Respond to Marlys Oliver post with two references. Describe and discuss one of the latest research on peripheral vascular disease and the latest ASSESSMENT and client teaching in the prevention of this major body system.Peripheral vascular disease is a blood circulation disorder that can happen in arteries or veins outside the heart or the brain, causing the blood vessels to narrow, block, or spam and causing blood flow to decrease. Common symptoms include fatigue and pain, usually in the legs while exercising, and improvement with rest (Marcin, 2018).

The most common cause of PVD is the buildup of plaque inside the artery wall, known as atherosclerosis. Blood clots that can be formed in the artery wall block off the major arteries by decreasing the blood vessel\’s inner size. The treatment goal is restoring blood flow and preventing disease progression.According to Peripheral Vascular Disease 2021, patients with the highest risk will be: patients over 50 years old, patients with heart conditions, usually male patients, women in the postmenopausal stage of life, and people with a family history of hypertension, peripheral vascular disease, and high cholesterol. Modifiable risk includes hyperglycemia, high cholesterol, high blood pressure, overweight and physical inactivity.The most common test used to diagnose PVD includes an X-ray of the arteries and veins to detect blockage or narrowing, called an angiogram. Ankle-brachial index (ABI) compares the blood pressure in the ankle with the blood pressure in the arm using a regular blood pressure cuff and a Doppler ultrasound device. Doppler ultrasound flow studies using high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Doppler ultrasound flow studies use high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Magnetic resonance angiography. The treadmill exercise test uses to monitor blood circulation during exercise. Photoplethysmography (PPG) similar to the brachial-ankle index. Pulse volume recording (PVR) waveform analysis and Pulse volume recording (PVR) waveform analysis, which is similar to an ABI (Peripheral Vascular Disease, 2021).Assessment of peripheral vascular disease

Assessment for the peripheral vascular disease includes obtaining pertinent information from the patient by asking if there are any leg pain or cramps present and the location of the pain, asking the patient to describe the type of pain (in case of pain) and if it gets worse when the patient walks or do any activities.  Ask the patient if there is any history of vascular problems, a heart condition, history of diabetes or hypertension, obesity, etc. Find out if the patient had noticed any swelling in the arms or legs, any lymph nodes enlargement, and which medications a patient took. It is essential to obtain a history of smoking since Tobacco smoking can cause arteries to spasm and constrict, decreasing blood flow to the extremities.Inspect arms and legs for skin color. Palpate to check for temperature, texture, turgor of the skin. Check for a capillary refill. Palpate radial, ulnar, and brachial pulses in both arms. Check for the epitrochlear lymph nodes through palpation; these nodes typically are not palpable. Check for tenderness while flexing the patient\’s knees and gently compress the calf against the tibia; no tender should be present. Assess the inguinal lymph nodes. Palpate peripheral arteries bilateral, including femoral, popliteal, dorsalis, pedis, and posterior tibial (Jarvis, 2020).

Patient TeachingCheck the feet often. Always look for any change in coloration on the skin, any blisters or cuts, check for any red spots, ingrown toenails, etc. Wash your feet regularly and dry them carefully. Keep\’s toenail trimmed. Keep yourself active. Never be barefoot. Keep the skin on your foot soft and smooth (Jarvis, 2020).On pages 633 and 634 of Jarvis book, how do you correlate these assessment findings in preventing and managing stroke. What are the latest assessment and treatments in managing stroke?A stroke is the disruption of the blood supply to a part of the brain, resulting in a sign of loss of brain function.

In the United States is the 5th most common cause of death. According to Jarvis 2020, evidence from more than 180 countries worldwide for over more than 20 years of data collection demonstrated that 90% of the stroke burden was due to modifiable risk factors. That is why it\’s essential while assessing a patient to find out a tobacco smoking history, diet, and physical activity, also accessing for metabolic factors as finding out if the patient has high blood pressure, obesity, hyperglycemia, high cholesterol. A stroke doesn\’t occur most of the time by managing and controlling modifying risk factors and baseline conditions.

When assessing a patient for an acute phase of stroke, it\’s important to check for changes in the level of consciousness or responsiveness; check for voluntary or involuntary movement of the extremities; neck stiffness or flaccidity; check the eyes if both open and compare the size of the pupils and the reaction to light; the ability to speak; check the blood pressure, etc. (Belleza, 2021).

Treatment in managing strokes include controlling high blood pressure; hypertension can increase a stroke\’s risk by two to four times. Maintain a healthy lifestyle by having a healthy weight, not smoking, following a healthy diet, daily exercise. Also, teaching the patients how to control heart disorders like atrial fibrillation, a risk factor for strokes (Jarvis, 2020)

Prostate Cancer Respond to Ivette Fonseca post using 3 references.

Prostate Cancer Respond to Ivette Fonseca post using 3 references.

ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS 

Prostate Cancer: Respond to Ivette Fonseca post using 3 references.

During the physical examination, a Digital Rectal Examination is usually conducted to evaluate the prostate gland\’s status. A normal prostate gland weighs approximately 20 to 25 grams and should feel smooth and easy to palpate. The abnormal findings may indicate a uniformly enlarged prostate that feels firm and rubbery when palpated (Jarvis, 2019). According to the statistic produced by the American Cancer Society (ACS), Prostate cancer is the second most common cancer affecting males over the age of 65. The diagnosis of prostate cancer is rare in men under the age of 40 years. The main problem associated with prostate cancer is the lack of knowledge about the disease in the population. It is diagnosed in over 16500 Americans annually, and the new ACS’s estimates indicate that it has accounted for approximately 34130 deaths in men (\”Key statistics for prostate cancer,\” n.d.). The growth of the prostate tumor is often gradual and begins in the posterior side. It has the potential to causes metastasis in the urethral mucosa, bladder wall, lumbar spine, and lungs. Prostate Cancer Respond to Ivette Fonseca post using 3 references.

Causes/ Risk Factors

The primary cause of prostate cancer remains unknown, but it has been associated with mutations of the DNA and hereditary traits. However, several factors may increase the chances of developing prostate cancer in an individual. Age is a common risk factor for acquiring prostate cancer as it is often diagnosed in men over 65years. Other risk factors include a family history of prostate cancer, ethnicity (found to be more common in non-Hispanic black men), inherited gene changes such as the BRCA1 or BRCA2 genes doubles the risk of men developing prostate cancer (\”Key statistics for prostate cancer,\” n.d.). Some factors have been associated with having an impact on prostate cancer but with little evidence, including high calcium diet, obesity, smoking, and sexually transmitted infections (\”Key statistics for prostate cancer,\” n.d.).

Prevention

The exact prevention of prostate cancer is still unknown, but individuals can aim at leading a healthy lifestyle to reduce their chances of contracting the disease. According to the ACS, a healthy diet composed of fruits, vegetables, and low calcium combined with regular physical activity can help minimize prostate cancer risk. Some medications have also been proven to effectively reduce the rate of prostate cancer, such as the 5-alpha reductase inhibitors. This medication prevents the formation of dihydrotestosterone, a primary contributor to the growth of the prostate gland. High levels of testosterone have been associated with prostate cancer; hence by blocking this action, the levels decrease, and the chances of developing prostate cancer also reduce.

Healthcare providers need to create awareness on prostate cancer hence need to include the physical assessment of the prostate gland during history taking. This helps in evaluating normal and abnormal findings and begin early treatment. The male should be educated on the significance of early detection of prostate cancer. This is because treatment is very effective during the early stages, thus preventing mortality cases. Even though prostate cancer in its early stages is associated with no symptoms, it is essential to conduct early screening. During the advanced stages, prostate cancer is associated with various symptoms such as weakness in the lower extremities, urinary system difficulties, erectile dysfunction, and hematuria. Therefore, the health promotion teaching strategies should comprise of the signs and symptoms of prostate cancer.

Colorectal Cancer

Subjective data

Subjective data are information from a patient’s point of view. It includes feelings, perceptions, and concerns exhibited during interviews. Objective data are measurable and observable data. Colorectal cancer commences when healthy cells in the colon or rectal lining transform and grow out of control.  A patient with colorectal cancer will complain of abdominal pain, cramping, and abdominal distention (American Cancer Society). Changes in bowel habits will also be observed, including constipation and diarrhea. The patient will also have a feeling that bowels do not empty. Narrowing of stool will also be observed. Furthermore, a patient will have rectal bleeding, dark stools, or blood in the stool. The patient will also complain of weakness and fatigue (Jarvis, 2019). There may also be weight loss with no known cause.

Statistics

Colorectal cancer has been estimated to be the third most common cancer among both genders in the United States, excluding skin cancers. The American Cancer Society estimates that there will be 104,270 and 45,230 new colon cancer cases and rectal cancer, respectively in 2021. Colorectal cancer is ranked as the second deadliest cancer disease in the United States in both men and women combined. The incidence of colorectal cancer in developed countries is 3-4 times that in developing nations. However, this statistic has been changing gradually. Over the years, the incidence has been rising steadily worldwide, especially in developing countries that have adopted the “Western” lifestyle. Obesity, tobacco, alcohol, and sedentary lifestyle are the reason for this rise.

Lifetime Risk

Anything that has the probability of increasing your chances of getting sick is what is referred to as a risk factor. In the case of cancer, different malignancies have different risk factors. However, having a risk does not mean that one will suffer from an illness. Modifiable and non-modifiable risk factors both exist. Modifiable risk factors are those factors that one can change, while non-modifiable are those that one cannot change (American Cancer Society). Modifiable risk factors are lifestyle-related. Examples of modifiable risk factors include diet, weight, and exercise.

Being overweight (and obese), physically inactive, and taking certain diet types increases one’s risk of developing colorectal cancer. A diet high in red meat increases the risk of colorectal cancer. Cooking meat at very high temperatures also creates chemicals that raise one’s cancer risk. Smoking and alcohol use is also considered a risk factor for colorectal cancer.

Non-modifiable risk factors for colorectal cancer include old age, family history, personal history of colorectal polyps or cancer and inflammatory bowel disease, and having an inherited syndrome. Examples of inherited syndromes include lynch syndrome and familial adenomatous polyposis (FAP). African Americans and people with type 2 diabetes also have a high risk of developing colorectal cancer.

Mortality Rates

Statistics for mortality are calculated using 5-year relative survival rates, which compares people with the same cancer type and stage to people in the overall population. This rate tells what percentage of people will live five years after the cancer is found (American Cancer Society). The survival rate for localized, regional, distant, and all stages combined in colon cancer between 2010 and 2016 is 91%, 72%, 14%, and 63%, respectively. In that period, that for rectal cancer is 89%, 72%, 16%, and 67%, respectively.

Assessment of colorectal cancer

Assessment for colorectal cancer involves both physical examination and history taking obtained from the patient. Data obtained is both objective and subjective data. Subjective data has already been discussed. Physical examination falls under objective data. Physical examination includes inspection, auscultation, percussion, and palpation. On inspection, there should be a localized distention (Jarvis, 2019). Bowel sounds should be normal on auscultation. Percussion should exhibit dullness over mass if the tumor reaches up to the skin. On palpation, one should clearly name the borders and have them different from an enlarged organ or normally palpable structure.

Get a 10 % discount on an order above $ 50
Use the following coupon code :
NURSING10

1. Based on course readings, epidemiology is defined as the study of occurrence and distribution of health-related states/events in defined populations, including the determinants that influence these states and the application of the knowledge in controlling these health problems (Stanhope, & Lancaster, 2020). According to CDC, Ebola virus disease (EVD) is a deadly disease that is caused by a group of viruses within the genus Ebolavirus, and commonly affects people and primates such as monkeys, gorillas, and chimpanzees (What is Ebola Virus Disease, 2019).

Ebola virus was first discovered in the year 1976 near the Ebola river which is now known as the Democratic Republic of Congo (DRC). It has been affecting people for a number of times in this nation, with outbreaks happening in central and west Africa from time to time. Little is known about its origin, nonetheless based on the nature of similar viruses it has been conceptualized to be animal-borne; bats/ non-human primates i.e., chimpanzees, apes, or monkeys constituting the most likely source. Infected animals can transmit the virus to others. The common mode of transmission in humans is through direct contact of contaminated blood/fluids/objects from a person who is sick/died from EVD to i.e., broken skin or mucous membrane in the eyes, nose, or mouth.

Symptoms of the Ebola virus disease are mainly characterized by fever, aches, and pains such as severe headache, weakness, fatigue, diarrhea, vomiting, abdominal pain, and unexplainable hemorrhaging. In later stages, red eyes, skin rash, and hiccups may develop. Outbreak characteristics include a fatality average rate of 50% which varied from 25% to 90% in previous outbreaks. The incubation period varies from 2 to 21 days. Infected persons cannot spread the virus until they develop symptoms. In terms of cases and geography, crowded areas increase the risk of infection. In areas where people follow burial practices such as washing the body, the rate of infection is expected to be higher.

The 2014-2016 Ebola outbreak in West Africa is categorized as the largest in history. The index patient was identified to be an 18 months old boy in a village located in Guinea that was reported to have been infected by bats (2014-2016 Ebola Outbreak in West Africa, 2019). At least 5 fatal cases of diarrhea occurred in this village and soon afterward spread to Conakry the capital city before being confirmed as EVD by Pasteur Institute located in France. It was declared an outbreak by the WHO as of March 23rd, 2014 where 49 people had been confirmed infected while 29 deaths had been recorded. CDC efforts were crucial as they provided surveillance, contact tracing, laboratory testing, and health education. The screening was intensified at travel points especially airports. The experimental vaccine rVSV-ZEBOV proved very effective in protecting against EVD in ending this outbreak (Henao-Restrepo et al., 2017).

This outbreak highly resembled the case definition as crowded areas depicted higher infection rates, and symptoms included fever, fatigue, headaches followed by vomiting, rash, and unexplained hemorrhaging. Total cases recorded were 28,600 while deaths were 11, 325; representing a fatality rate of around 40%.

References

2014-2016 Ebola Outbreak in West Africa. (2019). Retrieved from https://www.cdc.gov/vhf/ebola/history/2014-2016-ou…

Henao-Restrepo, A. M., Camacho, A., Longini, I. M., Watson, C. H., Edmunds, W. J., Egger, M., . . . Kieny, M. (2017). Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: Final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Suffit!). The Lancet, 389(10068), 505-518. doi:10.1016/s0140-6736(16)32621-6

Stanhope, M., & Lancaster, J. (2020). Public health nursing: Population-centered health care in the community. St. Louis, MO: Elsevier.

What is Ebola Virus Disease? (2019). Retrieved from https://www.cdc.gov/vhf/ebola/about.html#:~:text=E… virus was first discovered,where Ebola virus comes from.

2. Covid-19 outbreak

This is an infectious disease whose origin is traced from Wuhan City in China. The WHO was formally notified about some strange cases of pneumonia in December 2019. By January 2020, the number of known cases had risen to 59. The virus responsible for this respiratory disease was identified as SARS-CoV-2 and later known as Covid-19 (Mayo, 2020). The recorded cases had mushroomed to 282 and spread in three more countries, South Korea, Japan, and Thailand.

Signs and symptoms of covid-19 are likely to appear 2-14 days after an individual is exposed to the virus. The most common signs and symptoms include fever, cough, and tiredness. There are other known symptoms like shortness of breath, sneezing, sore throat, and headache. The less general symptoms that may be exhibited include nausea, vomiting, and diarrhea. Covid-19 symptoms can be severe or mild.

In some cases, the patients are asymptomatic and do not display any symptoms at all. While there are patients who may have many of these symptoms, the majority exhibit only a few. People with chronic illnesses like asthma, high BP, cancer, and diabetes have a higher probability of contracting the disease since their immunity is low. Also, older individuals are more vulnerable to the virus.

Information from the CDC indicates that the virus sticks on surfaces. When one touches the body and puts his hand in the mouth, nose, and eyes, they contract the virus. Also, the covid-19 virus can be airborne. Some of the preventive measures include social distancing, wearing a mask, regular washing of hands, and the use of alcohol-based sanitizers.

References

Coronavirus disease 2019 (2020) Mayo Clinic. Retrieved October 13, 2020, from

https://www.mayoclinic.org/coronavirus-covid-19/pu…

Coronavirus (2020) cdc. Retrieved October 13, 2020 from

https://www.cdc.gov/coronavirus/2019-nCoV/index.ht…

What additional objective findings would you be examining the patient for.

What additional objective findings would you be examining the patient for.

ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS 

Nursing case study

A 78-year-old female comes to your office escorted by a neighbor who is a patient of yours. The neighbor, who has lived next door to the older woman for years, relates that a week ago the elderly woman’s sister died and that she had been her caregiver for many years. The neighbor relates that although she would occasionally see the older woman, she did not visit the home. At the funeral last week, she noticed that the woman appeared fatigued, confused, sad, and gaunt in appearance. Later the neighbor approached the woman, inquired about her health, and determined that the woman had a very difficult time the past couple of months, caring alone for her sister until the end when hospice care was initiated. The neighbor convinced the woman to seek medical care and today is the first appointment with a provider that this 78-year-old female has had in 3 years. The older woman states that she is very fatigued and sad over the loss of her sister. Neither her sister nor the patient has been married. A distant niece came to the funeral but lives about 30 miles away. The woman states that she is not taking any prescription medication and relates no medical problems that she is aware of being diagnosed.

Vital signs: T 97.6°F, HR 98, RR 22, BP 95/60, BMI 21

Chief Complaint: Fatigue and sadness over the death of her older sister.

Discuss the following:

1) What additional subjective information will you be asking the patient?
2) What additional objective findings would you be examining the patient for?
3) What are the differential diagnoses that you are considering?
4) What laboratory tests will help you rule out some of the differential diagnoses?
5) What screening tools will you select to use on this patient?
6) What is your plan of care?
7) What additional patient teaching may be needed?
8) Will you be looking for a consult?

 

Get a 10 % discount on an order above $ 50
Use the following coupon code :
NURSING10

According to CMs subjective and objective data, she significantly reduces her weight from her last visit.

According to CMs subjective and objective data, she significantly reduces her weight from her last visit.

ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS 

Respond to Ivette post

Problems List

According to C.M.’s subjective and objective data, she significantly reduces her weight from her last visit. This could signify a problem in her nutritional intake due to drastic weight changes. C.M. faces a high risk of suffering from under nutrition due to poor physical and mental health. Leaving alone sets in a feeling of social isolation, and depression may follow hence unable to feed well. Given her age (89) years old, she is experiencing physiological and physical changes that affect her nutritional status, such as loose dentures, decreased G.I. absorption, and decreased salivary production. This may contribute to her inadequate dietary intake. From her past medical history, C.M. is a known client for hypothyroidism. Hence, this makes her vulnerable to fatigue and dry skin due to a reduced metabolic rate.

Nursing Diagnoses

C.M. presents with weight loss, poor calorie intake, poor skin turgor, loose dentures, dry oral mucosa, and bleeding gums. Looking at this information from the objective data, then the following are the likely nursing diagnoses: Imbalanced nutrition less than body requirements related to inadequate nutritional intake as evidenced by a weight loss from 115Ib to 105Ib, intake of only light meals, and poor skin turgor. Impaired skin integrity related to nutritional imbalances as evidenced by dry skin and poor skin turgor. Fluid volume deficit related to reduced metabolic rate secondary to hypothyroidism as evidenced by dry oral mucosa, bleeding gums, and poor skin turgor. Plan of Care

Since C.M. is diagnosed with hypothyroidism, it is essential to monitor the adverse outcomes related to severe cases of this condition, such as dehydration. Hence, in the plan of care, adequate intake of fluids should be included. It is vital to measure and assess the skin to identify malnutrition signs such as skin breakdown, skin turgor, and muscle tone.

It is also vital to include mouth and throat care in this patient. She reports having loose dentures, which could be associated with edema effects due to hypothyroidism. Hence, it is essential to ensure that the dentures are correctly fit in her mouth to avoid the bleeding of gums.

It is also vital to monitor the patient’s sense of smell. According to Jarvis et al. (2020), as individual ages, they have a high risk of losing their sense of smell, hence are predisposed to under nutrition. One of the most common physiological changes that occur as an individual age is saliva reduction that causes dry oral mucosa and decreased taste. Hence, it is essential to monitor for these signs to provide necessary interventions to prevent nutritional imbalances. Body Mass Index Body Mass Index = Weight (in pounds)/ Height (in inches) 2 x 703105/ (61)2 x 703= 19.84According to Jarvis et al. (2020), a body mass index of 19.84 among adults is classified as average weight. Amount of Calories a Day

Having recorded a weight loss of 15Ib since her last visit, C.M. needs to take the correct amount of calories a day to maintain her current weight of 105Ib.  With her sedentary lifestyle, as evidence by the subjective data that she does not go to the shop and stays alone, C.M. should take about 1800 calories a day (Jarvis et al., 2020).Laboratory Studies

It is essential to determine the nutritional status of elderly patients such as C.M. as malnutrition is often underdiagnosed among these populations. It aids in the accurate diagnosis and development of effective treatment plans. Various laboratory studies or markers can be used to evaluate the nutritional status of patients, including but not limited to, albumin, transferrin, and retinol-binding protein. A decrease in these laboratory markers indicates poor nutritional status. Blood tests can also be performed to evaluate the level of the thyroid-stimulating hormone (TSH), a reduction in this hormone is a primary indicator of poor nutritional status (Hanif et al., 2018).

Answer preview to according to C.M.’s subjective and objective data, she significantly reduces her weight from her last visit.

Get a 10 % discount on an order above $ 50
Use the following coupon code :
NURSING10