Pressure Ulcer Essay

Pressure Ulcer Essay
Pressure Ulcers Causing Pain in Hospitalized Patients
With pressure ulcers affecting 1 to 3 million people in the Untied States each year, pressure ulcers
can reduce overall quality of life because of the pain, the treatment, and the increased length stay
within a healthcare facility (Berlowitz et al., 2014). It is estimated that 60,000 patients will die each
year as a direct result to pressure ulcers (Berlowitz et al., 2014). The cost is between 9.2 billion, to
15.6 billion per year in the Untied States (Berlowitz et al., 2014). It is also stated that pressure ulcers
may be associated with sever pain (Berlowitz et al., 2014). So, are inpatient between the ages of 18
years or older who are "at risk" for pressure ulcers at increased risk for pain compared to other
inpatients between the ages of 18 years or older who are not "at risk" of having pressure ulcers
during their hospital stay?
In a research study, published in BMC nursing was to determine if ... Show more content on
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A weakness within the study was the authors inability to use 40.8% of hospital patients participation
in the pain prevalence study, this was due to illness, difficulty of assessment or patients were
unavailable either off the floor 24%, or in isolation (Briggs, et al., 2013). Another strength within the
study was the authors decision to use the 1998 European Pressure Ulcer Advisory Panel
classification (EPUAP), the reason for this was that the updated version for 2009 was not being used
at the participating hospitals, and this classification was familiar with the staff doing the skin
assessments, allowing for all participating hospitals to have the same standards of skin classification
in place (Briggs, et al.,
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The Livedqualitative Research : Critique . Experience of...
Running head: QUALITATIVE RESEARCH CRITIQUE
Qualitative Research Critique
The Lived Experience of Having a Chronic Wound: A Phenomenologic Study
Katelyn Adams
Nursing Theory and Research 390
October 12, 2006
Running head: QUALITATIVE RESEARCH CRITIQUE
Problem Statement: In my qualitative evaluation of The Lived Experience of Having a Chronic
Wound: A Phenomenologic Study, written by Janice Beitz and Earl Goldberg (2005), I found that
the need or rationale for this particular study, as do most qualitative research papers, focused on how
or what, as opposed to quantitative studies that focus on asking why? The problem statement is:
"Approximately 2 million people have ... Show more content on Helpwriting.net ...
The interviewees were Caucasian, of higher economic status, and retired. Interviews were accurately
recorded and participants signed a consent form before the interview. Each participant completed a
brief demographic questionnaire. A quiet area was used so that participants could reflect on their
experiences and audiotaping could be conducted. "Each interview was conducted by both
researchers, with two exceptions when one researcher was present, and consisted of the following
semi–structured, open ended requests for information: Please describe your experiences of living
with a chronic wound. Please include anything that you think would help us to understand what it is
like to be a person living with a chronic wound" (Beitz & Goldberg, 2005, p. 54). If necessary,
reflections or promptings were needed. In addition to taping, the researchers observed body
language and topic avoidance, making brief notes. Interviews lasted 30–45 minutes. The researchers
met at the conclusion of each interview to discuss their perspective of the interview and their
analytical notes that they wrote to record their thoughts, question and ideas (Melnyk &
Fineout–Overholt, 2005). Ethical Considerations: This study was reviewed and approved by La
Salle University Institutional Review Board. Furthermore, the researchers clearly specified how
informed consent and confidentiality was handled in the field of study. "Participants in the study
received a written

Pressure Ulcer
The purpose of this paper is to acknowledge pressure ulcers, including what a pressure ulcer is and
what it should look like in each stage of progression. Furthermore, it should educate the reader on
how a pressure ulcer is formed. After reading this paper you should see the importance of preventing
pressure ulcers altogether. Through review of various peer reviewed articles, as well as credible
internet sources, information will be gathered to show statistics of pressure ulcers in the elderly as
well as the contributing factors of this problem. There are solid ways to prevent elderly patients
from getting pressure ulcers. Pressure Ulcer Frequency in the Elderly A pressure ulcer is also known
as a pressure sore or a bed sore. Over time, ... Show more content on Helpwriting.net ...
These clients may even become septic, which can be fatal at such a fragile age. Additionally, these
patients are neglected the same time they are usually receiving care because nurses on the floor are
not always putting this issue as a priority on their plan of care. In conclusion, nurses should ensure
to incorporate time at any time possible to turn their patients, especially the elderly. By following
the nursing interventions for preventing pressure ulcers, it could prevent so much more than that. It
would be so easy to prevent the problem altogether than to see an elderly client conquer pneumonia
only to suffer from a pressure wound that could quite possibly result in a

African American Cultural Considerations : African...
RACE/ETHNICITY: African American CULTURAL CONSIDERATIONS: In the African American
community, the older generation is more conservative. Elders are respected and are usually taken
care of by their immediate family. The structure in African American community is often extended
to include non–related "family" members. For most African Americans, the abundance of fast food
chains combined with reduced access to healthy affordable foods contributes to the pervasiveness of
obesity and chronic illnesses. Moreover, older African Americans may be distrustful of doctors due
to experiences of past generations of African Americans with health care. However, in recent times,
African Americans are becoming gradually health conscious and are seeking health screenings and
treatments. African Americans usually have strong religious beliefs. Spirituality is an essential part
of how many people deal with medical difficulties and death. African Americans tend to believe in
the sacredness of life and tend to rely on their community and family at times of loss. Many
religious older African Americans, who believe in God's will, may also tend to believe that life
support should be continued as long as required. Gordon, Sharon. (2012). RELIGION/SPIRITUAL
CONSIDERATIONS: 1st: The patient stated that he is Christian. 2nd: Although the patient did not
mention any specific considerations, I know that there are some spiritual considerations that would
apply to him. Christians rely on their religious

Evidence Based Practice Essay examples
A critical appraisal of a published piece of research related to practice.
Evidence Based Practice – HEN62029–5
Student number 10039687
Word count 3150
The following ssion of this assignment attempts to critically appraise the venUS III randomised
control trial (RTC) published in the British Medical Journal.
As a student/healthcare worker who is new to critical appraisal I am aware that I do not fully
understand some of the calculations involved in reporting of findings, however Greenhalgh (2006)
argued, 'all you really need to know is what the best test is to apply in given circumstances, what it
does and what might affect its validity/appropriateness'. When caring for patients it is essential that
Healthcare Professionals ... Show more content on Helpwriting.net ...
The nurses providing treatment where not blind to which treatment had been allocated, this may
impact on construct validity as in some cases it is suggested that control subjects are compensated in
some way by healthcare staff or family for not receiving research intervention (Barker 2010). Nurses
who were blinded were employed to trace the ulcers. Participating patients were not blind to the
treatment/s. As one of the measured outcomes was patients perceptions of health, assessed by a
questionnaire (SF–12) it is reasonable to conceive that this assessment may have been influenced by
the patients awareness of the treatment type they were receiving thus creating the possibility for
assessment bias. Construct validity may also be impacted on peoples behaviours as a response to
being observed or to the treatment because they believe it will have a positive effect. (Barker 2010)
Healing date was assessed remotely by independent assessors who where blind to the treatment
allocation this guards against assessment bias.
Overall both treatment groups were equal in size. Both treatment groups had an almost equal
average age of study participants, this is important because inequality in age between the groups
would represent a heterogeneous population (Barker 2010). Venous leg ulceration is more common
in woman than men in those below 85 year of age (Moffat 2004)

Helicobacter Pylori Infection
Abstract
Helicobacter pylori is a bacterium responsible for worldwide chronic bacterial infection in human.
At least half of the world's population host H. pylori that causes various gastric pathological
outcomes with some leading to gastric cancer. The infection by this bacterium has directly or
indirectly caused an impact on economic and general well–being of the people; hence, there is an
urgent need to discover diagnostic markers that could be utilized for future development of
diagnostic kits that are highly sensitive and specific. Here, we brieﬂy review general aspects of H.
pylori infection and the diagnostic biomarkers currently used in laboratory tests for the diagnosis of
H. pylori infection with a focus on the role of microfluidic ... Show more content on Helpwriting.net
...
Besides that, protein based diagnostic kits are also available in ELISA and latex agglutination test
cards (20). Elisa Kits are the most specific and sensitive test for detection of H. pylori infection,
however, these tests are expensive and time consuming. Another lab–based serological method is
immunoblotting. Immunoblotting is also performed as a lab–based serological method. These assays
detect anti–H. Pylori antibodies in either fecal, whole blood, serum, or urine (20, 95–98). Most of
the commercial antibody–based tests for detecting H. pylori infection use bacterial lysate or partially
purified bacterial antigens. Only a few recombinant antigen–based tests have recently been
introduced into the market. Due to higher sensitivity and specificity over a single antigen, most
commercial diagnostic kits apply a mixture of antigenic extract (18–20, 29, 97). However, the
names of antigens used in commercial kits are usually undisclosed (Table 2). The cost of diagnostics
is also one of the important factors for developing rapid kits. To decrease the cost, several
parameters should be considered: (1) minimal use of expensive reagents, (2) inexpensive
manufacturing for mass–production, (3) quality control, and (4) miniaturization. In addition, for
clinical use of medical diagnostic devices in resource–limited settings, environmental

Peptic Ulcer Disease ( Peptic )
Peptic Ulcer Disease
Ever wonder how many diseases there are in the world? Well, there are tons. Some disease are more
harmful than others. With all the disease it is hard to choose which one is the best to learn. One
disease that is very fascinating is Peptic Ulcer Disease. A Peptic Ulcer is a sore on the lining of the
stomach or duodenum caused by Helicobacter pylori, which is a spiral shaped bacterium that is
found in the gastric mucous layer of the stomach, or NSAIDs. There is multiple things to learn about
a Peptic Ulcer: the history of one, what causes it, who can mostly get it, diagnosis, treatments, and
prevention.
In the early 20th century ulcers were believed to be caused my dietary and stress factors. If someone
was diagnosed with an ulcer they were hospitalized and put on a bland food diet. Then later on in
the 20th century gastric acid was blamed for causing ulcers. So then treatment changed to antacids
and medication that stopped gastric acid. In 1982 Robin Warren and Barry Marshall identified that
Helicobacter pylori and ulcers were connected to each other. People did not accept their findings.
People still believed it was stress, diet, or gastric acid that caused the ulcers. Many years later in
1994, A National Institutes of Health Consensus Development Conference concluded that
Helicobacter pylori was strongly related to ulcers and that the bacterium Helicobacter pylori could
be treated with antibiotics. Then, a year later in 1995 data showed that 75% of

H. Pylori Research Paper
Over half of human stomachs in the world are colonized by H. pylori. This bacterium is the culprit
for almost 80% of all gastric adenocarcinoma cases and upwards of 90% of all duodenal peptic ulcer
cases making it the second most common bacterial infection worldwide (6). Those colonized with
H. pylori have a two to six times increased risk of forming gastric cancer or ulcers. Because of this,
H. pylori has since been classified as a class I carcinogen. There are currently two completely
sequenced genomes of H. pylori (strain 26695 and strain J99) which have been revolutionary in the
research and understanding of its genetic diversity and pathogenic mechanisms. H. pylori are gram–
negative, spiral shaped, adorned with three to five polar ... Show more content on Helpwriting.net ...
pylori's expression of a Type IV secretion system suggests it utilizes horizontal gene transfer to
uptake DNA to and from host cells or other bacterial cells in its environment. H. pylori uses its
T4SS to inject the highly pathogenic cagA protein into the gastric epithelial cells of the human host
which then phosphorylates and interferes with human host signaling cascades related to cell
differentiation, proliferation, motility and cytoskeletal rearrangement causing H. pylori induced
proinflammatory responses via IL–8 activation and NF–κB stimulation. This sequence of events
results in the elongation of infected host epithelial cells, characteristic of H. pylori illness, termed
the "hummingbird phenotype (2)." It has been shown that almost 100% of all Eastern Asian strains
express the cagA protein while only about 60–70% of the Western strains express a functional cagA
protein. It is clear to see that geographical regions have dramatic differences in virulence and
pathogenicity of H. pylori strains further proving the vast diversity in the genetics of the bacteria.
The H. pylori T4SS can be assessed in three different clusters of genes. The first is the protein type
IV secretion system (pT4SS) whose primary function is to translocate the cagA protein. The cag
pathogenicity island uses 18 out of its 27 genes to translocate cagA into the host cells and 14 genes
are used in

Human Pathogen That Is Responsible For Ulcers And Stomach...
Nguyen 1
A. INTRODUCTION
Helicobacter pylori (H. pylori) is a human pathogen that is responsible for ulcers and stomach
inflammation. The organism had been researched by several scientists around the world since 1875;
however none of them was successfully culture it. Until 1982, Dr. Barry Marshall and Dr. Robin
Warren succeeded in observing the colonies, and thus became the first scientists to discover this
bacterium. By self–testing, Dr. Marshall drank a liquid that contained H. pylori culture. A few days
later, he got sick with many symptoms such as vomiting and nausea. After ten days, by undergoing
endoscopy, he was able to confirm the role of H. pylori in causing gastritis. Then he and Dr. Warren
also demonstrated the effect of ... Show more content on Helpwriting.net ...
Even though H. pylori is a "neutralophile", it can survive in the very acidic environment in the
human stomach due to a variety of acidic–adaptive mechanisms, such as the ability to utilize urease
to break down urea Nguyen 2 into ammonia, and thus neutralizing the surrounding acidic
environment. Also, H. pylori contains "hydrogenase" enzyme, which can oxidize molecules
hydrogen being produced by other gastric bacteria, in order to produce energy. Some other enzymes
that can be utilized by H. pylori are "oxidase" and "catalase", which are also used to test for the
presence of this organism. It can also form "biofilm" on the gastric mucosa epithelium, which results
in its ability to resist against many antimicrobials. From spiral form, it is able to convert into
"coccoid form" – one of its advantage which helps in its survival and epidemic potential [5].
– H. pylori has 4 to 6 "lophotrichous flagella" which are its favor in motility. Usually, the
"enterohepatic" and gastric Helicobacter have really strong flagella. Its flagella filaments mainly are
"FlaA and FlaB" [10].
Like other organisms, its outer membrane is composed of "phospholipids" and "lipopolysaccharide"
[7].
2. Pathophysiology
a) Adaptability
H. pylori is found in stomach, upper GI tract, intestines and other parts in the body but it usually
reside in stomach. Because it can only survive in neutral environment, once it penetrates the mucous
lining

Common Causes And Treatment Of Oral Ulcers
Oral ulcers are shallow sores inside the mouth or near the mouth. They may be referred to as canker
sores or cold sores, which are two types of oral ulcers. Many oral ulcers are harmless and go away
on their own, but some cases may require medical treatment to determine the cause and proper
treatment.
CAUSES
In some cases, the cause of this condition may not be known. Common causes include:
Viral, bacterial, or fungal infection.
Emotional stress.
Foods or chemicals that irritate the mouth.
Injury or physical irritation of the mouth.
Medicines.
Allergies.
Tobacco use.
Less common causes include:
Skin disease.
The herpes virus (herpes simplex). When oral ulcers are caused by herpes simplex, they are
commonly referred to as cold sores or fever blisters.
Oral cancer.
RISK FACTORS
Oral ulcers are more likely to develop in:
People who wear dental braces, dentures, or retainers.
People who don't keep their mouth clean and brush their teeth regularly.
People with sensitive skin.
People with conditions that affect their entire body (systemic conditions), such as immune disorders.
SYMPTOMS
The main symptom of this condition is one or more oval–shaped or round ulcers with red borders,
which are usually about ¼ inch (6 mm) in size. The cause of the ulcers can cause variation in the
symptoms that you experience, such as:
Location of the ulcers. They may be inside the mouth, on the gums and the insides of the lips

Diabetic Foot Ulcers
DIABETIC FOOT CARE HELPS Many are forced to amputate his foot as a complication of
diabetes. With simple measures like foot care, insoles and regular checks, the number of
amputations could decrease, which is supported by studies at the Sahlgrenska Academy. On the
Sahlgrenska Academy have orthopedic researchers since 2008 has studied foot complications in
diabetes. The focus has been on protecting feet against high pressure, and thus reduce the risk of
ulcers in the sole of the foot which can eventually lead to the foot had to be amputated. Gothenburg
researchers have now conducted a study of 114 Swedish diabetic patients had an increased risk of
developing ulcers in the feet. The study shows that with relatively simple measures such as ... Show
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– The results show that good shoes and inserts can halve the pressure on the foot compared to if you
were walking barefoot. The conclusion after twelve months is that all three types of posts effectively
distribute pressure under the ball of the foot and thus reduces the risk of ulcers, says Ulla Tang, leg.
prosthetist, worked at Sahlgrenska University Hospital. . The study also shows that although 83
percent of diabetic patients had calluses under the feet, had only 67 percent offered podiatry. – A
post cost between 850 and 1450 crowns. To heal a diabetic foot ulcers cost an average of 70 000 per
year, while an amputation cost upwards 1 million in social and healthcare costs. Preventing wounds
thus reducing not only the suffering of the individual, it's a big savings for society, says Ulla Tang.
At the international conference in India also presented a new digital tool developed in cooperation
between the Sahlgrenska Academy and Region V?stra G?taland, which can be used to easily and
securely rate risk of foot ulcers. The idea is that the tool should be used as a basis for
recommendation of suitable posts and

Capsaicin and the Stomach Essay
Almost everyone is told that consuming capsaicin causes stomach problems, but the opposite is true.
What is capsaicin? Capsaicin is found in chili peppers which originated in Latin America; due to it
pungent flavor was traded by Spanish and Portuguese explorers during the sixteenth century to
Europe and Asia and is now one of the essential spices in the world. Chili peppers have been used
for centuries in the seasoning of food, but recently, scientists have started using it for medical
purposes. Many speculate that capsaicin helps improve and treat various health problems, some as
simple as headaches to cancer and that it can promote blood circulation, maintain weight loss, and
prevent the deterioration of the lining of the stomach. ... Show more content on Helpwriting.net ...
The real culprits are bacteria called Helicobacter pylori, most commonly known as H. pylori,
aspirin, alcohol, stress, excessive acid secretion in the stomach, the reduction in gastric mucous
blood flow and anti–inflammatory medicine. H. pylori are bacteria that significantly contribute to
the formation of gastric ulcers as they promote the secretion of acid and deteriorate the mucus in the
stomach and when capsaicin is consumed it kills the bacteria. Also in a study conducted by a
researcher, two groups of volunteers with normal stomach linings were given aspirin to take daily,
the control group was just given the aspirin while the experimental group was given aspirin and
water with chili powder, the results were that the control group had the most deterioration of the
stomach mucus. It seems that capsaicin slows acid secretion and promotes the production of mucus
secretion. Mucus protects the lining of the stomach and when a person suffers from gastric ulcers it
is because their mucus production is low and they secret too much acid, which eats away at the
stomach's lining.
Although many scientists believe that capsaicin helps the stomach, others opinions differ, like in any
scientific study. These opposing scientists believe that capsaicin actually is a carcinogen, which
means that when used internally causes cancerous cells to form. In some experiments, rats treated
with capsaicin formed

Integrative Research On Patients With Venus Leg Ulcers
Integrative Review of Research on Patients with Venus Leg Ulcers
In the world of medicine, evidence base practice has been a great strength to show how through
research we can provide better quality care to our patients. Evidence base practice can be defined as
"the conscientious, explicit and judicious use of current best evidence in making decisions about the
care of the individual patient. It means integrating individual clinical expertise with the best
available external clinical evidence from systematic research"("Overview – Introduction to
Evidence–Based Practice – LibGuides at Duke University Medical Center", 2016).
There are many questions that one has to come into conclusion when doing research and that is the
validity of that ... Show more content on Helpwriting.net ...
In this review, we will look at three research articles that explore the effect on mental health and
disease perception in patients with Venus Leg ulcers and the effect it can have on disease
management and recurrences of these ulcers. This topic is very important for nursing because health
care costs are on the rise, and the decrease in reimbursements from Medicare based readmissions.
The goal in nursing is that we must prevent these types of patients, from being readmitted into the
hospital. We need to focus on ways to help these patients manage their leg ulcers at home with the
proper support and follow up care and by addressing the psychological effect of the leg ulcers it may
help these patients with their self–esteem and body image.
Breakdown
In all of the three articles, the research authors were qualified to perform the research concerning
Venus Leg Ulcers (VLU). These authors worked in a University setting in Australia and Liverpool
and having credentials at the level of a PhD, CNS, and BA in nursing. In the research of "Examining
factors that influence... Venus disease" (Miller, Kapp, & Donohue, 2012), their focus was the
relationship between education and health promoting behaviors based on patients whom participated
in e–learning educational sessions.
This research was a quantitative research; the patients that participated on the research received a
pre and post evaluation of their knowledge related to Venus leg

Ulcers: Curiosity In Science
Curiosity in Science
Before 1982, everyone "knew" ulcers came from stress, so they didn't want to look further into the
cause of ulcers. In 1982, Barry Marshall and Robin Warren challenged the belief by saying ulcers
were caused from bacteria. This shows that we have a problem with science; we began to believe
that we know everything about something but in reality we didn't. Descartes, French philosopher,
mathematician, and scientist believed that should not accept something true unless definitively
proven true. Science knows that we have this problem with this but it comes from the push to
always having them succeed. Before knowing that the Helicobacter Pylori bacteria caused ulcers,
people believed ulcers were known to be caused from stress. They refused to believe it was caused
from anything else because they believed that no bacteria could thrive in the highly acidic
environment of the stomach. There are links going back to 1940 by Dr. A. Stone Freedberg, who
was a cardiologist at Harvard, but his boss pressured him to abandon his research and he favored
him to do research in something that would be "easier to prove". Many scientists gave up on this
research is due to the overwhelming opposition from the wider scientific community. ... Show more
content on Helpwriting.net ...
At the time suggesting that ulcers weren't caused from stress was considered as career suicide. They
we're able to gain funding to help continue their research to prove that it was caused by the
Helicobacter Pylori bacteria. Their work was continuously rejected for publication and they received
constant criticism. The scientific community believed that the conclusions that they made we're all
premature and were not well supported. In June 1984, Barry Marshall tested it on himself and was
able to prove that the Helicobacter Pylori bacteria is indeed the cause of

Pressure Ulcers As A Hospital
Upon admission to a hospital, a patient may be at risk for numerous hospital–acquired conditions.
Pressure ulcers, also known as pressure sores or "bed sores", are a type of hospital–acquired
condition that may develop during a hospital admission if proper risk assessment is not performed
by a registered nurse (RN). Pressure ulcers form over bony prominences, such as the back, heel,
ischium, sacrum, and elbow, when circulation of these prominences is impaired (Jarvis, 2012).
Pressure ulcers may develop when a person is confined to a bed or immobilized, which impedes
proper delivery of oxygen and nutrients to the skin resulting in cell death (Jarvis, 2012). Pressure
ulcers are divided into four stages. In stage I, a nonblanchable redness of intact skin appears that
does not disappear for 24 hours after pressure is relieved. In stage II, there is partial–thickness
erosion of the epidermis or the dermis layer of the skin. Full–thickness pressure ulcers are a stage III
ulcer, which extend into subcutaneous tissue. Lastly, stage IV pressure ulcers involve all skin layers
and may expose muscle, tendon or bone. Pressure ulcers can be prevented if risk assessment is
performed and at–risk individuals are identified (DeLaune & Ladner, 2011). Risk assessment scales,
such as the Braden Scale and Norton Scale, are used to determine the likelihood of skin breakdown
in a patient. The Braden Scale is divided into six categories that help predict pressure sore risk and
each category is

Pressure Ulcer Prevention
Prevention of Pressure Ulcers
Pressure ulcer is a common geriatric syndrome seeing in patients suffering from acute and chronic
illness. Pressure ulcers can be acquired while in the hospital, long term care facilities or in the home.
Personal definition of Pressure ulcer is an injury to the skin and underlying tissue due unrelieved
pressure and other factors, including by not exclusive to decreased tissue perfusion, excess moisture,
and shear and friction. The NPUAP defines Pressure Ulcer as "injury to the skin and/or underlying
tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear
and/friction" (NPUAP as cited in Stonelake, 2015, p. 2). Pressure ulcers can be regarded as
negligence and poor nursing ... Show more content on Helpwriting.net ...
Prevention interventions include risk assessment, repositioning, frequent skin inspections, pressure
relieving devices, nutrition and hydration, and caregiver education. Risk assessment should be on
admission to the home health services, as as often as needed such as whenever the patient condition
declines. Similar to hospital policies, the Braden Scale can be used in home settings along with
nurse's clinical judgment.
Additionally, patients can be the nurse's allies regarding their own health care. Patients should be
encouraged to turn and roll in bed as often as possible. When the patient is immobile and self
turning and repositioning is not possible, the nurse and caregivers should be repositioning at least
every two hours. However, strategies for pressure ulcer prevention are not always successful.
"Pressure ulcers are an important problem in the home care" (Paquay, et al., 2008, p. 628). Pressure
ulcers can result in hospital readmission and health decline. Frequent skin inspections are essential
to find and treat pressure ulcers at early stages. Pressure relieving devices such as heel and elbow
protector, egg crate mattress or chair cushions, foam overlay and other prescribed devices can be
used to redistribute the

Helicobacter Pylori Research Paper
Helicobacter Pylori at Tight Junctions
Prior to the isolation of Helicobacter pylori (H. pylori} by Robin Warren and Barry Marshall in
1982, it was theorized that peptic ulceration, an ailment first described in 1857 by William Brinton,
stemmed from poor diet, tobacco use, and stress due to the failure to definitively identify a causative
agent as well as the belief that the inhospitable environment within the human stomach resulted in
its sterility (Tanenbaum 2005). Because physicians were ignorant to the existence of H. pylori,
individuals suffering from peptic ulcerations underwent ineffective treatments for over a century.
The successful isolation of H. pylori and identification of its role in gastric diseases earned Warren
and Marshall a joint Nobel Prize in Physiology or Medicine in 2005 (The Nobel Prize 2005).
Despite the passage of thirty–two years, modern medicine has been unable to definitively eradicate
H. pylori, but research continues in hopes of developing a more permanent cure as well as effective
methods of preventing initial peptic ulceration, as occurrence is linked to an increased risk of
developing gastric carcinomas.
Introduction to Helicobacter pylori at Tight Junctions
According to Stein, Ruggiero, Rappuoli, and Bagnoli (2013), H. pylori is present in the gastric
mucosae of more than half of the human population. H. pylori ... Show more content on
Helpwriting.net ...
This results not only in the abnormal assembly of tight junctions in areas colonized by H. pylori, but
also alters the "composition and function of the apical–junctional complex" (OMIM SOURCE
YEAR). Prolonged exposure to CagA results in dysplasia and prevents the epithelial barrier from
functioning

The Disease Of Behcet 's Disease
In 1937, a rare disease called Behcet 's Disease (BD) was first described by Dr. Hulusi Behcet, who
is a dermatologist in Turkey. The disease is also known as Behcet 's syndrome and described by The
American Behcet 's Disease Association (2014) as "a rare, chronic, autoimmune, autoinflammatory
disorder" (American Behcet 's Disease Association [ABDA], 2014). The disease, recognized
worldwide, can affect multiple systems in the human body and associated with morbidity and
mortality. Dr. Hulusi Behcet (2014) first described the disease as "a triad of oral ulcers, genital
ulcers and ocular inflammation" (ABDA, 2014). The epidemiology behind this disease indicates its
prevalence in multiple countries. It is less prevalent in the United States and Western Europe.
According to National Organization for Rare Disorders (2015),the highest prevalence rate, 80–370
cases per 100,000, of this disease is in Turkey, as well as in Japan, Korea, China, Iran and Saudi
Arabia (National Organization for Rare Disorders [NORD], 2015). According to the National
Institute of Arthritis and Musculoskeletal and Skin Disease, the disease affects more men than
women in Middle Eastern and Asian countries. However, it affects more women than men in the
United States (National Institute of Arthritis and Musculoskeletal and Skin Disease [NIAMS],
2015). It can develop in people of all ages but it tends to develop in people between the ages of 20 to
40. The Behcet 's disease symptoms vary from person

The Development of Cimetidine as Treatment for Peptic...
The drug cimetidine was launched in 1976, as a successful medication to treat peptic ulcers. Over
many centuries peptic ulcer has been a major cause of death, at any particular time about 4 million
people are effected with peptic ulcer, and the at least 6000 people die from this disease each year.
Peptic ulcer results from erosion within the walls three particular areas of the gastrointestinal tract
(GIT); the oesophagus, the stomach or the duodenum. This is due to the excessive production of
stomach acid, consisting of hydrochloric acid (HCl) and the enzyme pepsin, required for digestion in
the gastrointestinal tract; this can also lead the acid to reach the oesophagus. Under normal
circumstances the linings are protected from the ... Show more content on Helpwriting.net ...
However, following surgery the symptoms associated with ulcers were not cured. This lead to
further understanding of the causes of peptic ulcers, and that the regular use of NSAIDs medications
such as aspirin to treat other illnesses induces ulcers (figure 2).
Aspirin inhibits the enzyme COX – 1 which normally converts arachidonic acids to prostaglandins.
Prostaglandins are responsible for the positive feedback on non parietal cells to produce mucus and
bicarbonate protective layers and they show negative feedback on parietal cells, inhibiting acid
secretion. Thus inhibition of the COX–1 inhibits synthesis of prostaglandins hence decreased mucus
and bicarbonate production and increased acid production (figure 1).
Cimetidine treatment for NSAIDs/aspirin induced acid production was discovered upon
investigating histamine receptors located on the parietal cells. Histamine receptor activation, triggers
acid secretion, consequently, antagonising the histamine receptor decreases the gastric acid
production; thus aiming to treat peptic ulcers.
This discovery was initiated by James Whyte Black and William Duncan in 1964; with other
scientist's contributions, cimetidine was discovered at Smith Kline and French Laboratories (now
known as: GlaxoSmithKline) facilities in Philadelphia. Initially to design a histamine receptor
antagonist, its structure must be similar to that of the agonist histamine, thus it can competitively
bind to

Gastric Ulcer Case Study: Helicobacter P
Thirty five year old accountant presented to his physician with a steady burning pain just right of the
midline of the abdominal region in an area from 1 to 4 inches above the " belly button". The pain
was followed by meals (1– 3 hours after). He had several episodes of vomiting, which included
blood. The patient had no fever, the patient appeared fine. He had no evidence of weightloss.He
showed a slight rebound tenderness in the upper abdomen.An occult blood test revealed the
presence of blood. This patient was diagnosed with Gastric ulcer because of the fact that the pain is
located by the abdomen area and that the pain usually followed meals by about one through three
hours and with some episodes of vomiting including blood.The name of ... Show more content on
Helpwriting.net ...
As mentioned in the article published by Patient which is a trusted medical information and support
web: (http://patient.info/health/gastritis) "For most people, Gastric ulcer isn't serious and improves
very quickly". If it isn't treated correctly the it may worsen.For example, if a patient has Gastric
ulcers continuing to drink too much alcohol or using an NSAID such as ibuprofen will cause the
patient to not recover or decline health state.The way that these ulcers are treated depends on
identifying what caused the patient's ulcers. If the person is infected with the H.pylori this infection
should be treated by completing a full dose of antibiotics. Just as making sure that after the
antibiotics are completed to check for complete removal of the infection.Also, if the patient has an
ulcer and bled significantly the treatment might be done at the time of the EGD. During this
procedure the bleeding is controlled and then the gastroenterologist might infect medications using a
catheter to cauterize the ulcer or place a small clip to clamp off a bleeding vessel. This is only if the
patient is bleeding significantly keep in mind not all ulcers need to be treated in this way.Usually the
doctor that is performing the Therapeutic endoscopy will decide the method. The doctor uses a
lighted medical instrument to see inside the body and provide treatment. The treatment consists of
antacids which are medication that decrease stomach

The Influence Of His Elder Brother
Sir James Whyte Black explained that he chose to study Medicine mainly under the influence of his
elder brother, William Whyte, a graduate in Medicine from Scotland's St Andrews University. (The
Lancet 2010) Sir James Whyte Black attended Beath High School in Fife, Scotland where his
teacher, Dr. Watson enthused him to pursue his mathematics study. Furthermore, Dr. Watson "more
or less manhandled" (The Lancet 2010) him into sitting the entrance exam for St Andrews
University. James Black received the Patrick Hamilton residential scholarship and became an
undergraduate student in St Salvator 's Hall. James Black qualified in 1945 as a physician from the
St Andrews University in Scotland. (Notable Names Database, 2016). James Whyte Black began his
research in October 1946 where he joined Professor R.C. Garry's laboratory at the St Andrews
University's Physiology Department. Pharmacologist James Black, moved to Singapore in 1947
where he began lecturing at the King Edward VII College of Medicine. Then, James Black returned
to Scotland in 1950 where he was appointed the opportunity to start a new Physiology Department
at the University of Glasgow Veterinary School. During the years 1958 to 1964, Imperial Chemical
Industries employed James Black where he researched at their laboratory in Alderley Park,
Cheshire. From 1973 to 1977, James Black was employed by the University College in London and
later was selected to be the Chair in the Pharmacology Department. From the year

Causes and Treatments of Peptic Ulcer Disease
A peptic ulcer can be defined as an "excavation that forms in the mucosal wall of the stomach, in the
pylorus, in the duodenum, or in the esophagus" (Brunner, Suddarth and Smeltzer, 2008). According
to Fromm, (2009) Helobactor pylori is a gram–negative bacteria that is the cause of most peptic
ulcer disease and is considered a primary risk factor in the development of gastic cancer (pg. 394).
Other causes include stress, and excessive secrtion of Hydrochloric acid in the stomach.
Transmission of H. pylori according to Gurney, Carvalho, Gonzalez, Galaviz & Sonstein (2014)
states there is strong research supporting that H. pylori can be spread person to person through direct
contact with saliva, vomit, or fecal matter (pg. 393). H. Pylori is more prevalent in crowded areas
without reliable access to clean water. Other risk factors include poor hygiene, smoking, and close
living conditions with someone who is infected with H. pylori. Symptoms of an ulcer include a
burning sensation in the stomach and esophagus, vomiting, diarrhea or constipation and bleeding.
Treatment of Peptic Ulcer Disease includes antibiotics to eradicate H. pylori bacteria; proton pump
inhibitors are used to treat NSAID–induced ulcers and other ulcers not associated with the bacterial
infection, smoking cessation and dietary modifications. Surgical management is recommended for
ulcers that fail to heal after 12–16 months of treatments and the procedures include pyloroplasy,
anrectomy or vagotomy.

Wound Clinic Journal: The Usage Of Silver-Based Dressings
Wound Clinic Journal: The Usage of Silver–Based Dressings in Chronic Venous Ulcers
When nursing comes to mind, it is common to think of only acute care nurses working the floor of
the local hospital. However, nurses work in a variety of settings, one of which I was able to witness
at St. Mary's wound clinic. Of the five patients that I was able to interact with here, one of the most
interesting was the case of a 33–year–old male patient who presented to the clinic with a venous leg
ulcer. The ulcer, located on the lateral portion of the lower leg just below the patient's calf, was
draining a significant amount of serosanguinous fluid. Additionally, cellulitis infected the entire calf
area, while the skin immediately surrounding the wound ... Show more content on Helpwriting.net
...
Due to research such as this, the nurse believed that an Aquacel dressing would assist in fighting the
patient's infection and aid in overall wound healing. This was confirmed by the attending primary
care physician, who affirmed the usage of the silver based dressing.
Although silver has perceived benefits, research indicates that it may be toxic in fibroblast
contraction and cell viability (CITE). Additionally, no randomized clinical trials have been
conducted which prove the effectiveness of silver dressings in wound care. In fact, one study
conducted in South Australia concluded that the usage of silver dressings led to longer hospital stays
and more visits to healthcare providers (CITE). In order to provide the best care for this patient and
others with chronic wounds, the best evidence based practice must be determined through the
conduction of experiments on Aquacel and additional silver–based dressings.
Throughout the procedure, I was able to interact with the patient and communicate effectively with
him, discussing his pertinent health history as well as his experience in dealing with his chronic
wound. Such communication and patient interactions bring an abundance of positive feelings to any
clinical situation. I also felt positively about the decision of the nurse and healthcare provider in the
use of barrier cream to prevent further maceration of the peri–wound skin,

Formulation And Evaluation Of Bi Layer Matrix Tablets
Formulation and Evaluation of Bi–Layer Matrix Tablets Containing Amoxicillin and Pantoprazole
an Oral Modified Release Dosage Form for
Treatment of Peptic Ulcer
Sudhanshu K Chakravati1, Javed Khan Pathan1, Sapna Malviya1, Anil Kharia1
Modern Institute of Pharmaceutical Sciences, Indore (MP)
ABSTRACT
The aim of the present study is to formulate a dual therapy of peptic ulcer containing antimicrobial
agent amoxicillin and anti–secretory agent pantoprazole, utilizing the concept of bi–layer tablet
system for the effective treatment of H. pylori associated gastric/duodenal ulcer, in an attempt to
improve bioavailability and to get maximum therapeutic benefits and patient compliance about the
treatment. Different formulas of 575 mg amoxicillin were prepared as sustained release layer by wet
granulation method and different formulas of 40 mg pantoprazole in form of immeadeaye release
was prepared as extended release matrix layer by direct compression technique. The results showed
that formulas prepared with Hydroxypropylmethyl cellulose (HPMC K100M) and xanthan gum and
acasia as binder was capable to retard the release of Amoxicillin and Pantoprazole for 12 hr and 8hr
respectably which according to dosing frequency of amoxicillin in treatment of peptic ulcer (twice
daily) it will prevent drug free interval so achieve complete eradication of H. pylori, thus it was
selected for preparation of bi–layer tablet. Regarding Pantoprazole, formula PS–6 (which consist of
HPMC K 15 M,

Venous Stasis Ulcer
An ulcer is an open lesion of the skin resulting in tissue loss. It is estimated that venous stasis ulcers
affect 500,000 to 600,000 people in the United States every year and it is by far the most common
type of leg ulcer seen (Foot Pain Explained). A person may have an ulcer on one or both legs and
each leg may have multiple ulcerations. These ulcers are found in the inner part of the lower leg and
can be very painful. Venous stasis is a very common disease of the leg. A venous stasis ulcer is a leg
wound that does not heal because the veins of the legs are not pumping blood back to the heart. The
blood pools in the lower leg which causes the leg to swell, the skin to open and form an ulcer.
People who have a history of leg and feet ... Show more content on Helpwriting.net ...
This doesn't mean it's infected. If it is infected, there will be a lot more drainage and the area around
the ulcer will be much redder in color than normal. Venous stasis ulcers need to be cleaned and
debrided to remove all dead tissues and to promote formation of healthy granulation tissue. Some
doctors clean the wound with a mild soap and others use a wound cleaner. There are a few methods
doctors use to debride an ulcer but the most common is where the doctor takes a scalpel and scrapes
away all dead tissue within the ulcer and around the wound. If the ulcer has a lot of yellow fibrous
tissue, the debridement may have to be done under local anesthesia because this can be a very
painful procedure. Dead tissue has to be removed for two reasons; one it harbors bacteria so if the
wound is already infected it helps clear up the infection and if the wound is not yet infected it
greatly reduces the possibility of infection (Foot Pain Explained). Secondly, healthy tissue cannot
form where there is an abundance of dead tissue so healing will be delayed (Foot Pain Explained).
Depending on the wound, the doctor is the one who decides which method of debridement to use.
After the cleaning and debridement, a dressing is applied. There are many types of dressings: moist
dressings, hydrogel and hydrocolloid dressing, alginate dressings, collagen wound dressings,
antimicrobial dressings, and composite dressings.

Gastric Ulcer And Duodenal Ulcers
Chapter – 16
Peptic Ulcer (Gastric Ulcer/Duodenal Ulcer)
Both gastric (stomach) and duodenal ulcers are called peptic ulcers. Peptic ulcers affect 10% of the
world's population and men and women both equally. Duodenal ulcer incidence peaks in clients in
their fifties and sixties and gastric ulcers in those between ages 60 and 80. This is known as a
disease due to Hurry, Worry and Curry. Smoking, consuming alcohol in large amounts, use of some
drugs like NSAIDS for a long duration are causative factors of ulcers.
Peptic ulcer is a chronic ulcer formed in regions of the gastrointestinal tract where gastric juice
comes into direct contact with the mucous membrane. Such ulcer usually occurs in the first part of
the duodenum and in the stomach. They sometimes occur in the lower oesophagus; in the jejunum
after gastro–enterostomy or partial gastrectomy; and rarely, adjacent to aberrant gastric mucosa in a
Meckel's diverticulum. The term peptic ulcer is used to describe any localised erosion of the
mucosal lining of those portions of the alimentary tract that come in contact with gastric juice. This
integration of tissues can also result in necrosis. The defence mechanism of gastric and duodenal
mucosa is incredibly efficient. The normal mechanical, thermal or chemical insult from food is well
within its power to deal with. No single factor has been identified in the causation of chronic peptic
ulcer. A combination of factors leads to ulceration. Most ulcers are found in the

The Function Of The Human Digestive System
The human digestive system is like a machine composed of many parts of the body that work
together to turn foods and liquids into energy that the body requires to function.
The digestive tract begins with the mouth. This is where the enzyme amylase is released to initiate
the process of digestion.
The epiglottis is a small piece of tissue that covers the opening of the larynx.
Once food passes through the epiglottis, it goes to the gallbladder, a small pouch that stores bile. The
gallbladder releases bile into the duodenum to help digest fats in the food you eat.
The first part of the small intestine is called the duodenum. The word duodenum comes from the
Latin word duodeni and means "12 each." The duodenum was thought to be as long as the width of
12 fingers.
The middle section of the small intestine is called the jejunum, which is about 5 to 8 feet (1.5 to 2.5
meters) long.
The third part of the small intestine is called the ileum. It's also the longest tube, measuring 16 to 20
feet (5 to 6 meters) long.
It is called small intestine because of its width, not its length. The small intestine is actually much
longer than the large intestine. The small and large intestines form one continuous tube.
The large intestine consists of three parts, the cecum, the colon, and the rectum. The cecum is the
pouch–like beginning of the large intestine. The colon is the largest part of the large intestine and
has three parts – the ascending colon, the transverse colon, and the

Neuropathic Ulcers
Neuropathic Ulcers Homework 1. 1. Why does a high blood glucose level cause tissue damage?
There are a few different theories of why hyperglycemia cause tissue damage. One cause is caused
by the increase in microvascular pressures from the hemodynamic changes. It also changes RBC to
become less deformable making it harder to release oxygen, and more adhesive. The RBC will stick
to each other and to the capillary walls. Similar to RBC's, platelets become more adhesive,making
capillary walls thicker. The decrease in lumen size causes the increase in microvascular pressure.
Hyperglycemia also causes glucose to bind to protein forming glycosylate proteins , causing tissue
damage. 2. 2. You would think that increased blood

Ulcer Bug Essay
Ulcer bug
Eric Wichman
BIOSCI 202 – 401
February, 5th 2013
Case Studies in Human Anatomy and Physiology
Ulcer Bug Case Resolution Template
1) This case study focuses on the process of scientific inquiry. How did the researchers use this
process to learn about gastric ulcer disease, its causes, and its treatments?
Answer: The process started with the observation of Dr. Barry Marshall's observation of his patients
going through antibiotic therapy for non–related ailments. Dr Marshall then hypothesized that
helicobacter pylori was the causation of peptic ulcer disease and not the end byproduct of
inflammations. The researchers then used research and study of inflamed stomach mucosa through a
period of antibiotic regimen to ... Show more content on Helpwriting.net ...
Answer: I used emedicine to reference more statistical history on H. pylori and its common
applications in relation to the ulcer bug currently. Using the same data that was gathered from the
study referenced on D2L the protocols for treatment have vastly improved over the last couple
years. I thought about the long term effect that antibiotic treatment of this bacteria and how the
bacteria itself "burrows" itself into the stomach mucosa thus causing the ulceration. The article I
read also mentioned that this specific bacteria is also responsible for inflammation in the duodenum
(part of the small intestine). In summation there also is a higher risk for stomach cancer and
lymphoma also associated with this bug.
4) What does each of these additional items contribute to the solution of the case? For example, the
item contains data from specific tests, trials, or experiments, or presents analyses that can be used to
understand the main issues in this case. Answer: The additional information was more of a statistical
analysis of current day treatments, protocols and outcomes. The main issue for this specific case is
the presence of the bug and causing the gastritis and that issue still applies today. In the article
referenced above 50% of the world's population is infected with this bacterium. Though vastly more
prevalent in third world nations roughly 20–30% of

Symptoms And Treatment Of Peptic Ulcer Disease
What is PUD – H. Pylori?
In the system of the gastrointestinal tract, there are some conditions that can affect quality of life and
is common. One of these conditions is called peptic ulcer disease (PUD) or also known as H. Pylori
(Helicobacter pylori), which is the bacteria associated with PUD that causes the infection that leads
to PUD. Almost two thirds of the world is affected with this infection, unbeknownst to the host
(Moscou, page 421). This infection is introduced in the body through contaminated sources of food
or water. It also can be transmitted through person to person contact by kissing. Once ingested,
buffers are released and the bacteria is able to survive despite the acidic conditions of the stomach.
Most people do not produce symptoms of the infection, however, there are some that may
experience irritation and tissue damage from overproduction of gastric acids and peptic ulcers.
Duodenal ulcers, which form in the upper region of the small intestines, are more common in
younger people. Peptic ulcers tend to be more common with age as they are more likely to be
infected. This disease is treatable and obliteration of the H. pylori results in ulcer cure and
prevention of recurrences (Zoorob, page 243)
Symptoms of PUD The symptoms of the peptic ulcer will depend on the location of it. A gastric
ulcer located in the stomach will result in pain of the upper abdomen approximately 15 to 30
minutes after consumption of food. Because of the pain, one may be afraid

A Case of a 62 Year Old with Epigastric Pain
Mr. A.M, a 62 year old man presented at the outpatient clinic with a two month history of epigastric
pain. He also reported that the pain was strongly correlated to meals. He also felt that his appetite
has decreased, however he did not lose any weight. He has a history of gastroesophageal reflux
disease (GERD), which dates back 5 years ago, which he took proton pump inhibitors for one
month. He is smoking for the last 40 years around one package a day, and does not consume any
alcohol. He had an appendectomy when he was 12 years old. Mr. A.M is married and just retired six
months ago from his former job as an accountant. He is currently on an ACE inhibitor for the
control of his hypertension. On examination, he appears comfortable and well. He has an abdominal
distention. Chest is clear on auscultation, his blood pressure is 125/75mmHg and pulse rate is
85/min. He is tender 2cm below the sternum when deep palpation is performed, no lumps are felt,
and the pain does not radiate. Liver is palpable 2cm below costal margins. There is no shifting
dullness or fluid thrill. 3. INVESTIGATIONS A referral to the cardiologist was made to exclude any
cardiac causes since the pain Mr. A.M felt was epigastric. Physical examination along with ECG as
the preferred test by the cardiologist did not reveille any abnormalities. CBC count and LFT's were
ordered. Mr. A.M was later on referred to a gastroenterologist for focused examination on the
gastrointestinal system.

Symptoms And Treatment Of Ulcers
In today's world, elderlies suffering with ulcers are very common. Ulcers are sores that occurs on the
external surface or internal surface of the body, which is caused by a break in the skin that does not
fully recover or fail to heal. Ulcers come in different forms, targeting different areas, due to different
reasons with some slight similarities to them.. People with ulcers has many treatment options,
depending on their case, stage, and kind of ulcer, for example stasis and pressure ulcer. Stasis and
pressure ulcer are two ulcers that has lack of blood flow as a factor why it occurs, even though it
gives a different outcome for both ulcers. Pressure ulcers is also known as pressure sores or bed
sores, these sores occur when an individual is not being repositioned for some time, causing
constant pressure to an area. Some of the etiology of pressure ulcers stated by Jones, D (2013) are,
"poor nutritional status, posture problems, medications, reduced blood flow, and reduced mobility".
Elderly nursing home patients has a very high rate of gaining this kind of ulcer due to limited or
reduced mobility and bed rest causing the blood flow to be cut off due to the constant pressure. On
the other hand, there is stasis ulcer, also known as venous stasis ulcer, a skin condition which occurs
in people with poor circulation. The stasis ulcer usually occurs in the lower legs. The etiology of
stasis ulcer stated by Beckerle, Carla Moore, "Pathogenesis of venous system can result in

Pressure Ulcers
According to the textbook, nurses in various settings are adopting a research–based (or evidence–
based) practice that incorporates research findings into their decisions and interaction with clients.
How do you see this being applied in your workplace? In my workplace, we have recently
implemented that if a patient is admitted from the ER or directly admitted from a physician's office
and they have any sensory impairment we must order them a "Stryker" overlay mattress. The stryker
softcare overlay mattress is a single patient use mattress put in place in hope of preventing pressure
ulcers. The mattress works by redistributing pressure to other areas by removing the constant
pressure on pressure points along boney surfaces. This assist ... Show more content on
Helpwriting.net ...
Doctors are not as a matter of course anticipated that would experience this expansive meaning of
beneficence.an illustration is resuscitating a suffocating casualty. On the other hand, no–maleficence
intends "no mischief." Physicians must avoid giving inadequate medications or acting with
noxiousness toward patients. This standard, in any case, offers minimal helpful direction to doctors
subsequent to numerous valuable treatments likewise have genuine dangers. The appropriate moral
issue is whether the advantages exceed the weights. Doctors ought not to give insufficient medicines
to patients as these offer danger with no probability of advantage and along these lines have a
possibility of hurting patients (Gabaldón & Aguilera, 2008). Moreover, doctors should not do
anything that would intentionally hurt patients without the activity being adjusted by relative
advantage. Since numerous solutions, systems, and intercessions reason hurt notwithstanding
advantage, the rule of non–perniciousness gives minimal solid direction under the watchful eye of
patients. An illustration from my practice is halting a solution that is appeared to be destructive 5.
Health care providers are obligated to provide for those entrusted in their care. To what extent do
they meet this obligation? How might their obligation to others conflict with their obligation to
themselves? The obligation to give care and to react to affliction is

The Prevalence Of Pressure Ulcers
The prevalence of pressure ulcers in elderly patients is of an epidemic proportion (Bansal, Scott,
Stewart, & Cockerell, 2005). The annual cost of treating pressure ulcers in the United States (U.S.)
is estimated at more than $20 billion and is increasing (Jones, 2013). Pressure ulcers occur when an
injury is caused to the skin and underlying tissue at the pressure points resulting in transient or
permanent damage to the underlying tissue (Margolis, 1995). The prevalence is seen in patients who
are immobile because of chronic health conditions or lying on hard surfaces for prolonged periods
(Pham et al., 2011). A pressure ulcer can be disruptive and disabling to frail elderly patients (Landi,
Onder, Russo & Bernabei, 2007). A pressure ulcer can also result in complications, which can lead
to mortality (Nigel & Chow, 2002; Gary, Berlowitz & Paul, 2001). Development of pressure ulcers
is no longer limited to acute or sub–acute facilities alone. As the population is aging, more elderly
are receiving heath care in their homes (Ablaza & Fisher, 1998). As a result, all stages of pressure
ulcers are also seen in the homes (Park–Lee & Caffrey, 2009). However, there are limited studies
that show the magnitude of the problem when compared to acute, sub–acute, and nursing homes
(Asimus & Li, 2011). This project will conduct a retrospective chart review at a community–based
primary care provider to determine the prevalence of pressure ulcers among elderly individuals who
are

Chinchilla Pets
Now, you might say that I can't have a chinchilla because of the dogs or maybe because I'm not
responsible enough to take care of three pets. (Bailey, Shadow and the chinchilla) If I am
responsible enough to take care of two dogs: feed them, let them out, set up the dog bowls, and
break them up by myself when they are fighting outside. I also do chores when asked. If there is any
other thing you want me to do, just ask me. I also still manage to get good grades and still stay in the
honors class and keep my grades at a's and b's. For the cage we can just move my bed so the cage
can be next to me in case something happens. Even if you're worried about the dogs getting to the
chinchilla I will always be in the room with him. After the chinchilla ... Show more content on
Helpwriting.net ...
Commercial pellet food for chinchillas.
Hay, Timothy or alfalfa hay are popular choices.
Various treats including commercial pet treats, nuts, seeds, and dried fruits.
Bloat is caused by an excessive gas build up in the gastrointestinal tract. Causes of bloat are a rapid
change in diet, feeding gas producing foods, infections or obstructions in the gastrointestinal tract.
Symptoms are severe pain, gurgling in the stomach, laying down, rolling, and a reluctance to
move.Gastroenteritis is an inflammation of the stomach and intestines. It is often caused by bad food
or a change in diet. Symptoms are diarrhea, pain, loss of weight, and dehydration.If a chinchilla eats
bad, moldy or rough hay, he can develop a stomach ulcer. bad hay, moldy hay or coarse hay they can
develop stomach ulcers. Ulcers can be difficult to detect and the only symptom may be a poor
appetite. When a chinchilla's fur becomes wavy and weak it is usually a result of too much protein
in the diet. Over time, a healthy balanced diet can restore the fur to its normal

Stress Related Mucosal Disease ( Srmd )
Stress–related mucosal disease (SRMD), an acute erosive gastritis that may potentially lead to stress
ulcers and/or stress–related injuries, remain a significant concern for patients within the critical care
setting.1 The initiation of anti–secretory therapy (AST) for stress ulcer prophylaxis (SUP) within the
critical care setting has gained widespread use as it has been noted to protect against SRMD and
clinically important gastrointestinal (GI) bleeding.2 Although the use of these agents is well
established in the critical care setting, several research studies have confirmed the extensive and
inappropriate use of AST in both intensive care unit (ICU) and non–ICU patients, based on current
recommendations.3 Proton pump inhibitors, in most hospital settings, have been the mainstay drug
of choice for SUP. Since the introduction of the first proton pump inhibitor (PPI) in the late 1980s,
the use of PPIs has risen dramatically, with sharp increases noted up to 456% in the 1990s.4 As one
of the world's most frequently prescribed medications5, expenditures are estimated to surpass seven
billion dollars annually,6 falling only second to HMG CoA reductase inhibitors. There is strong
evidence demonstrating that SUP can be an efficacious and effective preventative care measure.
However, a perceived favorable safety profile has contributed to the significant overutilization of
PPIs. STRESS ULCER–RELATED RISK FACTORS Stress ulcers are either single or multiple
gastroduodenal

Problems of Pressure Ulcers
Boettger, J. (1997). Effects of a Pressure–Reduction Mattress and Staff Education on the Incidence
on Nosocomial Pressure Ulcers. Journal of Wound Ostomy Continence Nursing. 24 (1): 19–25.
Overview– Pressure ulcers are serious problems surrounding hospital care. They cause the patient
considerable pain and interrupt recovery. There is physiological pain associated with serious tissue
necrosis as well as psychological trauma that is as a result of altered body image and dependency
needs. The problem is quite serious; about 9% of hospital patients and almost one–quarter of all
nursing home patients are affected by pressure ulcers, with 60,000 deaths attributed to ulcer–related
complications (Balestrino, 2000). The purpose of the Boettger study was to determine if a two–
pronged approach to the issue would decrease the incidence of pressure ulcers: 1) replacing standard
hospital mattresses with a pressure reduction mattress, and; 2) educating and training the patient
care team on Agency for Health Care Policy and Research prevention guidelines for pressure ulcers
(Boettger, 1997).
Protection of Human Participants Consent to perform the research was obtained from an academic
institutional review board, but required no individual consent because the subject's privacy rights
were not violated and the variables studied were non–sensitive. To protect patient confidentiality,
study numbers were used. The study was pre– and post–intervention, and the variables were meant
to find

Peptic Ulcer Disease and Pediatric Patients
PUD is not as common in pediatric patients when compared to adult incidences. The most common
cause of PUD in pediatrics is due to Helicobacter pylori (H.pylori) infection (Guariso & Gasparetto,
2012). Primitive ulcers, due to H. pylori, cause changes in the gastric or duodenal mucosa and alter
gastric function such as overproduction of HCl and pepsin, resulting in ulcer–forming lesions
(Guariso & Gasparetto, 2012). NSAIDs, stress and other extra–gastric pathogenic events cause
secondary ulcers within the stomach. The underlying pathology of PUD is due to the reduction of
prostaglandins that serve as a protective mechanism on the gastric mucosa. Patients most commonly
present with dull stomach ache or pain usually after a meal. Gas, bloating, nausea and vomiting are
some less common symptoms. PUD, although rare when compared to adults, is reported worldwide
in children and most commonly identified as initiated by H. pylori infection and the use of NSAIDs
occurring in the second decade of life. Other events such as stress, shock, or major trauma can
trigger acute ulcers in children but there is a hereditary family history component that increases acid
output and accelerates gastric emptying in more than 20% of patients (Guariso & Gasparetto, 2012).
Although H. pylori infection is the more common cause of PUD, the use of NSAIDs increases the
risk of acquiring PUD (Guariso & Gasparetto, 2012).
Investigations
Guariso & Gasparetto (2012) thoroughly investigated the cause of

The Responsibilities Of Nurses Are Numerous And Diverse
The responsibilities of nurses are numerous and diverse. Nurses have a duty of care and a
professional responsibility for the treatment of the sick and injured patients and are accountable for
their actions. Nurses asses and treat patients, promote and restore health, provides education,
prevent illness and reduce the suffering for the patients. This reflective case study will provide a
written account of the nursing care delivered to two patients Claire and Justin.
The first case study is about Claire, a 61 year old female diagnosed with osteoarthritis and
osteoporosis who sustained a left colles' fracture and a fractured right tib/fib. This reflective case
study will provide a written account of the post–operative nursing care specific to the closed and
open reduction procedure done to repair her fracture and interventions specific to the events that
followed.
The second case study is based on Justin a 33 year old car salesman who administers over the
counter anti–inflammatories for chronic back pain sustained in a car accident several years ago.
Justin a social drinker and ex–smoker, has been experiencing significant abdominal pain and
diarrhoea after trip to Singapore and Thailand. He is admitted with a provisional diagnosis of gastro
oesophageal reflux +/–peptic ulcer disease. This reflective case study also looks into the preparation
of patients for colonoscopy and nursing management post procedure.
CASE STUDY 1
Osteoarthritis can be caused by ageing, hereditary,

Pressure Ulcer Essay

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