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Chronic Obstructive Pulmonary Disease (COPD) – Reading & Sharing

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. It is highly prevalent, and as it progresses, causes patients to become too disabled to work, thus creating substantial economic and social burdens. In 2010, U.S. healthcare data estimated the total economic burden from COPD at $50 billion, of which $30 billion was related to direct medical expenditures and the remaining $20 billion related to morbidity, loss of work, and premature death. There are also unacknowledged and unquantified costs including the economic value of care provided by family members and their potential lost wages as they stay home to care for the patient.

As the disease progresses, some patients will choose mechanical ventilation as a palliative treatment option. although the patient with advanced disease is eligible for hospice care, many hospices cannot afford to accept the patient with mechanical ventilation into their programs because this high-tech intervention drives the cost of care beyond the standard insurance reimbursement. Thus, patients and families may be deprived of the benefits of hospice care.

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Pacemaker- Cardiac Pacing (Reading & Sharing)

A cardiac pacemaker is an electronic device that delivers direct electrical stimulation to stimulate the myocardium to depolarize, initiating a mechanical contraction. The pacemaker initiates and maintains the heart rate when the heart’s natural pacemaker is unable to do so. Pacemakers can be used to correct bradycardias, tachycardias, sick sinus syndrome, and second- and third-degree heart blocks, and for prophylaxis. Pacing may be accomplished through a permanent implantable system, a temporary system with an external pulse generator and percutaneously threaded leads, or a transcutaneous external system with electrode pads placed over the chest.

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Metformin- Oral Antidiabetic Drug (reading & sharing)

Metformin (Glucophage) is currently the only biguanide oral antidiabetic drug. It works by inhibiting hepatic glucose production and increasing the sensitivity of peripheral tissue to insulin. Because its mechanism of action differs from that of sulfonylurea drugs, it may be given along with these drugs.

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All About Nursing · CNE self study · Nursing Continue Education

Cystic Fibrosis (Reading & Sharing Part 2)

Bronchiectasis develops early in the course of cystic fibrosis, being detectable in infants as young as 10 weeks of age, and is persistent and progressive. Recent data reveal that neutrophil elastase activity in BAL fluid in early life is associated with early bronchiectasis in children with cystic fibrosis.

Nursing Assessment

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All About Nursing · CNE self study · Nursing Continue Education

Cystic Fibrosis (Reading & Sharing)

Systic fibrosis is an inherited autosomal recessive disease in which abnormally thick mucus affects the reproductive, gastrointestinal, and respiratory tracts. Cystic fibrosis causes respiratory disease, characterized by chronic infection, obstructive airway disease, and progressive decline in lung function. Death is most commonly the result of respiratory failure. The life expectancy of patients with cystic fibrosis has increased to the mid-30s as a result of advances in treatment. Adult palliative care providers will be caring for more patient with cystic fibrosis as life expectancy of these patients continues to increase.

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