Abstract The paper discusses the insertion of a chest tube that is used for spontaneous pneumothorax, a common clinical problem involving air in the pleural space, between the lung and chest wall. The paper explores the goals of nursing regarding this procedure, which include pain management, prevention of complications and health teaching for the patient and family.
From the Paper "Insertion of a chest tube is used for spontaneous pneumothorax, which is a somewhat common clinical problem involving air in the pleural space, or air between the lung and chest wall. Traumatic pneumothorax is rare and results from injury to the chest. In either case, if excess fluid or air accumulates in the pleural space, the patient will experience shortness of breath and increased respiratory rate and effort. A chest tube inserted into the pleural space will drain the air or excess fluid and relieve respiratory distress Coughlin & Parchinsky, 2006). "Nursing care includes preventing complications, resolving the pneumothorax, managing pain, and educating the patient and family" (Roman & Weinstein, 2003, p. 161)."
Abstract This paper provides a literature overview of chest tube removal with regard to pain management. It further discusses the appropriate nursing interventions that are most applicable to chest tube removal in the light of the research data and studies that are available. It concludes, based on the literature, that there is a need to explore new avenues in addition to the present standard protocols. It also examines how these new techniques, and means of reducing pain in chest tube removal, revolve around a more inclusive and interactive approach to pain management, where aspects such as anxiety and information flow are catered to.
Outline:
Introduction
Literary Overview of the Problematics of Pain Management
Conclusion
Appendix
From the Paper "Standard pain management techniques for chest tube removal relate to medications such as Morphine. " Morphine is one of the most often, if not routinely, used opioids for treating pain due to chest tube removal." (Puntillo and Ley, 2004) However, this is not always the most effective procedure in this situation. "...when morphine was used in small doses (ie, a mean [less than or equal to] 3 mg), pain associated with chest tube removal was rated as moderate to severe. Higher morphine doses have not been tested for their effect on such pain. " (Puntillo and Ley, 2004) Other medications include the use of Ketorolac, which is a nonsteroidal anti-inflammatory drug and is considered to be an effective analgesic for pain due to chest tube removal. "
Abstract This paper studies how medical professionals diagnose and treat thrombolysis during critical care for patients experiencing chest pain. The paper provides a detailed analysis of scientific and clinical evidence indicating that patients experiencing acute myocardial infarction benefit from the early administration of thrombolytic therapy. The paper then discusses the challenge for multidisciplinary providers in ensuring that patients give true informed consent for all procedures, from administration of medication to invasive procedures. The paper explains that the setting can be chaotic, however, it maintains that effective communication between patients and providers is imperative.
From the Paper "The definitive diagnosis of AMI is best obtained by following a standard chest pain protocol. Most accident and emergency wards have these in place. It is standard to initially obtain a 12 lead electrocardiogram (ECG) and begin cardiac monitoring. Patient's routine laboratory studies include electrolytes, blood urea nitrogen (BUN), complete blood count (CBC) and markers for myocardial injury (Creatinine Kinase isoenzyme-myocardial (CK-MB) or troponin). Normal serial CK values rule out an acute infarction but are negative in the setting of acute unstable angina. A slight rise in CK-MB or troponin indicates myocardial injury but is not specific for ischemic syndromes. Troponin assay is highly sensitive for identifying acute coronary syndromes. Troponin has longer half life in the system than CK-MB but is less specific for the identification of infarction as opposed to repeated episodes of myocardial ischemia. As the total CK greater than two times the upper ranges of normal is indicative of infarction it can be used as an adjunct in diagnosis ischemia versus infarction and also in determining the relative efficacy of reperfusion. Serum troponin may take up to six hours to become diagnostically sensitive enough (Dougan, 2001)."
Abstract This paper relates that evaluation of chest pain is possibly one of the most important elements of nursing assessment skills. The paper then provides an assessment of myocardial infarction versus angina and shows how discerning angina from a myocardial infarction is a difficult task, requiring the rapid use of evaluation skills as well as the prompt administration of treatment.
Outline:
Introduction
Clinical Paper
Conclusions
From the Paper "Chest pain is notoriously difficult to assess. Depending on the signs and symptoms, findings on the ECG and lab results the management of the patient differs significantly. The classic presenting symptoms of a myocardial infarction (MI) is chest pain or discomfort. Angina pectoris may present the same way but will generally be of shorter duration. Both may be described as pain, pressure, tightness, heaviness, burning or squeezing. Both may radiate into arms, shoulders, jaw or back. Not all patients will have these classic symptoms."
Abstract This paper examines the standards set by the National Service Framework for coronary heart disease regarding emergency cardiac care for patients presenting to the accident and emergency system at a hospital. The paper explains that these standards place a priority on aggressive management and providing early thrombolysis and that this type of treatment is controversial because it is questionable whether, given the suggested timeline and the need to differentiate from non-cardiac causes of chest pain, an adequate history and physical can be performed to prevent the administration of thrombolytics in patients where they are contraindicated. To further examine this topic, the paper gives a clear definition of acute myocardial infarction, looks at how to diagnose a patient with acute chest pain, explores the history, indications, and contraindications of thrombolysis, and reviews a multidisciplinary approach to thrombolytic administration.
From the Paper "The definitive diagnosis of AMI is best obtained by following a standard chest pain protocol. Most accident and emergency wards have these in place. It is standard to initially obtain a 12 lead electrocardiogram (ECG) and begin cardiac monitoring. Patient's routine laboratory studies include electrolytes, blood urea nitrogen (BUN), complete blood count (CBC) and markers for myocardial injury (Creatinine Kinase isoenzyme-myocardial (CK-MB) or troponin). Normal serial CK values rule out an acute infarction but are negative in the setting of acute unstable angina. A slight rise in CK-MB or troponin indicates myocardial injury but is not specific for ischemic syndromes. Troponin assay is highly sensitive for identifying acute coronary syndromes. Troponin has longer half life in the system than CK-MB but is less specific for the identification of infarction as opposed to repeated episodes of myocardial ischemia. As the total CK greater than two times the upper ranges of normal is indicative of infarction it can be used as an adjunct in diagnosis ischemia versus infarction and also in determining the relative efficacy of reperfusion. Serum troponin may take up to six hours to become diagnostically sensitive enough (Dougan, 2001)."
Abstract Discusses the Coleman Company's development of the graphite flashlight. Early manufacturing of quality camping products including lanterns, tents, sleeping bags, portable stoves and ice chests.
History of company. Patents. Merger with Sunbeam Company. Cost, availability, materials and manufacturing process of the graphite flashlight. Expansion into hardware line. Illustrations.
From the Paper "Introduction
The Coleman Company built its reputation on lanterns used for camping, but the company also manufactures tents, sleeping bags, portable stoves, ice chests and many other products designed for outdoor leisure use. It has a reputation for high.quality products and was, until recently, a publicly owned corporation. Today, the company is part of the larger Sunbeam Company, although it is operated as an independent subsidiary. One of its product lines, the graphite flashlight, follows in the tradition of the company's original lantern products. This research considers the history of Coleman in general, and the development and manufacture of the graphite flashlight in particular."
Abstract This paper discusses cardiopulmonary resuscitation,often abbreviated to CPR, a potentially life-saving procedure to temporarily restore blood flow and breathing to a person whose heart and lungs have stopped. It also looks at how the phrase is sometimes used to refer to interventions used to attempt to save patients already hospitalized, as well as to skills any person can acquire and use on a loved one or total stranger in an emergency. It looks at the discovery and development of the process, whether it actually works, and also discusses its limitations.
From the Paper "CPR by itself is unlikely to save a person's life. The best outcomes occur when CPR is followed by defibrillation as soon as possible followed by intensive medical support at a medical center. Unless CPR is begun within 4 - 6 minutes of when breathing has stopped, the person is likely to suffer significant brain damage, so early intervention is crucial. If there is only one person who is not strong enough to do both breathing and chest compressions, then chest compressions should be done. If the person's hear resumes beating, often the person will begin breathing again as well. Together, the American Heart Association and the American Red Cross train more than five million people each year in CPR (De Milto, 1999)."
Abstract This paper explores the topic of asthma and the methods of prevention. The writer explores the interventions that nurses can use to help patients avoid being hospitalized. The writer also discusses preventative measures that nurses can use to educate their patients who have asthma.
From the Paper "Many experts agree that the key to controlling and treating asthma and its symptoms is education. Seminars, pamphlets, books and other methods are used to reach and teach asthma patients nationwide in how to handle their disease. Asthma nurses are often charged with the routine care and treatment of people who have asthma. The patients will see a doctor as well but the nurse who sees an asthmatic patient, both in the middle of an attack and for preventative care has a significant impact on the interventions used to prevent hospitalization of the asthma patient."
Abstract This paper explains that Dean is a social liberal, whose stance on such issues as abortion and same-sex unions remains consistent. The author points out that Dean is strongly in favor of repealing the 2001 Bush tax cuts and is emphatic about balancing the federal budget.The paper relates that Dean has relied heavily on the Internet for support and for fund raising, and his Internet BLOG sets his campaign apart from other candidates.
Table of Contents
Candidate Profile
Voting Records and Public Stands on the Issues
Campaign War Chest/Money Raised
Position in Political Opinion Polls
Major Endorsements
Campaign Themes
Major Assets
Major Obstacles
Summary
From the Paper "Dean's political career began in the early 1980s, when he was elected to the Vermont State House of Representatives. He served there from 1982 until 1986, when he was elected as Lieutenant Governor of Vermont. He was re-elected to that post twice, in 1988 and again in 1990. Dean first became Governor of Vermont in 1991 not by being elected but because the sitting Governor, Richard Snelling, died suddenly of heart failure. However, Dean was re-elected five times, in 1992, 1994, 1996, 1998, and 2000. He did not seek re-election in 2002. After his fourteen-year tenure as Governor of Vermont, Dean decided to step down from his office to chase after the big seat in the White House. He became the first democrat to formally enter the 2004 Presidential Race in May 2002."
Abstract Asthma is an intermittent disorder, which affects the patient from time to time. Resistance to airflow may be triggered by external factors, such as inhalation of substances, or resistance can occur without any external stimuli. The paper explains that the clinical symptoms of asthma include wheezing, chest tightness, and breathlessness. It also shows that, in America alone, there are more than seventeen million people suffering from asthma, and asthma attacks alone are responsible for some 500,000 hospitalizations every year. The paper presents details of the disease and explores treatment options.
Table of Contents:
Introduction
What is Asthma?
Asthma and the Immune System
Diagnosis of Asthma
Radioallergoabsorbent Test [RAST]
Prick Tests
Treatment
Steroids
Bronchodialators
Conclusion
Bibliography
From the Paper "Our lungs are equipped with elaborate defense methods to guard against the potential invasion of foreign bodies. The tiny hair like protrusions called the cilia, constitutes the first line of defense. The cilia pushes the trapped particles (along with the mucus) into the mouth which we swallow and the pathogens are destroyed by the action of the digestive enzymes. The bronchioles constitute the second line of defense."
Abstract This paper introduces the Zoll model Automatic Electrical Defibrillator as "a machine used by this office that is designed to shock and provide electricity to the heart to stop the heart from beating in two bad rhythms called ventricular fibrillation and ventricular tachycardia." The author asks the question, "How do you know that someone should be shocked using this equipment" Check for responsiveness.? The paper presents a FAQ:"When shocked, what happens" Slight jerk of the body, muscle contraction of the chest.?
Table of Contents
Instructions
Voice Prompts
Maintenance
Precautions
FAQ
From the Paper "REMEMBER! The AED will only shock someone that the electrodes sense have one of the irregular rhythms the machine can restore. If a shock is not indicated, the machine will instruct you in performing CPR on the patient. It will not do anything harmful to someone not in one of the two rhythms described above." (Printed in red.)
Abstract This paper looks at how the administration of thrombolytics is the gold standard for the treatment of acute MI. Nurses involved in the management of patients having thrombolytic therapy must be aware of the indications and contraindications for early thrombolysis and must feel comfortable that the medication is being appropriately administered only after a careful history and physical is obtained. It discusses how there are many conjunctive medications, which will be used to support blood pressure and ventricular dysfunction in the setting of AMI, and how nurses must be very aware of chest pain diagnosis and management protocols, as well as the possible interactions of medications.
From the Paper "Thrombolysis is considered the gold standard in the management of patients who are found to be truly experiencing acute myocardial infarction. But thrombolysis is a time-limited intervention and the medications are fraught with risks of their own. How can the managing nurse be assured that the medication will be appropriately administered to the patient who has been diagnosed acute myocardial infarction? What kind of management is then required to maintain the patient physiologically? What are the risks and benefits involved? These are all issues to be considered in any nurse who is caring for a patient receiving thrombolytic therapy."
Abstract This paper explains that "The Scarlet Letter" is an important work of fiction because it relates how people lived in Puritan times and shows how unbending the Puritan religion was when one of its members made a mistake. The author points out that the main symbol is the child, Pearl, who represents Hester's unending punishment even more than the letter "A" she wears on her chest. The paper relates that Pearl also symbolizes the devil and the intolerance of the Puritan religion, which would not even accept an innocent child who was the product of a mother's mistake.
From the Paper "A symbol in literature is something that represents something else to the reader, or the character of the book. It is usually something important that the author wants the reader to understand or recognize. Hawthorne uses numerous symbols in "The Scarlet Letter" to represent many things that happened in the 1700s, when the book takes place. Religion was the most important thing to the people of the time, and the Puritan religion was very strict. Therefore, Hester Prynne is punished for her sin in the book, and many things throughout the book are symbols of her sin. The biggest symbol of her sin is the daughter she had because of her affair. Hester is the main character of the book, and the Puritans in her town of Boston have discovered she had an affair, and so, she goes to prison."
Abstract This paper examines the system most suited for the use of evaluation of the catheter positioning in the chest of the patient in the intensive therapy unit environment. Traditionally, these images are difficult to process. The paper determines whether the images produced through digital radiography or those produced through computed radiography are optimal in terms of the best system in order to reduce risk to the patient due to higher radiation doses or incorrect positioning.
From the Paper "The Department of nuclear medicine and diagnostic Imaging, at Kyoto University School of Medicine and the physicians named as Tadamura, Kubo, Yamamuro, and Konishi wrote in their work that "Nuclear cardiology has played a significant role in the diagnosis and risk stratification of patients with coronary artery disease. MRI and multidector-row CT (MDCT) has recently been introduced in the filed of clinical cardiology. For the management of patients with suspected coronary artery disease, it is important to understand the advantages and disadvantages of various imaging modalities. Tadamura, Kubo, Yamamuro, & Konishi (1998). The work entitled "Digital Imaging with a Photostimulable Phosphor in the Chest of Newborns" states that when comparing imaging of newborn mediastinum, lung bones, and soft tissues the images ere "significantly better on computed radiographs than on half-exposure computed radiographs and that visualization of the lungs, bones and soft tissues was statically significantly better on screen-film radiographs than half-exposure computed radiographs."
Abstract This paper explains that clothing is rarely recognized as a political force; yet fashion and design may be one of the most internationally regarded forms of trade, communication, and influence among countries worldwide. The author points out that the Orient has been a wellspring of fashion influence for both the Eastern and Western world since ancient times; the Edo period in Japan was the beginning of several Japanese styles that remain popularized by Western culture fashions for centuries, including the "Kamishimo," worn by both males and females of the Samurai warrior class during special occasions featured stiff shoulder garments that crossed the shoulders and chest, elements vital to the Samurai image held by Hollywood and other popular culture creations in the West today. The paper relates that today very young Japanese girls, as seen in exported Japanese movies, manga comic books, and anime television, are setting global fashion trends, including miniskirts, short pants flared out at the bottom, and loose, baggy socks deliberately allowed to lap over the tops of their shoes.
From the Paper "Fashion evolves as quickly as any other fast-paced element of society, never becoming stagnant. Some people are critical of the movement and growth of the industry, claiming it encourages people to become materialistic, rushing at every opportunity to spend more and more money on unnecessary items. However, this change and growth is precisely what makes fashion a true form of human expression. Diversity, experimentation, expression, and metamorphosis are what define human culture and fashion culture. As cultures touch, fashions exchange and spread. The in-look for the young rebels is eventually passed on to the older generations. The styles of one region are sent to another. "Young people, enjoy the diversity that changing fashion can apparently provide, seeing the constant change as a way to satisfy their desire to experience 'new' and 'interesting' things. Note too though that fashion can change to enforce uniformity, as in the case where so-called Mao suits became the national uniform of Mainland China." "
