COMMENT1

Ulcerative colitis (UC) and Crohns disease are inflammatory bowel diseases, not to be confused with inflammatory bowel syndrome (IBS). Describe the differences in symptom manifestations, and how those manifestations relate to where the disease presents in UC and Crohns. What patient education is important for each and what treatment options are available? I look forward to reading your comments!

COMMENT2

GI bleeding can occur in the upper or lower GI tract and can be acute or chronic. What are the different manifestations of GI bleeding and how can you determine where the bleed originates based on the symptoms? Discuss the common diagnostics, treatment and patient education for GI bleeding.

Advanced Pharmacology

            A number of large studies have investigated the topic of epidemiology of allergies and much depends on the type and symptoms.  Three studies used a random calling methodology with administration of a survey, with methodologic variations among the studies (Hutyrová & Bystroň, 2018).  Epidemiological studies on representative populations clearly demonstrate a significant general increase of atopic diseases during the last decades, mainly for pollinosis. For the manifestation of an atopic disease both allergen exposure, which leads to specific IgE antibody formation, and the presence of additional realization factors are required. The nature of the latter is still partially unknown.

            Most pharmacoeconomic treatment options for allergies can be obtained from over-the-counter medications.  Lifestyle changes like using air filters and avoiding triggers are important, too.  Prescription antihistamines include Azelastine eyedrops (Optivar), Azelastine nasal sprays, Astelin, Astepro), Carbinoxamine (Palgic) and Cyproheptadine.

            Compared to second generation, H1 antagonists, also called H1 blockers, are a class of medications that block the action of histamine at the H1 receptor, helping to relieve allergic reactions. Agents where the main therapeutic effect is mediated by negative modulation of histamine receptors are termed antihistamines; other agents may have antihistaminergic action but are not true antihistamines.

            Allergies can put a strain on the patient, which underlies the need to educate this patient on how to maintain a state of health that enables him to continue working. Determination of symptoms and identification of allergens will ensure that the patient acquires knowledge on how to adopt preventive measures.

References

Beasley, S. (2018).  Addressing allergies and treatment options. Virginia Quarterly Review, 94(4), 20–27.

Hutyrová, B., & Bystroň, J. (2018). Treatment options for severe allergic asthma and allergic comorbiditie. Advances in Dermatology & Allergology / Postepy Dermatologii i Alergologii, 35(5), 510–515. https://doi.org/10.5114/ada.2018.77243

Comment 1

Principalism has really evolved into a practical approach for ethical decision-making which concentrates on common ground moral principles for autonomy, justice, beneficence, as well as non-maleficence (Döring, 2011). Principalism is also referred to as four-principal approach because of the four ethical principles which entail bioethics.  Let us look at these four principals.

The first one is respect for autonomy. This involves respect for what happens to person’s own bodies. This implies that patients may decide the kind of treatment one want as well as their right to refuse medications, treatment, and surgeries and this decision must be respected by caregivers (Döring, 2011). A good example is blood transfusion in a patient who is a Jehovah Witness believer. Even though the patient totally in need of blood, we must respect the fact that Jehovah Witness followers refuse blood transfusions. The other principle is nonmaleficence. This means doing no harm (Döring, 2011). It implies making of best medical decision as well as abiding by rules and regulations to ensure that patients are safe. This can even be small assignments such as hand hygiene as a way of preventing various infections. The other ethical principle beneficence which involves promoting all that is good (Döring, 2011). It involves striving to improve patient’s health based on the situation. The last principle is justice. This means that fairness within treatment and patient care need to be practiced to carry out justice. Distribution of resources should also be given equally.

These principles should be ranked the way I have written them, i.e., respect for autonomy, nonmaleficence, beneficence, and justice with the first one being the most important. Allowing patients to participate in their treatment and making their medical decisions is very important (CİVANER, 2016). This allows for an equal diplomatic approach to healthcare where both parties are involved. Even when we bring in Christian biblical narrative of creation, redemption, fall, and restoration, autonomy is important because it allows patients to choose what they want (CİVANER, 2016). Eve when God brought a human into the world, He enabled them to choose what is right for them and what is wrong for them.

Comment 2

The four principal approaches consist of four universal ethical principles, it consists of respect of autonomy which states to make autonomous decision that people can take and that should be respected. The other principal is non-maleficence states about an obligation to not harm anyone; beneficence is the action to benefit others and to simply improve any situation. Lastly, justice is the principle that works on the distribution of benefits which also engage risks and costs (Page, 2012). Thus, the principle of biomedical ethics claims that no one principal is more important than the other.  Above all it is the justice that should be given to all. We should be just towards others and always respect others, their decision and autonomy. 

It is first the justice, and then respect after that comes non-maleficence and then beneficence. On the biomedical ethical grounds in the United State, it merges all the other grounds in one sphere and also differentiates one from the other in certain aspects. Justice trumps over all other values or principals and it is the one above all. Therefore, in the case study autonomy has been held above all. The doctor did not pressurize the family to take any decision instead gave Mike and his wife full autonomy to decide the right path and take the call.         

Please read the following introduction and complete the following steps for your initial discussion post:
Theory provides the basis of understanding the reality of nursing; it enables the nurse to understand why an event happens. Please share your thoughts about nursing theory.Which nursing theory do you feel will have the greatest impact on your practice and why.Is there an article that you particularly found most useful in utilizing theory in your area of practice?Which of the units’ discussion questions did you find most challenging; discuss why you chose that one?Which discussion did you find more useful to understand nursing theory and its application in your area of practice?Supplement your discussion with personal and professional experiences.Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.Please be sure to validate your opinions and ideas with citations and references in APA format.  

A 35-year-old comes to the clinic. He states, “It’s getting close to allergy season and I need something to keep me from getting sick. Last year the doc gave me a shot, a spray, some pills, and an inhaler. They worked really  well but I don’t remember what they were. Can I have those things again? I just can’t afford to miss work.”

Please answer the following questions in a narrative format: 

1. Discuss the epidemiology of allergies.
2. What are your treatment options (consider pharmacoeconomic)? Compare first and second-generation antihistamines.
3. What education will you provide to the patient?

 APA 6th format. All posts must be supported by peer-reviewed articles no older than 5 years of publication.