Sophoan Davis 2 postsRe: Topic 1 DQ 2

The first education recommendation from the IOM I agree with is to allow “interprofessional team training of nurses, physicians and other health care providers” (2011). I attended a leadership course a few years ago. The group consisted of physicians, nurses, pharmacist, laboratory technicians, nurse aids, etc. It was eye opening to listen to the stories of personal and organizational struggles from different fields. We realized we had common ground: Patient-centered care. Also, I currently work in a program with multidisciplinary team members. My team consist of a medical director, a nurse practitioner, a psychologist, two physical therapist and two registered nurses. It is rewarding to work with providers who are open to discussing a patient’s care plan, bounce ideas and hear suggestions. Allowing interprofessional team training will influence comradery which in turn will boost quality patient care.

The second education recommendation from the IOM I agree with is to allow nurses to move seamlessly through the education system to higher levels of education (IOM, 2011). I believe the most difficult thing for working nurses is to balance work and school. If the education program structure can allow for this, we will have more nurses in school with higher degrees. “Nurses with graduate degrees will be able to replenish the nurse faculty pool; advance nursing science and contribute to the knowledge base on how nurses can provide up-to-date, safe patient care; participate in health care decisions; and provide the leadership needed to establish nurses as full partners in health care redesign efforts” (IOM, 2011).

The APRN role is evolving. The realization of the role and responsibilities are becoming widely known and discussed. Patients are sharing quality of their care. With the shortages in primary care providers, more people are trusting and turning to APRNs. And rightly so.

Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US); 2011. 1, Key Messages of the Report. Available from: https://www.ncbi.nlm.nih.gov/books/NBK209881/

 Topic 2 DQ 1

According to the CDC one out of four children have been victims of abuse in their lives and action needs to be taken immediately to prevent it. Abuse is defined as any harm, potential harm, or the threat of harm to children 18 years and younger by a parent, caregiver, or someone in a custodial role. There are four types of child abuse 1. Physical, 2. Sexual, 3. Emotional, 4. Neglect. Neglect is the most common of the four, followed by physical abuse, (The Red Flags of Child Abuse, 2021)

My discussion reflects on the infant. During a thorough assessment as the professional we must advocate for this age group. Signs of neglect would be observed as poor hygiene, poor growth patterns/developmental delays, inappropriate clothing for the season, and hunger. The physical signs of abuse to look for include bruising, burns, welts, injuries that mirror the shape of an object, fractures, dislocations, and new/healing lacerations. Another major finding is a brain injury which may cause retinal hemorrhages caused by shaken baby syndrome. The signs of possible sexual abuse to look for are redness and swelling of the genitalia, bleeding, recurring urinary tract infections, and signs of sexually transmitted diseases. Early recognition is crucial to initiate treatment to minimize or prevent further abuse, (The Red Flags of Abuse, 2021).

Parents have a great deal of leeway in decision making on medical care and religious beliefs. In some states religious beliefs that prevent seeking medical treatment for a child is not considered abuse. It becomes complicated when parents deny medical care treatment for their child, especially when they feel that their religion is more powerful. In the United States religious freedom is valued to the extreme where states grant parents the right to refuse life saving medical treatments if the parents can prove that administering treatment violates their religious beliefs. Such religions include Christian Scientist, Jehovah’s Witness, and Orthodox Jews, (The Red Flags of Abuse, 2021).

In the state of Georgia, the procedure for reporting child abuse is to call 911 if you conclude that the situation needs immediate attention. If no immediate danger is present, contact your local police department and The Division of Family Services, (DFCS). DFCS is a child protective service and reporting can be don 24 hours a day and 7 days a week, (Department of Humans Services, DFCS).

As Professional Nurses we have a responsibility and are mandated to report child abuse. Laws used to mandate reporting child abuse has triggered global controversy. The definition of child abuse differs between jurisdiction and the lack of a uniform definition causes problems for mandatory reporters. Reporting includes notifying child protective services, and law enforcement. It is imperative to report child abuse quickly to ensure the child’s safety. Reporting abuse is not an accusation it is simply a request for an investigation and assessment, (Liu,B. 2019).

References:

Respond to the above post with 200-300 words APA format with references supporting the discussion

Reply to my Peers

Peer 1

Initial Post: Summarize the pathophysiology of Peptic Ulcer Disease as compared to GERD and explain which one of his symptoms most closely represent. Support with evidence.

Peptic ulcer disease is a break or an ulceration in the mucosal lining of the lower esophagus, stomach, or duodenum which is supposed to protect these organs (McCance, 2018). Peptic ulcers may be an acute finding or can occur chronically. There are risk factors that can increase the occurrence of peptic ulcer disease including, genetics, smoking, COPD, obesity, acute pancreatitis and excessive use of alcohol and/or NSAIDs. According to Yim, Kim & Lee, peptic ulcer disease may also be caused by helicobacter pylori (H. Pylori) infection (2021). The most chronic type of peptic ulcers are known as duodenal ulcers. When duodenal ulcers are present there is chronic intermittent pain in the patient’s epigastric area. The pain begins 30 minutes to 2 hours after eating when the stomach is empty and is relieved with food and antacids. 

GERD an acronym for gastroesophageal reflux disease. GERD occurs when there is an increase in acid and pepsin refluxes from the stomach in the esophagus that causes irritation to the esophagus. This irritation is known as esophagitis. The lower esophageal sphincter is typically lower than normal due to transient relaxation and/or weakness of the sphincter (McCance, 2018). Increased abdominal pressure such as vomiting, coughing, lifting, bending, obesity or pregnancy can also contribute to the diagnosis of GERD as well. The symptoms of GERD are as follows: Heartburn due to acid regurgitation, chronic cough, asthma, sinusitis, and/or upper abdominal pain within the first hour of eating.

The symptoms that the patient has presented with are closer to the symptoms that are present in peptic ulcer disease due to the presentation of daily aspirin usage, pain and burning sensation in the mid sternum and epigastric region, and daily alcohol consumption. His occasional coughing could be related to GERD, but his symptoms seem to be more within the category of peptic ulcer disease. 

Reference

McCance, K.,L., & Huether, S., E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed) St Louis, MO: Mosby Inc; ISBN-13: 978-0323583473. 

Yim, M. H., Kim, K. H., & Lee, B. J. (2021). The number of household members as a risk factor for peptic ulcer disease. Scientific Reports, 11(1), 1–10. https://doi-org.su.idm.oclc.org/10.1038/s41598-021-84892-5.

Peer 2

Gastroesophageal Reflux Disease

            Gastroesophageal Reflux Disease is a condition cause by abnormalities of lower esophageal function, esophageal motility, gastric motility, and gastric emptying. This occurs when the resting tone of the lower esophageal sphincter is lower than normal. There are a multitude of factors that contribute to this development including vomiting, coughing, lifting, bending and obesity. These influence the tone of the esophageal sphincter due to the increased abdominal pressure they cause. 

            Disorders such as gastroparesis, gastric ulcers are associated with delayed gastric emptying which lengthens the time span in which reflux is possible and increases the acid content of Chyme. Exaggerating the symptoms of reflux. 

            The severity of this condition depends on the composition of gastric contents and esophageal mucosa exposure time. When gastric contents are highly acidic or contain bile salts and pancreatic enzymes reflux can be severe. In the individual with weak esophageal peristalsis, reflux chyme remains in the esophagus for a longer period of time causing damage to the mucosa which can eventually become cancerous. 

            Symptoms of GERD include heartburn, chronic cough, asthma attacks, laryngitis, sinusitis, weight loss and upper abdominal pain within an hour of eating. Symptoms may be exacerbated when laying down or after consuming alcohol or acidic foods. 

Peptic Ulcer Disease

            Peptic Ulcer Disease occurs when there is a break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum. Peptic ulcers can be singe or multiple, acute or chronic, and superficial or deep. Superficial ulcerations are called erosions because they erode the mucosa by but do not penetrate the muscularis mucosa. True ulcers extend throughout the muscularis mucosa, damaging blood vessels, causing hemorrhage or perforating the gastrointestinal wall. 

            The chronic use of NSAIDs suppress mucosal prostaglandin synthesis, decreasing bicarbonate secretion and mucin production while increasing the secretion of hydrochloric acid. H. Pylori, a bacterium, typically found in the stomach, interacts with NSAIDs causing disruption of the mucosa, exposing submucosal areas to gastric secretions and auto digestion, leading to erosion and ulcerations. 

            Symptoms include chronic intermittent epigastric pain, often occurring 30 minutes to 2 hours after eating and in the middle of the night. This pain may be relieved by food or antacids and exacerbated by acidic foods and muscle spasms. Loss of appetite and weight loss are often present in this condition. These symptoms most closely align with they symptoms experienced by the patient in the discussion scenario (McCance & Huether, 2019)

References: 

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2019). Pathophysiology: the biologic basis for disease in adults and children (8th ed.). Elsevier

module 05 Content

1. Purpose of Assignment
   The goal of creating a newborn nutrition teaching presentation is to prepare the nursing student to provide evidenced based education to the pre and postpartum client on lactation.
   Competency
   Select safe, effective nursing interventions for the postpartum client and newborn.
   Instructions
   Create a teaching tool to promote breastfeeding. The material created to educate new mothers on breastfeeding will influence the mother’s decision to breastfeed, including duration, based on the quality and content of the teaching.
   Assignment Requirements
   Your teaching tool will be a trifold and must include this relevant content for a mother considering the risks and benefits of breastfeeding a newborn.
   
   • Explain how breast milk is formed in the mammary glands and the physiology of breast milk
   • Include two 2020 National Health Goals related to newborn nutrition to support breast feeding as the best choice. See the link below:
   • https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health
   • Discuss the advantages of breastfeeding related to immunities transferred to the newborn
   • Describe three additional benefits of breast feeding with supporting rationales
   • Include at least two supporting resources
   • Document must be written
   • Format
   • Standard American English (correct grammar, punctuation, etc.)
   • Logical, original and insightful
   • Professional organization, style, and mechanics in APA format
   • Submit document through Grammarly to correct errors before submission
   • Resources
   • https://guides.rasmussen.edu/apa
   • How do I create a patient education brochure/pamphlet?
   • Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.