Sunday, January 26, 2020
Chronic Obstructive Pulmonary Disease (COPD) Causes
Chronic Obstructive Pulmonary Disease (COPD) Causes Herla Dorvil Chronic Obstructive Pulmonary Disease (COPD) is one of many public health issues America faces. It is among the leading causes of death in the United States. It is affects more Americans just as any other disease. People with COPD are impacted where it can affect daily living. Due to the destruction of the alveoli in lungs, more individuals are requiring hospitalization frequently. Many people are diagnosed with COPD each year. COPD is a group of chronic pulmonary diseases such as chronic bronchitis and emphysema that impair air flow to the lungs causing difficulty in breathing. According to (Chen et al., 2013), the World Health Organization has reported approximately 5/100 deaths worldwide due to COPD. Although COPD is a huge issue in public health, still many are unaware of the risk factors, target population it affects and the impact this creates in someones life. There are many ways that people can develop COPD. COPD occurs mostly in current or former smokers. Cigarette smoking and long-term exposures irritates and damage the lungs. â€Å"Cigarette smoke causes progressive destruction of the lung tissue, resulting in irreversible narrowing and scarring of the airways and loss of the alveolar interface where gas exchange takes place.†(Barnes et al., 2011, p. 612) Environmental factors such as air pollution, dust particles, and chemicals are also detrimental to one getting COPD. People who work around chemicals for a long time are at risk to damaging their lungs. The chemicals that are inhaled from the work environment and air pollution causes serious affects to the lungs. Breathing in secondhand smoke also poses a risk because they are around it all the time. People are most likely to develop COPD after being around family members who smoke or have a history of smoking. Another factor is the heredity of alpha one antitrypsin deficiency . An absence of alpha one antitrypsin increases your risk for lung disease. The lungs are protected by this protein and it is produced in the liver. It protects the body from unwanted effects from other proteins that cause harm to different organs of the body (Cox, 2011). Some patients that have asthma are usually categorized under chronic obstructive pulmonary diseases. It affects the lungs by narrowing the airways and making it hard for one to breathe and usually have to take maintenance drugs if necessary. Common symptoms that are seen with COPD are chronic cough, increase in sputum production, chest tightness, wheezing, and shortness of breath. People with COPD usually have exacerbations, which is when their condition becomes worst over time. COPD is more common in older age groups and is said to be prevalent in women. People who get COPD are usually 18 years and older. Sometimes individuals are unaware that they have COPD until later in life after it progresses and they start developing symptoms. Studies say that women are twice as likely as men to get COPD. Although COPD affects all ages and mostly older age, the prevalence is high among adults less than 65 years old (Barnes et al., 2011). Due to under diagnosis the amount of people who have COPD may be higher. Many people don’t go to get regular check-ups and don’t have the money to do so, therefore they go a long time without noticing symptoms and end up finding out when it exacerbates. COPD is a chronic progressive disease that affects the pulmonary system creating a huge burden on ones life depending on the severity. Some patients with COPD experience weight loss skeletal muscle dysfunction and it makes it difficult to perform daily living activities as well as physical activities. The disease can cause one to experience shortness of breath with any type of movement. Kulich, Molen, Polkey, Rabinovich, Troosters, Vogiatzis (2013) emphasizes that the lack of physical activity contributes to the progression of the disease and creating poor outcomes. It is marked as reasons for mortality in hospitalized stations for many individuals. When physical activity is increased, it produces better outcomes for the patient. As the disease progresses individuals are frequently hospitalized, thus creating increased debt and healthcare expenditures. According to Chen et al. (2013), the average amount of medical expenses for a COPD patient is estimated at $27,656 per year, which i s four times higher than the average cost for patients without the disease. The individual has to constantly buy medication and it also creates problems at home where it interferes with their economic stability. It causes one to become unstable and unable to pay their bills and incompetent to take care of their selves which then leads them into depression. â€Å"In individuals with COPD, depression is significantly associated with decreased functional status; impair quality of life and disease progression and mortality.†(Das, Negi, Pandey , Raval, Sarkar, 2014 p.403) Due to the clinical depression, patients may not be in compliance with their management programs such as taking their medications, attending smoking cessation programs and pulmonary rehabilitation. By not taking these measures it leads to poor clinical outcomes and patients tend to relapse. COPD Individuals with depression cause higher financial problems for themselves. Das et al (2014) also showed that the occ upational status of a person showed an association with the presence of depression which develop into mood disorders. Not only is there an economic burden and depression, it also triggers other illnesses that will generate further complications (Chen et al., 2013). Some people later get peripheral artery disease, stroke and lung cancer. The impact of COPD can causes people to completely stop working because of the severity and the complications it produces. An understanding of the chronic disease complexity can help improve the quality of life for those individuals living with chronic obstructive pulmonary disease. Recognizing the impact of COPD may help the population to better identify, to get proper treatment and to reduce severity and exacerbations. The population of young, older men and women has to be educated and be made aware of the risk factors and importance of preventing the disease progress for a better and an improvement in life expectancy. References Chen, P., Livneh, H., Lu, M., Sung, F., Tsai, T. (2013). Increase risk and related factors of depression among patients with COPD: A population-based cohort study. BMC Public Health, 13. doi: 10.11.1186/1471-2458-13-976 Coz, L.A. (2011). A casual model of obstruction pulmonary disease risk. Risk Analysis, 31(1), 38-62. doi: 10.1111/j.1539-6924.2010.01487 Barnes, N., Buist, S., Fishwick, J., Fletcher, M., Hutton, J., Jones, P., Walsh, J. (2011). COPD uncovered: an international survey on the impact of chronic obstructive pulmonary disease on a working population. BMC Public Health, 11(1). doi: 612.62410.1186/1471-2458-11-612 Das, P., Negi, H., Pandey, K., Raval, A., Sakar, M. (2014). Presence of depression and its risk factors in patients with chronic obstruction pulmonary disease. The Indian Journal of Medical Research, 139(3), 402-408. Retrieved from http.www.ebcohost.com Kulich, K., Molen, T., Polkey, M., Rabinovich, R., Troosters, T., Vogiatzis, I. (2013). Improving physical activity in COPD: Towards a new paradigm. Respiratory Research, 14(1),115. doi:10.1186/1465-9921-14-115
Saturday, January 18, 2020
Persuasive speech Essay
`Americans should be considered equal and allowed the opportunity to marry a person of the same sex if they desire`.               For years, marriage has been defined as the union of a man and woman. In fact, in the United States, the Defense of Marriage Act has been passed by the Congress. This has prohibited and denied same-sex marriages. According to democracynow.org, this issue on same-sex marriages has continued to bring out divided and different opinions from people, though some states have stepped towards allowing legal rights to gay marriages. According to law.richmond.edu, same sex marriage has become a major constitutional issue.               In all these debates, my stand is that we should allow this kind of marriage. I believe that every person, whatever his or her gender is, should be treated with equality.               Mary Bonauto, the Civil Rights Project Director of Gay & Lesbian Advocates & Defenders, said that civil rights movements make an effort â€Å"to create a world without privileged places from which individuals or groups of people are excluded solely because of personal characteristics.†They have struggled for women, African Americans and now lesbians and gays in America. Are we to overlook and disregard those struggles? If they have fought for equality for women and for African Americans and we have learned to accept it, why can we not give way to equality in terms of marriage? Gays and lesbian couples want to get married simply because they love each other deeply. Bonauto said that these people view marriage as the ultimate means of expressing their love for each other, just like other people do. Many of these couples would want to marry if only they were allowed to do so, according to bc.edu.               According to law-library.rutgers.edu, Mary Becker, Professor of Law at DePaul University College of Law found the real good in marriage, it being â€Å"an intimate human connection that transcends gender and procreation†. Professor Becker suggests that the government should support a model that advances â€Å"human happiness and well-being†in its regulation of marriage.               There had been a lot of arguments on this, though. I quote from a press release from white house.gov, â€Å"America is a free society, which limits the role of government in the lives of our citizens. This commitment of freedom, however, does not require the redefinition of one of our most basic social institutions. Our government should respect every person, and protect the institution of marriage. There is no contradiction between these responsibilities. We should also conduct this difficult debate in a manner worthy of our country, without bitterness or anger.†              Also, the site cwfa.org cites things that gay marriages can result to, such as weakening of the family and the encouragement of people to remain homosexual.               Well, what I have to say is I think that every person has a choice to become what he wants to be. He can choose what to make of that right. What steps can we do to solve this issue? For starters, if we are to respect every person in the real sense, we are not to let discrimination hurt anyone. And I know that each of us can handle this debate without bitterness. I hope we could all open our eyes and see beyond ourselves, to see where other people come from and what they believe in and to respect what they uphold. If we say that we are a free society then let’s show it. Let us give gay couples the freedom to marry if they want to.               At some point in our lives, we may have experienced discrimination in various ways. And we know that doesn’t feel good. You see, we all have rights. And we need to treat all people, including gays and lesbians equally and with respect, just like how we want to be treated. Same-sex marriage is not a bad thing. Gay marriages just prove that marriage, love and commitment pass beyond gender. Think of this. What if you were in their shoes, not having the chance to marry the person you love because of gender biases? How would you feel? Live and let live. Sources: Becker, M., â€Å"Family Law in the Secular State and Restrictions on Same-Sex Marriage: Two Are Better Than One,†University of Illinois Law Review, 2001:1-56, Retrieved November 21, 2006 from http://law-library.rutgers.edu/SSM.html#pro Bonauto, M. L., â€Å"Civil Marriage as a Locus of Civil Rights Struggles,†Human Rights, 30(3):3-7 ( 2003) (American Bar Association, Section of Individual Rights and Responsibilities) Retrieved November 21, 2006, from http://www.abanet.org/ Henkle,G. (2004). Same Sex Marriage In The News. Retrieved November 21,2006, from http://law.richmond.edu/ Knight, R. (2003). ‘Gay Marriage’ Is Not Only Wrong; It’s Socially Destructive. Retrieved November 21, 2006, from http://www.cwfa.org/ Wriggins,J. MARRIAGE LAW AND FAMILY LAW: AUTONOMY, INTERDEPENDENCE, AND COUPLES OF THE SAME GENDER, Retrieved November 21, 2006, from http://www.bc.edu/ Gay Marriage in Native America (2005). Retrieved November 21,2006, from http://www.democracynow.org/ President Calls for Constitutional Amendment Protecting Marriage (2004). Retrieved November 21, 2006, from http://www.whitehouse.gov/
Friday, January 10, 2020
Staff Development Teaching for Preventing Falls in the Elderly Long Term Care Facilities
In the United States, unintentional falls are the most common cause of nonfatal injuries for people older than 65 years. Up to 32 percent of community individuals over the age of 65 fall each year. Females fall more frequently than man in this age group, especially due to the fact that most female elderlies have bone weakness such as osteoporosis, which makes the fall to cause fatal injuries sometimes. Fall related injuries are the most common cause of accidental death in those over the age of 65. Approximately 40 fall related deaths per 100,000 people per year.Thus, fall are a growing public health problem that need to be addressed. Patient would not only suffer from such fall but the facility goes through hardships as well to deal with the patient. Fall related death rate in elderly group has been increasing in USA. Recently, falling has been occurring a lot in the long-term facilities. Falling has the highest rate of incident in the long-term facility because most of the patients are elderly. Falls can cause serious injuries and accidental death. In order to prevent falls in the elderly is very important.There are several different approaches to deal with predispose factors for elderly type of injury. I am going to reviews the major risk fators of falls and how to prevention for elderly populations living in long term care facilities. The effective falls intervention programs should take a multifaceted approach.Assess the staff for ability of learning and understandingI explained the background of important fall precaution to our licensed nurses and CNAs, the ones who gives care to the patients with ADL most closely. The Staff members, Licensed Nurses, and CNAs have different nationalities with different language. Licensed Nurses are 70% LVN and 30% RN. The experience in the healthcare facility for most of them is at least 3month. Because 90% of staff can fully understand in English, it is not necessary for the educational materials to be in other languages than English. The learners already are familiar with this topic because they already have had experiences in long-term facilities.How to educate and when is the best time for as much as possible participated in service. In order to prevent further falls, fall precaution presentations will be held during the weekdays in the conference room. Staffs can come in 30 minutes before or after the shift change, and spend an hour on this topic. First, I will show some fall cases through video, so I can induce the staff’s interest in this subject through visualization. Even though the staffs are well aware of the fall incidents, it is not easy to keep an eye on every patient 24/7, which can be frustrating and tiring to the staffs. However, I can explain how much this is important and tell them to try to understand and do the best. I will be identifying what risk factors or what kind of patient has high risks of falling using a current published brochure and video.What is the cost effect of a fall?Fall related injuries among elderly are associated with economic costs, which is much greater than the cost to implement a fall prevention program. In the long-term care facilities, even with an interdisciplinary team with physicians, nurses, social worker, physical therapy and administrators, fall prevention is still difficult because there is no way of knowing when one of the patients is going to fall. That is why it is crucial to educate staffs and patients to help reduce these barriers over time. Fall-related injuries account up to 15 percent of re-hospitalizations in the first month after the discharge from hospital. Falls carry staggering economic costs. Annual acute-care costs related to falls are estimated at $1.08 billion and long-term care costs at $4.9 billion.According to the Centers for Disease Control and Prevention, medical costs related to falls totaled more than $19 billion in 2007–$179 million for fatal falls and $19 billion for nonfatal fall-rela ted injuries. By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion. While falls have a tremendous impact on the patients, they also directly affect a healthcare organization’s cost per case and length of stay. Injuries from falls lead to a 61% increase in patient-care costs. Nearly every nurse can recall an incident in which a patient fell or nearly fell. As patients continue to age and present with increasing vulnerability and comorbidities, their potential for harm increases.Predisposing factorsMulti-factorial Medications: Lots of medications such as benzodiazepine, tricyclic antidepressant, selective serotonin uptake inhibitors, and trazadone should be identified as high risk for fall. Most elderly long term care residents are reffered to as â€Å"polypharmacy†which is high risk for fall. Education (reorientation): fall prevention programs should be reoriented as much as possible call to increase safety awareness and r educes the fear of falling. Environment: frequently check environment that is very important. Web areas, clutter, poor lighting, and other environmental factors can reduce the risk of falling in nursing home.How to prevent fall1. After completed fall assessment upon admission, initiate fall precaution as soon as possible. Before appropriate technology and equipment can be chosen to help prevent falls, the patient’s fall risk, functional readiness, and mobility must be assessed. Most of patients consider for high risk for fall. Post-fall assessment is important because a lot of incidents are related to fracture, which is a serious matter. Fall prevention interventions should be assigned that are appropriate for individual based on the result of fall risk assessment2. Educate patients about predisposing and precipitating factors. This supports them to understand and enable them to do multi-disciplinary approaching. It should be built on initial risk screening results and involv e not just nurses but an interdisciplinary team of physicians, pharmacists, and physical and occupational therapists.3. Educate about basic knowledge of medication to CNA who is closely giving care than others.Essential implementation of safety caring in long term care facility1. Transfers: Patients rise from a sitting position to a partial stand to keep the center of gravity relatively low. Transfer the patient to the stronger side with the wheelchair at approximately 45-degree angle from the bed. If patients are unable to bear weight through the lower extremities due to weakness, place one end of the transfer board under the patient between the buttocks and back of the thigh, then place the other end in the seat. Have the patient push up with the arms while slightly lifting the buttocks and slowly moving toward the wheelchair.2. Get belts: during transfer, obtain a standing position, turn and sit onto another surface or stand and walk to a new location, then turn and sit onto a new surface. The belt is better choice than the alternative placing one arm under the patient’s arm for the lift and holding onto the patient’s clothing or gown, which can injure the arm or shoulder, but care individual need to basic training from PT/OT personal.3. Bed and toileting safety: height- adjustable beds, safety rails, and raised toilet seats can reduce fall. To promote safety when the patients stands or for transfers, raise the bed. Otherwise, a weak patient who tries to stand could fall. Transfers onto and off a toilet, fix raised toilet seats and safety rails on either side of the toilet are needed. Patients can hold onto these to steady themselves when transitioning from a standing to a sitting position, and to push off from while standing after toileting. If the patient is unable to safely ambulate with assistance to the bathroom, provide a bedside commode.4. Mobility devices: mobility devices such as canes, walkers, and wheelchair mobility should be ma de sure that it has been evaluated and deemed approporiate and in a good working order. If it isn’t proper working contact a physical therapist for further evaluation. All mobility devices should be adjusted to the patient’s height and other characteristics as appropriate.5. Walkers: Nurse can walk next to the patient as the patient ambulates. Walker with seat must lock the brakes when ready to sit or transfer and complete the activity. Patients who become dizzy from nauseas or orthostatic can easily turn and sit on the seat without falling. This arrangement is much safer than having another staff member trail behind with a wheelchair and lower the patient to the wheelchair seat if patient becomes fatigued or dizzy or loses balance.6. Wheelchairs: individualized wheelchair prescriptions must be customized to each patient because the standard wheelchair does not work for all patients. For example, a dementia patient with memory deficits cannot be expected to remember to lock the wheelchair.What to do for caring for high risk fall patient1. Visual check every 2hours or more often 2. Keep bed in low position all the time 3. Lock wheels, call light, water pitcher, urinal in easy to reach. 4. Provide well lit path 5. Check shoes ; check well fitting, floppy shoes or loose clothing 6. Keep room clutter free, floor dry ad not slippery 7. Check bed, wheelchair alarm, or bedside mattress as ordered 8. Promptly answer for need help with call bell systemEvaluationVerify the education and providing data is effective or not. Throughout this education program, it is important to find a way to help nursing staff deal with issue of patient fall. Staff members recognize how vital it is to be aware of the possibility of fall during care. This program provides gaining more confidence to staff in their abilities to work with care. Even though falls can’t be prevented 100%, applications of fall prevention educations will create a safer, healthier, and happier place for both patients and staffs.
Thursday, January 2, 2020
The Lottery Examples Of Literary Terms, And A Journal Entry
A. 1) The tone, mood or atmosphere in the story begins with that of happiness and euphoria, by setting us up with a wonderful day that most everyone would enjoy. (Quote: â€Å"The morning of June 27th was clear and sunny, with the fresh warmth of a full-summer day†¦Ã¢â‚¬ [pg147] ) However, later on in the story, it takes a different tone, and by the very end the tone is that of panic, disdain and fear. (Quote: â€Å"‘It isn’t fair, it isn’t right,’ Mrs. Hutchinson screamed, and then they were upon her.†[pg 155] ) 2) The conflict in this story is person versus environment (society) And to a lesser extent, person versus person. (Quotes: â€Å"I tell you it wasn’t fair, you didn’t give him time enough to chose. Everybody saw that.†[pg154] â€Å"‘Be a good sport,†¦show more content†¦Summers. ‘You didn’t give him enough time to take any paper he wanted, I saw you, it wasn’t fair.’†[pg 153]†5) The situational irony in the story is that in the beginning a fun filled happy day with a fun contest is expected and what actually occurs is something barbaric and murderous. (Quotes: â€Å"They stood together away from the pile of stones in the corner and their jokes were quiet†¦Ã¢â‚¬ [pg148] â€Å"Tessie Hutchinson was in the middle of a clear spot by now, and she held her hands out desperately as the villagers moved in on her, ‘It isn’t fair,’ she said. A stone hit her on the side of the head†¦Ã¢â‚¬ [pg 155] ) 6) The lottery itself is symbolic of the paradox of the human psyche between compassion on one hand and the thirst for violence on the other. An example of this is when the children are enjoying a break from school, playing and being children, and suddenly they are being joined by adults stoning a mother to death. It appears that this tradition has blinded these people, making them unable to think of a reason why this possibly should not be happening. (Quotes: â€Å"Bobbie Martin had already stuffed his pockets full of stones and the other boys soon followed his example selecting the smoothest and roundest stones.†[pg147] â€Å"The pile of stones the boys had made earlier was ready. Tessie Hutchinson was in the center of a cleared space by now, she held her hands up desperately as the villagers moved in on her, ‘It isn’t fair,’ she said. 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