My paper is regarding pain management in advanced cancer. As with all pain management for all diseases, there is room for much improvement even though this was identified as a priority in 2003 by the IOM. While there have been many research studies regarding pain management using both pharmacologic and nonpharmacologic methods, both healthcare providers and patients still exhibit barriers in the treatment of pain.
Of particular interest to us as nursing students are the recommendations to provide additional education to cancer patients regarding pain medications, side effects, alternative treatments. Adequate education by healthcare providers was one way to overcome patient barriers to pain control. One technique that was interesting was teaching patients to use a pain diary in order to monitor pain over the long-term disease process and to assist healthcare providers in assessing effective pharmacologic and nonpharmacologic treatments. Teaching healthcare providers to utilize standardized pain assessment tools and utilizing better protocols for reassessing pain following treatment were also recommended. The use of advanced practice nurses to train staff nurses in assessment and reassessment was also recommended. As many as 60-90% of cancer patients experience pain, so using EBP tools would greatly benefit their care.
While the typical use of OTC pain medications and opioid-based medications was mainly discussed along with the use of radiation and chemotherapy, I was disappointed that for the most part nonpharmacologic interventions were not shown to greatly improve pain outcomes. While many are effective in reducing pain, most are used as adjuncts to traditional pharmacologic measures.
Few of us may treat cancer patients, however, all of us will treat patients who are in pain. The use of better standardized tools and use of better reassessment techniques will greatly improve our care of not only cancer patients, but all of our patients.
Wednesday, December 16, 2009
Childhood Obesity
One major problem our country faces is childhood obesity. Obesity is a major health risk for many chronic illnesses. In the past thirty years childhood obesity has doubled among children ages 2-5 and adolescents ages 12-19. It has tripled in children ages 6-11. It is estimated that more than 9 million children over the age of 6 are obese. (Committee on Progress in Preventing Childhood Obesity, 2006). Our youth are becoming more and more obese. What is going to happen if this is allowed to continue? What does obesity lead to? It is a risk factor for type II diabetes, heart disease, asthma, psychological and social problems, and many more. We need to step up and take action to combat this very real and dangerous problem.
What are we going to do about childhood obesity? The Committee on Progress in Preventing Childhood Obesity suggests many interventions to help fight childhood obesity. They include, empowering communities through education so they can become active in the fight and work towards change. Changing the physical environment and building communities so they facilitate more physical activity such as building more play places and parks. Create partnerships between local businesses, state and local governments, community based organizations, and industry to bring people together for a common goal of change. Gain political support to initiate measures to help prevent childhood obesity, such as requiring nutrition information on food from restaurants. Educate the public about the causes and effects of obesity and about proper nutrition so they can make informed decisions about their food choices. Identify leaders to serve as role models and teachers for children. Lastly we need to evaluate programs and interventions in order to see what is working. Once we know what works we can then make these changes to other communities (2006).
The longer we let this trend continue the more health disparities we will begin to see. The causes of childhood obesity are numerous and multifactorial. In order to reverse the trend of childhood obesity our interventions need to be on a large scale. We need to work with communities and state and local governments to bring about change and programs designed to fight childhood obesity. We must educate the public so they have the knowledge to obtain a healthy weight and lead a healthy lifestyle. We can serve as role models in our community. We must be leaders in the fight against childhood obesity.
What are we going to do about childhood obesity? The Committee on Progress in Preventing Childhood Obesity suggests many interventions to help fight childhood obesity. They include, empowering communities through education so they can become active in the fight and work towards change. Changing the physical environment and building communities so they facilitate more physical activity such as building more play places and parks. Create partnerships between local businesses, state and local governments, community based organizations, and industry to bring people together for a common goal of change. Gain political support to initiate measures to help prevent childhood obesity, such as requiring nutrition information on food from restaurants. Educate the public about the causes and effects of obesity and about proper nutrition so they can make informed decisions about their food choices. Identify leaders to serve as role models and teachers for children. Lastly we need to evaluate programs and interventions in order to see what is working. Once we know what works we can then make these changes to other communities (2006).
The longer we let this trend continue the more health disparities we will begin to see. The causes of childhood obesity are numerous and multifactorial. In order to reverse the trend of childhood obesity our interventions need to be on a large scale. We need to work with communities and state and local governments to bring about change and programs designed to fight childhood obesity. We must educate the public so they have the knowledge to obtain a healthy weight and lead a healthy lifestyle. We can serve as role models in our community. We must be leaders in the fight against childhood obesity.
Tobacco dependency
My report was about tobacco dependency. The article gave different ideas on how to prevent the use of tobacco problems and ways to help people that are already addicted to tobacco. One of the ways was to stop adolescents from starting to use. Most smokers start before they are at the age of 18. There are laws that should be followed, higher taxes raised, education, different ideas on how to stop smoking. As nurses, I think that it is very important to be able to follow up on the different sources to help people. We can turn around and educate and support our patients about them.
Cancer Biomarkers
I chose to discuss the importance about Cancer biomarkers. Biomarkers is any charactoristic that can be objectivley measured and evaluated as an indicator of normal biological or pathogenic processes, or of pharmacological response to therapeutic intervention. A well known example is the estrogen receptor. This paticular biomarker helps in the prognosis and predictor of response to endocrine therapies for breast cancer. The patient is tested for this particular biomarker and if the patient is positive for it 50-60% of the patients will respond to the therapy.
Biomarkers will play an increasingly important role in designing new drugs and improving the detection and treatment of cancer. Some other biomarkers that are widely used are the CA125 which help in the diagnosis of ovarian cancer, and prostate-specific antigen which helps to diagnosis prostate cancer. Since genetic and disease profiles differ from person to person this type of testing can help Doctors to tailor their treatment for that individual, and enhance the effectiveness and safety of cancer care.
Unfortunately progress for biomarkers has been slow. Most candidate biomarkers never advance beyond the discovery phase, and the number of biomarkers approved for clinical use is very small. Biomarkers will be clinincally valuable if they encourage appropriate selective use of treatments or identify cancers at a stage that is easier and less costly to treat. I think there needs to be more studies done to help find more biomarkers to help in the treatment of cancer.
Biomarkers will play an increasingly important role in designing new drugs and improving the detection and treatment of cancer. Some other biomarkers that are widely used are the CA125 which help in the diagnosis of ovarian cancer, and prostate-specific antigen which helps to diagnosis prostate cancer. Since genetic and disease profiles differ from person to person this type of testing can help Doctors to tailor their treatment for that individual, and enhance the effectiveness and safety of cancer care.
Unfortunately progress for biomarkers has been slow. Most candidate biomarkers never advance beyond the discovery phase, and the number of biomarkers approved for clinical use is very small. Biomarkers will be clinincally valuable if they encourage appropriate selective use of treatments or identify cancers at a stage that is easier and less costly to treat. I think there needs to be more studies done to help find more biomarkers to help in the treatment of cancer.
Putting an End to Childhood Obesity: Lost Cause?
I started this leadership assignment with the pre-conceived notion that doing some research and typing up a paper on how we can apply this finding of these reports to our nursing practice would be a piece of cake. As I read more and more articles regarding childhood obesity, the more daunting the topic became. We as nurses have been fighting this growing, epidemic if you will, for years and yet the number has more than tripled over the past 4 decades and currently stand approximately around 9 million with 15% of the rest of them at risk for becoming obese. So, hence the title, I researched a few different ways for us as nurses to approach this matter. Also while researching how we can help I came across some very interesting theories as to why the number of children who are obese is on the rise.
One theory pointed to food marketing to children and youth and how the majority of adds were found to promote foods that were high in sugar, calories, salt, fat and low in nutrients. Although kids are more inclined during this day and age to sit in front of the t.v. instead of go outside and play, these adds only contribute to the problem as they are promoting very unhealthy snacks. These articles also went in to much detail on how habits are learned from other family members and that children will tend to eat foods that are readily available to them and eat greater quantities of these foods when larger portions are provided. So for every caregiver that places a plate of these high calorie/sugar/salt/fat with low nutrient content out for them to grab, they are going to go for the food no questions asked.
So after reading all of the contributing factors and how many different people and things help to form the unhealthy habits in kids, I was pleased to read that there are many options for us as health care workers to intervene. One proposal was directed towards Social Marketing ( having the behavior you would like to see changed exchanged for another activity that is attractive and wanted by the family and the child). Since we as nurses are constantly teaching our patients and making/adjusting/ and implementing our plans of care, this is a easy approach that can be implemented. The road blocks come up when the rest of the family is not agreeing to make the change. "Do as I say, not as I do" is not the best way to promote change in young individuals as their family in their key socializing agent. So in hopes of decreasing morbidity/ mortality rates among individual that illness stems from their obesity, all sectors must work together to make the change and all members of the caregivers and family members must be on board!
PS: just another statistic- 80% of children who have 2 obese parents will become obese themselves, 40% with one obese parent, and only 7% when neither of their parents are obese.
One theory pointed to food marketing to children and youth and how the majority of adds were found to promote foods that were high in sugar, calories, salt, fat and low in nutrients. Although kids are more inclined during this day and age to sit in front of the t.v. instead of go outside and play, these adds only contribute to the problem as they are promoting very unhealthy snacks. These articles also went in to much detail on how habits are learned from other family members and that children will tend to eat foods that are readily available to them and eat greater quantities of these foods when larger portions are provided. So for every caregiver that places a plate of these high calorie/sugar/salt/fat with low nutrient content out for them to grab, they are going to go for the food no questions asked.
So after reading all of the contributing factors and how many different people and things help to form the unhealthy habits in kids, I was pleased to read that there are many options for us as health care workers to intervene. One proposal was directed towards Social Marketing ( having the behavior you would like to see changed exchanged for another activity that is attractive and wanted by the family and the child). Since we as nurses are constantly teaching our patients and making/adjusting/ and implementing our plans of care, this is a easy approach that can be implemented. The road blocks come up when the rest of the family is not agreeing to make the change. "Do as I say, not as I do" is not the best way to promote change in young individuals as their family in their key socializing agent. So in hopes of decreasing morbidity/ mortality rates among individual that illness stems from their obesity, all sectors must work together to make the change and all members of the caregivers and family members must be on board!
PS: just another statistic- 80% of children who have 2 obese parents will become obese themselves, 40% with one obese parent, and only 7% when neither of their parents are obese.
Children and PTSD
Hi!
Upon searching the IOM website for "the perfect" topic I found something mentioning Post Traumatic Stress Disorder (PTSD) in war veterans. We always hear about the war Vets and other adults experiencing stress but I thought, "What about children who experience PTSD?" So I used the brief from IOM and twisted it to something that not only completed the assignment, but caught my interest as well.
I remember being a kid myself and hearing from adults as I became older, "Children are resilient! Nothing effects them because they don't have life experience or understand what's going on around them." "Children are prone to develop PTSD if they are the vicitms of kidnapping or rape, school shootings, car accidents, child abuse, or are a friend or relative of someone who has committed suicide or has been killed" (Oliver, 2007). In fact, the younger the child is, the more likely they will experience PTSD. Unfortunately, children are underdiagnosed with the disorder because of false beliefs of resilience. I teach a 3-4yr old class in Sunday School. One child is in foster care and another child's mother is a recovering drug addict and has recently divorced an abusive husband. One child is hyperactive, aggressive, and has developmental delays. The other child is disruptive, disobedient, and refuses to participate in class. This is an example of the s/s children may display if they have experienced a traumatic event.
We have learned in previous classess that children can be best assessed by their behavior. They are less likely to explain in detail what's wrong, but can show us based on abrupt differences in their behavior. As nurses, it's important to know and understand appropriate developmental stages to be able to interrpret abnormalities in children's behavior. It's also important to perform body assessments as appropriate and VS. Nurses must develop trust in the child to help develop an effective plan of care.
With children, treatment includes cognitive and psychopharmacology therapies. We know children have difficulty sitting listening to adults speak and have a hard time expressing themselves in words. Children are able to express themselves best through play. According to Varcarolis, play therapy, dramatic play, therapeutic games, bibliotherapy, and therapeutic drawing can help children express their emotions. Pictures drawn, playing with toys, and telling stories all unconsciously reveal the child's perception and emotions of the traumatic event. Psychopharmacological medications used alongside with therapy can result in better outcomes. Studies are being done regarding the complete "recovery" of PTSD. It has been recommended that nurses and other mental health pros establish appropriate goals and outcomes rather than expecting a child to completely recover.
Upon searching the IOM website for "the perfect" topic I found something mentioning Post Traumatic Stress Disorder (PTSD) in war veterans. We always hear about the war Vets and other adults experiencing stress but I thought, "What about children who experience PTSD?" So I used the brief from IOM and twisted it to something that not only completed the assignment, but caught my interest as well.
I remember being a kid myself and hearing from adults as I became older, "Children are resilient! Nothing effects them because they don't have life experience or understand what's going on around them." "Children are prone to develop PTSD if they are the vicitms of kidnapping or rape, school shootings, car accidents, child abuse, or are a friend or relative of someone who has committed suicide or has been killed" (Oliver, 2007). In fact, the younger the child is, the more likely they will experience PTSD. Unfortunately, children are underdiagnosed with the disorder because of false beliefs of resilience. I teach a 3-4yr old class in Sunday School. One child is in foster care and another child's mother is a recovering drug addict and has recently divorced an abusive husband. One child is hyperactive, aggressive, and has developmental delays. The other child is disruptive, disobedient, and refuses to participate in class. This is an example of the s/s children may display if they have experienced a traumatic event.
We have learned in previous classess that children can be best assessed by their behavior. They are less likely to explain in detail what's wrong, but can show us based on abrupt differences in their behavior. As nurses, it's important to know and understand appropriate developmental stages to be able to interrpret abnormalities in children's behavior. It's also important to perform body assessments as appropriate and VS. Nurses must develop trust in the child to help develop an effective plan of care.
With children, treatment includes cognitive and psychopharmacology therapies. We know children have difficulty sitting listening to adults speak and have a hard time expressing themselves in words. Children are able to express themselves best through play. According to Varcarolis, play therapy, dramatic play, therapeutic games, bibliotherapy, and therapeutic drawing can help children express their emotions. Pictures drawn, playing with toys, and telling stories all unconsciously reveal the child's perception and emotions of the traumatic event. Psychopharmacological medications used alongside with therapy can result in better outcomes. Studies are being done regarding the complete "recovery" of PTSD. It has been recommended that nurses and other mental health pros establish appropriate goals and outcomes rather than expecting a child to completely recover.
Depressed adults and the effects on children
Hi everyone,
I wrote my paper about how having a depressed parent or parents is negatively impacting millions of childrens and adolescents and what needs to be done to to minimize some of these effects. Over 15 million children under the age of 18 will reside with a depressed parent each year. This results in these children having problems with growth and development, depression, behaviour, and socialization.
Currently there are several tools that screen for depression in adults, they don't however take the next step and pick out adults that have children at home. Implementing such a tool seems so easy, "Do you have children living in your household?" yes or no. If the answer is yes, additional intervention needs to be implemented to ensure that the kids are not being adversely affected.
Addtionally, I would like to see a simple questionaire for adults and children who are entering the healthcare system for other reasons. Doing this would allow for early intervention, and would open up treatment options for more people. Depression is such a huge problem, I feel as a nurse it is my personal responsibility to be on the look out for it, to provide education to patients about it, and to help people get the help that they need.
I wrote my paper about how having a depressed parent or parents is negatively impacting millions of childrens and adolescents and what needs to be done to to minimize some of these effects. Over 15 million children under the age of 18 will reside with a depressed parent each year. This results in these children having problems with growth and development, depression, behaviour, and socialization.
Currently there are several tools that screen for depression in adults, they don't however take the next step and pick out adults that have children at home. Implementing such a tool seems so easy, "Do you have children living in your household?" yes or no. If the answer is yes, additional intervention needs to be implemented to ensure that the kids are not being adversely affected.
Addtionally, I would like to see a simple questionaire for adults and children who are entering the healthcare system for other reasons. Doing this would allow for early intervention, and would open up treatment options for more people. Depression is such a huge problem, I feel as a nurse it is my personal responsibility to be on the look out for it, to provide education to patients about it, and to help people get the help that they need.
The Significance of weight gain during pregnancy
I wrote my paper on the significance of weight gain during pregnancy. Studies show that there are adverse maternal outcomes when too much or too little weight are gained. There can be an increased risk in maternal Type 2 diabetes, pregnancy related hypertension, obesity after pregnancy, and excess weight can lead to difficulties with breast feeding, among many other issues. There are recommended guidelines on weight gain that should be taught to mothers before they even become pregnant to help prevent any potential issues. Babies who are large at birth tend to have a greater increased risk of obesity later in life and underweight babies tend to have a higher incidence of neonatal death. It is important to remember however that there are many factors that come into play such as genetic issues that cannot necessarily be changed.
Education is key in teaching women of childbearing years proper nutrition and exercise habits. If a woman is obese before pregnancy, this can increase her risks for many potential negative outcomes. With obesity on the rise, this is a huge problem for us to address. It is best if the obesity is addressed before conception and lifestyle changes are made before rather than after she becomes pregnant. We as nurses have a huge role in educating our patients about healthy lifestyles and ways to modify them. We can set good examples by using what we teach ourselves. There are many resources for us to utilize in educating patients if we are willing to seek them out and use them.
Education is key in teaching women of childbearing years proper nutrition and exercise habits. If a woman is obese before pregnancy, this can increase her risks for many potential negative outcomes. With obesity on the rise, this is a huge problem for us to address. It is best if the obesity is addressed before conception and lifestyle changes are made before rather than after she becomes pregnant. We as nurses have a huge role in educating our patients about healthy lifestyles and ways to modify them. We can set good examples by using what we teach ourselves. There are many resources for us to utilize in educating patients if we are willing to seek them out and use them.
New developments in contraception and the implication on the future
My paper focuses on the impact of unplanned pregnancies and the unmet need for new contraceptive methods. This is an area that greatly impacts public health for all and in turn has a big impact on nursing. The IOM is helping to push for development of new contraceptive methods to fill this gap and in turn answer some of the world's biggest health problems.
Some areas that are affected by unplanned pregnancies include maternal mortality, maternal depression and increased risk of physical abuse. The impact of having children to close together also has a negative impact on the health of the world. Child spacing and planned pregnancy statistically shows an increase in infant survival and healthier children in general. Unplanned conception contributes to financial hardship for women and families. In addition new methods that could provide dual protection against HIV and other STD's would have a large impact on world health.
There are a variety of methods that are available today for contraception. However there are special groups of people in great need of more options. For example some include, postpartum breastfeeding women, women approaching menopause, men and women with health problems that limit choices and those with limited access to health care.
Fortunately there is a lot of promise for developing new products. The IOM has created some important guidelines for directing this research. The impact of creating these new options for family planning is great.
Providing knowledge to others that changes are happening in this area is an important thing as a nurse. Increasing the number of planned pregnancies will have large implications for changing the health of the world.
Some areas that are affected by unplanned pregnancies include maternal mortality, maternal depression and increased risk of physical abuse. The impact of having children to close together also has a negative impact on the health of the world. Child spacing and planned pregnancy statistically shows an increase in infant survival and healthier children in general. Unplanned conception contributes to financial hardship for women and families. In addition new methods that could provide dual protection against HIV and other STD's would have a large impact on world health.
There are a variety of methods that are available today for contraception. However there are special groups of people in great need of more options. For example some include, postpartum breastfeeding women, women approaching menopause, men and women with health problems that limit choices and those with limited access to health care.
Fortunately there is a lot of promise for developing new products. The IOM has created some important guidelines for directing this research. The impact of creating these new options for family planning is great.
Providing knowledge to others that changes are happening in this area is an important thing as a nurse. Increasing the number of planned pregnancies will have large implications for changing the health of the world.
"Obesity" Soon to be the new social norm.
My paper covered the topic obesity. I was able to learn that obesity is actually a much larger problem than society thinks it is. Obesity is actually an epidemic of disease proportion. In one of the articles I read, it is stated that if the obesity trend continues on the path it is currently taking, without interventions, by 2025 obesity will become the new social norm and "anyone" with a BMI of less than 30 will be considered small.
Obesity is not a new disease, but with the recent advancements in technology, current fast food trends, and the general populations apathy toward health, society has become more and more idle and indifferent to their well being. Over the past 30 years alone obesity rates of American children have more than doubled among preschool to age 5 and 12-19 years of age and more than tripled among children aged 6-11. These numbers were gathered by the CDC and used in the report I used. This is a shocking number to me especially since this same report correlated this increase directly to the change in family situation. Over this same period the women in the work force has increased dramatically taking mothers out of the home and causing a decrease in the amount of time spent cooking for the family. This was either due to lack of energy, convenience or get this socialization needs among family's. Because of fast food the American family has a new kitchen table or so it would seem.
Obesity is not a new disease, but with the recent advancements in technology, current fast food trends, and the general populations apathy toward health, society has become more and more idle and indifferent to their well being. Over the past 30 years alone obesity rates of American children have more than doubled among preschool to age 5 and 12-19 years of age and more than tripled among children aged 6-11. These numbers were gathered by the CDC and used in the report I used. This is a shocking number to me especially since this same report correlated this increase directly to the change in family situation. Over this same period the women in the work force has increased dramatically taking mothers out of the home and causing a decrease in the amount of time spent cooking for the family. This was either due to lack of energy, convenience or get this socialization needs among family's. Because of fast food the American family has a new kitchen table or so it would seem.
Tuesday, December 15, 2009
Childhood Obesity
I too chose to do my leadership paper on childhood obesity. I is no secret that America's waistline is growing at a very unhealthy rate, and it's no wonder with our sedative lifestyle and our supersized meal portions at fast food restaurants. The only exercise some of our young ones get is wiggling their thumbs over the buttons of their pretendo games. Childhood obesity rates have doubled in the last 30 years with an obvious health disparity seen in low income, Hispanic, African, and Native American children.
Ok so they're fat kids what's the big deal? Along with obesity comes a whole slew of unhealthy complications: greater rates of depression, poor body image, low self concept, and a higher rate of eating disorders. Some of the physiological complications include: Type 2 diabetes, hypertension, high serum cholesterol, low LDL, sleep apnea, early puberty, and skeletal problems. It is far easier to treat these patients when they are just obese instead of treating them when they are an obese diabetic patients with hypertension and cardiovascular disease.
I wasn't surprised to learn, through my research, that many nurses find it difficult to broach the subject of obesity with their patients, because I feel the same way. They feel uncomfortable about focusing on a childs weight in the absence of a related condition. Some parents may become defensive or deny there is a problem. They may feel they are being blamed for the problem. Some parents use food as a symbol of affection and feel uncomfortable about denying food to their children. Some nurses feel that because many parents of obese children are obese themselves they are hidered in their ability to manage the child's obesity.
As nurses, we will be in an ideal position to deal with this growing epidemic by: identifying at risk groups, identifying hidrances to treating obesity, teaching nutritional needs, explaining complications associated with obesity, and outlining exercise needs for our obese patients.
CF
Ok so they're fat kids what's the big deal? Along with obesity comes a whole slew of unhealthy complications: greater rates of depression, poor body image, low self concept, and a higher rate of eating disorders. Some of the physiological complications include: Type 2 diabetes, hypertension, high serum cholesterol, low LDL, sleep apnea, early puberty, and skeletal problems. It is far easier to treat these patients when they are just obese instead of treating them when they are an obese diabetic patients with hypertension and cardiovascular disease.
I wasn't surprised to learn, through my research, that many nurses find it difficult to broach the subject of obesity with their patients, because I feel the same way. They feel uncomfortable about focusing on a childs weight in the absence of a related condition. Some parents may become defensive or deny there is a problem. They may feel they are being blamed for the problem. Some parents use food as a symbol of affection and feel uncomfortable about denying food to their children. Some nurses feel that because many parents of obese children are obese themselves they are hidered in their ability to manage the child's obesity.
As nurses, we will be in an ideal position to deal with this growing epidemic by: identifying at risk groups, identifying hidrances to treating obesity, teaching nutritional needs, explaining complications associated with obesity, and outlining exercise needs for our obese patients.
CF
Antibiotic Overuse and Resistance
I chose to do my paper on antibiotic resistance. I chose it primarily because it is a topic that I am confronted with on a frequent basis by friends and family. Basically, I wanted to delve into the causes for antimicrobial resistance and steps to thwart it.
I discovered as we all know from lectures that a wide variety of bacterial strains are becoming more and more resistant to antibiotics due to a combination of factors: inappropriate use by patients and too frequently prescribed antibiotics by healthcare providers.
Primary care providers are overly prescribing antibiotics due to pressure from patients, a fear of losing patients, heavy workloads (more patients means that there is often less time available to individual patients, so there is pressure to get them in and out), and demands to keep the public happy (happy patients equals more money).
The public is also to blame for their often inappropriate use of antibiotics. We are all knowledgeable about the importance of educating our patients on the need to take their full course of antibiotics. However, I stumbled across an article that stated that it is becoming more and more common for people to order antibiotics online without a prescription (self-medicating). Therefore, we are in a position to educate our patients not only on the reasons for their antibiotics and on the importance of taking them correctly, but also on the reasoning for their not being prescribed what they think is a necessary tool for getting better. They need to understand what determines antibiotic use or not (viral vs bacterial and broad spectrum antibiotics vs gram specific antibiotics). Other measures to control infection are equally important to impart to out patients (e.g., handwashing).
I discovered as we all know from lectures that a wide variety of bacterial strains are becoming more and more resistant to antibiotics due to a combination of factors: inappropriate use by patients and too frequently prescribed antibiotics by healthcare providers.
Primary care providers are overly prescribing antibiotics due to pressure from patients, a fear of losing patients, heavy workloads (more patients means that there is often less time available to individual patients, so there is pressure to get them in and out), and demands to keep the public happy (happy patients equals more money).
The public is also to blame for their often inappropriate use of antibiotics. We are all knowledgeable about the importance of educating our patients on the need to take their full course of antibiotics. However, I stumbled across an article that stated that it is becoming more and more common for people to order antibiotics online without a prescription (self-medicating). Therefore, we are in a position to educate our patients not only on the reasons for their antibiotics and on the importance of taking them correctly, but also on the reasoning for their not being prescribed what they think is a necessary tool for getting better. They need to understand what determines antibiotic use or not (viral vs bacterial and broad spectrum antibiotics vs gram specific antibiotics). Other measures to control infection are equally important to impart to out patients (e.g., handwashing).
Major Depression
My topic for this leadership paper is this:
Major Depression: Screening and Treatment
I found some useful information about the subject, a lot we have already covered in mental health. Basically there are several risk factors that we should be looking for such as gender (oh, your a female...), age (over 65?), family history of depression, chronic illness, drug/alcohol abuse, among others. We should screen these people for depression using one of the many depression assessment tools out there (Zung, Geriatric, etc.) But what about those that don't have risk factors for depression. Well, screen them anyway. It is possible that a person can have zero risk factors but still suffer from depression. Early recognition and treatment make screening worth it.
A nurse leader should know about treatment modalities for depression. Psychopharmacology and psychotherapy are among the most used. We should know that the use of antidepressants can actually increase suicide attempts and watch for that. We should learn about different drug interactions that can occur (SSRIs + MAOIs = not good), not to mention adverse reactions that can occur using the drug alone (mentioned).
As nurse leaders we should know that depression will be found throughout the medical field, not just tucked away in the mental health sector all neat and easy. This is why screening is so important: because it can be so easily missed.
PS. While We're on the Subject is Jacque :)
Major Depression: Screening and Treatment
I found some useful information about the subject, a lot we have already covered in mental health. Basically there are several risk factors that we should be looking for such as gender (oh, your a female...), age (over 65?), family history of depression, chronic illness, drug/alcohol abuse, among others. We should screen these people for depression using one of the many depression assessment tools out there (Zung, Geriatric, etc.) But what about those that don't have risk factors for depression. Well, screen them anyway. It is possible that a person can have zero risk factors but still suffer from depression. Early recognition and treatment make screening worth it.
A nurse leader should know about treatment modalities for depression. Psychopharmacology and psychotherapy are among the most used. We should know that the use of antidepressants can actually increase suicide attempts and watch for that. We should learn about different drug interactions that can occur (SSRIs + MAOIs = not good), not to mention adverse reactions that can occur using the drug alone (mentioned).
As nurse leaders we should know that depression will be found throughout the medical field, not just tucked away in the mental health sector all neat and easy. This is why screening is so important: because it can be so easily missed.
PS. While We're on the Subject is Jacque :)
Diabetes
I chose to write my leadership paper on diabetes. It has always been an interesting disease and there is tons of research on the subject. Also, this disease hits close to home. My father has been diagnosed with Type II diabetes for about 15-16 years and it has greatly impacted my family's life. My family and I are a little more health conscious and have seen some of the complications that occur with this disease. I am hoping that one day there will be a cure and as a nurse, I can help educate people on disease management and/or prevention.
Through research, I learned that often time's diabetes education is overlooked and critical information is often not explained to the diabetic patient. This leads to patient noncompliance and serious complications (i.e. retinopathy, neuropahty, renal failure, etc.). Many health care providers don't realized that diabetes is a disease where 99% of diseae management is the patient's responsibility. Some strategies nurses could use to to assist with patient self management are: basic education (using simple, easy-to-understand terms and instructions), help with setting specific, realistic goals, engendering a sense of control (self-efficiency), arranging for professional or social support, and providing feedback. Also research is proving that physicians who collaborate with a diabetic educator (usually a specialized RN) can increase patient compliance throgh the evidence of good A1c conrtol (<7%), blood pressure of <130/80 mmHg, LDL cholesterol (<100 mg/dL) and meal/activity plan.
Bottom line is that more education and motivation we provide our patients, the more likelihood that our patients will take on an active role in their disease management. Also, as Phyllis and Tanya mentioned childhood obesity, we as nurses, are going to be seeing a huge increase in diabetes and so we need to take the intitiative now to educate ourselves about diabetes and share this with our colleagues and the public. After all, we are the best care providers to our patients in that we provide better education, spend more time them, are better listeners, and know our patients better than the physician.
Through research, I learned that often time's diabetes education is overlooked and critical information is often not explained to the diabetic patient. This leads to patient noncompliance and serious complications (i.e. retinopathy, neuropahty, renal failure, etc.). Many health care providers don't realized that diabetes is a disease where 99% of diseae management is the patient's responsibility. Some strategies nurses could use to to assist with patient self management are: basic education (using simple, easy-to-understand terms and instructions), help with setting specific, realistic goals, engendering a sense of control (self-efficiency), arranging for professional or social support, and providing feedback. Also research is proving that physicians who collaborate with a diabetic educator (usually a specialized RN) can increase patient compliance throgh the evidence of good A1c conrtol (<7%), blood pressure of <130/80 mmHg, LDL cholesterol (<100 mg/dL) and meal/activity plan.
Bottom line is that more education and motivation we provide our patients, the more likelihood that our patients will take on an active role in their disease management. Also, as Phyllis and Tanya mentioned childhood obesity, we as nurses, are going to be seeing a huge increase in diabetes and so we need to take the intitiative now to educate ourselves about diabetes and share this with our colleagues and the public. After all, we are the best care providers to our patients in that we provide better education, spend more time them, are better listeners, and know our patients better than the physician.
Childhood Obesity
It took me awhile to decide what I wanted to do my topic on for this paper. I found childhood and adolescent obesity to strike my interest. It's no secret that our nation has an outbreak of not only adults becoming increasingly overweight and obese, but now children too. Through my research for this paper I confirmed what I already knew and gained more knowledge r/t why obesity is prevalent in children and adolescents. Genetics, behavioral factors, and environmental factors contribute to the childhood obesity in the U.S. As Phyllis mentioned nearly 1/3 of the U.S. children and adolescents are overweight or obese. Determinging obesity in children and adolescents is done a little bit differently than an adult. BMI is still used but it's determined by and obesity and overweight for children is defined a BMI at or above the 85th percentile and lower than the 95th percentile. Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex. Among the contributing factors we all know that kids now a days have so many media influences. These include video games, computers, their cell phones, & television. In my paper I also included the fact that television isn't like it was when I was little and growing up. Children now can record their shows that they want to watch and this allows for even more time in front of the television daily. Children 8-18 years old spend an average of 3 hours per day with one or more media influence. This is just an average, I have seen up to 6+ hours with several different kids in front of the television or playing video games. These things are allowing for decreased physical activity and an increased sedentary lifestyle among children and adolescents. It has been reported that Children and adolescents who participate in physical education (P.E.) in school on a daily basis have dropped 14% in the last 13 years. This is obsurd to me, and especially with the kind of lifestyles children have now compared to 13 years ago. P.E. should be a requirement and participation should be required unless doctor execused. This is the way it was when I was going to school clear up until I graduated and that was only 4 years ago that participation was required it was your grade no matter what. With the exception of a doctor's excuse. This information is not only beneficial for us as nurses and especially the people who want to work with PEDS, but for the people who are parents and whose children go to school or a day care facility.
Monday, December 14, 2009
Leadership Paper on Childhood Obesity
I chose to do my paper on childhood obesity and what local governments are doing about it. This particular topic has been a concern of mine for sometime now. I have been noticing that we are seeing more obese children than ever before.
I learned some surprising facts through my research because I was under the impression that no one was really doing much about childhood obesity. I have heard of a few schools trying to change lunch programs or get sugar and candy out of school vending machines but it did not seem as thought that was doing much.
I have learned through several articles that the Institute of Medicine (IOM) created a committee for childhood obesity prevention. This committee came about due to some government officials that also thought no one was targeting this growing dilema.
The committee was created with the focus on identifying practices that would serve as the basis for a set of recommendations for local governments to consider in planning, implementing and refining obestiy efforts for children in their local areas.
The target age group was 12 - 19 year olds and the approach to action was preventing childhood obesity is the first action to healthier adults through healthier environments, providing better health care, involvement and collaboration with local entities, and implementation of school programs.
It was stated in the report (IOM, 2009) that local governments were the first place to start because they have the means to make policy changes through law to focus on resoures and implement plans to start childhood prevention programs. Local governments also have provisions for evaluating the effectiveness of the programs.
The committee recommended that raising awareness of healthy eating and diet, physical activity goals, and decreasing sedentary behavior were just a few places to start with educating the public.
I really felt like the schools were an important place to start with this education with children and according to (Moyers, et al, 2005) school nurse thought overall this was a really good idea but were very discouraged because they were not getting support from parents or counseling within the schools.
As a nurse leader I still think the schools would be a good place to start with the childhood prevention programs. I think that teams need to be formed with parents, educators, administrators, school nurses, school dietary staff and any other person interested in seeing children growup healthy and happy.
I believe that if we target childhood obesity now, we as nurses will see less cardiovascular, hypertension and diabetes in the future and we will see an all around heathier world full of people.
I learned some surprising facts through my research because I was under the impression that no one was really doing much about childhood obesity. I have heard of a few schools trying to change lunch programs or get sugar and candy out of school vending machines but it did not seem as thought that was doing much.
I have learned through several articles that the Institute of Medicine (IOM) created a committee for childhood obesity prevention. This committee came about due to some government officials that also thought no one was targeting this growing dilema.
The committee was created with the focus on identifying practices that would serve as the basis for a set of recommendations for local governments to consider in planning, implementing and refining obestiy efforts for children in their local areas.
The target age group was 12 - 19 year olds and the approach to action was preventing childhood obesity is the first action to healthier adults through healthier environments, providing better health care, involvement and collaboration with local entities, and implementation of school programs.
It was stated in the report (IOM, 2009) that local governments were the first place to start because they have the means to make policy changes through law to focus on resoures and implement plans to start childhood prevention programs. Local governments also have provisions for evaluating the effectiveness of the programs.
The committee recommended that raising awareness of healthy eating and diet, physical activity goals, and decreasing sedentary behavior were just a few places to start with educating the public.
I really felt like the schools were an important place to start with this education with children and according to (Moyers, et al, 2005) school nurse thought overall this was a really good idea but were very discouraged because they were not getting support from parents or counseling within the schools.
As a nurse leader I still think the schools would be a good place to start with the childhood prevention programs. I think that teams need to be formed with parents, educators, administrators, school nurses, school dietary staff and any other person interested in seeing children growup healthy and happy.
I believe that if we target childhood obesity now, we as nurses will see less cardiovascular, hypertension and diabetes in the future and we will see an all around heathier world full of people.
Cord Blood
For some reason guys I found this topic to be of great interest. Not only because I am pregnant, but because Labor and Delivery is a huge interest to me. This topic kind of goes along strongly in this field of nursing. Anyhow, my article focuses on Hematopoietic Progenitor Cells (HPC's)used in stem cell research. HPC's are one of many types of cells found in cord blood. The topic was so broad that I needed to focus my attention on just one type for the time being and hopefully research more later. HPC have been found to help, and even work in the treatment and recover of illness and disease such as blood disorders like leukemia, sickle cell crisis, and immunodificiency's according to the report I read titled, "Cord Blood: Establishing a national Hematopoietic Stem Cell Bank Program."
The article and my paper further discuss some of the research that has been done on this type of cord blood, the three different types of Stem Cell Bank Programs; Public, Private, and Mixed, what each type of bank does, and some of the legal and ethical delimas that are found with this topic and research. While I feel like I have just scratched the surface on my research related to this topic, I also feel that given the situation as a nurse, if I was ever presented with questions regarding this topic; I would know how to answer them in the most holistic way possible. Also, if I didn't know the answer to a question, I am confident that after this research I would no where to begin in order to obtain the information requested. If anyone in class would like to read my paper, please e-mail me via webcampus and I will send it to you as quickly as possible. Thanks for your time.
The article and my paper further discuss some of the research that has been done on this type of cord blood, the three different types of Stem Cell Bank Programs; Public, Private, and Mixed, what each type of bank does, and some of the legal and ethical delimas that are found with this topic and research. While I feel like I have just scratched the surface on my research related to this topic, I also feel that given the situation as a nurse, if I was ever presented with questions regarding this topic; I would know how to answer them in the most holistic way possible. Also, if I didn't know the answer to a question, I am confident that after this research I would no where to begin in order to obtain the information requested. If anyone in class would like to read my paper, please e-mail me via webcampus and I will send it to you as quickly as possible. Thanks for your time.
Sunday, December 13, 2009
LeadershipPaper
I chose to do my leadership paper on depression and how it effects parents. I found two articles that addressed this issue. The article I found on the IOM website was not as detailed as the other, but they both seemed to try to put out the same idea...
Depression in parents is very prevelant, but usually goes unnoticed. This means that the depression that affects parents also goes undiagnosed and is undertreated. Most parents will bring their child in to see a health care professional if they feel there is something wrong with their child, whereas they are a lot less likely to seek help for themselves. Because of this, it is important for nurses to keep a watchful eye for signs of depression in parents when they bring their child in for care. This will help recognize the parents' issue more quickly so they can be screened and diagnosed sooner. Early screening and diagnosing will also help those parents get much needed medical attention more quickly.
Nurses can also take on the role of establishing policies, procedures, and/or protocols for all health care providers to follow so everyone will have the responsibility to help these suffering parents. By helping the parents suffering from depression, we will also be helping the children of these parents.
Depression in parents is very prevelant, but usually goes unnoticed. This means that the depression that affects parents also goes undiagnosed and is undertreated. Most parents will bring their child in to see a health care professional if they feel there is something wrong with their child, whereas they are a lot less likely to seek help for themselves. Because of this, it is important for nurses to keep a watchful eye for signs of depression in parents when they bring their child in for care. This will help recognize the parents' issue more quickly so they can be screened and diagnosed sooner. Early screening and diagnosing will also help those parents get much needed medical attention more quickly.
Nurses can also take on the role of establishing policies, procedures, and/or protocols for all health care providers to follow so everyone will have the responsibility to help these suffering parents. By helping the parents suffering from depression, we will also be helping the children of these parents.
MMR vaccine and autism.... is there a link?
I wrote my leadership paper on the possible link between the Measles-Mumps-Rubella (MMR) vaccine and autism. My goal was to find the truth behind this very controversial argument. I feel it is important for all of us to stay up on the current research so we can keep our patients informed.
I researched the validity of the argument that the MMR vaccine does cause autism, I found this argument to be false. Most of the arguments for vaccines causing autism are just media hype. The true facts are that there is a higher number of diagnoses of autism is due to the broadened diagnostic criteria. Another factor that leads parents to believe that their child has contracted autism from their immunizations is that the signs and symptoms of early onset autism do not show up until the child is about two years old, around the same time they are recieving their vaccinations. There is no genetic link between autism and the MMR vaccine. There are no facts leading us to believe that immunizations cause autism.
The main focus of my paper was the importance of the nurse to educate their patients about the true facts regarding immunizations and autism. This will allow parent, patients and families to make an informed decision about vaccines. There is no evidence that immunizations cause autism, however, there is evidence that immunizations decrease disease. We, as nurses, need to let our patients know about the importance of vaccines to keep our society safe.
I researched the validity of the argument that the MMR vaccine does cause autism, I found this argument to be false. Most of the arguments for vaccines causing autism are just media hype. The true facts are that there is a higher number of diagnoses of autism is due to the broadened diagnostic criteria. Another factor that leads parents to believe that their child has contracted autism from their immunizations is that the signs and symptoms of early onset autism do not show up until the child is about two years old, around the same time they are recieving their vaccinations. There is no genetic link between autism and the MMR vaccine. There are no facts leading us to believe that immunizations cause autism.
The main focus of my paper was the importance of the nurse to educate their patients about the true facts regarding immunizations and autism. This will allow parent, patients and families to make an informed decision about vaccines. There is no evidence that immunizations cause autism, however, there is evidence that immunizations decrease disease. We, as nurses, need to let our patients know about the importance of vaccines to keep our society safe.
Thursday, November 19, 2009
NURS 257 IOM Assignment
The Institute of Medicine (IOM) was established in 1970 as part of the National Academy of Sciences. The task of IOM is to “..ask and answer the nation’s most pressing questions about health and health care.” Information is provided from the IOM to policy makers and other influential people who can make changes to improve health care. (“Institute of Medicine”, 2009)
Comments to this posting are from students in NURS 257. Their assignment is to summarize a report from the IOM as it relates to Nursing and how nurse leaders may utilize this information. Enjoy!
Institute of Medicine. (2009, November 19). The National Academies. Retrieved November 19, 2009, from http://www.iom.edu/.
Comments to this posting are from students in NURS 257. Their assignment is to summarize a report from the IOM as it relates to Nursing and how nurse leaders may utilize this information. Enjoy!
Institute of Medicine. (2009, November 19). The National Academies. Retrieved November 19, 2009, from http://www.iom.edu/.
Sunday, November 8, 2009
"You're going to make a great nurse..."
OK, I'll blog...
First a shout out to all my fellow classmates and our instructors. Can't believe how quickly this semester is going by and how much we have learned this year already.
The other day someone told me that I will be a great nurse. Wow!! What do you say to that? In my mind I quickly did all the buts...
First a shout out to all my fellow classmates and our instructors. Can't believe how quickly this semester is going by and how much we have learned this year already.
The other day someone told me that I will be a great nurse. Wow!! What do you say to that? In my mind I quickly did all the buts...
- but I can't get an IV in for the life of me
- but I might not pass the NCLEX
- but I haven't put in a catheter on a real person
- but I haven't memorized all the medications yet
- but, but, but, but.........
Instead, I just humbly said thanks. As the date of our graduation slowly inches closer, I have to keep reminding myself that I will be a nurse. And I hope that I will be someone's great nurse. I think it is really true that people's perception of you is changed the minute they find out you are a nurse. Their expectation of you rises - you shine a little brighter!! Am I ready for that? I hope. It made me realize that I need to keep up the hard work, learn all those medications, put in that IV and catheter, pass the NCLEX. I want to be that great nurse!!
Has this happened to you yet? How did you respond?
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