Research Topics: Nursing Paper

Case Pictorial Analysis

Case Pictorial Analysis   Introduction               Health care is a community concern where it needs the contribution of many individuals. Among these many individuals that contribute to the provision of health care are the nurses. From all corners of the globe, we see individuals taking up studies in nursing. We do not know for sure if they are in it for the money or because they love the profession of taking care of someone else. What we do know is that these individuals in the field of nursing make it to one of the top occupations in health care in terms of job growth. Hopefully, they would soon be taking good care of those who need health care services.               The nursing profession faces incredible challenges in caring for patients and their families after a trend of the continued decline in nursing school enrollment, the nursing shortage, and increasing staff nurse dissatisfaction with the current workplace environment ( 2003). Many factors contribute to nurse dissatisfaction and subsequent turnover and burn out. The problem of the nursing shortage is not necessarily the decline in individuals enrolling in nursing but rather nurses who aren’t really fit for the profession.   This paper though is not focused solely on the challenges faced by the nursing profession. In the next pages, this paper will examine and analyze two photographs which are related to the nursing profession. This could include the many other challenges that are being faced in the nursing profession. Different people have different perspectives about nurses and nursing care. A nurse could be different from one person to another. We all have different understanding of the nursing profession.   Context   There are two photographs that are provided for the analysis in this paper. There is first and foremost a need to describe the photographs in detail. Second, nursing issues will be presented based on the images. There will then be a discussion on these issues raised from the two photographs.   The first photograph is actually an advertisement in nursing featuring male nurses. The photograph is in black and white. It has nine male nurses in the photograph who are nurses. Written below each person are their names, their former occupations or other professions. These nine men are of different ages and different ethnicities. Looking at them, you would never guess they are nurses. Judging by their faces, these men could be at any other profession other than in nursing. Some of the men are wearing nursing outfits while the others were wearing ordinary clothes and the others still in clothes suited for their sports or hobbies.   On the photograph, the words are written in big bold letters: Are you man enough to be a Nurse? At the bottom of the photograph are written the words: If you want a career that demands intelligence, courage, and skill, and offers unlimited opportunity, consider nursing. Below it are the words: For information about careers in nursing, and educational and financial resources in Oregon, go to  Beside these two lines is the logo for Oregon center for nursing.   The second photograph is a colored one yet it isn’t as clear as the first picture. In this photograph, there are only three persons. On the front is a white man who, judging by his clothes, is a medical doctor. Behind him, on each side are two women. One woman is dark skinned while the other woman‘s ethnicity cannot be judged since she further back and the picture starts to blur. This picture seems to be taken within the hospital itself where they work. There are no written words on the photograph.   This second photograph looks like more of a picture for a primetime television show featuring doctors and nurses within the hospital setting. In the picture, these three people are posing like models with arms folded and feet apart and staring straight into the camera with serious determined faces, or at least that’s what it looks like by the doctor’s face. They were wearing hospital suits.   Identification and Discussion of Issues               From the first photograph, there are three issues I can think of. First is the increasing number of male nurses. The second issue is the one of male nurses as the minority in the nursing profession. The last one is the issue of professionals from other fields changing to nursing profession.   Social, political, and economic systems continue to perpetuate the image of nursing as a female-dominated profession. It is mostly females we see in pictures as nurses, dressed in white uniforms with white shoes, white stockings and a white nurse cap. Seldom do we see men as nurses. But although social, political and economic systems perpetuate nursing as a female-dominated profession, it doesn’t cover the truth that there are many working male nurses out there.   Since the majority of the nursing field is predominantly women, the presence of a male nurse is a bit unusual. Although this phenomenon is changing as men begin to enter the work force of nursing, they still continue to be the minority on most nursing staffs (1996). Nursing is now seen as a profession for men as well as women and this has been helped by popular TV programs which show male nurses. These TV programs make the viewing population aware that health care is more diverse than it used to be.   There is a problem though with male nurses and this has been seen in a study. Although increased numbers of men are joining the ranks of professional nursing, disproportionate numbers of male nurses are leaving nursing, compared to female nurses. New male nurses are changing professions within 4 years of graduation at almost twice the rate of female nurse graduates. Job dissatisfaction, lack of respect from the medical community, and problems working in a female-dominated profession are speculative reasons for male nurses leaving the profession (2006).   The experience of male nurses as a minority group seems to be that of encountering a lack of social approval, acceptance, and adequate role models beginning in nursing school. Perceptions of threats to sexuality, role strain, social isolation, and different performance expectations reported by male nursing students indicate that little has changed within nursing programs to enhance feelings of belonging to the nursing profession (2006).   A man’s career transition from say a US army as can be seen in the photograph to being a nurse is hard to describe. Male nurses are a minority. Men are discouraged from showing their emotions, while a nurse’s willingness to share emotions is part of the profession. This man worked hard to make patients comfortable, always making extra effort to demonstrate his caring attitude. A nurse’s excellence should be judged by the quality of care for their patients, not by their gender (1996).   Although we see too many jumping to the nursing bandwagon, we could not really tell if they are in it because they love to care for the sick or they are in it for the money. This is not a gender-related issue but rather one which depends on the caring attitude of a person. A man could have been a Harley rider and still be nurse, what matters is that he’s got what it takes to be a good nurse.   In the second photograph, there are two issues that can be identified. First is that nurses work with other health care professionals in the provision of health care services and herein lies the need for team work. The second is that nurses work frontline in the provision of health care services along with other health care professionals.   As depicted in the photograph, nurses work with doctors. Partnership between doctors and nurses is seen to be an essential prerequisite to the success of providing the best quality of care to the patient, and the key to successful partnership within health visiting practice is mutual respect and open communication between parties. There should be no feelings of jealousy, instead, health care professionals should collaborate and cooperate with each other.   In any place of employment, there should be proper collaboration of health workers. Through this, the shifts in a hospital environment could run smoothly and the patients will be cared well. It is thus recommended that there is cooperation within health care professionals and should work as teams in order for hospital shifts to run smoothly and for both doctors and nurses to be able to provide high levels of quality of care for the patients. Nurses and other health care workers must work together and find ways to improve patient health and satisfaction.   As the old saying goes, “two heads is better than one.” How much more a team? Each member of a team can contribute ideas for the care of the client. This could definitely give the team options and chose what is best for the client and his situation. Having a team to take care of a patient can significantly increase the quality of care offered to the patients. Aside from that, team work can enhance relationships between nurses and also provide many options for the care of the patient.               But there seems to be a problem here. Physicians are closely linked to nurses, but have traditionally been perceived to be less favorable to teaming up with nurses or with any other profession. Physicians’ traditional behaviors of reluctance to associate themselves with others need to be understood and monitored, given the very important role they play in patient care. Without such an understanding, no maximum impact could be achieved through restructuring (1996)               The critical assessment of physicians lack of collaboration with other health care providers has often depicted nurses in a subservient role, leading the leaders of the nursing profession to seek clarification of their relationship to physicians and to attempt to achieve greater professional recognition. This is one issue that needs to be dealt with in the health care scenario.   Teamwork and involvement have always been important components of the nurse’s job. The concept of the health care team, with significant input and participation by nursing staff, is not new. Further, nurses value teamwork and involvement as parts of their job. Yet, continuous quality initiatives and changes brought about by a renewed focus on performance and process improvement have made an impact on the way nurses conduct their everyday work through teams (1998).   Nurses, along with doctors work in the front line of providing health care. When patients go to the hospital and seek for help, it is usually the nurses that they encounter first. And all throughout their stay in the hospital, no doubt they are assisted by the nurses.             Comparison and Differentiation   The two photographs have many differences. For one, the first photograph is a black and white photograph which is more like an advertisement of a nursing center. The second photograph on the other hand is a colored one and looks more like a television promotion picture.   The first photograph shows nine men who are promoting the profession of nursing. They show themselves as from other professions or with different hobbies coming together as nurses. The second photograph emphasizes team work within health care settings especially one between nurses and doctors.   In the provision of health care services, it is inevitable that there should be collaboration among health care professionals. By working in partnership with doctors and even clients, nurses can best represent their needs and redistribute power for the good of all concerned. A critical appreciation of the sources of influence in health care is important. Yet, more importantly, unless nurses can learn to represent themselves, their interests and those of their clients more effectively, they will continue to be a large body of professionals with a relatively small voice within the wider political, social and health care arenas (1999).   Conclusion               The two photographs presented realities in the nursing profession. These are the increasing number of male nurses and the need for other health care professionals with the nurses in the provision of health care services. The nursing profession is not only for females. Although stereotyping made it seem like a female-dominated profession, there are actually many male nurses in the world today. There should not be any gender-biasness as being a good nurse is not determined by gender but rather by how well the nurse performs his or her duties. There are many individuals who are shifting to the nursing profession. This is not bad as long as they really have their hearts in it and are really willing to serve the sick and the needy. In the provision of health care services, it is inevitable that there should be collaboration among health care professionals.                               Credit:ivythesis.typepad.com

Case Pictorial Analysis

Case Pictorial Analysis Introduction Health care is a community concern where it needs the contribution of many indivi...

DISCHARGE PLAN

DISCHARGE PLAN   Patient profile             Mrs. Kristina (not the real name of the patient) is a 70 year old widowed woman. She is a retired teacher who is living alone since her only daughter got married 5 years ago. Her husband died 8 years ago. Her daughter lives only two blocks away from her and visits her regularly about five times a week and helps her with gardening or shopping. Mrs. Kristina stated that her daily activities consisted of spending a great deal of time at her home. She does general cleaning at her own pace, watches television, waters her plants, and reads. Mrs. Kristina is with a diagnosis of possible pneumonia. She has been admitted for her complains of general body malaise and a recurring cough which worsens during the night. Her vital signs upon admission are as follows: blood pressure, 150/90 mm Hg; pulse rate, 92 beats per minute; respirations, 22 breaths per minute; and temperature, 38.5°C.             During the initial assessment, she coughed violently for 40 to 45 seconds without expectorating. Her lungs have wheezes and rhonchi in both bases and are otherwise clear. Mrs. Kristina complained that her chest hurts every time she coughs.             Mrs. Kristina was encouraged to increase fluid intake and was given Tylenol 650mg PO as ordered for fever. An hour after that, she was resting in bed and the vital signs are as follows: blood pressure, 130/86 mm Hg; pulse rate, 86 beats per minute; respirations, 22 breaths per minute; and temperature, 37.7°C. The client complained that she was unable to sleep. Her fluid intake was found out to be 200ml of water.             The nursing diagnosis for Mrs. Kristina identified deficient fluid volume. A day after her admission, she has had fluid intake of about 600 ml, and her urine output was 300 ml of dark concentrated urine. Her temperature is back up to 38.3°C, her mucous membranes are dry and she stated that she feels very weak.             Several days later, following treatment of intravenous therapy, Mrs. Kristina is feeling much better and preparations are being made for her discharge. She was instructed to take Keflex, 500 mg every six hours for the next 10 days. She is also to continue drinking extra fluid and get extra rest. These instructions are also informed to Mrs. Kristina’s daughter who has been there all the time throughout the admission of the client.   Criteria/measures to be met for client discharge             Three important criteria or measures which should be met before Mrs. Kristina can be safely discharged from hospital are the following: (1) stabilization of temperature/returning it back to normal since the client has been having fever, (2) elimination of the recurring cough and the accompanying chest pain, and (3) returning fluid volume back to normal levels as the client has been diagnosed to have deficient fluid volume. Since her admission, Mrs. Kristina has been having changes in her temperature and even had a fever. In order for her to be discharged, her temperatures needs to get back to normal and should be stabilized during the rest of her hospital stay. As found out in the initial assessment, the client coughed violently without expectorating and her lungs have wheezes and rhonchi in both bases and are otherwise clear. She also complained that her chest hurts every time she coughs. The cough should not be allowed to worsen and there should be marked improvement in the client’s cough, if not elimination, before she can be discharged. Although Mrs. Kristina is generally cooperative, she does not like drinking too many fluids or taking pills, and this presents a problem. In order for Mrs. Kristina to be discharged, she has to make up for her water and fluid losses through appropriate nursing inteventions as her nursing diagnosis stated that she got deficient fluid volume.   Rationale and Interventions for each criteria No single core temperature level can be considered to be normal, because measurements in many normal people have shown a range of normal temperatures measured orally from less than 36°C to over 37.5°C (Marieb, 2004). When the rate of heat production in the body is greater than the rate at which heat is being lost, heat builds up in the body and the body temperature rises. Fever, which means a body temperature above the usual range of normal, can be caused by abnormalities in the brain itself or by toxic substances that affect the temperature-regulating centers (2000). The procedures used to intervene and treat the temperature depends on the cause, any adverse effects, and the strength, intensity, and duration of the elevation of temperature. Nursing interventions for fever includes obtaining blood cultures when it is ordered. The rationale for doing this is to coincide with temperature spikes when the antigen-producing organism is most prevalent (2004). Therapies should also be initiated in order to minimize heat production and maximize heat loss. Therapies include letting Mrs. Kristina be allowed rest periods and her physical activity limited. The external covering of the client’s body should also be reduced in order to promote heat loss through radiation and conduction. The clothing and the bed linen has to be kept dry in order to increase heat loss through conduction and convection (2004). Therapies should be initiated to meet requirements for increased metabolic rate. This would include providing measures to stimulate appetite and offer well-balanced meals. Fluids should also be provided to replace fluids lost through insensible water loss and sweating from the fever. Therapies to promote client comfort have also to be initiated. This includes encouraging oral hygiene and controlling temperature of the environment without inducing shivering. Other nursing interventions for fever includes the identification of the onset and duration of febrile episode phases, examining previous temperature measurements for trends, and initiating health teaching (2004).             Antipyretics, drugs that reduce fever, can be given to Mrs. Kristina in order to lower her body temperature. Nonsteroidal drugs such as acetaminophen and salicylates reduce fever by increasing heat loss. Corticosteroids can also reduce heat production by interfering with the immune system and can mask signs of infection but it cannot really treat the fever. Cough is a sudden, audible expulsion of air from the lungs (2004). It is a protective reflex usually serving to expel secretions, exudates, transudates, or extraneous materials from the respiratory tract. When cough is serving any such useful function, it should not be suppressed except under special circumstances like when it is exhausting the patient. Useless cough should be suppressed or, if possible, made useful and effective (1998). Any symptomatic treatment of cough should be accompanied by measures aimed at diagnosis and treatment of the underlying cause.             Mrs. Kristina has to be assessed of the frequency of her cough. She will be instructed to try to produce some sputum, being careful not to simply clear the throat to produce a sample of saliva. The nurse will then inspect it for color, consistency, odor and amount (2004).             The chest pain that she experienced with her cough could be a possible complication of pneumonia which Mrs. Kristina has a possible diagnosis. The underlying condition has to be diagnosed. A bronchoscopy can be performed in order to come up with the possible causes of the chest pain that Mrs. Kristina experiences every time she coughs. Water is added to the body by two major sources: (1) it is ingested in the form of liquids or water in the food, which together normally add about 2100 ml/day to the body fluids, and (2) it is synthesized in the body as a result of oxidation of carbohydrates, adding about 200 ml/day (Guyton & Hall, 2000). The maintenance of a relatively constant volume and a stable composition of the body fluids like water is essential for homeostasis. Some of the most common and important problems in clinical medicine arise because of abnormalities in the control systems that maintain this constancy of the body fluids (2001). The administration of intravenous (IV) therapy is helpful in increasing fluid intake and correcting deficient fluid volume in Mrs. Kristina. The goal of IV fluid administration is to correct or prevent fluid and electrolyte disturbances. It allows for direct access to the vascular system, permitting the infusion of continuous fluids over a period of time. Intravenous fluid therapy must be continuously regulated because of continual changes in the client’s fluid and electrolyte balance (2004). Mrs. Kristina has to be taught of health promotion activities in the area of fluid, electrolyte, and acid-base imbalances. Clients and caregivers need to recognize risk factors for these imbalances and implement appropriate preventive measures. All clients with a chronic health alteration are at risk for developing changes in their fluid, electrolyte, and acid-base balances (2004). Mrs. Kristina, as well as her daughter, needs to understand their own risk factors and the measures to be taken to avoid these problems in the future. Through diet education, Mrs. Kristina can learn the types of food to avoid and the suitable volume of fluid that they should take daily.   Referral letter             Greetings! This letter is written to refer our patient Mrs. Kristina to your good agency in order for her to get support in the community and at the same time help minimize the likelihood of her readmission to the hospital.             To provide a background of the client, Mrs. Kristina has a possible diagnosis for pneumonia and has been admitted to our hospital for deficient fluid volume. Upon discharge, her temperature has already stabilized and returned to normal, her cough has lessened and her fluid volume increased which was assessed by various diagnostic tests.             We strongly advise that her medications have to be taken religiously and she should also avoid the foods that can contribute to decrease in body fluids. She should also get plenty of rest.             Mrs. Kristina is not fond of taking in fluids and her medications so we hope that you can help her with this. We would also like to inform you that she should make an appointment with a physician for one week from the day of her discharge from the hospital for check-ups. Any development of symptoms of recurrence warrants a visit to the physician or the hospital. We trust that Mrs. Kristina will be in good hands with your agency and all her medical and health needs will be catered to.             Lastly, we urge that you will continue providing client education to Mrs. Kristina with regards to her medical condition. We hope that you would do everything you can in supporting her in the community and minimizing her likelihood for another trip to the hospital. Thank you.   Credit:ivythesis.typepad.com

DISCHARGE PLAN

DISCHARGE PLAN Patient profile Mrs. Kristina (not the real name of the patient) is a 70 year old widowed woman. She is...

REPRODUCTIVE CANCERS: NURSING RESEARCH

REPRODUCTIVE CANCERS   Globally, women are increasingly reported to be dying from reproductive cancers. The reproductive cancers included breast, ovarian, endometrial, uterine and cervical cancers among others. There are more than 100 different types of cancer. The most common causes of cancer deaths are not necessarily the most frequently occurring cancers. Cancer is a disease of the body’s cells. Normally cells grow and multiply in an orderly way. Occasionally, however, if something causes a mistake to occur in the cells’ genetic blueprints, they may behave abnormally and spread out of control. Cancer is caused in all or almost all instances by mutation or by some other abnormal activation of cellular genes that control cell growth and cell mitosis. The abnormal genes are called oncogenes. As many as 100 different oncogenes have been discovered. Also present in all cells are actioncogenes, which suppress the activation of specific oncogenes. Therefore, loss of or inactivation of actioncogenes allows activation of oncogenes that lead to cancer ( 2000). As mutant cells grow and divide a mass of abnormal cells or tumor is formed. In some cases, the cells do not form a lump or tumor. Some tumors grow but do not spread beyond the immediate area in which they arise. These are called benign tumors, and are not cancerous. Other tumors can spread into surrounding areas, or to different parts of the body. These are known as malignant tumors commonly referred to as cancers. Cancer cells can break away from the mass (or tumor) and travel via the bloodstream or lymphatic system to different parts of the body and form new masses there. These cells can settle in other parts of the body to form a secondary cancer or metastasis. Cancers arising from epithelial cells which line the body’s internal and external surfaces are called carcinomas, while leukemias are cancers of blood-forming organs, lymphomas from reticulo-endothelial lymph node organs, and sarcomas from connective tissues. Why do cancer cells kill? The answer to this question is usually simple. Cancer tissue competes with normal tissues for nutrients. Because cancer cells continue to proliferate indefinitely, their number multiplying day by day, one can readily understand that the cancer cells soon demand essentially all the nutrition available to the body or to an essential part of the body. As a result, normal tissues gradually suffer nutritive death (2000).             According to the World Cancer Report of the World Health Organization, released April 3, 2004, Lung cancer is the most common cancer worldwide, accounting for 1.2 million new cases annually; followed by cancer of the breast, just over 1 million cases; colorectal, 940,000; stomach, 870,000; liver, 560,000; cervical, 470,000; esophageal, 410,000; head and neck, 390,000; bladder, 330,000; malignant non-Hodgkin lymphomas, 290,000; leukemia, 250,000; prostate and testicular, 250,000; pancreatic, 216,000; ovarian, 190,000; kidney, 190,000; endometrial, 188,000; nervous system, 175,000; melanoma, 133,000; thyroid, 123,000; pharynx, 65,000; and Hodgkin disease, 62,000 cases.             In 2000, there were more than 4.7 million cases of cancer in women worldwide, 54% of which occurred in less developed countries. Gynecologic tumors, including cancer of the endometrium, ovary, vulva, vagina, placenta and adnexa, accounted for 8% of all female primary tumors worldwide and 45% of all genital cancers. Breast cancer is the second most common cancer in the world and the most common cancer in women, accounting for 18% of all female malignancies ( 2003). The annual mortality rates range from 27/100,000 women in northern Europe to 4/100,000 in Asia. In the US, breast cancer is the second leading cause of cancer deaths. There were 192,000 breast cancer cases and 40,000 deaths reported in 2001. The incidence rate of breast cancer-defined as the number of new cases in a given year per 100,000 persons – rose dramatically in the years between 1940 and 1990. Between 1990 and 1997, White women reported the highest incidence of breast cancer (114 per 100,000) and African American women reported the second highest incidence rate (100 per 100,000). For most American women, the mortality rate of breast cancer has steadily declined. However, for older African American women-those 75 years of age and above-the mortality rate has increased since 1990.             Asian women have traditionally had low breast cancer rates. But at present, invasive breast cancer cases have grown significantly among Japanese and Chinese women, and especially among South Asians and Koreans. Researchers suspect that Asians’ breast cancer rates have risen as immigrant women have adopted elements of a Western lifestyle, especially having fewer children and delaying having children until later in life. Breast cancer is the most common cause of cancer-related death in Australian women. One out of eleven women is diagnosed with breast cancer before the age of 75. A total of 11,791 women are diagnosed with breast cancer and 2,594 women died from breast cancer in Australia in 2001. Cancer of the breast is generally not painful, though a vague discomfort may sometimes be present. The great majority of breast cancers appear as a slowly growing painless mass. Among the physical signs to look for are a retracted nipple, bleeding from the nipple, distorted areola or breast contour, skin dimpling over the lesion, attachment of the mass to surrounding tissues including the underlying fascia and overlying skin, edema of the skin of the breast with ”pitted like an orange skin” appearance, and enlarged axillary or supraclavicular lymph nodes. Although one in eight women will eventually develop breast cancer, it is important to note that this is a cumulative lifetime risk that increases with age. More than three fourths of breast cancer cases occur in women 50 years or older; more than half in women older than the age 65. For women between the ages of 35 and 55 without major risk factors, the chance of developing breast cancer is approximately 2.5% (2003). Breast cancer risk factors include family history, menstrual history, pregnancy and breast conditions and diseases.             Breast cancer is sometimes found in women who are pregnant or have just given birth. In women who are pregnant or who have just given birth, breast cancer occurs most often between the ages of 32 and 38. Breast cancer occurs about once in every 3,000 pregnancies.             The best method for early clinical detection of breast cancer is mammography. BreastScreen Australia is the national mammographic screening program of Australia. It provides free screening mammograms for women aged 50-69, with the aim of reducing deaths from breast cancer in this target group. A woman found to have invasive breast cancer is always at higher risk of dying prematurely than women without breast cancer. Even thirty years after her diagnosis she is up to sixteen times as likely to die of the disease as a woman in the general population. That is why responsible researchers in this field avoid the word “cure.” Even as they report advances, they must acknowledge the reality: Post-surgical chemotherapy and anti-hormonal therapy do buy time–an important advance. The slowed progress of the disease can give a woman additional years of life and even allow her to die of other, less traumatic, causes. Cervical cancer is the second most common cancer affecting women after breast cancer, with an estimated 500,000 diagnosed annually worldwide. Cervical cancer accounts for three to five per cent of all deaths among women worldwide. Approximately, 80 per cent of these cervical cancer cases are not diagnosed until they are at an advanced stage. Each year there are about 400,000 new cases of cervical cancer—80% of which occur in women living in developing countries. The vast majority (99.7%) are associated with infection with one or more cancer causing types of human papillomavirus (HPV), which is sexually transmitted. Although women generally are infected with HPV in their teens, 20s or 30s, invasive cancer may not develop for as long as 10 or 20 years after infection. The disease occurs more frequently in younger women. Mortality rates due to cervical cancer are higher among obese women than among their thinner counterparts. Incidence and mortality rates for cervical cancer can be decreased significantly with early screening for all women beginning at the onset of their sexual activity. Cervical cancer is reported to be the leading cause of death among the Pacific Island women. Cervical cancer is the eighth most common cancer affecting women in Australia. One in 101 Australian women will develop cervical cancer in their lifetime. The estimated national participation rate in the three-year period 1992-1994 for women aged 20-69 years was 61 per cent, but this has since risen and according to state and territory statistics is now approaching 70%. Cervical cancer is one of the most preventable and curable of all cancers. It is estimated that up to 90% of the most common type of cervical cancer (squamous cell carcinoma) may be prevented if cell changes are detected and treated early. In recognition of this, in 1991 Australia adopted an ‘organized approach’ to preventing cervical cancer, now known as the National Cervical Screening Program, which recommends and encourages women to have Pap smears every two years, throughout their lives. Each year in Australia more than 1,000 new cases of cervical cancer are diagnosed and over 300 women die from this disease. However with regular Pap smears at two year intervals, and appropriate treatment when abnormalities are detected, most cervical cancer could be prevented. The National Cervical Screening Program of Australia aims to reduce the incidence and death from cervical cancer through a more organized approach to cervical screening. The Program seeks to integrate all elements of the cervical screening process. The Program includes implementation and monitoring of adherence to a nationally agreed screening policy; establishment of cervical cytology registries in each state and territory; and development and enhancement of other quality management strategies across the screening pathway. Based on State and Territory statistical reports, the current national screening rate is approaching 70%. However, screening is still low among older women. The risk of cervical cancer increases with age. Although the Pap smear has its limitations, it is the best way currently available for preventing the development of cervical cancer. A national advertising campaign to increase screening rates began in June 1998. The campaign aims to raise awareness of the need to have two-yearly Pap smears and the benefits of doing so. The campaign encourages all women over 18 to have regular Pap smears. It focuses however on the 35 to 70 year age group as these women participate in screening less frequently than younger women. The national campaign is supported by activities undertaken at a local level by each State and Territory. The National Cervical Screening Program is a joint health initiative of the Commonwealth and State and Territory governments. In the US, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), administered by the Centers for Disease Control and Prevention (CDC), helps low-income, uninsured, and underserved women gain access to lifesaving screening programs for early detection of breast and cervical cancers. This program, funded at 0.6 million for fiscal year 2003, provides both screening and diagnostic services. Cervical cancer, which is almost always preventable, continues to be a large public health problem in many developing countries because of limited access to screening and treatment. Ovarian and uterine cancers are also common cancers of the reproductive system. Accounting for 3% of all cancers in women and figuring more than 165,000 new cases estimated in 2001, ovarian cancer is the sixth most frequent female cancer and the sixth leading cause of death in women worldwide. It has been reported that the incidence of ovarian cancer is on an increase but not as alarming a rate as breast or cervical cancer. For example, Japan has recorded an increase in ovarian cancer incidence from 3.5 per cent in 1955 to 10.5 per cent in 1985. There is substantial variation in incidence rates of ovarian cancer internationally, from 3/100,000 in central Africa to 13/100,000 in northern Europe. Developing nations have incidence rates that are approximately half those of the most resource-rich countries. Canada and the United States are among the countries with the highest rates of ovarian cancer worldwide, with rates of 12 and 11 per 100,000 respectively. In the US, there are 25,580 new cases for ovarian cancer and is responsible for 13,900 deaths. In Australia, there are 1,201 new cases of ovarian cancer and accounted for 780 deaths in 2000. Early detection of ovarian carcinoma is difficult, since an ovarian neoplasm usually remains occult until it enlarges or extends enough to produce symptoms. An ovary may grow to considerable size before displaying clinical symptoms. The earliest symptoms are vague lower abdominal discomfort and mild digestive complaints. Swelling of the abdomen due to ovarian enlargement or accumulation of ascetic fluid, pelvic pain, and anemia appear very late in its course. Additional physical signs include the effects of functional tumors like hyperthyroidism. Endometrial or Uterine cancer is the most common cancer of the female reproductive organs. It is the most deadly of the gynecologic cancers. Endometrial cancer (EC) is the seventh most common malignancy affecting women worldwide, with almost 190,000 cases annually. There is great variation in the incidence rates of EC internationally. The highest risk areas are Central and North America and Polynesia, whereas rates that are 10 times lower occur in western Africa. In the US, there are 40,320 new cases for uterine cancer in 2004. In Canada, there are 3,800 new cases in women of uterine cancer in 2004. And in Australia, there are 1,654 new cases of uterine cancer in 2000.             Malignant tumors of the uterus and cervix usually produce vaginal bleeding, but it may occur late in the course of the disease. Cervical cancer in situ is best treated by total abdominal hysterectomy with removal of several cm of vagina. Cancer of the uterine fundus usually requires total abdominal hysterectomy with inclusion of both adnexa and a generous portion of vagina and sacrouterine ligaments. Carcinoma of the cervix frequently occurs in postmenopausal women and is discovered by examination and cytologic smear and confirmed by biopsy. Other possible reproductive health cancer warning signs are: unusual discharge or bleeding; any unexplained change in toilet habits; a lump in the breast, neck, armpit or anywhere else in the body; and new skin spots, or a spot or mole that has changed in size, color or shape.             For most women with reproductive health cancers, psychological functioning is indistinguishable from that of physically healthy women 12-24 months after diagnosis if the treatment is complete and the cancer controlled. Although most women remain psychologically strong in the face of cancer diagnosis, several domains of functioning may be affected at various points during diagnosis and treatment. Tremendous emotional upheaval is common after being diagnosed with cancer. Many cancer patients experience feelings disbelief, shock, fear, and anger. They may also feel overwhelmed by the girth of information about their cancer and their treatment options, by the decisions they are required to make, and by the sudden changes in their lives. It takes time to accept and understand the diagnosis. As overwhelming and painful as a diagnosis of cancer is initially, many cancer survivors say that their struggle against cancer gave them an opportunity to re-evaluate their lives and to find strengths and abilities that they hadn’t known they possessed. Research shows that lifestyle changes are very common after a reproductive health cancer diagnosis. These changes could be a healthier diet or increased exercise or use of a dietary-supplement. Almost all of the cancer-diagnosed patients overwhelmingly feel that such changes improve their health and well-being. There is somehow hope in cancer-diagnosed patients that a lifestyle change could at least lengthen their lives. People cope with cancer in their individual ways, but generally after the initial shock of diagnosis and the beginning of treatment, most people are able to resume living as they did prior to cancer. Cancer no longer equals death. With the advances in medical knowledge about prevention, early detection and treatment, more than half of those diagnosed with cancer today will be effectively treated. Almost nine out of 10 children with cancer are effectively treated and go on to live normal lives. Every day, knowledge about cancer increases and new, more effective treatments are developed, meaning the number of people living with cancer, or in remission, is increasing. An example is the substantial fall in the death rate for breast cancer as a result of early detection and improved treatment. The type of cancer treatment or combination of treatments that a patient has depends on the type and stage of the cancer. The most common types of cancer treatment are surgery, chemotherapy and radiation therapy. Some cancers can be cured if the tumor is detected and surgically removed before the cancer cells spread. Chemotherapy (anti-cancer drugs) and radiotherapy (radiation treatment) can also cure cancer, by killing cancer cells or stopping them from multiplying. Often these treatments are most effective when used together. The main goal of treatment is to cure the disease, but if cure is not possible, different treatments may be used to control the cancer. Many people with cancer consider alternative treatments in addition to, or sometimes in place of, the treatment recommended by their doctors. Complementary therapies are supportive methods that are used to complement, or add to, mainstream treatments and these are often recommended by your doctor or another health professional. Complementary methods are not given to cure disease, rather they may help control symptoms and improve well-being. Examples include massage therapy, yoga, meditation, herbal teas and acupuncture. There are many alternative therapies that are promoted as cancer cures. But they are unproven because they have not been scientifically tested, or were tested and found to be ineffective.             Cancer prevention is defined as the reduction of cancer mortality by reducing the incidence of cancer. This can be accomplished by avoiding a carcinogen or altering its metabolism; pursuing lifestyle or dietary practices that modify cancer-causing factors or genetic predispositions; and/or medical intervention to successfully treat precancerous lesions. Preventive health care is more dynamic than health maintenance because it requires the individual to enhance his or her health status actively, rather than maintain the status quo. The three levels of prevention are primary, secondary, and tertiary ( 2001.) Primary prevention consists of health promotion activities that are focused on protecting against the occurrence of cancer. It includes teaching patients about healthy lifestyle behaviors. The most consistent finding, over decades of research, is the strong association between cigarette smoking and cancers of many kinds. Not smoking, or giving up, is the single most effective strategy to prevent cancer. One in eight cancer cases and more than one in five cancer deaths – over 7,700 deaths every year – is caused by cigarette smoking. At least one in three cancer cases are preventable and the number of cancer deaths could be almost halved by the implementation of effective cancer prevention programs. Smoking directly affects a woman’s reproductive organs and her reproductive health in general. Smoking has been identified as a risk factor for cancers of the uterus, cervix, vulva and has been linked to breast cancer. It is estimated that 19% of cervical cancer and 40% of vulvar cancer are attributable to smoking. Many cancers occur as a direct result of dietary influences, from infectious agents or exposure to radiation, while a few result from inherited faulty or altered genes. An estimated 6000 deaths from cancer per year are due to inadequate intake of vegetables and fruit. A recent Australian study estimates that 10 per cent of cancers could be due to insufficient intake of vegetables and fruit. Other examples of modifiable cancer risk factors that are open to primary prevention include alcohol consumption, physical inactivity, and being overweight. Based on current evidence, it is now thought that avoiding excessive alcohol consumption, being physically active, and maintaining recommended body weight may all contribute to reductions in risk of certain cancers; however, compared with tobacco exposure, the strength of the effect is modest or small, and therefore the strength of evidence is often weaker. Recent studies in Australia also indicate that regular moderate exercise and maintaining a healthy body weight seem to reduce the risk of some common cancers. Other lifestyle and environmental factors known to affect cancer risk include certain sexual and reproductive practices, the use of exogenous estrogens, exposure to ionizing radiation and ultraviolet radiation, certain occupational and chemical exposures, and infectious agents. At present national screening programs exist for breast and cervical cancer exist in Australia. The Cancer Council Australia’s National Cancer Prevention Policy advocates for a concerted and comprehensive national approach to the prevention of cancer. It offers clear recommendations on how Australia can enhance its achievements in cancer prevention. The most important preventable cause of cancer is smoking – which directly causes more than 11,000 new cases of cancer each year – that is 12.5% of all new cases of cancer. The National Cancer Prevention Policy 2004-06 advocates for a concerted and comprehensive national approach to the prevention of cancer. It offers clear recommendations on how Australia can reduce the 85,000 new cases of cancer diagnosed each year. The first section outlines a strategic approach to reducing preventable risk factors relating to: tobacco, ultraviolet radiation, diet, physical activity, obesity/overweight and alcohol. The second section discusses areas where population screening may be an effective approach to reducing the burden of disease. The policy makes specific recommendations for national action by governments and non-government organizations, including programs and strategies to reduce the incidence of cancer. It does not provide information about cancer prevention for individuals. In the absence of screening programs in poorer countries, primary prevention should take place through health education. By informing women on the early warning signs of reproductive cancers and encouraging them to seek medical examinations and treatment, women would not have to die needlessly.             Lower cancer mortality data does not necessarily reflect a lower incidence rate, especially for developing countries where there is a lack of screening program and national cancer registries. Secondary prevention refers to health behaviors that promote early detection, early treatment, and limited disability. For example, genetic testing for high-risk individuals, with enhanced surveillance or prophylactic surgery for those who test positive, is already available for certain types of cancer, including breast cancers. Cervical cytology testing (using the Pap test) leads to the identification and excision of precancerous lesions. Over time, such testing has been followed by a dramatic reduction of cervical cancer incidence and mortality ( 2001).             Tertiary prevention is directed toward rehabilitation after a disease or condition already exists to minimize disability and help the person to live productively with limitations. Tertiary prevention is used when disability is permanent and irreversible. This type of prevention is aimed at minimizing disease progression effects and disability.             The presence of cancer in a family produces not only physical but also mental and social problems, which are impossible for the family to cope with alone. There is a demand on the part of the nurse for sympathetic understanding and support in building and maintaining morale of the patient and his or her family.                                                             Credit:ivythesis.typepad.com

REPRODUCTIVE CANCERS: NURSING RESEARCH

REPRODUCTIVE CANCERS Globally, women are increasingly reported to be dying from reproductive cancers. The reproductive cancers inc...

Nursing Quality Care Accomplished by International Standards

Introduction The quality of health care among the people is given by the medical practitioners most specifically the nurses. Through their help, there is a significant early recovery of the patients. Their knowledge on the area of health and care is unmeasured but there is an assurance that every nurse gives their expertise through the international standards. Background and Statement of the Problem Certain roles are placed in the shoulders of the nurses and there are changing roles of the nurses that sometimes depend on the given situation. The nurses can be the assistant of the doctors and most of the time they are the partners of the patient for their early recovery. Through the different roles of the nurses there are issues that are hitting them abreast about the quality of health care they give. Research Objectives The first objective of the study is about the nursing quality practice and caring procedures. The second objective is pertaining to the international standards that the nurses follow to accomplish their responsibilities and duties.       Research Questions The study understands that different issues pertaining to the predicament of the quality of health care. Therefore, several questions that prepared which are all focused on the practice and alignment of the nurses regarding the standards of care. 1.      What are the common practices of the nurses in accordance to the standards? 2.      What are problems that the nurses usually faced during the performance of their duty in hospitals? 3.      What are the actions of the officials in the standardization created within every hospital? Literature Review In the health care settings, every personnel are entirely oriented about their specific roles. The creation of the standards in the hospitals has a purpose to help the nurses as well as the other personnel remains align in their oath. The set of rules, guidelines, or desired characteristics for the physical objects, materials, activities, behaviors, performance, quality, or their results, which are consolidated in a technical document and aimed at the achievement of an optimum degree of order in the functioning of any equipment, procedure, system, or organization. Standards are evolutionary in nature. They are established by consensus, and approved by a peer-recognized professional or technical body of experts, or by a regulatory or governmental agency. It is expected that standards will be used universally for the specific area where they apply. For a given context, information system standards address issues of order and compatibility in the design, development, implementation, and operation of information systems and information technology. In following the certain standards there are specific health outcomes that are specifically present among the patients. The outcomes such as mortality and morbidity are well-understood measures but may not be particularly informative for understanding the effects of nursing interventions. Outcome measures more sensitive to the effects of nursing actions are needed, such as functional, physiological, and psychological status; stress level; satisfaction with care received; symptom control; home functions; caregiver burden; goal attainment; quality of life; utilization of service; safety; and cost of care. On the other hand, there are illnesses that positive outcomes are hard to settle for the patients. Most of the illness or diseases are the various cancers especially when the situation reached the final level and the cardiovascular problems. The nurses find it challenging to work in the environment wherein the impact of care is mostly needed. The opportunities for the patient to acquire the support and the professional care of the nurses are a great help and their hope to live longer is establish. But there are certain circumstances that the nurses, even if she or he followed the rules, the situation cannot be changed. Methodology The applied method in the study is the use of the experiment wherein the researcher/s can observe the different reaction of the nurses in performing their duties in the hospitals. The participants are all nurses in their age, gender, and years in practice are determined. Through the use of the experiment the current situation regarding the level of understanding in the quality of health they provide their patients.   Conclusion Every professional follow certain standards in which they follow. Through that specific standard, the quality of their work can be delivered. The complex work of the nurses includes the care planning and delivery with the adequate knowledge, monitoring, caring behaviors, safety, ensuring the quality of health care. Through their responsibilities, the added pressure to save lives became part of their whole being to deliver the care. References: Cardiovascular Nursing Scope & Standards 2006 [Online] Available at: http://www.acc.org/qualityandscience/clinical/cvscope.pdf [Accessed 05 March 2010]. PAHO, 2000. Pan American Health Organization, Essential Drugs and Technology Organization and Management of Health Systems and Services Human Resource Development Building Standard-Based Nursing Information Systems [Online] Available at: http://www.ehealthstrategies.com/files/nursing_IS_standards.pdf [Accessed 05 March 2010]. Wiener, J., Freiman, M., & Brown, D., 2007. Nursing Home Care Quality [Online] Available at: http://www.kff.org/medicare/upload/7717.pdf [Accessed 05 March 2010]     Credit:ivythesis.typepad.com

Nursing Quality Care Accomplished by International Standards

Introduction The quality of health care among the people is given by the medical practitioners most specifically the nurses. Throu...

The safety and efficacy of medicine use in children

Safety Medicine for Pedia A drug taken by mouth goes through three phases-pharmaceutics (dissolution), pharmacokinetic, and pharmacodynamic as drug actions occur. In the pharmaceutics phase, the drug becomes a solution so that it can cross the biologic membrane. When the drug is administered parentally by subcutaneous, intramuscular or intravenous routes, there is no pharmaceutics phase. The second phase, the pharmacokinetic phase, is composed of four processes: absorption, distribution, metabolism (or biotransformation), and excretion. In the pharmacodynamic phase, biologic or physiologic response results are being discussed here. In the case of the neonates and the pediatrics receive special treatment, certain adaptation in assessments and evaluation of nursing care because of physiologic, psychologic and developmental differences inherent in this population. Pharmacology as it relates to the nursing of infants, children and adolescents is limited by the research available in providing protocols of recommend dosages, safe practices and key assessments and important nursing implications. The research is limited for the reason that it is difficult to obtain a pediatric sample because of the informed consent and research risks. Parents and guardian are reluctant to provide consent for children to participate in research studies because of the risk involved and the potentially invasive nature of the studies. Due to limited resources of the research about the safety and efficacy in administering drugs to the pediatric client the modern medicine is very delicate in prescribing drugs. For this reason, before giving any drugs to the client, it undergone a thorough assessment of the client, first they will consider the age of the client, the psychological factors and lastly the physiologic factors. It is important that in administering the drugs to the pediatric client, the medical team should assess the blood volume or the plasma serum level. This is important for the reason that it through them that we can conclude that the drug is effective and the patient is out of danger. That is why this modern day lots of technique about micro analytical is being invented and use in diagnosing one’s patient. Because of the changes in pharmacokinetics and pharmacodynamics inherent of pediatrics clients, a key nursing role is to monitor the client for therapeutic effect and adverse reactions. This micro analytical technique is used to measure plasma or serum drug levels, which indicate the amount of medication in a client’s body. The monitoring of serum drug levels can assist in the establishment of appropriate dosages, schedules, and routes of medications for a client. It can also assist in indicating when the dose is too high (toxic) or too low (not therapeutic). The ranges established for many drug levels are based on studies on adults, which indicate the importance for the nurse to assess pediatric clients in conjunction with monitoring blood levels. Serum blood levels are not available for all medications because of the lack of methods available to measure medications. As a result, client clinical responses to medications are especially important in the monitoring of medications. On the other hand, pharmacogenetics play also important role in administering of drugs to the pediatric client in a safer way. Pharmacogenetics is somehow related to pharmacokinetics and pharmacodynamics. In this study, it shows the individual genetic differences that could affect efficacy and processing of the drugs to the body. It is primarily focused on specific genes, such as drug metabolizing enzymes that signals the entire network to determine if the drugs is responding through to the system. In pharmacogenetics, where the genetic factors have the great impact in dealing with clinical factors that can alter the patient’s response to drugs, where the clinical factors include the age, sex, weight, general health and liver function. What makes pharmacogenetics similar to pharmacodynamics and pharmacokinetics is that it helps to explain why some individuals respond to drugs and others don’t. Through pharmacokinetics helps the medical team especially the doctors to determine patients who requires a higher or lower doses and who will respond to a drug therapeutically and who might have an adverse drug reaction that threaten the life of patients. In order to make the pediatric patient will be able to comply all the drugs being prescribed by the doctors, the medical team especially the nurse will administer the client must anticipate the developmental needs that may affect in taking the drugs. These include stranger anxiety: maintain a non threatening approach and move slowly, Fear of mutilation: explain the procedures carefully, use intrusive routes whenever possible and such as the oral route. Furthermore, advances in drug administration therapy continue to enhance safety, increase accessibility to sites, promote client mobility, and improve client adherence. Examples of these advances include the following: small size needles or safety needle and syringes that help prevent accidental needle sticks and patient controlled analgesia. In this advance technology it promotes safety and comfortable to the pediatric clients.   References:   James E. Barrett, Travis Thompson, Peter B. Dews; L. Erlbaum, 1977     Jeanne L. Wissmann, Margaret Chamberlain Wilmoth; Journal of Community Health Nursing, Vol. 13, 1996     John M. Roll, Frances K. Mcsweeney; The Psychological Record, Vol. 49, 1999     Norman A. Krasnegor, David B. Gray, Travis Thompson; Lawrence Erlbaum Associates, 1986       Credit:ivythesis.typepad.com

The safety and efficacy of medicine use in children

Safety Medicine for Pedia A drug taken by mouth goes through three phases-pharmaceutics (dissolution), pharmacokinetic, and pharmacodynam...