I need to post 6 comments to my peers. Responses to peers or faculty should be 150 min words and include one reference.
I need to post 6 comments to my peers. Responses to peers or faculty should be 150 min words and include one reference.
Comment 1:
Asthma is a common respiratory dysfunction. Asthma is a chronic lung disease affecting people of all ages. It is caused by inflammation and muscle tightening around the airways, which makes it harder to breathe. World Health Organization. (2023, May 4). One of the primary causes of asthma is a combination of genetic and environmental factors, including allergens (such as pollen, dust mites, pet dander), air pollution, respiratory infections, certain medications, and even stress. Prevention includes identifying triggers, avoiding those triggers, medication, lifestyle modification, and education. Understand and identify triggers that worsen asthma symptoms. This might involve keeping a diary to track symptoms and potential triggers, such as exposure to allergens or respiratory irritants. Once triggers are identified, take steps to minimize exposure to them. This could include using air purifiers, regularly cleaning living spaces to reduce dust and allergens, avoiding outdoor activities during high pollen seasons, and minimizing exposure to tobacco smoke. Follow prescribed asthma medications consistently, including controller medications to manage inflammation and prevent symptoms, as well as rescue inhalers for acute symptom relief. It’s crucial to understand how and when to use each medication as prescribed by a healthcare provider. Adopt a healthy lifestyle that supports respiratory health, including regular exercise, maintaining a healthy weight, and avoiding exposure to environmental pollutants. Educate yourself and others involved in asthma management about the condition, its triggers, medications, and proper inhaler techniques. By implementing these strategies, individuals with asthma can better control their symptoms, reduce the frequency and severity of exacerbations, and improve their overall health status. CDC’s National Asthma Control Program works to help Americans with asthma achieve better health and improved quality of life. The program funds states, school programs, and non-government organizations to help them improve surveillance of asthma, train health professionals, educate individuals with asthma and their families, and explain asthma to the public. Centers for Disease Control and Prevention. (2023, May 22).
Comment 2
The heart is an amazing, complicated, and vital muscular organ in humans. The heart pumps blood and carries oxygen and nutrients to the body through the circulatory system’s blood vessels. Heart dysfunction refers to when the heart doesn’t pump blood properly to deliver enough oxygen and nutrients to the body. When heart dysfunction becomes severe, many diseases can manifest, for example, myocardial infarction (MI), heart failure, angina, coronary artery disease (CAD), etc. According to the Centers for Disease Control and Prevention, the most common type of heart disease in the United States is coronary artery disease (CAD), which affects the blood flow to the heart. Decreased blood flow can cause a heart attack (CDC, 2023). Cardiac dysfunction has many causes, for example, unhealthy lifestyles and harmful habits such as smoking, heavy alcohol, using illegal drugs, or an unhealthy diet containing high levels of unhealthy fats, sodium, sugar, etc. Other diseases, such as lung disease, diabetes, HIV, etc., can increase the risk of heart or blood vessel conditions.
As professional nurses, we know the risk factors for heart disease. The key step necessary to prevent heart dysfunction is educating patients on managing their conditions when they have apparent heart disease. Teaching patients different ways to achieve a healthy lifestyle, eating healthy foods and drinks, regular physical exercise, keeping a healthy weight, not smoking, etc. Additionally, checking blood pressure, cholesterol, and blood sugar levels regularly can also help prevent heart disease by spotting signs early. It is also important to teach patients the signs and symptoms of heart attack and how men and women may experience them differently. Patients should perform self-care behaviors in order to sustain wellness. When nurses provide evidence-based education to patients, it allows them a measure of control over their condition and, ultimately, their lives (Falkner, p 32).
Comment 3
Persistent Pulmonary Hypertension (PPHN) is abnormal elevation of pulmonary vascular resistance that results in left to right shunting of deoxygenated blood which causes hypoxemia (Martin, 2022). PPHN occurs in neonates during the transition post delivery. PPHN is caused by developmental delays, maladaptation, or maldevelpment other conditions include diaphramatic hernias, meconium aspiration, or infection. These infants present with respiratory distress and cyanosis within the first 24hrs of life. Initial diagnosis requires arterial blood gas sampling, chest x-ray, sepsis evaluation and continuous pulse oximetry monitoring (Cleveland Clinic, 2023). These infants are among the sickest to be admitted to the NICU. These infants require extensive respiratory support and fluid therapy. The idea for treatment is that we will be able to open up the aveoli and the neonates will be able to properly oxygenate and maintain normal PVR.
Patient (Parent) education is extremely important because of how quickly these infants can deteriorate. The most severe cases require ECMO. Most require intubation. These infants require minimal stimulation, a quiet environment, and as much sleep as possible to promote recovery (Cleveland Clinic, 2023). Although difficult, parents often can’t hold these infants until a few days if not a full week after delivery because of their sensitivity to stimulation.
Comment 4
Atrial fibrillation is most common cardiac dysrhythmia, and its prevalence is increasing worldwide (Nesheiwat, et al., 2023). Atrial fibrillation (afib) occurs because the abnormal electrical activity of the atria is causing irregular, chaotic beats which move at different rates as the ventricles (Grand Canyon, 2022). Patients with afib are at higher risk for the development of blood clots as blood has the potential to pool in the ventricles. Common symptoms related to afib often depend on patient variability such as asymptomatic regardless of rate to symptoms such as palpitations, shortness of breath, nausea, dizziness, and diaphoresis (Nesheiwat, et al., 2023).
In order to prevent dysfunction, it is imperative that the patient understands the various factors that may contribute to the development of the dysrhythmia such as caffeine intake, strenuous exercises, illicit medications, or even excessive alcohol consumption. The patients need to be educated on the importance of medication adherence to their rate control and anticoagulation preventatives (Nesheiwat, et al., 2022). In order to improve health status, the nurse needs reinforce education on medication adherence to prevent incidence of ischemic stroke, encourage healthy lifestyle and regularly checking heart rates and following up with their care team (Nesheiwat, et al., 2022). The reinforcement of disease management is a responsibility that needs to be continuous in both the inpatient and the outpatient settings. The more a patient understands about their disease and how to manage it, the better their outcomes will be.
Comment 5
About 6.2 million adults in the United States have heart failure, as reported by the Centers for Disease Control and Prevention (CDC, 2023). This condition significantly impacts healthcare systems and patients’ quality of life, necessitating effective management and follow-up resources after hospital discharge. Common take-home resources for patients include detailed discharge plans, medication management guides, symptom tracking tools, dietary and activity recommendations, and access to follow-up care and remote monitoring services. These resources aim to help patients manage their condition at home and reduce the likelihood of readmission.
Since 2012, Medicare has penalized hospitals for high readmission rates as part of the Affordable Care Act, with safety-net hospitals facing significant financial burdens due to their high proportion of low-income patients who often have challenges in post-discharge care. Recognizing these challenges, Medicare revised its evaluation process in 2019 by grouping hospitals with similar patient socio-economic profiles and comparing their readmission rates within these groups (Rau,2019). This change aimed to reduce unfair penalties on safety-net hospitals, resulting in a decrease in their penalties by about a fourth compared to the previous year, even as more than half of U.S. hospitals continued to face penalties, with the most severe being a 3% reduction in Medicare reimbursements Rau, 2019).
These readmissions technically result in decreased health outcomes for the patient (usually because readmission is usually from a complication or insufficient initial recovery). In addition this readmission will certainly have financial and emotional costs for the individual.
Comment 6
Myocardial Infarction can be either a ST-elevated myocardial infarction (STEMI) or a non-ST-elevated myocardial infarction (NSTEMI). The difference between the two is that a STEMI occurs when a coronary artery is completely occluded and a NSTEMI involves a nearly occluded artery. Obviously, a STEMI is much more serious and deadly due to cardiac muscle being starved of oxygen which results in cellular death. Death of vital cardiac muscle contraction causes circulation to halt and brain death will result within minutes. A STEMI requires immediate use of thrombolytics to revascularize the tissue, followed by a visit to the cardiac cath lab to determine whether to place a stent or do open heart surgery and bypass the damaged artery. A NSTEMI does not cause damage to the entire cardiac muscle like a STEMI does, and cannot be treated with a thrombolytic since proteins and platelets working differently in this phenomena. Blood thinners are used to prevent further clotting (Johnson, 2022).
According to the CDC, common risk factors for heart disease are high blood pressure, unhealthy cholesterol levels in the blood stream, diabetes mellitus, and obesity. To decrease ones chance of heart disease, avoid foods high in saturated fats such as fried foods, fatty meats, and certain dairy products such as ice cream and Velveeta cheese. Drinking an excess of alcohol and smoking tobacco also increases your risk, so one should quit these two habits if they wish to prolong their life. Physical exercise such as walking, running, biking and swimming increases circulation and burn off superfluous calories which is part of a heart healthy routine. (Centers for Disease Control (CDC), n.d.).
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