...The physiological and social effects that a myocardial infarction can have on a patient can be very debilitating not only for the patient but for the caretaker as well. Having a heart attack is very scary for both patient as well as the patient's entire family. The patient can suffer from depression. “Having a heart attack can be frightening and traumatic, and it is common to have feelings of anxiety afterwards. For many people, the emotional stresses can cause them to feel depressed and tearful” (NHS, 2014). These patients may need extra care to assist them in their daily activities as well as some counseling to assist them with their emotional capabilities as well. Patients who have suffered from a myocardial infarction may have a constant...
Words: 610 - Pages: 3
...Stem cell research is one that is widely debated amongst various religions, cultures, and political groups. The question as to when life actually begins is the epicenter of this worldwide quarrel, and may not be settled for some time. Although this may be true, one fact that cannot be denied is that stem cell research has led to many life saving discoveries in various sectors of scientific research. In regards to the ethical dilemma of stem cells, recent developments in induced pluripotent stem cells (iPSCs) have made it possible to explore the applications of stem cells while avoiding the ethical problems associated with embryonic stem cell research (Seki & Fekuda, 2015). One intriguing area in stem cell research is the potential applications for them in the treatment of cardiac diseases. Studies have explored the potential uses for stem cells for the treatment of heart disease (Yamakawa & Ieda, 2015). Additionally, stem cells have been explored for the treatment of heart failure and myocardial infarction (Rasmussen, et al., 2013). Stem cells and how they may be used for the treatment of various cardiac diseases is an exciting topic and has the potential to change future approaches to the treatment. This paper will examine the applications and significance of stem cells in relation to these common cardiac pathologies. Heart disease is one of the leading causes of death in developed countries and currently there are few effective treatment options available (Yamakawa & Ieda...
Words: 1567 - Pages: 7
...Beta Blockers After Myocardial Infarction Clinical Scenario The acute care nurse practitioner on the cardiology service treats a 67 year-old-male admitted after recovering from an acute ST-Elevation Myocardial Infarction (STEMI). His risk factors include obesity, Type II diabetes mellitus, and family history. Upon exam the patient asks why he has not been started on a beta blocker yet. He explains further that when his brother had a “heart attack” in 2005, he was immediately placed on a beta blocker because the cardiologist reported how beta blockers reduce mortality after myocardial infarction (MI). The patient wants to know if a beta blocker would reduce his chance of mortality? Using the Patient-Intervention-Comparator-Outcome (PICO) format we formulated the following question. In a 67-year-old male with multiple co-morbidities with MI (P), does treatment with a beta blocker (I), compared with no beta blocker or placebo (O), reduce mortality rate (O)? Risk Factors, Incidence and Prevalence of Disease * US incidence rates of cardiovascular disease, including MI, are seen in men more than women (Alexander et al., 2007). This trend is also true in Utah ("Impact of heart," 2007). * The incidence rates of cardiovascular disease increase with age (Alexander et al., 2007). * Risk factors for cardiovascular disease include not eating enough fruits and vegetables, lack of physical exercise, smoking cigarettes and the co-morbidities of diabetes, hypertension, hyperlipidemia...
Words: 3414 - Pages: 14
...presenting with Acute Coronary Syndrome (ACS). This Policy consists of four basic nursing treatments and a time sensitive intervention goal. The 4 nursing treatments are summarized by the acronym M.O.N.A (morphine, oxygen, nitroglycerin and aspirin). The goal is for every patient that is presenting with ACS is to be on the table in the cath lab undergoing intervention within one hour of presenting to the hospital with symptoms. In this paper we will address the acronym of M.O.N.A. As the protocol stands right now there are parameters for the administration of three out of the four treatments, these are morphine, nitroglycerin and aspirin. For example, the policy states we are not able to give nitroglycerin if the systolic blood pressure is below 90mm/mg or if the patient has taken any phosphodiesterase medications within 12 hours. However, there are no parameters for the administration of oxygen. Coronary heart disease is the leading cause of death within the US. Oxygen has long been advocated as standard treatment in the management of chest pain and myocardial ischemia, although, for over 60 years the scientific background for this has been questioned (Ripley, Riley, Shome, Awan, McCloskey, Murphy & DeBelder, 2012). Recent studies have shown possible negative reactions with the administration of pure oxygen with patients that were not presenting with hypoxia. The possibility for oxygen toxicity to those with ACS could cause more cardiac tissue injury due to vasoconstriction and decreased...
Words: 3165 - Pages: 13
...Case study This paper will use a case study approach to explore the registered adult nurse’s role in the holistic care, in the first 24 hours, given to patient presenting with chest pain, caused by a myocardial infarction (MI). Using clinical guidance and evidence based research. The case study will use the ABCDE assessment framework. The resuscitation council (2006) recommends that nurses should follow the ABCDE method when assessing acutely and critically ill patients as it ensures nurses quickly and accurately identify acute illness and promptly begin management of the condition/ illness (Jevon, 2010). The aim of the assessment is to determine the cause of the chest pain efficiently and prioritise care needed. The main priorities were; pain control, informing appropriate medical staff and the nurse in charge, reperfusion of myocardial tissue, managing anxiety and monitoring for complications of MI and the effects of the treatment given. A MI occurs when a coronary artery becomes occluded, most commonly by a thrombus due to the rupture of an atherosclerotic artery which results in the necrosis of myocardial tissue because of the ischemia the thrombus causes (O’Neil, 1996). For the purpose of this case study and in order to protect confidentiality and anonymity the patient used will be fictitious and given a pseudonym. However the events the case study follows are very much a reality (Edwards, 2002). Case scenario Brian, a 64 year old male, was recovering...
Words: 1046 - Pages: 5
...1. Introduction This assignment is a critique on the study published in The New England Journal of Medicine (NEJM) entitled ‘Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction’ by Bonaa et. al (2006) (also known as The NORVIT study). NEJM’s most recent impact factor was 51.296 (in 2006). NEJM boasts the largest paid circulation among medical journals, with close to 200,000 paying subscribers. It is printed weekly in the United States, Canada, the Netherlands, and Japan, and a range of translated articles reaches approximately 140,000 (New England Journal of Medicine.org, 2006). The NORVIT study was designed as a randomized, controlled, double-blind, intervention study. It included 3,749 men and women who had suffered and acute myocardial infarction within the last 7 days. The rationale behind the study was that high homocysteine levels are considered a risk factor for cardiovascular disease (Bonaa et al, 2006). The aim was to measure how effective lowering blood serum homocysteine levels with B vitamins was in preventing a secondary event. A collaborative meta-analysis published in The Journal of the American Medical Association, states that homocysteine levels are an independent predictor of ischemic heart disease and that studies on disease risk of genetic variants affecting homocysteine may help establish whether homocysteine is causally linked to vascular disease (2002: cited by Bonaa et al, 2006). The meta-analysis suggests that a large...
Words: 3026 - Pages: 13
...British Journal of Nutrition (2006), 96, Suppl. 2, S61–S67 q The Authors 2006 DOI: 10.1017/BJN20061865 Nuts and coronary heart disease: an epidemiological perspective ´ John H. Kelly Jr and Joan Sabate* Department of Nutrition, School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA The epidemiological evidence for the cardio-protective effect of nut consumption is presented and reviewed. Four large prospective epidemiological studies of primary prevention of coronary heart disease are reviewed and discussed (Adventist Health Study, Iowa Women’s Health Study, Nurses’ Health Study and the Physicians’ Health Study). Other studies of nuts and coronary heart disease risk are addressed. The combined evidence for a cardio-protective effect from nut consumption is summarized and presented graphically. The risk of coronary heart disease is 37 % lower for those consuming nuts more than four times per week compared to those who never or seldom consume nuts, with an average reduction of 8·3 % for each weekly serving of nuts. The evidence for a causal relationship between nut consumption and reduced risk of coronary heart disease is outlined using Hill’s criteria for causality and is found to support a causal cardio-protective relationship. Nuts: Cardiovascular: Coronary heart disease: Diabetes: Cohort studies: Causality: Hill’s criteria Nuts have constituted a part of mankind’s diet since pre-agricultural times (Eaton & Konner, 1985), providing a complex food...
Words: 5862 - Pages: 24
...http://ccforum.com/content/12/2/R36 Research Vol 12 No 2 Open Access Detecting myocardial infarction in critical illness using screening troponin measurements and ECG recordings Wendy Lim1, Paula Holinski1, PJ Devereaux1,2, Andrea Tkaczyk2, Ellen McDonald2, France Clarke2, Ismael Qushmaq3, Irene Terrenato4, Holger Schunemann2,4, Mark Crowther1 and Deborah Cook1,2 1Department 2Department of Medicine, McMaster University, Canada of Clinical Epidemiology and Biostatistics, McMaster University, Canada 3Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia 4Department of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy Corresponding author: Deborah Cook, debcook@mcmaster.ca Received: 6 Dec 2007 Revisions received: 22 Jan 2008 Accepted: 4 Mar 2008 Published: 4 Mar 2008 Critical Care 2008, 12:R36 (doi:10.1186/cc6815) This article is online at: http://ccforum.com/content/12/2/R36 © 2008 Lim et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction To use screening cardiac troponin (cTn) measurements and electrocardiograms (ECGs) to determine the incidence of elevated cTn and of myocardial infarction (MI) in patients admitted to the intensive...
Words: 2698 - Pages: 11
...Volume 3, number 2 What is critical appraisal? Sponsored by an educational grant from AVENTIS Pharma Alison Hill BSC FFPHM FRCP Director, and Claire Spittlehouse BSc Business Manager, Critical Appraisal Skills Programme, Institute of Health Sciences, Oxford q Critical appraisal is the process of systematically examining research evidence to assess its validity, results and relevance before using it to inform a decision. q Critical appraisal is an essential part of evidence-based clinical practice that includes the process of systematically finding, appraising and acting on evidence of effectiveness. q Critical appraisal allows us to make sense of research evidence and thus begins to close the gap between research and practice. q Randomised controlled trials can minimise bias and use the most appropriate design for studying the effectiveness of a specific intervention or treatment. q Systematic reviews are particularly useful because they usually contain an explicit statement of the objectives, materials and methods, and should be conducted according to explicit and reproducible methodology. q Randomised controlled trials and systematic reviews are not automatically of good quality and should be appraised critically. www.evidence-based-medicine.co.uk Prescribing information is on page 8 1 What is critical appraisal What is critical appraisal? Critical appraisal is one step in the process of evidence-based clinical practice. Evidencebased clinical practice...
Words: 4659 - Pages: 19
...The aim of this essay is to explore an acute deterioration in the health of an adult I have encountered during a clinical placement, in an acute care setting. The essay will begin with a definition of acute care, followed by the introduction of my patient and predisposing factors. This essay will include an explanation of the significant pathophysiological changes and related clinical manifestations and a critical analysis of the nursing interventions implemented during the acute episode of care, focusing on holistic care, rationale and evidence base. It will then describe the actual deterioration in the patient’s condition, and discuss the nurse’s role in the recognition and assessment of the actual deteriorating condition following the trusts policies. Assessment tools, monitoring, detecting and reporting will be considered. Finally this essay will include a discussion of the importance of multidisciplinary team collaboration in the diagnosis and provision of care during the acute episode, and a discussion on whether the deterioration could have been prevented by identifying any areas of practice which could change in relation to evidence based practice. For the purposes of privacy and confidentiality, in accordance with NMC (2008) code of conduct, the name of the patient will be changed to Peter and the placement area will remain as an acute care setting. According to McFerran (2008) the term “acute” is described as a disease of rapid onset, severe symptoms, and brief duration...
Words: 4236 - Pages: 17
...How to control complication of type 2 Diabetes Palakkumar Patel Monroe College Abstract This paper is presenting about how to control complication of type 2 diabetes. In the USA 90% of diabetes patients suffering from type 2 diabetes. In every year lots of patients going to die due to type 2 diabetes complication. In previous studies review is presenting about due to type 2 diabetes so many complications are occurring in different part of the body and some study is presenting about due to health education we can reduce the problem in community. By doing heath education, continues health check up and doing some personal health counseling about diet and personal lifestyles.in school health education also effect on child on diet personal life styles. How to control complication of type 2 Diabetes Chapter 1: Introduction Diabetes is a leading cause of adult-onset blindness, kidney failure, and non traumatic limb amputations; significantly higher risk for coronary heart disease, peripheral vascular disease, and stroke, and they have a hypertension, dyslipidemia, and obesity; Diabetes is a the seventh leading cause of death in the United States (1). USA is expending $245 billion annually for health care expenditures and productivity losses and is a leading driver of growing Medicare expenditures for controlling glucose levels, blood pressure (BP), and lipid levels and avoiding tobacco, singularly or in combination, reduce the incidence of costly and disabling micro- and...
Words: 3883 - Pages: 16
...Introduction This aim of this research review paper is to discuss the various types, causes and cost for medical errors. After reading this paper, the reader should be able to realize the importance of understanding the know how of medical errors and also understand how various interventions can be used effectively to prevent such errors. The paper also aims to stimulate critical thinking in terms of awareness about medical errors. I have worked in the critical care field for eight years in the past and have been a part of policy implementation with regards to medical errors. Most of the thoughts discussed in this paper are research-based, however, a few are from my personal and professional experiences working in the intensive care field. Causes of Medical Errors A. Diagnostic 1. Error or delay in diagnosis Failure to diagnose an ectopic pregnancy causing rupture and possible acute abdomen. The reason could be either because the obstetrician did not feel the need to order an ultrasound thinking the mild complain of pain to be insignificant to warrant an ultrasound or on the other hand, the radiologist fails to identify an ectopic pregnancy while performing an ultrasound, either due to incompetency or due to negligence. 2. Failure to employ indicated tests Failure to check blood glucose levels for a known hypertensive patient who presented with altered or loss of consciousness. Delayed checking of blood sugar was found to be 20mg/dl] 3. Use of outmoded tests...
Words: 590 - Pages: 3
...The Australian Charter of Healthcare Rights (ACHR) was developed by Australian Commission on Safety and Quality in Health Care to provide a nationally agreed statement of the rights of the patient (Dunbar, 2009). According to ACHR (2008), everyone who is seeking or receiving the care in Australian Health has some rights regarding the nature of that care. The main objective of these rights is to make sure that care provided is of high quality and safety (Dunbar,2009). The Charter allows patients, consumers, families, carers, clinicians and services providing health care to share an understanding of the rights of people receiving care (Dunbar, 2009). The rights that are included in Charter are as follows: • Access: I have right to health care. • Safety: I have right to receive safe and high- quality care • Respect: I have right to be shown respect, dignity, and consideration. • Communication: I have right to be informed about the services, treatment, options and costs in clear and open way • Participation: I have right to be included in the decisions and choices about the care. • Privacy: I have the right to privacy and confidentiality of my personal information. • Comment: I have right to comment on my care and to have my concerns addressed (Australian Charter of Healthcare Rights, 2008) The purpose of this essay is to look at the evidence- based approaches to psychosocial intervention offer better respect and participation for a patient with Coronary Heart disease and...
Words: 2098 - Pages: 9
...Research Paper: Toxicant MOS 5425 – Advanced Toxicology 2/3/2015 Background This paper will compare and contrast a toxin that affects the nervous system, one that affects the endocrine system and another that affects the cardiovascular system. Identify the characteristics that are shared by these toxins and characteristics of these toxins make these toxins vulnerable to toxicity of these specific systems? Central Nervous System Environmental contamination has exposed humans to various metal agents, including mercury. This exposure is more common than expected, and the health consequences of such exposure remain unclear. Mercury in the past was used in a numerous different activities, and now, exposure to this metal from both natural and artificial sources is significantly increasing. According to Azevedo, et al (2012), numerous studies show that high exposure to mercury can induce the following changes to humans such as the central nervous system, potentially resulting in irritability, fatigue, behavioral changes, tremors, headaches, hearing and cognitive loss, dysarthria, incoordination, hallucinations, and death. Endocrine System According to the Canadian Centre for Occupational Health and Safety, Endocrine disruptors are found in synthetic chemicals used in industrial solvents, lubricants, and their byproducts such as polychlorinated biphenyls (PCBs), polybrominated biphenyls (PBBs), and dixons. Other examples of endocrine disruptors include bisphenol A (BPA)...
Words: 652 - Pages: 3
...Professional Presence and Influence Melissa A. Cummings Western Governor’s University Abstract This paper examines my personal professional presence and how my personality influences both my personal and professional life. It will examine how I can use mindfulness and self-awareness to improve my professional practice with co-workers and patients and how I can bring mindfulness into my own life. Professional Presence and Influence Professional Presence Larry Dossey discusses three eras medicine in his book, Reinventing Medicine. Era I is a time period which began in the 1860’s and focused on the physical body as the reason for illness. The body was treated with surgical procedures and drugs. Era II focused on the body also, but it was realized that emotions and feelings could influence the body’s functions. The third Era, Era III says that “the mind is not confined to the body, that the mind is boundless and unlimited” (Dossey, n.d.). Era I equates to a purely “physical body” model of health and healing. This model does not view the person as a whole, but rather the ailment independent of the person. If a person had an intestinal disorder, medications may be prescribed, but there may be no discussion as to how the disorder came to be. In this era, we would not look at the patient’s nutrition or life situations which may have precipitated their illness. Era III, the modern era of health and healing, looks at the patient as a whole person. If this patient sought...
Words: 2190 - Pages: 9
