATMENT is none. * Atrial Flutter: atrial tachycardia resulting in recurring, regular sawtooth flutter waves. The ratio of atrial to ventricle contractions is 3:1. TREATMENT is synchronized cardioversion (like defibrillation but the less Joules, 150-200 vs 300, and you must push the “sync” button to synchronize the energy so as to not direct it onto the T wave and send the patient in V-fib) and ablations. * Valve Replacement: patient must be put on blood thinner afterwards and must be anticoagulated more than normal. 3-4x INR vs 1.5-2x INR * Atrial Fibrillation: total disorganization of atrial activity and ineffective atrial contractions. TREATMENT is Coumadin (to prevent DVTs) or Xarelto. You want a skinny QRS wave which is about 0.12 seconds; a wide one is bad. Elevated T wave indicates ischemia. * 1° Heart Block: each impulse is directed to the ventricles but the...
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...Risk factors, clinical manifestations, and management of thoracic and abdominal aneurysms, venous insufficiency, venous stasis ulcers, PAD, acute arterial ischemia. (be sure to know the difference in venous and arterial disease!) PAD (thickening of the artery walls, which results in the progressive narrowing of the arteries of the upper and lower extremities) -risk factors: tobacco use (most important), hyperlipidemia, elevated high sensitivity C-reactive protein, diabetes (occurs much earlier), uncontrolled hypertension, increases with age, African Americans, 2 times higher in Mexican/Hispanic American women then white women -PAD is a marker for advanced systemic artherosclerosis** -atherosclerosis is the leading cause** -these patients are more likely to suffer from CAD and cerebral artery disease -artherosclerosis= migration and replication of smooth muscle cell, deposition of connective tissue, lymphocyte and macrophage infiltration, and accumulation of lipids -clinical symptoms occur when the vessel is 60 to 70 percent occluded Thoracic and Abdominal aortic aneurysms -aneuryisms happen more in men than women, increases with age - most occur as abdominal aortic aneurisms -thoracic= often asymptomatic, chest pain extending into interscapular area (most common symptom), hoarseness, dysphagia -abdominal= often asymptomatic, abdominal pain, back pain, pulsatile mass pre-umbilical and slightly to the left -abdominals a. are caused by artherosclerosis (male gender...
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...ORGANIZATIONAL BEHAVIOR PROJECT MBA (18) _ID# 15-2364 As I work as an inhalation therapist at the hospital, I choose to present to you a case study that occurred with me in October 2013, and a debate that I had with the financial department manager due to a purchase of an equipment used to resuscitation and intubation for patients in need of cardiac and respiratory reanimation. Patient Case Study: Fluid & Electrolyte Imbalance INTRODUCTION• Patient.History: Mr. Khoury presented to accident and emergency on the 6th October 2013, primarily due to the progressive deterioration of end stage motor neuron disease that was diagnosed two years ago. Coupled with a medical history of Alzheimer's disease, renal stones, enlarged prostate, hypertension, and an esophageal rupture, Mr. Khoury's health has continued to deteriorate as evidenced by weight loss, lack of appetite, decreased mobility, muscle wasting, poor oral intake and dysphasia. Prior to his admission to hospital, Mr. Khoury was cared for at home by his wife, however due to severe cognitive disturbances together with motor neuron features, his wife can no longer take care of him at home as she cannot determine his needs or understand his complaints. Mr. Khoury and his wife have both accepted his poor prognosis and deterioration as reflected by orders not to resuscitate, intubate or ventilate. His reason for admission is not an acute illness but to determine which palliative measures can be taken to relieve discomfort whilst...
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...getting any better.” Mrs. C. also said that her husband has vomited, over the last 2 days. R.’s chief complaint (c/c) is abdominal pain, voiding frequently, and hasn’t been taking insulin due to nausea. Vital signs (RR) 32, and oxygen saturation (SAO2) 95%. He is alert & orientated (A&O) A&O x 1 (oriented only to person), and his mouth and mucous membranes are very dry. Doctor’s Orders: After seeing Mr. C. the doctor orders: CBC, Chem Panel, Electrolytes, UA with ketones, ABG, 12 lead EKG, and sliding scale insulin to be given IVP, oxygen at 2L/min per nasal cannula, and IV bolus of 500 cc/NS. After initiating a peripheral IV catheter, blood samples are drawn for labs and the nurse administers the 500 cc/NS and rechecked VS: Temperature (T) 100.3, P-106, BP-92/56, and RR-28. Labs The labs return with blood glucose of 625, K+5.3, bicarb (HCO3) 8 mEq/l, large amounts of ketones in urine and serum. ABG of pH-7.19, PO2-89, CO2-25, and HCO3-15. EKG The EKG is noted for tented T waves. Based off above initial findings, R. has hallmark signs and symptoms (s/s) of Diabetic Ketoacidosis (DKA) which include polyuria, gastrointestinal (GI) upset/abdominal pain, dehydration, orthostatic hypotension, bradypnea with deep respirations, also known as “Kusssmaul breathing.” Also, patient’s breath is acetone which is commonly interpreted as “fruity” and can be...
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...ETHICAL DILEMMAS FACING NURSES ON END-OF-LIFE ISSUES BASED ON CONFERENCE PROCEEDINGS HELD IN ELDORET, KENYA Author: Kamau S. Macharia: BScN (Moi), MSc (studying) Nursing Leadership & Health Care Systems Management (University of Colorado, Denver), Higher Dip. Critical Care Nursing (Nbi). Graduate Assistant, School of Nursing & Biomedical Sciences, Kabianga University College (A Constituent College of Moi University), . P 0 Box 2030 20200 Kericho, Kenya , Tel +254 722224577, Email: symomash@gmail.com ETHICAL DILEMMAS FACING NURSES ON END-OF-LIFE ISSUES BASED ON CONFERENCE PROCEEDINGS HELD IN ELDORET, KENYA ABSTRACT Problem Statement: A conference to discuss on ethical dilemmas is thought to be a good way of airing out issues. It is unfortunate that at times a patient in our care may die no matter what we do. Profound ethical questions on end of life issues confront the medical personnel as they watch and wait helplessly. This paper touches on ethics, law, social and public policy as they affect nursing practice. Setting: This is a conference proceedings report augmented with a case study of Nelly from a local setting and compares it with two others from elsewhere which were also presented during the conference. Conference was organized by Federation of African Medical Students Associations (FAMSA), Eldoret 2011. The author was a presenter...
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...effectively to meet the body’s needs for nutrients or has lost adequate filling capacity. Clinical presentations of heart failure depends on which ventricles have failed to pump blood adequately; left ventricular failure, also known as congestive heart failure (CHF) is more common than right ventricular failure (McCance & Huether, 2014). The most common symptoms of heart failure are shortness of breath, fatigue, and peripheral edema. HF is not a disease, but rather a manifestation of a diseased heart. Large number of disorders can lead to heart failure, and with the aging population and many surviving primary cardiac events, it is no surprise that the most common reason for hospitalization in patients older than 65 years old is heart failure (McClintock, Mose, & Smith, 2014). Heart failure has become a major public health problem because it is the only cardiac condition that continues to increase in prevalence (McClintock, Mose, & Smith, 2014). Organizations such as American Heart Association (AHA), National Heart, Lung, and Blood Institute (NHLBI), and Heart Failure Society of America (HFSA) are helping raise awareness and are invaluable resources to the increasing heart failure population. Because heart failure affects so many Americans, it is important to discuss heart failure in its complexity and analyze the pathology...
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