Abstract The paper relates that the use of patient simulation is one of the fastest growing technologies used in nursing education curriculum today, and confirms that patient simulation provides a standardized clinical circumstance in which a student can learn. The paper continues and comments that rupturing and dissecting abdominal aortic aneurysms are among the highest misdiagnosed areas of medicine today. Nursing student and novice nurses rarely get an opportunity to engage with this type of patient in a learning environment. The paper concludes that use of patient simulation may be a device educators can use to bridge the gap between aortic aneurysm and the novice nurse.
Outline:
Introduction
Advantages to Patient Simulation
Adult Learning Theory and Student Centered Learning
Theoretical Framework
Abdominal Aortic Aneurysms: Where Simulation Can Help
Curriculum
Tenets for Teaching using Technology
Components for Implementing Simulation
Evaluation
From the Paper "Prior to the use of simulation, students learned through skills labs and practiced on fellow students. When students perform assessments on peers, they rarely find anything abnormal and usually find values in normal ranges (Medley & Horne, 2005, 33). Patient simulation lessens the difficulty nursing students experience when transitioning from clinical lab to actual patient situations (Medley & Horne, 2005, 31). This becomes particularly important in patients with difficult diagnoses. In addition, patient simulators can provide clinical situations that may not be fully developed in real life (Waldner & Olson, 2007, 1). Clinical situations can often be unpredictable or not meet the students' needs at that particular time. Patient simulation provides a standardized clinical circumstance in which a student can learn (Waldner & Olson, 2). Patient simulation offers opportunity to either interrupt simulation or wait until the end for discussion."
Abstract In this patient care study, the author looks at a 62-year-old female with complaints of lower abdominal pain, with hematuria and dysuria. The patient lives at home with her husband. She has seven grown children as well as grandchildren and admits to financial concerns. The author describes the patient's full medical history and all the medical tests and treatments she has undergone prior to this study. The paper gives the results of an intravenous pyelogram, cystoscopy, and biopsy as reported in patient history and gives a full summary of all of the laboratory results. Based on the information given in the tests and the patient's history, the author concludes that the patient has type II diabetes. He suggests that she needs to work on her lifestyle in order for recurring problems not to happen.
Table of Contents
Patient History
Laboratory Tests
Other Nursing Measures
Nursing Process and Care Plan
Nursing Diagnoses
Discharge Summary
Summary
From the Paper "An intravenous pyelogram produces an image of the kidneys, ureter, and bladder by administering a radiopaque contrast medium that is cleared from the bloodstream and concentrated by the kidneys. This part of the initial assessment of a suspected urologic problem provides a rough estimate of kidney infection. Pre-procedure nursing considerations include: assessment of patient for allergies, the use of laxatives for the elimination of feces and gases from the intestinal tract, liquid restriction 8 to 10 hours before test, and instructions concerning the procedure itself and sensations felt during the procedure. A cystoscopy is the direct visualization of the urethra and bladder using a cystoscope. Sedatives may be used prior to the procedure. A brush biopsy may be performed after a cystoscopic examination in order to obtain cells and surface tissue fragments for histologic analysis."
Abstract This paper examines the connection between an aortic graft to a duodenum fistula as a cause for upper GI bleeding. Generally, aortic grafts are used to treat abdominal aortic aneurysms. The paper defines aortic aneurysms as a weak area in the wall of the abdominal aorta, the artery that carries blood from the heart to the rest of the body. The paper concludes that aortic grafting can be a major cause of GI bleeding as an after effect of treating an abdominal aortic aneurysm and a method of treatment requires replacement of the stent-graft.
From the Paper "Treatment of abdominal aortic aneurysms may require surgery but for some patients, a new non-surgical treatment called stent-graft repair can be performed. The following is the results of a prospective, nonrandomized, multicenter clinical trial that compared endovascular stent graft exclusion of abdominal aortic aneurysms with open surgical repair. During an 18-month period, 250 patients with infrarenal aneurysms underwent treatment at 12 study sites. 190 patients underwent endovascular repair using the Medtronic AneuRx stent graft (Sunnyvale, California), and 60 underwent open surgical repair. There was no significant difference in operative mortality rates between the groups. The patients who underwent stent grafting had significant reductions in blood loss and days in the intensive care unit and in the hospital, with an earlier return to function. Primary technical success at the time of discharge for the patients with stent grafts was 77%, largely as a result of a 21% endoleak rate. At one month, the endoleak rate had decreased to 9%."
Abstract This paper explains that ovarian cancer is the 'Silent Killer' because, 70 to 75% of the time, by the time the cancer is discovered, it has spread to other areas of the body, especially into the abdomen. By then, it is too late to hope for a recovery. The author points out that abdominal swelling, abdominal or pelvic pain, and a feeling of fullness are some of the symptoms of ovarian cancer, which are common symptoms to many other disorders; therefore, doctors, presented with these symptoms immediately should perform a pelvic and recto-vaginal examination, order some blood tests including CA125, and order a transvaginal ultrasound examination. The paper relates that, although the direct cause of ovarian cancer is not known, some of the major risk factors are family history and breast cancer at an early age; other factors are menopause, obesity, early menarche, late first pregnancy, the use of clomiphene citrate to encourage pregnancy, and infertility.
From the Paper "Sometimes it so happens that the cancerous cells break away from the original tumor and end up in another entirely different part of the body. This process is known as 'metastasis'. Many different kinds of tumors can be formed within the ovaries of a woman, in fact more than thirty known types. However, ovarian cancers are generally divided into three main categories, according to the type of cells that formed them, which are epithelial cancers, that are the most common form of ovarian cancers, and which are formed from the various cells that line or cover the ovaries. The second broad category of ovarian cancer is the germ cell cancer, which in other words means that this cancer starts from germ cells within the ovaries."
Tags: laparotomy, ultrasound, gene, breast, surgery
Abstract In this paper the author looks at the concept of critical thinking. He examines the world of academia, which he suggests is saturated with ideas, assumptions and statistics. He suggests that many educators strive to teach the skills to utilize these ideas, assumptions and statistics in both a scholarly context and in real life situations. He then contends that to assume that critical thinking skills are so easily transferable is far more complex. With this in mind he moves on to look at Stephen Jay Gould's essay, "The Median Isn"t the Message,? in which he suggests that Gould describes the difficulties of taking statistics and academic studies out of context. Gould does this by referring to a time when he was diagnosed with a disease and how easily he could have been misled by the statistics had he chosen not to use his own critical thinking.
From the paper:
?Gould points out these personal experiences to send a message to his readers. Generally one does not relate such personal details of one's life to simply prove some academic concept. Gould wants his readers to take his experience and apply it. He tells the reader through his own account, to question everything, especially statistics. Humans have a tendency to hear statistics and interpret them without questioning what is really being said.?
Abstract The paper shows how there is a common misconception in people that having an aneurysm means bleeding in the brain when in fact an aneurysm is a balloon-like swelling in a blood vessel that can affect any large vessel in your body; these larger vessels being arteries. The paper examines the risk for the patient, the difficulty in diagnosing them and the various treatments available.
From the Paper "It is extremely difficult to diagnose an aneurysm. Having a thin body and a moderately large sized aneurysm is the ideal conditions in which you or your doctor may be able to detect one. Most of the aneurysms are discovered as a result of medical imaging for other conditions, by ultrasound exams, CAT scans, MRI's, or even plain X-rays of the abdomen. Aneurysms are also detected by physical exam, on a basic chest or stomach X ray, or by using ultrasound. The size and location can be found through echocardiography or radiological imaging, such as arteriography, magnetic resonance imaging (MRI), and computed topography (CT) scanning."
Abdominal emergencies can be broadly grouped into patients who present with either abdominal injury, abdominal pain, or both. In any case, the physician must determine the severity of the situation (9:1418). Urgent circumstances require attentiveness to the patient's immediate needs (9:1418).
In cases of abdominal injury, immediate life.threatening injuries should take precedence (9:718). A useful way to organize this effort is according to the ABCs of trauma: specifically, obtaining an airway, assuring adequate ventilation, and restoring circulating blood volume (9:718). Only at that point can further steps towards treatment be undertaken.
Furthermore, anytime a patient comes into the emergency department with severe abdominal trauma, a surgeon should be ..."
From the Paper "Abdominal injuries are common and are the most frequent cause of unnecessary death due to hemorrhage and rupture. Emergency treatment of abdominal injuries or trauma, as with other injuries, begins with assessing the severity and giving immediate care (5:256). It is important to ensure adequate airway. Intubate if necessary, and administer oxygen. The cervical spine should be immobilized if cervical spine injury is possible.
The next step is to assess ventilation. Auscultate the chest for the presence of symmetric breath sounds. A search of flail segments and chest wounds should be made, and a thoracostomy as indicated for pneumothorax should be performed. After this, adequacy of circulation should be noted. Palpate for the presence of pulses, look for signs of shock, and stop gross..."
Abstract This paper examines a common assumption that children and adolescents with inflammatory bowel disease or functional gastro-intestinal complaints are children who have impaired psycho-social adjustment and how coordinated care for maintenance of optimum functioning is often required. It considers a two-year-old girl with gastro-intestinal problems which include recurrent abdominal pain, diarrhea, constipation and vomiting and how she is obviously not able to communicate well about what is happening in her body.
Outline
Introduction
Case Study
Tests
Possible Diagnoses
Problem Management
From the Paper "Given the results from the MRI, several other diseases were dismissed as likely causes of the child's problem. At this point, the tendency of the team was to identify the child as having one of the functional gastrointestinal disorders. As Hyams (1999) noted, this is often a diagnosis that is seen as pejorative, or as indicating that it is the child's problem, and that it is more psychological than physiological. However, Hyams indicated, this is a negative, and inaccurate, way to look at the problem. There clearly is a disease state existing for most of these children, but technology and testing are not able to pinpoint the exact source of the problem. Thus, we are left with diagnoses like irritable bowel syndrome, chronic nonspecific diarrhea, functional constipation, non-ulcer dyspepsia, and indeterminate colitis."
Abstract This paper attempts to define and explain Irritable bowel syndrome (IBS), which affects approximately 20% of the Western population, and accounts for frequent absenteeism from work and impaired quality of life. The paper outlines how it is characterised by altered bowel habits and abdominal pain, in the absence of any other GI problems and diagnosis is based on the Rome criteria. Despite the the heterogenous nature of the disorder, the writer succeeds in giving a general overview of this disease for the reader.
From the Paper "Psychiatric disorders are recorded in 50-80% of patients with IBS in some studies, although a single disorder is not well defined. Anxiety, depression, somatization, and neurosis have all been recorded1. In patients with IBS, acute psychological attacks have been shown to significantly alter their gastrointestinal motility2. Drossman et al found that patients with IBS undergo more suffering from psychosocial distress than non-patients with IBS3. Osterberg et al, on the other hand, found that there were minute differences in psychological distresses between patients with IBS, and non-patients with IBS4. Thus, assorted studies have conclusions that vary from each other. Altered gastrointestinal motility seems to be associated with the aetiology of IBS, but is not diagnostic. Serotonin (5-HT) has been studied for its role in regulating colonic motility in humans, but it is not yet known whether alterations in the colonic 5-HT system are involved in the pathophysiology of irritable bowel syndrome5. Lincoln et al established that the total indoleamine (5-HT plus its metabolite 5-HIAA) concentration in the sigmoid colon in patients undergoing partial or total colectomy for treatment of idiopathic constipation, attributed to IBS, was considerably higher than in normal subjects6. In unstimulated conditions, the colonic myoelectrical and motor activity are normal, whereas under stimulated conditions, IBS patients shown more abnormalities than normal subjects7. Lanng et al, found that all investigations regarding motility disorders showed variation, supporting the general theory of IBS being a broad-spectrum motility disorder."
Abstract This paper explains that domestic water supplies across the world vary enormously in quality. The author points out that aluminum has long been linked with an increased risk of Alzheimer's disease, bone diseases, and anemia, and nitrates are known to have gastric effects, neurological implications, and other effects on human health. The paper relates that lead is well-documented to play a role in intellectual retardation, impacts abdominal pain, and has other health effects.
Table of Contents
Introduction
Aluminum
Nitrate
Lead
From the Paper "Interestingly, aluminum in drinking water may be introduced into the water supply by water treatment processes themselves. Aluminum sulphate is added as a coagulant that removes suspended matter during the water treatment process in many facilities. The aluminum nitrate is then removed through filtration and clarification, but trace amounts may remain. In the European community, the maximum acceptable concentration of aluminum in drinking water in the UK is 0.2 mg/l, based on the incidence of problems with dirty water, rather than health implications."
Abstract This paper explains that the symptoms of campylobacter food poisoning usually present within 2-5 days after the consumption of the organism and include diarrhea, which may have blood or white blood cells in it, fever, abdominal pain, nausea, headache and muscle pain. The author points out that campylobacter is commonly found in raw chicken, raw milk and non-chlorinated water; the bacteria can be destroyed, thus preventing food poisoning, by cooking chicken, pasteurizing milk, and chlorinating drinking water. The paper relates that, although they are rare, there are a number of complications associated with the disease: Reactive arthritis, hemolytic uremic syndrome, septicemia and infections of organs, meningitis, recurrent colitis, acute cholecystitis and Guillain-Barre syndrome; the estimated case/fatality ratio for all C. jejuni infections is 0.1, meaning one death per 1,000 cases.
Table of Contents
Introduction
Cause and Nature
Victims and Extent of Disease
Complications
Foods and Outbreaks
Remedies
Conclusion
From the Paper "While there is usually only a small population of people affected at a time, generally fewer than 50, Bennington, VT experienced a "large outbreak involving about 2,000 people while the town was temporarily using a non-chlorinated water source as a water." Dairies can be responsible for outbreaks when children become infected during field trips, or if they do not properly pasteurize the milk according to industry standards, such as the case in 1986 when 32 students of an elementary school became infected."
Abstract The paper discusses the need for more parental awareness on the dangers of choking among children ages 1 to 4. It recommends that health care administrators and agencies use the health belief model as a routine tool for educating parents about the potential dangers associated with toddler choking. It proposes that this model supplies ample information about choking prevention and can supply parents with the education they need to intervene in a choking situation. It also explores how adopting this model will help, not only promote awareness, but to educate parents about the specific strategies they can adopt to remove this hazard from their environment.
Outline:
Introduction
Prevention Need Toddlers
Health Promotion Model/Rationale for Selection
Significance of Study and Model
Recommendations
From the Paper "There is much support for the health belief model as an effective technique for educating parents and preventing choking in toddlers. Chew, Kim & Palmer (1998) conducts a longitudinal study promoting use of the health belief model for adapting nutrition behavior among motivated participants. Their results lend positive support for use of this model. Epstein et al. (1993) suggest that the health belief model is a theory driven model that provides positive findings in most cases. Further their research investigations suggest the health belief model is ideal for adapting behavior and promoting positive and compliant health related behavior among parents (Epstein et al. 1993)."
Abstract This paper explains that premenstrual syndrome refers to a condition in which women commonly experience bouts of depression, abdominal cramps and other emotional disturbances just before their monthly period. The author discusses the debate over whether the condition is a psychological or a real medical condition and points out that, even if the condition has more psychosocial factors than physiological, it is important that patients be given proper treatment, especially women suffering from extreme cases of PMS. The paper stresses that the treatment of PMS, which varies from woman to woman, includes lifestyle changes and medication.
From the Paper "Since the problem has only been recently recognized as a medical condition, there is little research available on the causes of PMS. Another reason why no cause has been determined so far is because many people still maintain that PMS can be a purely psychological problem, which is only triggered with hormonal change in the body, and therefore it is more important to treat that depression or emotional changes instead of treating PMS itself. This is why PMS has remained such a vague medical problem and no definite causes and treatment are available."
Abstract In this article, the writer studies various research concerning the value of exercise to a pregnant woman and her unborn baby. The writer notes that the benefits of physical fitness and enhanced body image have been enough motivation for women to continue exercise during pregnancy. The writer points out however, that exercise has not been recommended to those of diverse cultural background who have a high prevalence of obesity and overweight. To those who find exercising to be culturally acceptable, the American College of Obstetricians and Gynecologists (ACOG) suggests proper screening in order to avoid extreme environmental conditions and activities, which can lead to abdominal trauma. The writer concludes that experience, opinion and increasing measurable evidence combine to point to the advantages and benefits of exercise before, during, and after pregnancy and as an overall boon to the health to every individual.
From the Paper "On the other hand, there have been separate and new researches, which reported multiple benefits of exercise during pregnancy for both woman and baby. These include improved cardiovascular function, less weight gain, improved attitude and mood and less difficult or complicated labor, faster recovery and greater fitness. The pregnant woman only needs to be cautious about the type of exercise, its intensity, duration and frequency. The unborn baby also benefits from the improved stress tolerance and advanced neurobehavioral maturity, which exercise can bring. The unborn child of a woman who exercises during pregnancy tends to become leaner and smaller but also has better early neurodevelopment. There have been no studies, which showed that moderate exercise created problems on the developing embryo. Doctors have just probably been playing safe and were apprehensive over the increase in body temperature during exercise as having adverse effects on the fetus."
