Asthma - 4/30/13

Did you know that asthma affects more than 34 million Americans?  According to the WebMD Asthma Health Center, asthma affects this many people with symptoms such as wheezing, coughing, and tightness of the chest. 

http://www.webmd.com/asthma/default.htm

The above link will take you to the main home page for the Asthma Health Center, and from there, you can explore many different routes depending on the information you are searching for.  I chose the WebMD website because it is has an award-winning senior staff and editorial team.  WebMD is widely known for their in-depth, credible information and news.  It is written and edited by medical doctors that have been or are continuing practice. 

Much of the same information found on WebMD can be found in other sources such as the CDC website, Mayo Clinic, and Medical News Today.  WebMD seems to be easier to understand for most people and is directed towards your everyday person that didn’t attend any medical schooling.  They also tend to cover all aspects of care and the multiple variations that come among different people.  WebMD is directed towards parents and families, so it tends to be less intimidating than other informative sites. 

I think one of the main things to take away from the WebMD website is that the cause of asthma is not known.  This means that you should avoid the triggers that are known to correlate strongly with asthma.  Allergies are known to play a large role in whether or not a person develops asthma.  It is also well known that family history and genetics weigh heavy on the chances of having asthma.  Also, whether you already have been diagnosed with asthma or you are trying to prevent being diagnosed, it is important to avoid anything that is harmful to the respiratory system.  This especially includes smoking, second-hand smoke, occupational dusts, or environmental pollutions for example. 

 

All about asthma. (n.d.). Retrieved from http://www.medicalnewstoday.com/info/asthma/

Asthma. (2013, March 27). Retrieved from http://www.cdc.gov/asthma/

Asthma. (2012, May 26). Retrieved from http://www.mayoclinic.com/health/asthma/DS00021

Asthma health center. (n.d.). Retrieved from http://www.webmd.com/asthma/guide/asthma-overview-facts

Honors Credit: Cardiac Nursing

The emphasis of my honors topic is cardiac nursing. Ever since I was little I have been fascinated with how the heart works and its anatomy. This topic is also very near to my heart because I have many family members and friends that have had severe heart problems.  Additionally, the risk of heart disease and obesity runs prevalently high in both side of my family. Since I was young I vowed to always try and live a lifestyle that would prevent these issues, and if possible, help others do the same.

I have selected the American Heart Association (AHA) logo to represent my honors topic because it affects all people on a health promotional level. This organization is well known for promoting and maintaining a healthy lifestyle for your heart and overall well-being.  They provide information regarding nutrition, exercise, warning sign of strokes and heart attacks, stress management and much more educational tips for the young and the old. One way the AHA helps on a community level is by offering CPR courses that millions of health care providers have used.  Also AHA is one of the leaders in research and many people get involved to raise money for cardiac research and health. I remember in grade school our school participated in Jump Rope for Heart. This is a great program because it teaches children within the community, and schools everywhere, the importance of an active lifestyle in a fun and easy way. This event is not only for kids, but encourages teachers and parent involvement (American Heart Association, 2013).

Finally, there are many family theories that can relate to cardiology and the AHA. One in particular that is relevant is the family stress theory. This this theory explains how families react to stressful events that are either expected (ex. parenthood) or unexpected (ex. Illness/ unemployment).  In this event of an unexpected heart attack, this happens simultaneous while other life issues are going on. It can also put other members of a family at risk for break down (Hockenberry & Wilson, 2011). As nurses it is our role to offer coping and other resources to help families focus on getting through these events.  Nurses could use the AHA information for nutrition and exercise guidelines for changing a lifestyle for the individual and family. Another resource is stress management tips for the coping individual and family member. As we can see, this can also be in combination with family systems theory, where the family is made up of parts and that work together as a whole; what affects one members health will  affect the family’s dynamic (Hockenberry & Wilson, 2011). In the case of a heart attack it can affect everyone so it is important to be an advocate for health promotion and coping. One example that shows family systems theory clearly is if a parent was overweight, chances that their children will be overweight are increased due to similar lifestyles and nutrition. Most parents want to be a healthy and be and positive role model for their children, so by helping them with control their health their actions will also affect the lifestyles of their children.

References

 

American Heart Association. (2013). Retrieved from http://www.heart.org/HEARTORG/.

Hockenberry, M.J., & Wilson, D. (Eds.).  (2011). Wong’s nursing care of infants and children (9^th ed)

 (pp.  48).  St. Louis, MO: Saunders/Elsevier.

Wisconsin Air Quality- 4/29/13

According to the AIRNow.gov website, the overall air conditions for the United States ranged from good to moderate. On April 29^th, 2013 most of the central, east, and west areas of the U.S. had an air quality considered good while the Midwest had an air quality considered moderate. On the website good air quality (0-51) on the Air Quality Index (AQI) is considered satisfactory and air pollution poses little or no risk. Moderate (51-100) is acceptable air quality, however in a very small number of people who are unusually sensitive to pollution there is a moderate health concern. Overall, the greater the number on the AQI means a greater level of pollution, directly correlating health concerns. As I looked closer into Wisconsin’s air quality, it was categorized as “moderate.” Today, the state was colored yellow to demonstrate a moderate risk for health concerns; those who are unusually sensitive to air pollutants may experience some side health effects. 

The other categories a state may be categorized as are as follows. Unhealthy for Sensitive Groups (101-150) is when the general public will usually not be affected. Unhealthy (151-200) is where everyone may begin to experience health effects and those that are sensitive experience more serious health effects. Very Unhealthy (201-300) is when everyone is experiencing more serious health effects. Hazardous (301-500) is the worst and health warnings are sent out for emergency conditions; the entire population likely to be effected.

This site was very user friendly, and I had no trouble navigating to find information.  What a parent/caregiver can do as far as using this site is to click on the state of location or type in the zip code to pull up current city. For example, if a parent was taking care of their children in Eau Claire, today would show them that today is “good,” but tomorrow has a predicted index as “moderate.” If a child were unusually sensitive to air pollutants, parents/caregivers could plan out appropriate activities and administer PRN allergy medication as necessary. There is also a Parents Reference Page and a Teacher Reference page that breaks down the AQI for kids. Children are a vulnerable population and often feel the direct effects from air pollution. Because children are developing and often play outside, it is important that they understand what is going on as well. The site explains AQI intended for children from K-1^st grade by differentiating the levels by colors. As children get older, it will be easier for them to communicate how they are feeling and understand why by looking at the “color” for today. There are also games and quizzes available to test children's knowledge on air quality. 

When I first visited the airnow.gov website, one of the things that stood out to me the most was how one state’s air quality could be completely different from another. For example, today April 29^th, 2013 showed Minnesota’s AQI forecast as “good,” but as soon as I looked over at Wisconsin, the AQI was “moderate.” After I analyzed Minnesota a little more closely, the AQI forecast for today and tomorrow including highs/lows does not reach higher than a 38 on the AQI. On the other hand, Wisconsin showed a “moderate” warning for today and tomorrow with a high of 70 in Green Bay.  I thought this was interesting because Minnesota is a large state and all the cities are at little to no health risk. Wisconsin shows risk to those unusually sensitive to air pollution. I wonder what factors may contribute to the differences between these two neighboring states. Population density and location by Lake Superior and Lake Michigan are two factors that may affect Wisconsin’s pollution level along with the increase in temperature.

References

AIRNow. U.S. Environmental Protection Agency (EPA). Retrieved from http://www.epa.gov/airnow/index.html.

Extra Credit: Faith vs Medicine

Article: http://abcnews.go.com/Health/DiabetesResource/story?id=4536593&page=1#.UXntxLWfjsU

      Similar to what we talked about in class, I found one of the earlier articles dealing with the diabetic girl, Kara Neumann, from Wisconsin whose parents refused to seek treatment for her undiagnosed diabetes, which resulted in her death. Of specific interest to choosing this article was when I found that concern was brought to Kara’s Aunt, Ariel Gomez’s attention long before Kara slipped into a diabetic coma. Gomez’s call to the authorities alerted a cause for investigation of the child’s medical condition. Kara’s parents had been using the days during Kara’s declining health to pray for her wellness and not believe in the use of medicine as a cure. This of course brought up a major issue on the ethical standing of the rights a parent has to their child and their religious practices and to what situation calls for intervention by the state for the sake of the child’s wellbeing. This article is quite immensely relevant to the topic of religion and nursing care. As nurse’s we now know situations like these happen, but what we do not know is the best way to go about providing the best care for a patient without stepping on the toes of their personal beliefs and practices.

My questions for you on this topic are:

1. What interventions could have been implemented to Kara’s parent’s that might have prevented her death?

2. How far does the nurse’s responsibility reach in terms of suspecting a case like this? If caught earlier, should it be reported? Why?

3. It is the nurse’s responsibility to remain respectful and not allow personal religious beliefs get in the way of patient care. If asked directly by your patient about your own beliefs that you know are different from theirs, what would you be most inclined to say? (This happened to me once with a patient who had cancer, it was not easy to respond to)    

Vulnerable Populations: April 23, 2013

I found these articles to be incredibly interesting to read and they both got me thinking about the flaws of our health care system and how we can strive to make it better equipped to help people, which is its intended purpose. The article Funding healthy society helps cure health care makes me wonder how many cases that are brought into hospitals and clinics could be prevented by simple interventions such as eating healthier, or eating enough in this specific child’s case. It reminds us that we must focus on the root of the problem instead of just focusing on the problem itself. Some physicians and medical professionals have developed tunnel vision when it comes to the treatment of their patients. Instead of focusing on the patient as a whole they focus solely on the symptoms. As health care providers it is important to remember that there is a face that goes along with these symptoms. The patient’s case is a multifaceted system and in order to provide the best care we must delve into all possible causes of the issue, which may not be exclusively medical.

The second article also discussed problems with health care and associated programs attempting to make a difference. Health Leads is a program of trained college students who provide patients with connections to necessary resources such as food banks. According to the article they serve roughly 9,300 patients and families and the program is quickly gaining recognition and momentum. I think this is an awesome project for college students and a great way for us to help make a difference in our world. Another program discussed in the article was Medical-Legal partnership for children, which brings lawyers into the hospital setting to assist patients with situations where physicians are unable. Examples include unsafe living conditions or domestic violence. This is a beneficial program because it allows people to receive the most appropriate care and assistance. For example if a physician is consistently seeing a patient with problems associated with domestic violence the physician can help to cure the patient of their symptoms, but we are not solving the ultimate issue at hand. In this case a lawyer would be able to fix the problem at the source instead of just treating the associated symptoms.

Poverty has a huge effect on the health of an individual or a family. If people are unable to afford enough food to meet adequate nutritional requirements they risk becoming malnourished. According to the U.S. Nation Library of Medicine malnutrition can cause mental and physical disabilities, illness and death (2011). A non-medical problem associated with hunger and lack of food is decreased focus and attention. Children who go to school hungry have a harder time focusing on the task at hand than a child who ate a nutritious breakfast. Several schools have created programs to assist children in this situation by offering free or reduced-cost meals. Adults who go to work hungry may face the same issues. It is hard to be focused and alert when all you can think about is your growling stomach. It is obvious that lack of focus will lead to poor performance in schools and at the work place. Without proper education it is hard to get a well paying job, and poor performance at work may lead to termination. Both of these situations propel the line of poverty that already exists for these individuals.

Families and individuals living in poverty are often times not living at an optimum health status and this can hurt the community as a whole. Exposure to unsafe living conditions, inadequate nutrition and a variety of stressors takes a toll on the health status of people. With limited money and resources they may not be able to seek adequate health care and therefore will remain ill. Disease and illness can travel quickly in run down communities with poor sanitation and limited health precautions. Community-wide pneumonia, TB and influenza are all possible outcomes. Another way that poverty affects a community is an increase in crime. According to Blake Taylor from economics.fundametalfinance.com there are several reasons why areas of poverty experience more crime. The stress of poverty may lead people to participate in crime and other violent acts. Also, people in poverty may see stealing as the only way to obtain material goods (2006). Poverty does not only affect individuals and families, it is a community wide issue that creates a multitude of problems.

Specific interventions that could be done to address and help alleviate the problems associated with poverty are outreach and health teaching. Outreach “locates populations of interest at risk and provides information about the nature of the concern, what can be done about it and how services can be obtained” (Nies & McEwen, 2011, p. 15). This could be achieved by informing people of resources in their community that offer needed assistance. Examples include food banks, free clinics, free immunization drives, family planning clinics and additional resources. Many people are unaware that these types of programs exist and it is our job as nurses to inform our patients of these opportunities. Another intervention would be health teaching, which “communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of the individuals, families, systems, and or/communities” (Nies & McEwen, 2011, p. 15). As nurses we establish a trusting relationship with our patients and we have the opportunity to educate them about ways to live a healthier life. We can focus on the benefits of healthy eating, exercise and techniques to cope with stress to promote the health of our patients. Leading a healthy lifestyle may prevent costly and time-consuming visits to health facilities, which may be of limited access to those living in poverty. Eating a well balanced diet, getting enough exercise and maintaining an appropriate body weight helps to greatly reduce the risk of many diseases and health complications. By teaching patients prophylactic steps to avoid health complications we can attack the problem at the source and save them a lot of time, money and stress.

References

Nies, M.A. & McEwen, M. (2011). Community/public health nursing: Promotion the health of

 populations (5^th ed.) St. Louis, MO: Saunders/Elsevier.

Taylor, B. (2006). Poverty and crime. Retrieved from

 http://economics.fundamentalfinance.com/povertycrime.php

Zieve, D., & Eltz, D., R. (2011). Malnutrition. Retrieved from

            http://www.nlm.nih.gov/medlineplus/ency/article/000404.htm

Vulnerable Populations

          My initial reaction to the article “Funding healthy society helps cure health care” was that of astonishment. As we continue learning through the nursing program and of the importance of patient health history, it is hard for me to think of this as a common problem physicians overlook.

           The article discussed multiple diagnostic testing done for a young patient whose “abdominal pain” was nothing more than hunger. We know through the review of systems that nutrition is an essential role that leads to diagnosing a problem. The NY Times piece that discussed the issues of overlooking the social effects of health is a major problem indeed. New ways of teaching must be instilled in both healthcare workers and in turn to members of the community. A point should be stressed that although testing and imaging provides many answers, it is important to look at all aspects that could have brought the patient there to begin with. Physicians are often overworked and primary care doctors have become a shortage, time and money plays a large role for the way things have become. The hundreds and possibly thousands of dollars spent on this one child for testing could have been put to better use to treat the cause and not just the illness. Impoverished and underserved families are not being educated or directed on what they need to support a healthy lifestyle. Health Lead is a great community intervention that involves college students pursing healthcare to volunteer and practice teaching the importance of preventing illness and is a type of upstream thinking instead of simply treating the illness. In this effort, we as nurses can address community health issues before they become a problem.

           Poverty puts individuals and families at a higher health risk. The environment they live in may not be suitable for optimal health. Living in dirty, small, densely populated areas encourages bacterial growth and heightened disease transmission. Due to lower socioeconomic status, people living in poverty are limited in resources which put them at a knowledge deficit about health risks. Education on nutrition, exercise, sanitation and general healthy living choices must become known to families a

nd individuals who have not had the basic understanding of what health can mean to them and to their community. Poverty makes a community vulnerable to health risks. People living in poverty cannot seek healthcare when they are sick and when they can’t receive care, they are risking exposing the community to illness. Children in the community are greatly affected by the health risks poverty can bring. Children who are not raised with healthy decisions are more susceptible to obesity and can have the foreseeable consequences of unprotected sex and STD transmission among other health issues if they are not being taught healthy living choices.

         Two great interventions to educate impoverished communities involve outreach and referral and follow-up. Outreach programs such as food banks and health safety services to low income families and communities can go a long way to a better way of living. Like Health Lead, reaching out to families about basic nutrition and exercise and referring them to places where they can receive the materials they need, will reflect opportunities of healthy living. With more effort put into these types of interventions, we can hope to have fewer health problems and have visits to the doctor be only for checkups to observe improvement.   

Nies, M.S. & McEwen, M. (2011). Community/public health nursing: promoting the health of populations

          (5^th ed.) St. Louis, MO: Saunders/Elsevier

Extra Credit: Contagion

I had heard of the movie Contagion many years ago when it first came out but never had an interest in seeing it. After listening to the lectures on Epidemiology I became intrigued with the spread of disease and decided to watch it. Overall I really enjoyed that movie and give it 5 stars. I thought that for the most part Contagion accurately depicted the spread of disease and showed the effect it could have on a world wide scale.    

The story begins when Beth, a business woman on a trip to Asia, returns home to the United States and develops what seems to be a cold. However, within two days she ends up having a severe seizures and is sent to the hospital where she suddenly dies.  At first doctors did not realize the severity of this event and they inform her husband Mitch (played by Matt Damon in the movie) that the cause of death was unknown. Mitch then returns home to find his son Clark dead in his bedroom and realizes that he contracted something very contagious from his mother because Clark had similar cold symptoms a few days prior. The movie then depicted the chain of command that would be activated in the event of disease outbreak starting with the public health department of Minnesota and progressing to the notification of federal agencies (CDC and WHO). Eventually when the gravity of the situation leads to the public there is complete chaos. Though this was a dramatic depiction, I believe something similar would occur if this type of outbreak were to occur in real life.  Investigators attempt to trace the spread of the disease from Beth using descriptive epidemiology and detailing her every move.

It was very interesting to see how the principles discussed in class would play out in real life, of course this was a Hollywood version but nonetheless it gave me a better idea of the work that goes on with health professionals and the CDC behind the scenes and what could occur when such a virulent disease of unknown origin attacks a community.

 Eventually research lead to the creation of a vaccination (an example of primary prevention) and due to the limited quantity they decided to distribute the vaccination based on a birthday lottery. So, people with a birthday on the date drawn were to receive the vaccination first, and so on. 

The basic epidemiological model states that in order for a disease to spread there must be an agent, a host, and environment. The host and environment were revealed at the end of the movie when they showed a flashback of how the virus spread to Beth. An infected bat is shown eating a banana, a piece of the banana drops into a pig pen, the pig eats the banana and becomes infected. That pig is later selected to be butchered. The chef buttering the pig does not wash his hand before shaking hands with Beth and therefore spreads the infection to her.