Discharge Planning

Discharge Planning
Discharge Plannin
Discharge planning is a process that aims to improve the coordination of services after discharge
from hospital by considering the patient's needs in the community. It seeks to bridge the gap
between hospital and the place to which the patient is discharged, reduce length of stay in hospital,
and minimise unplanned readmission to hospital.1
Discharge planning is an established part of hospital care, but the process varies and is not entirely
evidenced based. A Cochrane review analysed 11 randomised controlled trials looking at discharge
planning in over 5000 patients and failed to show a reduction in mortality among elderly medical
patients, lower readmission rates, or a shorter length of hospital stay.1 However, two ... Show more
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A key aim of discharge planning is to provide good continuity of care to ensure good patient
outcomes, hence effective handover to primary care. This is most often achieved through the
immediate discharge document.13 Limited data are available on discharge documentation, but
recent audits have shown that key facts and data such as follow–up arrangements, new diagnoses,
and accurate medication lists are often omitted.14 15 16 The Scottish Intercollegiate Guidelines
Network (SIGN) has recommended that senior staff should approve every immediate discharge
document.13 Box 3 outlines the recommended minimum content for discharge documentation. In
complex or unwell patients, contacting the general practitioner, community matron, or specialist
nurse before discharge may be necessary to ensure an effective handover. See also the scenario box
(Case study part 4).
The Department of Health guidelines suggest that preparation for discharge needs to involve health
professionals, family members, social services, and the patient.4
Staff involvement
Increasingly, the process of discharge is coordinated by the discharge coordinator (a new post in
health care), who is often recruited from a nursing or social services background. Discharge
coordinators provide a single point of contact for all involved in the discharge planning process.4 In
some hospitals, however, this planning role may still lie principally with junior members of the
... Get more on HelpWriting.net ...

Obesity Is A Disorder That Involves Extreme Amount Of Body...
Obesity Introduction Obesity is a disorder that involves extreme amount of body fat. It is an
important issue because of the disturbing rate it has reached over the past years, especially when it
comes to children. It's important to teach them healthy habits so they would stick to these habits
when they are older. It's hard to keep up with what they are learning. Since children spend many
hours a day in their school or child care place, a new way to include new habits in the children's life
is to involve their schools. This topic interest me because I have seen obese children and have seen
their struggles and I'd be glad to find new ways to help them become healthier. Review of Article
Obesity can affect a person's life in a lot of ways. One way it can increases the risk of diseases and
health problems such as heart disease, high blood pressure and diabetes. In other way, it can increase
the risk of emotional difficulties. According to the American academy of Child and Adolescent
Psychiatry, teenagers who are obese have much lower self–esteem and are less known in their
school. They also note that disorders such as depression and anxiety can happen to these teenagers.
To attack the obesity issue between young children and teens, the schools are helping them to eat
healthier by encouraging the kids to grow and prepare the food themselves. This approach might
help the children to change their food preferences and choose what's best for them. Researchers
found that children

Factor VIII Hemophilia A: A Genetic Disease
First described by Babylonian Jews more than 1700 years ago (NCBI, 2011), hemophilia A has been
considered a very interesting genetic disease ever since. In addition, hemophilia A gained
widespread attention after Queen Victoria transmitted the disease to several royal families in Europe
(NCBI, 2011). As scientists gain more knowledge regarding this genetic disease, more effective
treatments have emerged as a result. Hemophilia A is classified as a hereditary blood disorder
(NCBI, 2011), and is caused by a lack of blood clotting protein, known as factor VIII (NCBI, 2011).
The specific gene that codes for factor VIII is known as the HEMA gene (NCBI, 2011). Factor VIII
is mainly synthesized in the liver (NCBI, 2011). Any lack of factor VIII ... Show more content on
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The reason for this is due to carriers. A female who is heterozygous for hemophilia A (she
essentially has a normal X and an X chromosome with a HEMA defect) is considered a carrier.
Therefore, if a carrier female mates with a male who does not have hemophilia A, their children will
not have hemophilia if they are female. However, if they are male, there is a 50% chance that they
will have hemophilia A (Figure 2B). As previously mentioned, hemophilia A varies in severity,
which in turn includes symptoms (Iorio et al., 2010). Obviously the main symptom is excessive
bleeding. Usually, hemophilia A is first noticed when an infant is circumcised (Iorio et al., 2010),
however milder cases of hemophilia can be noticed later in life. If this is the case, mild cases can go
unnoticed until after a surgery or injury in which internal bleeding would be a problem (Iorio et al.,
2010). In addition, victims of hemophilia are recommended to get a hepatitis B vaccine due to the
fact that they may receive blood products (Iorio et al.,

A Study On A Computer Aided Search22 Of Medline
1. Are the studies contained in the review RCTs? Knols et al. (2005) included thirty–four
randomized clinical trials and controlled clinical trials in their systematic review. 2. Does the review
include a detailed description of the search strategy to find all relevant articles? The review provides
a very detailed description of their search strategy. Knols et al. (2005) states, "a computer–aided
search22 of Medline (Winspirs, PubMed, Gateway; 1966 to June 2004), CINAHL (1982 to 2004),
the Cochrane Library (2004), CancerLIT (2004), and PEDro (all up to June 2004) was performed to
identify relevant RCTs and CCTs." They also include the keywords used in their search strategy
which included: "cancer, neoplasm, randomized or randomised, tumor or tumour* (where * is a
truncation sign), malignanc*, sports, exercise*, physical activity, graded activity, physical function,
body mass, fat–free mass, symptom*, depressive disorder, fatigue, anxiety, depressive, mood status,
psychology, and quality of life" (Knols et al., 2005). The study also discusses the inclusion criteria
for the randomized clinical trials and controlled clinical trials to be included in their review. The
researchers stated, "to be included in the review, all RCTs and CCTs had to have examined the
effects of physical exercise after surgery or during or after chemotherapy, radiotherapy, and/or
hormonal therapy" (Knols et al., 2005). They go on to define what an intervention during cancer
treatment and after cancer

Aorto-Iliac Occlesions: A Case Study
T rans–Atlantic Inter–Society Consensus (TASC), open surgeryis the first choice for treatment of
long occlusivelesions. Major changes in lesion classification came with therelease of TASC II in
2007 reflecting the rapid growth ofendovascular treatment. More and more centers have
reportedsatisfactory results with endovascular treatment (EVT) forlong segment aorto–iliac
occlusive lesions.(Gandiniet al, 2008) The aim of this study was to evaluate the outcomes
ofendovascular treatment for aorto–iliac TASC C andTASC D lesions by performing a systematic
review and ameta–analysis of the technical success and midterm patencyof these procedures. In
addition, the influence of lesionclassification and stenting strategy on the outcome wasanalyzed.
(Gandiniet al., 2008) ... Show more content on Helpwriting.net ...
The followingkeyword combinations were used for both databasesand the results combined: "iliac
artery occlusion", "endovascular", "endoluminal", "aorto–iliac artery occlusion", "TASC C", and
"TASC D". Additional "relatedarticles" suggested by MEDLINE or EMBASE, referencelists of
retrieved articles, and reviews on the subject werealso evaluated to identify any additional relevant
publishedstudies. RESULTS Literature search A total of 596 articles were identified. From these,
16articles providing sufficient data concerning the twomajor endpoints were identified and selected
for thismeta–analysis. Within these articles, 13 addressed technicalsuccess, 12 addressed primary
patency at 12months, and 12 addressed long–term primary patency. Study characteristics The 16
articles included data from 958 patients whoreceived EVT for TASC C or TASC D aorto–iliac
lesions.(AbuRahma et al.,

Medical Abstracts: An Observational Study
The Distribution of Probability Values in Medical Abstracts: An Observational Study Abstract A
generally high rate of p–values beneath and above 0.05, have been seen narratively distributed in
Medical Publications. In the event that P values are less than 0.05 are over–represented, such a
dispersion may reflect the genuine fundamental distribution of p esteems or might be because of a
false conveyance. In the event of an error, a predictable over–portrayal of P values underneath 0.05
would be an efficient blunder due either to production inclination or bias within examinations.
Materials and methods The objective was to test a substantial delegate sample of the medical
literature, a random sample of all abstracts containing a p–value was

System A & A Case Study
After reviewing Figure 1 & 2, I recommend the practice purchase System B. Both System A & B
offer many of the same key attributes needed of a computer–based patient record system identified
by the Institute of Medicine in 1991. However, one main reasoning for choosing System B over A is
that System A does not have the capacity to offer tailored views. The benefit of an EMR/EHR
system that can offer tailored views, goes beyond meeting functionality needs and is a benefit that
can greatly aid in the successful user integration of the computerized order entry function (CPOE) of
the system. Recent studies show there is great value in having an EMR/EHR system that is
specifically designed to meet the practice's needs or offers tailored views to reduce user fatigue and
support the proper use of the system (Russ, Zillich, McManus, Doebbelingb & Saleem, 2012).
Tailored views improve the user's experience with the technology, make it easier ... Show more
This feature links patient portals and EHRs to consumer health information (Medline Plus, 2015).
For example, MedlinePlus Connect is a free service of the National Library of Medicine (NLM),
National Institutes of Health (NIH), and the Department of Health and Human Services (HHS) that
offers an added benefit to the provider–patient relationship as an authoritative up–to–date health
information resource for providers, their patients, and their families (Medline Plus, 2015).
Implementing MedlinePlus is a one–time effort, doesn't require registration, and can be configured
to link to more than one source of consumer health information (Medline Plus, 2015). Medline Plus
links both health care, drug, and lab data results through medication codes, and an EMR/EHR
system that has the capacity to use Medline Plus is a great asset in helping the practice achieve one
of the criteria's for meaningful

Essay On Scholarly Articles And Internet Resources
Comparing Scholarly Articles and Internet Resources Advances in technology, computer systems
and internet enabled nursing professionals to access medical and nursing databases and health
information for practice, education and research. The quantity of information available is so
extensive that it is almost impossible to keep abreast of them. There are several kinds of articles
available in computer databases, scholarly journals and published from various government and
private organizations. Each of them serves different purposes and intended for a variety of
audiences, from scholars to general population. The purpose of this paper is to compare and contrast
a scholarly article with an internet resource, on a health topic relevant to ... Show more content on
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The following guidelines can be used to identify a scholarly article: 1. Authors: clearly identified
authors, noted expert or professional; credentials provided 2. References: lists of works cited at the
end 3. Title: usually descriptive, lengthy, and uses professional terms 4. Reading level: advanced,
technical, often with specialized vocabulary or jargon 5. Purpose: give information in a specific
field; report research findings 6. Length: usually four to five pages or longer 7. Article format: often
very structured, with sections such as abstract, introduction, literature review, methodology, results,
discussions or limitations 8. Article submission: articles are reviewed by peers; editor and editorial
staffs are experts in the field and work at a variety of institutions. "Development and evaluation of a
shaken baby syndrome prevention program" is a research article meets all the criteria of a scholarly
article. The objective of this article is to evaluate parents' and nurses' opinions regarding the
adequacy of an educational program on shaken baby syndrome: the Perinatal Shaken Baby
Syndrome Prevention Program (PSBSPP). This research study was done in two birthing institutions
in Montréal, QC, Canada: a university hospital and a regional center. The participants of the study
were two hundred and sixty–three parents (73.8% mothers, 26.2% fathers) received the intervention
after the birth of

Speech and Language Deficiency
Speech and Language Deficiency
Medline Plus (2012) says, "Speech disorders refer to several conditions in which a person has
problems creating or forming the speech sounds needed to communicate with others. Three common
speech disorders are: articulation disorders, disfluency, and voice disorders. Speech disorders are
different from language disorder in children, such as: getting their meaning or message across to
others, understanding the message coming from others" (Zieve). Also, Medline Plus says,
"Language disorder in children refers to problems with either: getting their meaning or message
across to others (expressive language disorder), or understanding the message coming from others
(receptive language disorder). Some ... Show more content on Helpwriting.net ...
The symptoms for language disorder are as listed in Medline Plus:
"A child with language disorder may have one or two of the symptoms listed below, or many of the
symptoms. Symptoms can range from mild to severe.
Children with a receptive language disorder have difficulty understanding language. They may have:
A hard time understanding what other people have said
Problems following directions that are spoken to them
Problems organizing their thoughts
Children with an expressive language disorder have problems using language to express what they
are thinking or need. These children

Preventing Urinary Tract Infection
Urinary tract infection (UTI) is most common bacterial infection in female, occurs after adhesion of
bacteria to the mucosal lining of the urinary bladder. There are numerus factors which can cause
UTI including unhygienic practices, sexual activities, catheter use etc. and mainly bacteria called E.
coli (Escherichia coli). Since inappropriate use of antibiotics can lead to bacterial resistance
(Gomella, 2014). This research essay will formulate PICO (Population, Intervention, Comparison
and Outcome) framework to establish the question in the given scenario where a 31–year–old
female Yani suffering from recurrent UTI and has been prescribed antibiotics to treat the infection.
However, after reading the sources on internet she is considering ... Show more content on
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Jepson, R. G., Williams, G., & Craig, J. C. (2012). Cranberries for preventing urinary tract
infections. Cochrane Database Syst Rev, 10(10). This article demonstrates Meta–analysis of 24
studies on over–all 4473 people was conducted by Jepson, Williams and Craig in 2012. They
mentioned that there were few evidences which show that cranberry juice decreases the number of
symptomatic UTI. However, while reviewing the outcomes of larger, it does not show any major
and important difference in the result indicating that cranberry juice had any effect in UTI. In
MEDLINE, the table 2 is showing the search process and limiters applied to get the valid results for
the essay question. Table 2: Search process and limiters (used in MEDLINE) Action Search Mode
Results No Limiters Adult females, cranberry juice, antibiotics, prevention of urinary tract infection
Find all search terms 3453 No limiters (Adult females ) AND ( Cranberry Juice ) AND ( Antibiotics
OR antibacterial agents) AND ( Urinary tract

Genetically Modified Foods For The Health Of The General...
Granny smith apples are a favorite snack for many people. This healthy grab and go snack can be
found at nearly every grocery store and food stand in the U.S. Packed full of full flavor and
nutrition, granny smith apples hold another hidden secret in its sweet and sour flesh..it's genetically
engineered. Tangelos, nectarines, and plums are also among the foods that have been genetically
engineered (ISAAA). Although GMOs (genetically modified organisms) and GM foods have been
deemed safe for the environment and human consumption, there is an ongoing debate regarding the
safety of genetically modified foods. Some people have concerns about the effects that consuming
genetically engineered foods will have on the health of the general public ... Show more content on
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Many of the foods consumed on a regular basis are products of genetic engineering. For example,
approximately 85% of all corn grown in the U.S. is genetically modified (Young). Other examples
of GM foods include nectarines, papayas, tomatoes, squash, zucchini, and even milk. It is noted that
"GMOs are present in nearly 70% of prepackaged foods sold in grocery stores" (Genetically
Modified Foods). It is this stated fact that has raised questions about the safety of genetically
modified foods. While some believe that genetically modified foods are safe and beneficial, others
feel that there may be side effects and risks associated with consuming the engineered foods.
According to the Institute for Responsible Technology, "genetically modified foods have been linked
to toxic and allergic reactions, sick, sterile and dead livestock, and damage to virtually every organ
studied in lab animals," (Medline Plus).
One of the most frequently discussed concerns of consuming GM foods is the effects they may have
on the health of those that eat them. As a result of food genes being modified, it has been suggested
that the cross breeding of food genes can affect people that suffer from food allergies that had not
been previously experienced (Lemouse). For example, if peanut are in tomatoes due to genetic
engineering, someone with a peanut allergy could quite possibly react to tomatoes (Medline Plus).
This is an example of the reasons presented by

Prevention and care of pressure ulcers
�PAGE � �PAGE �1� Prevention and Care of Pressure Ulcers
Running head: PREVENTION AND CARE OF PRESSURE ULCERS
Prevention and Care of Pressure Ulcers
NUSC 434
PREVENTION AND CARE OF PRESSURE ULCERS
Pressure ulcers are a commonly seen problem among elderly hospitalized patients. Despite new
findings about the causes and approaches to treatment, the incidence of these wounds is still
increasing. Scott, Gibran, Engrav, Mack and Rivara (2006) revealed that during the thirteen years of
their study, the incidence of pressure ulcer development has more than doubled. As our elderly
population becomes greater in number, and older in age, this problem is expected to escalate. It is of
great importance for the patients as well as for the ... Show more content on Helpwriting.net ...
Literature suggests that the heels should be suspended, with a pillow or a blanket placed under the
lower legs (Maklebust). Additionally, the use of pressure relieving mattress is encouraged, but it
does not eliminate the need for frequent position changes (Hess, 2004).
Furthermore, another factor creating a risk for pressure ulcer development is malnutrition. Wysocki
(2002) observed that 10 to 50% of hospitalized patients are malnourished. Nurses should be alert to
inadequate nutrition and its effects. Also, Cobb and Warner (2004) noted that when thirty percent of
weight is lost, spontaneous pressure ulcers begin to develop, and prevention strategies might not
work. In addition, urinary and fecal incontinence are also significant risk factors. Incontinence
results in excess moisture, and irritation of the skin. The nurses and assistive personnel in XY
hospital often do not assist their incontinent patients for long periods of time, and they do not utilize
the available skin protectants. Studies confirmed the effectiveness of no–rinse cleansers and
moisture barrier creams, and found that they were less likely to harm skin integrity than soap and
water (Thompson, et al., 2005). The findings also advise that checking the patients for soiling every
two hours adds to the effectiveness. Although not all pressure ulcers are preventable and curable, the
literature provides supportive evidence that appropriate prevention protocols decrease the incidence
of stage one and two

Medline Plus, Genetics Home Reference and National...
The websites chosen to research was Medline Plus, Genetics Home Reference and National
Institutes of Health. The topic researched was narcolepsy.
According to MedlinePlus Medical Encyclopedia, the common symptoms of narcolepsy are periods
of extreme drowsiness during the day (MedlinePlus Medical Encyclopedia). People with narcolepsy
feel a strong desire to sleep, usually followed by a short nap. The sleep attacks last about fifteen
minutes but can be longer. Often times, these sleep attacks happen after eating, during driving, and
other everyday tasks. After a short nap, a person usually wakes up feeling refreshed and energized.
As stated by Medline Plus Medical Encyclopedia, "Another symptom is dream–like hallucinations
between sleep and wakefulness" (MedlinePlus Medical Encyclopedia). This is when a person
experiences seeing or hearing right before they fall asleep. Sleep paralysis and cataplexy are also
common symptoms of narcolepsy (MedlinePlus Medical Encyclopedia). Sleep paralysis is not being
able to move as you are falling asleep or upon waking up. According to the National Institute of
Neurological Disorders and Stroke, it usually goes unnoticed because it occurs during REM sleep
(NINDS). REM sleep is rapid eye movement sleep. It occurs in breaks when rapid eye movements
occur along with bodily movement. Similarly, cataplexy is a sudden loss of mobility. This is also
associated with strong emotion like laughter or anger, which can trigger cataplexy

How Blood And The Body Is Made Up Of Many Different...
Blood Disorders
Natasha Hurndon
HCA/240
Janet Jowitt
October 13, 2014
The blood in the body is made up of many different components. The components of the blood
include red blood cells, plasma, and platelets, each having a specific function. In this paper I will
explain the difference between the three and the specific function they carry out within the human
body, as well as how the relate to the scenarios in this week's assignment. Red blood cells are the
most needed of the three components. Basically, the main purpose of red blood cells is to transport
oxygen throughout the body (BloodSource, 2014). A person who is experiencing extreme blood loss
would definitely need red blood cells in order to survive. The liquid part ... Show more content on
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"Iron deficiency anemia is due to an insufficient amount of iron (Mayo Clinic, 2014)." If there is a
lack of iron the body cannot produce enough substance in red blood cells in order to transport
oxygen (Mayo Clinic, 2014). As with any condition there are always symptoms. The symptoms for
iron deficiency anemia includes extreme fatigue, pale skin, weakness, shortness of breath, chest
pains, frequent infections, headaches, dizziness, cold and feet, poor appetite and the list goes on
(Mayo Clinic, 2014). All of Lily's symptoms can be compared with the ones that I just mentioned.
Despite the symptoms iron deficiency anemia can usually be corrected with iron supplements.
However, it is important that Lily's mother takes her to see a doctor so that she can be properly
diagnosed before giving her any types of supplements. There maybe be other test or treatments that
the doctor may want to perform. Next there is Davon, a 5 year old African American male who
carries the sickle cell trait. There are many individuals with the sickle disease. However, those of
African descent such as Davon are affected more and are at greater risk for having this trait. People
who have the sickle cell trait inherit the gene from one or both of their parents (CDC, 2013). People
with the sickle trait have one sickle cell gene and one normal

Chronic Pressure Injury
Pressure injury remains a frequently encountered, challenging and costly problem in every health
care institution especially among the elderly, inpatients admitted to hospitals and the bed–confined
individuals. Pressure injuries are associated with an increased risk of morbidity and mortality.
Patients with a single pressure injury are 3.5 – 5 times more likely to stay in the hospital than those
without ulcer (Arnold, 2004). With the extended hospitalisation, the annual cost of treating pressure
injuries is substantially high. In particular, the quality of life perspective that includes pain, exudate,
body image and healing are the issues of greatest concern to patients (Fox, 2002). Malnutrition has
been found to delay pressure injury healing and increase the risk for developing chronic pressure
injury. Furthermore, malnourished patients at risk of pressure injury or with established pressure
injury often have problems in fulfilling their nutritional needs with normal food intake (Langemo,
Anderson, Hanson, Hunter, Thompson et al., 2006). Providing an oral or enteral nutritional
supplement for patients with pressure injuries in addition to regular diet is a logical way to replenish
shortages of macro– and micronutrients and to supply nutrients for preserving skin tissue,
strengthening of tissue resistance and promoting tissue repair ... Show more content on
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Additionally, there will be a table to summarise the key characteristics of the studies relevant to the
clinical question. Furthermore, there will be a critical review of the findings and on how this review
could be incorporated into practice with consideration to the facilitators and barriers to
implementing evidence, and strategies to support a validated framework in my workplace. Finally,
this paper will conclude with a brief summary of the main points

Tmj Disease Research Paper
Running head: WHAT IS TMJ DISEASE? 1
What is This Pain in My Jaw?
Ricki L. Chase
Bradshaw Mountain High School
WHAT IS TMJ DISEASE? 2
Abstract
Keywords: TMJ, treatment, causes, pain
What is This Pain in My Jaw?
TMJ disease, also known as Temporomandibular Joint disorder which is a group of conditions that
cause pain and dysfunction in the jaw and in the muscles that control jaw movement (NIH). Some
signs and symptoms of this disease include pain or tenderness of the jaw, aching pain in and around
your ear, difficulty chewing or discomfort while chewing, aching facial pain, and locking of the joint
which makes it hard to open or close your mouth (Mayo
Clinic Staff). The way a normal healthy jaw works is a lot different than ... Show more content on
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Sometimes pain will return in the future and if that happens then they start treatment (Medline Plus).
[Heading 51 As far as research goes right now TMJ isn't too serious. It doesn't lead to other diseases
usually and it is almost always treatable. The outcome has a high success rate because of all of the
different treatments doctors and dentists have discovered. It is however very painful,
WHAT IS TMJ DISEASE? 5 more for some people than others. They usually start off with splints
and then depending on how bad it gets they move on to surgery if they have to (TMJ Hope).
References
Stacy. (2013). TMJ Disorder Splint Therapy. TMJ Hope.
NIH Publication. (2013). TMJ Disorders. National Institute of Dental and Craniofacial
Research.
Mayo Foundation for Medical Education and Research. (1998–2015). Diseases and Conditions
TMJ Disorders. Mayo Clinic.
A.D.A.M., Inc. (1997–2015). TMJ Disorders. Medline Plus Trusted Health Information for You
Elsevier Inc. (2012). Depressive and Anxiety Symptoms as Risk Factors for Temporomandibular
Joint Pain: A Prospective Cohort Study in the General Population. The Journal of Pain Official
Journal of the American Pain

Advanced Practice Nurse
Among older adults aged 65 years and older are found to have difficulty in reading and to
comprehend discharge instructions. This has been found to be a concern regarding continuing care
and re–admission concerns throughout urban and rural hospitals. Does the integration of Advanced
Practice Nurse (APN) guiding discharge education, along with a follow–up contact with the patient
after discharge effect compliance and readmission rates, more than not having an APN guiding
discharge teaching to help decrease readmission rates?
P ( Patient, population or problem): For patients greater than 65 years old
I (intervention): Does integrating an APN–guided discharge process
C (comparison): Compared to no APN–guided instruction
O ( outcome): Effect compliance ... Show more content on Helpwriting.net ...
Integrating an Advanced Practice Nurse into the discharge process to help guide proper
understanding of discharge instructions to help decrease non–compliance, along with re–admission
rates. The best types of research evidence will include clinical practice guidelines (CPG), Random
Controlled Trials (RCT), Primary Research Studies. I included other types of studies but come up
with small results. I used different variables when searching the literature. Some of these included,
literacy level, different types of a disease process, use of pictograms, re–admission percentages,
along with non–compliance.
Text Words for Searching:
1) MeSH– Literacy, coaching, outreach improvements, pictograms, education, nurse guided,
discharge
2) Keywords– Discharge Instructions, follow–up care, geriatric patients greater than 65,
comprehension, patient discharge education.
3) Inclusion Criteria– Hospital re–admission after six months, follow–up care, qualitative study,
RCT, clinical trials. I searched English written articles between the years of 2011 and 2017.
Databases Searched:

sc131 CrystalElmalahUnit7Assignment
Crystal Elmalah
Unit 7 Assignment
Anatomy & Physiology II
Respiratory acidosis is a condition that occurs when the lungs cannot remove all the carbon dioxide
the body produces. This causes body fluids, especially the blood, to become too acidic. Chronic
respiratory acidosis occurs over a long period of time, this leads to a stable situation, because the
kidneys increase body chemicals, such as bicarbonate, that help restore the body's acid–base
balance. Acute respiratory acidosis is a condition in which carbon dioxide builds up quickly, before
the kidneys can return the body to a state of balance. Some of the symptoms may include:
confusion, fatigue, lethargy, shortness of breath, and sleepiness. Some causes of ... Show more
Other causes for metabolic acidosis include: kidney disease, poisoning by aspirin, and severe
dehydration. With metabolic acidosis, respiration will increase to blow off CO2, decreasing the
amount of acid in the blood. In some cases, sodium bicarbonate may be given to reduce the acidity
of the blood. (Medline Plus, 2014). Metabolic alkalosis is a condition in which the body fluids have
excess base. The kidneys and lungs maintain the proper balance of chemicals, called acids and
bases, in the body. Decreased carbon dioxide or increased bicarbonate level makes the body too
alkaline. There are different types of alkalosis such as: respiratory alkalosis, which is caused by a
low carbon dioxide level in the blood. This can be due to: fever, lack of oxygen, lung disease, or
liver disease; hypochloermic alkalosis is caused by an extreme lack or loss of chloride, from
prolonged vomiting; hypokalemic alkalosis is caused by the kidneys' response to an extreme lack of
potassium, this can occur from taking certain water pills. Compensated alkalosis occurs when the
body returns to the acid–base balance to normal in cases of alkalosis, but bicarbonate and carbon
dioxide levels remain abnormal. Symptoms of alkalosis can include: confusion, hand tremor, light–
headedness, muscle twitching, vomiting, and numbness or tingling in the face, hands, or feet.
Treatment for alkalosis depends on

Literature Review On Bronchiolitis
Bronchiolitis Article Review
Bronchiolitis is characterized as an acute inflammation of the bronchioles. Bronchiolitis is a viral
illness; it may cause a fever, runny nose, wheezing, and a cough. It is a frequent cause of acute
respiratory distress or respiratory failure in the pediatric population (Kelsall–Knight, 2012).
Bronchiolitis is commonly caused by respiratory syncytial virus (RSV). It can also be caused by
adenovirus, influenza, and parainfluenza (Medline Plus, 2017).
Current Statistics
RSV accounts for 50–90% of all bronchiolitis cases. These cases account for approximately 20,000
hospital admissions every year (Maraqa, 2017). 25% of children under the age of 1 have a
respiratory infection, and nearly every child will have a respiratory infection by the age of two years
old (Maraqa, 2017). In healthy infants who were full–term, bronchiolitis occurs in the first year in
80% of hospitalizations. However, in the first 30 days of life, less than 5% of hospitalizations are
due to bronchiolitis (Maraqa, 2017).
Clinical Guidelines Typically, bronchiolitis presents with a one or two–day history of upper
respiratory tract infection (Kelsall–Knight, 2012). Patients will have an increase in secretions or
mucus production which can cause a productive or moist cough. The increased mucus can also
cause difficulty breathing or difficulty eating. When assessing infants, the ability to feed
appropriately helps to determine the severity of the bronchiolitis (Kelsall–Knight,

Dr. Samantha Maracco Evidence Based Practice
Your post was very informative; it shows the processes involved in finding the evidence about our
clinical questions. With regards to your question about a systematic diagram, that can be used in our
search for evidence I remember a schema presented during our residency training by Dr. Samantha
Maracco in her lecture on Evidence–Based Practice. The diagram consisted of sequence of actions
or processes which formed a continuous cycle (Maracco, 2015): 1. Create and modify your
questions– The first step is to ask a question that is answerable. It must be concrete and focused. The
focus must always be on the interests of the patient (Fitzpatrick, 2002). Maracco (2015) suggested
using the acronym PICO. P=patient or target population; I = issue

The Miller 's The Snow Child
"I 've always regretted that I didn't do more, Not that we could have saved that one. But that I didn't
do more. That I didn't have the courage enough to hold our baby and see it for what it was"(Ivey
231). The novel The Snow Child takes place during the early 1900's, a time that saw a marriage
without children taboo and incomplete. It 's not very often that people openly talk about their
miscarriages, in today 's society we tend to turn a blind eye on the subject. Miscarriages have
happened since the beginning of time, but it's such a sensitive subject it hard for people to talk
about. The psychological along with the physical effects of a miscarriage are never asymmetric,
from one person to another, this included the medical aspect, the ... Show more content on
Helpwriting.net ...
This happens a lot more than one would think, 15–20% of known pregnancies end in a miscarriage
(Miscarriage Medline), to some this number is comforting to know they are not alone. Almost all
miscarriages will happen before the 2nd trimester begins which is at the 14 week mark. Most people
going through a miscarriage for the first time want to know why it happened was it something they
could have done differently, but there isn 't anything you can do to prevent a miscarriage (Sifferlin
Most).
While a women in pregnant there are many things she should stray away form, she should also be
watching her body very closely for early signs of a miscarriage . A women expecting can take every
preliminary precaution to prevent a miscarriage, but that doesn 't mean it won 't still happen. The
most common are of course avoiding drugs, alcohol, smoking, and toxic environments (Miscarriage
Medline). Most of the causes are somewhat out of the mother's control for example hormone
problems, problems with reproductive organs, and chromosomes problems (Miscarriage Medline).
The symptoms that can be associated with a miscarriage can often be ambiguous or common
discomfort like lower back or abdominal pain in the form of a dull, sharp, or cramping pain
(Miscarriage Medline). These are often overlooked for various reason, but the most common is these
symptoms are not thought as a big deal or anything to worry about. Know symptoms associated with

Myelomeningocele Essay
INTRODUCTION Myelomeningocele (MMC) is a congenital anomaly in which the posterior
portion of the neural tube fails to close during development. Exposure of neurologic tissue to the
amniotic fluid and inappropriate neurulation results in multiple neurological defects. Nearly all
those affected by MMC have associated Chiari malformation, and most children develop
hydrocephalus requiring ventriculoperitoneal shunts. Neurodevelopmental delays are also
associated, leading to significant lifelong disabilities that include paraplegia, hydrocephalus, sexual
dysfunction, skeletal deformation, and bowel and bladder incontinence.1,2 Early diagnosis and
correction of Myelomeningocele is vital to delay and prevent the evolution of neurological damage.
Intrauterine MMC repair has significantly better outcomes than postnatal–surgery. Compared with
those repaired after birth, prenatal surgery decreases the risk of neonatal death or need for shunting.
Also improves the degree of hindbrain herniation associated with the Chiari II malformation, with
better motor and mental function outcomes.3 Open fetal surgery, in particular, remains constrained
by the ever–threatened morbidity of premature rupture of membranes and pre–term delivery
associated with this approach.5 As with any fetal procedure there is an inherent risk of preterm
delivery, premature rupture of ... Show more content on Helpwriting.net ...
The databases included Ovid MEDLINE Epub Ahead of Print, Ovid Medline In–Process & Other
Non–Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of
Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. The search strategy
was designed and conducted by an experienced librarian with input from the study's investigators.
Controlled vocabulary supplemented with keywords was used to search for tocolysis on open fetal
surgery. Search was conducted using the terms

The Skeletal System and its Diseases
The Skeletal System and its Diseases The human body is a complex system that often malfunctions.
Many people believe that numerous diseases are a natural reflection of the body aging and cannot be
avoided. The goal of my paper is to change this perception and demonstrate that healthy eating and
active lifestyle can result in a healthy body at any age. To narrow my focus, I will be looking at
diseases of the skeletal system and how to treat them. The most common bone disease is
osteoporosis. The bones become weak and are more likely to break. It is most common in elderly
women, though anyone can get it. A similar disease is osteopenia which is low bone density. There
can be some genetic factors that lead to these two diseases, but mostly they result from a poor diet
and an unhealthy lifestyle (Medline Plus). Osteoporosis and osteopenia have been on the rise.
People over 50 are most likely to get it, and women are particularly prone to it. In the United States,
4.5 million women have osteoporosis, whereas only 0.8 million have it. A higher number of people
have osteopenia. An estimated 22 million women suffer from it, and around 11 million men have it.
It affects all races, but white and Asian people are more prone to it (Rheumatology.org).
Osteoporosis and osteopenia are "silent" because there are no symptoms until a bone breaks or is
fractured. Even a very minor injury can cause the bone to break or fracture. Most commonly this
will happen in the wrist, spine, and

Why Marijuana Should Be Legal
Marijuana has been one of the most misunderstood herbal medicines in today 's culture. With today
's lifestyle turning to herbal, natural remedies including marijuana should be included. It boasts
many medicinal qualities that society has overlooked, due to the stigma surrounding this drug.
Society needs to put aside preconceived ideas that it is a drug that makes you high and realize the
full potential of a natural remedy that is used to treat many conditions including cancer patients.
That 's not the only benefits of marijuana, there are many more to be considered before we can
determine to really ban this miracle drug. But first we have to discuss the history of Marijuana.
During the 19th century Americans would use the term "cannabis' rather than marijuana.At this
time, it was common to find cannabis in common medicines. Doctors would often put cannabis in
medications. So why did the word cannabis deteriorate from the American word to name the plant?
The reason was because of the Mexican Revolution.
The Mexican Revolution began in 1910. During the war, most people wanted to flee to the south
borders of the United States. This is where they often carried this plant which they called
'mariguana'(Marijuana: Medline). After crossing over, Mexicans feared rules against themselves in
the southwest. These rules intensified after the Great Depression and that was when the first
marijuana laws were established. In order to keep the quantities of marijuana and immigration law,

Efficacy Of Lisinopril
Human health and theIR quality of life have been improving in the past 100 due to changes in
medicine and in public health (Mattes et al., 2013). Patients are placed on multiple medications at
the same time and it important to understand their safety, efficacy, drug interaction, and toxicity
(Mattes et al., 2013). As Mr. Cynthia Nurse practitioner, my job is to understand what affect her
prescribing medication is having on her body. I have place Mrs. Cynthia on Lisinopril for her
hypertension and metformin for her type II diabetes. Efficacy of Lisinopril Lisinopril medication is
an angiotensin–converting enzyme (ACE) inhibitor, which treats heart disease by causing
vasodilation of the arteries and control extracellular volume (Amador, & ... Show more content on
Helpwriting.net ...
Lightheadedness and fainting may also be signs of toxicity (Medline Plus, 2015).While patients are
taking Lisinopril their blood pressure should be monitor closely and they should have BUN/or ALT
and AST did to check their liver function (Micromedex, 2017). Mrs. Cynthia is at risk of developing
hyperkalemia because she is diabetic and taking this drugs (Toxnet, 2017). Other patients that are at
risk are those with renal impairment, those taking drugs that can elevate their potassium level
(Toxnet, 2017). A patient who is pregnant should not take Lisinopril and if they become pregnant
they should stop the medication and inform their doctor. It can harm both mother and baby by
causing low blood pressure, damage to the kidney and even cause the death of the newborn
(American Heart Association, 2017). Drug–drug interaction (Lisinopril) I am concerned with the
drug to drug interaction with Mrs. Cynthia. She has hypertension, type II diabetes, and she is old.
Her body mechanism metabolism the medication at a slower rate or it may metabolism too quickly.
Cynthia labs result closely because she is also diabetic and is taking Lisinopril. I am concerned with
her taking a potassium–sparing diuretic, potassium supplement, and aspirin. Patients who are taking
potassium–sparing diuretics, potassium supplements, potassium–containing salt substitutes should
not be placed on Lisinopril (mmm ) Lisinopril is

What is Nursing Informatics? Essay
"The intensive care unit (ICU) often is called the epicenter of infections, due to its extremely
vulnerable population (reduced host defences deregulating the immune responses) and increased
risk of becoming infected through multiple procedures and use of invasive devices distorting the
anatomical integrity–protective barriers of patients (intubation, mechanical ventilation, vascular
access, etc.)" (Brusselaers,Vogelaers, & Blot, 2011). The purpose of this paper is to develop a
research question regarding the prevention of spreading bacteria in ICU and to identify databases
and search words to collect data by using the continuum of data, information, knowledge, and
wisdom . Also, I will describe how informatics can be used to gain ... Show more content on
Helpwriting.net ...
According to McGonigle and Garver (2012), "data are discreate entities described objectively
without interpertation" ( p. 97). The fist step in the plan is to gather data from the internet databases
and related books and journals. This data obtained will not be interpreted but will be group together
inorder to continue to the second step of the plan; obtaining relevant information about my research
question. " Information is data that are interpreted, organized, or structured" (McGonigle & Garver,
2012, p.97). This step requires precise interpretation and analization of the data was obtained. The
information will be organized and structured into each of the PICO variables. McGonigle and
Garver (2012), describe knowledge as "information that is synthezized so that relationships are
identified and formalized" (p.97). It is important to use this concept when making the decisions of
which of the information will be used and what the potential outcomes of the information chosen
will have on my reasearch question; will it favor the topic or will it unfavor it? The final concept of
the plan is the use of wisdom. "Wisdom focuses on the appropriate application of knwledge"
(McGonigle & Garver, 2012, p.99). The use of wisdom guides the decisions about what would be
the most appropriate use of

Mucormycosis Case Studies
Mucormycosis is a rare but a very dangerous infection that affects immunocompromised patients.
This infection is more popular among poor population compared to wealthy population. Mucor
produces spores which spores will ruptured and will be dispersed, and get into airborne. People get
infected after being exposed to the fungus. The spores can be found in air, water, and on a host.
Lungs, brain, sinuses and nervous system are the most body parts that get infected. This infection is
more common in people with weakened immune system and immunocompromised patients. Iron
metabolism impacts considerably mucor infections. It is proved that Deferoxamine can creates some
conditions that favorable predisposes to mucormycosis by supplying the fungus ... Show more
Nurse gives antipyretic to keep the fever down, to give oxygen therapy as ordered. Nurse should
encourage the patient to turn and reposition to prevent pressure ulcers, patient in a semi or high
fowler's position to help promote breathing comfort
The physician knows that mucor can be deadly and therefore should treat it in aggressive way.
Medications that I will recommend will be Amphotericin, Itraconazole or Posaconazole. The drugs
alter cell permeability, cause their death and therefore, halting fungal spread (Drugbook, 2015). The
physician may be prescribed zofran, metoclopramide because the incidence of nausea and vomiting
that occur with patient taking these med. A possible surgery for a surgical excision of the fungus can
be done when necessary. An infectious disease consult and a dietitian consult would be
recommended.
References
Davis's drug guide for nurses. (2015). Philadelphia: F.A. Davis
Mandanas, R. (n.d.). Fungal Pneumonia. Medscape. Retrieved, October 22, 2015 from
http://emedicine.medscape.com/article/300341–overview
Medline Plus. (2015). White blood cell count. Retrieved from

Nursing Practice And Discussion Paper
In my area of nursing practice, I deal with patients or their power of attorney to choose the option of
hospice. As Tornøe Danbolt, Kvigne, & Sørlie,(2015) stated "Nursing must provide more end of life
care, due to the international trend of downsizing hospital units and cutting health care costs in
secondary health care. Primary health care will increase to encounter dying patients' spiritual and
existential suffering" (p.2). Hospice care is a different kind of care a nurse provides. On my unit, as
nursing professionals use scholarly articles to help us understand and improve our skills in these
kind of patients. A nurse professional can utilize scholarly articles about hospice using a database.
The two databases I used to find scholarly

Genital Herpes Research Paper
Genital herpes is a sexual transmitted disease that is caused by herpes simplex virus. It is also called
HSV and HSV–antivirals. The herpes simplex virus has two type. People usually call the first type
by HSV–1, and the second type by HSV–2. (Medline Plus)The genital herpes used to be caused by
HSV–2, but the HSV–1 caused more and more genital herpes cases. (Beigi) The symptoms for
genital herpes are different depending on the severity of the disease at the beginning stage. For most
of the people, they have rather mild symptoms that is unnoticeable or skin itching. If there are any
noticeable symptoms, including decreased appetite, fever, malaise, muscle ache, and swollen lymph
nodes, the disease could be very severe. In the later stage,

Hydatiform Mole Case Study
Hydatiform Mole 1. Mayo Clinic defines this as a benign tumor that develops in the uterus after a
fertilized egg transforms into a mass of cysts. 2. Medline states that the cause is from
overproduction of tissues that develop into the placenta due to problems during fertilization, while
Mayo Clinic and Dr. Lisa Moore state that either the father's or the mother's chromosomes are lost
during fertilization causing duplication of the 23 present chromosomes. This leads to an egg with no
working nucleus. 3. Signs and symptoms, as listed by Mayo Clinic, include rapid uterine growth,
dark brown or bright red vaginal bleeding, severe nausea/vomiting, passing clots, rare pelvic pain,
high BP, and anemia. 4. Medline lists diagnostic tests as pelvic exam,

Inherited Disease Study
Inherited diseases.
This is also known as genetic disorders and is transmitted from the parents to their children (NHS
choices, 2017). In Britain the most common type of genetic disease are the cystic fibrosis which
results in breathing difficulty and infections (s–cool, 2017). This is transferred from the parents who
carry the faulty gene and not have any symptoms. As this is a genetic disorder there is no cure for
the diseases.
Mental disorders
These are the group of conditions that affect the person's mood, thinking and the behaviour (Harris,
2013). Examples are schizophrenia, eating disorders, anxiety and depression.
Some mental diseases are caused by the degeneration of the brain tissue like in the Alzheimer's,
which results in the deterioration ... Show more content on Helpwriting.net ...
In the case of vector borne diseases it can be prevented by either destroy the agents or by preventing
the contact with these agents. Moreover, infection by a pathogen can be prevented by vaccination
(NIH, 2017). Examples for these are vaccination against meningitis, mumps, rubella etc.
Furthermore, if the disease develops in the body the drugs such as antibiotics, antiviral medication
or antifungal medications are using to treat the condition depends upon the cause of the

The Power of Drinking
Many people across the world deal with the problem of alcohol. Every year, hundreds to thousands
of people die from either alcoholism or drunk driving. Most people do not understand what alcohol
can do to the body and the long term effects of it. These days, teenagers are now starting to drink
more alcohol than ever even though the age limit is twenty one. Also, friends have the biggest effect
on other teenagers if they drink or not. Even though friends can have a huge connection on underage
drinking for many teenagers, the law needs to be stricter to teenagers about drinking alcohol because
alcoholics can put other people in danger. Alcohol goes back for over one hundred years and is more
power full than ever today. There are ... Show more content on Helpwriting.net ...
To avoid these near death symptoms, you need to cut down on you drinking slowly and not all at
once. If you need help with this, you need to go to your doctor as soon as possible (Alcohol 5). As
an alcoholic, there are many health risks that you can do to you body. If can also may make you
have different disorders to the brain and how you operate mentally. Some risks are irritation of the
stomach suck as ulcers, high blood pressure, cirrhosis of the liver and alcohol kills the brain cells
leading to brain damage. If you do have higher blood pressure than normal, and you are a heavy
drinker, you are at higher risk of a stroke or heart attack (Alcohol Addiction 1). There are many
different kinds of drinking. One kind of drinking is called binge drinking. Binge drinking is a way of
drinking not all the time, but drinking very heavy at a short period of time to get buzzed or drunk.
This binge drinking is usually done alone because it is called a self medication for the body so that
the person can feel relaxed and nobody can find out (Prof. David J. Hanson, Ph.D. 1). There is also
another kind of drinking called moderate drinking. This kind of drinking is ok for the body. If you
do have medical conditions, such as being pregnant or you have high blood pressure or something
else. Always ask your doctor if you are healthy enough for moderate

Obsessive Compulsive Disorder: Nature or Nurture? Essay
Imagine feeling like a slave in your own body. Being forced to do ridiculous rituals and having
constant compulsions to do things that you know don't make sense. This is what it is like to live with
Obsessive Compulsive Disorder (OCD). In the United States alone, over 2 million people suffer
from OCD (Parks, 2011) but no one has found the cause of this disorder. It affects people of all
races, genders and socioeconomic backgrounds (Parks, 2011). Since it's discovery and modern
conceptualization, there has been an ongoing debate whether OCD is caused by environmental
factors or if it is inherited through genetics. However, since both sides of the debate raise a solid
argument and there is not enough hard evidence, the source of the disorder ... Show more content on
Helpwriting.net ...
His findings were supported by Thomsen (1994) who found that the brain structure of 24 patients
from OCD–like familial structures did not differ substantially from patients with severe mental
illnesses. Even though the Adams and Thomsen studies raise a fair point, of all the studies done on
the correlation of OCD and families, a majority of them support genetic transmission (Nestadt et al,
2010). Therefore, OCD is more likely to be caused by heredity and genetics than family structures.
One of the more compelling theories of the cause of OCD is the serotonin theory. Two different
theories based on serotonin are more prominent than the rest. Giddens (2009) explains the theory by
stating that OCD is caused from a lack of a chemical substance called serotonin (a neurotransmitter).
Her theory is supported by the use of drugs that increase the amount of serotonin in the brain which
relieve many symptoms of OCD. On the other hand, Penzel (2000) describes the serotonin theory as
a disrupted transmission of serotonin. When the serotonin is being returned to it's vesicle chamber,
the last step of neural–transmission takes place prematurely, which then causes a brain dysfunction
and forms compulsions. Though both serotonin theories do not agree with each other, both theories
argue on behalf of nature in the nature versus nurture debate since serotonin and the lack or faulty

Causes Of Hyperemesis Gravidarum
Kelsey Crooks
OB Project Week 1
CLTCC–Alexandria
Index
Hyperemesis Gravidarum.....3
Incomplete Abortion.....6
Incompetent Cervix.....9
Ectopic Pregnancy.....11
Hydatidiform Mole.....13
Rh Incompatibility.....16
Iron Deficiency Anemia.....18
Neonatal Sepsis.....20 Hyperemesis Gravidarum
Define
Extreme, persistent nausea and vomiting during pregnancy (Hyperemesis Gravidarum: Medline
Plus)
Cause. Risk Factors.
According to Medline Plus:
The cause of nausea and vomiting during pregnancy is believed to be a rapidly rising blood level of
a hormone human chorionic gonadotropin.
Symptoms
Severe, persistent nausea during pregnancy
Salivating a lot more than normal
Weight loss
Dehydration
Light–headedness, weakness, headaches, or fainting ... Show more content on Helpwriting.net ...
Educate parents on proper hand–washing techniques 3. Educate mother on importance of Rhogam
injections 4. Advise mother to get shot on time 5. Monitor infant for any signs of jaundice 6.
Monitor for any signs of distress from mother 7. Provide emotional support for family 8. Educate
mother on relaxation breathing techniques 9. Monitor daily weight 10. Encourage a healthy diet for
mother
Iron Deficiency Anemia

Definition
A condition in which the body does not have enough healthy blood cells. RBCs provide oxygen to
body tissues. It occurs when the body doesn't have enough iron.
Cause. Risk factors
Losing more RBCs and iron than your body can regenerate. Body does not do a good job absorbing
iron, not consuming enough foods with iron.
Symptoms and

Knowledge Management System Essay
Knowledge management systems are an incredible asset to an organization, because they are not just
a data collection repository. This unique system is multi– faceted and involves more than just
technology as it is a multi–disciplinary field that encompasses theories in sociology, healthcare, and
economics (Morrissey & Schoemaker, 2005). A KMS combines these theories in order to create a
cohesive community within an organization in order to facilitate knowledge and address solutions to
practical problems. This system increases collaboration and knowledge sharing among all staff
members. Knowledge management can be applied to various fields, but there are four essential
components that it contains. These components are creation of a ... Show more content on
Helpwriting.net ...
Thus training is an essential component as the key players will be the ones to identify and resolve
areas of improvement that they find in the knowledge management system (Pfeffer, 1998). The OSE
is unique because it is a scientific organization with a public health mission. In order to meet its
mission, individuals must have varying expertise, a diverse skill set, and the ability to collaborate
together. The learning curve that is needed in this field is extremely steep, because workers must
acquire a broad conceptual knowledge on topics outside their own field of work. Managing the
myriad of drug life cycle data, new drug regulations, and staying current in the field of expertise is
vital to career success, maintaining licensure, and crisis response. A KMS provides a database that
allows users quick and easy access to both external and internal resources on topics of particular
interest to them. This feature of the system is especially important when emergency situations arise.
In these crisis times, employees must drop their current research and have access to "just in time"
knowledge in order to correctly respond to crisis medicinal errors or new disease developments.
Even a drug that is generally safe for the public can cause unexpected outbreaks during its time on
the market. For example, an investigation conducted by the state health department confirmed that
contaminated epidural injections

Hyperbilirubinemia Case Study Answers
Kelsey Crooks
OB Project Week 4
CLTCC–Alexandria
Index
Hyperbilirubinemia.....3
Respiratory Distress Syndrome.....6
Fetal Alcohol Syndrome.....9
Cephalohematoma.....11
Spina Bifida.....13
Cleft Lip/Palate.....15
Hip Dysplasia.....17
Neonatal Abstinence Syndrome.....19
Hyperbilirubinemia
Define
High levels of bilirubin in the baby's blood. Also known as newborn jaundice. (Hyperbilirubinemia:
Medline Plus)
Cause. Risk Factors.
Several causes such as abnormal blood cell shapes, Rh incompatibility, high levels of red blood
cells, and cephalohematoma.
Risks include: certain medications, infections at birth, disease that affects the liver or biliary tract,
low oxygen level, and many different inherited blood disorders. ... Show more content on
Helpwriting.net ...
(n.d.). Retrieved June 28, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/001559.htm
Neonatal respiratory distress syndrome: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved June
28, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/001563.htm Fetal alcohol
syndrome: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved June 28, 2016, from
https://www.nlm.nih.gov/medlineplus/ency/article/000911.htm Infant Cephalohematoma Symptoms.
(n.d.). Retrieved June 28, 2016, from http://www.cerebralpalsysymptoms.com/brain–injury/infant–
cephalohematoma/symptoms Spina Bifida: MedlinePlus. (n.d.). Retrieved June 28, 2016, from
https://www.nlm.nih.gov/medlineplus/spinabifida.html Cleft lip and palate: MedlinePlus Medical
Encyclopedia. (n.d.). Retrieved June 29, 2016, from

https://www.nlm.nih.gov/medlineplus/ency/article/001051.htm Developmental dysplasia of the hip:
MedlinePlus Medical Encyclopedia. (n.d.). Retrieved June 30, 2016, from
https://www.nlm.nih.gov/medlineplus/ency/article/000971.htm Neonatal abstinence syndrome:
MedlinePlus Medical Encyclopedia. (n.d.). Retrieved June 30, 2016, from

Pathophysiology Of Asthma Essay
1. Define asthma and its pathophysiology
a. Asthma, a chronic respiratory disease, affects countless people around the globe each and every
year (WHO, 2014, para. 1–2). Although this respiratory disease can affect people of all ages, it is
most prominent during the childhood years (Adams et al, 2014, p.587). Specifically, as defined by
the text, Pharmacology for Nurses: A Pathophysiologic Approach asthma is defined as, "a chronic
pulmonary disease with inflammatory and bronchospasm components" (Adams et al, 2014, p. 586).
This inflammation and tightening of the airways makes it very difficult for a person with asthma to
fill their lungs with air and thus they have great difficulty when trying to breathe (WHO, 2014, para
1–2). Furthermore, ... Show more content on Helpwriting.net ...
Salmeterol– This drug is also classified in the therapeutic class of bronchodilators and but unlike
Albuterol it is within the pharmacologic class of long acting beta–adrenergic agonists (Medline Plus,
2010, para 2). Salmeterol's mechanism of action is the same as albuterol but it should not be used
for the treatment of acute asthma attacks because its affects last significantly longer (Adams et al,
2014, p. 589). According to Medline Plus, Salmeterol should be taken via a dry powder inhaler and
only taken twice a day and 12 hours apart (Medline Plus, 2010, para 3). The possible adverse effects
of this drug include but are not limited to: uncontrollable shaking, headache, nervousness, tingling,
nausea, flu like symptoms, chest pain, and a fast heart rate (Medline Plus, 2010, para 13–14).
Additionally, it is imperative that Salmeterol is not taken to control an acute asthma attack because
doing so can lead to death. (Adams et al, 2014, p. 588). Although in the same class, Salmeterol is an
effective drug in treating the effects of chronic asthma but should not be used in the same way as
Albuterol to treat acute

Advantages And Disadvantages Of Systematic Review
Introduction and Statement of the problem
The most important criterion that distinguishes and characterizes systemic reviews from other
narrative reviews is "being comprehensive ". That's why developing an explicit and comprehensive
search strategy is considered a must and an indispensable step of systematic reviews, failure to attain
such step through searching all available channels of information is a potential threat to the validity
of the systematic review.
The information sources for systematic review comprise three main fold:
Academic bibliographic databases
Hand searching for printable journals, conferences and databases.
Informal channels for further data searching.
Limitations of quick searches:
Searching only one academic database suffers major shortcomings. First, that won't ensure retrieval
of all relevant literature, according to previous study only 30–80 % of the available studies will be
retrieved during searching a single database. Second, most databases tend to publish studies which
shows effectiveness of interventions, not adverse effects. And finally databases like Medline for
example English articles represent most of the indexed studies. To sum up searching a sole data
bases will ends up with a systematic review that suffers selection bias, language bias and publication
bias.(Suarez–Almazor, Belseck, Homik, Dorgan, & ... Show more content on Helpwriting.net ...
Considering it's ease of use, simplicity and capability of obtaining a great number of relevant studies
in a minimum time. It's worth noting that electronic searching should be pertained mainly to
academic databases like PubMed and Cochrane central. The use of search engines like Google
scholar, Intute and TRIP or publisher's website as springer link and science direct should limited.
Making a systematic review from articles obtained from such sources will surely suffer publication
and selection bias.(Higgins & Green,

A Brief Note On Low Grade Inflammation And Cardiovascular...
low grade inflammation, however despite the risk factors clustering, studies have not been able to
correlate a uniform association between PCOS and cardiovascular disease (Pasquali et al., 2011).
Oxidative stress can also be present in non–obese PCOS patients. Cardiovascular disease is
increased by PCOS, therapies for this particular symptom could include the use of antioxidants as a
corrective measure, to improve the effects of oxidative stress by reducing insulin resistance and
hyperandrogenism (Deasaiet al, 2014). A less understood element of PCOS are the psychological
impacts such as severe mental health issue in the form anxiety, depression, body dissatisfaction,
decreased sexual satisfaction, eating disorders, and decreased health–related quality of life (McCook
et al., 2014). Additionally, comorbidities like obsessive–compulsive, interpersonal sensitivity,
depression, aggression and psychoticism scores in comparison to health matches. Investigators
concluded that PCOS significantly increased the risk for psychological morbidity (McCook et al.,
2014). Infertility is a hallmark indicator of PCOS, and is often in initiator of diagnosis. Women who
are unable to conceive from PCOS experience a significant decrease in quality of life (McCook et
al., 2014). Person Women of reproductive age are at risk for developing PCOS, however, women
who are obese or have a mother or sister have a higher risk of developing PCOS. Most often
diagnosis happens during the age range

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