All about nursing – Learning & Sharing
The hypertension guidelines recommend that high risk patients should begin medications if their average BP is ≥130/80 mmHg. For lower risk patients (no history of cardiovascular disease or an ASCVD risk <10%) medications are recommended for primary prevention when their average BP is ≥140/90 mmHg.
高血压指南建议，如果高危患者的平均血压为 ≥130/80 mmHg，则应开始药物治疗。对于低风险患者（无心血管疾病病史风险 <10%），当平均血压为 ≥140/90 mmHg 时，建议使用药物进行一级预防。
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The most recent American College of Cardiology/ American Heart Association clinical practice guidelines define hypertension as systolic BP greater or equal to 130 mmHg or diastolic BP greater or equal to 80 mmHg. Patients are then classified as having either stage 1 or stage 2 hypertension. Stage 2 usually requires medication in addition to lifestyle modifications to control blood pressure. If the diastolic and systolic blood pressure readings fall into different classifications, the higher classification is used. To make a clinical diagnosis of hypertension, two or more blood pressure readings obtained over two or more visit must fall into a particular classification (but not during acute illness or pain).
最新的美国心脏病学会/美国心脏协会临床实践指南将高血压定义为收缩压大于或等于 130 mmHg 或舒张压大于或等于 80 mmHg。然后将患者归类为患有 1 期或 2 期高血压。2 期高血压除了改变生活方式外，通常需要药物治疗来控制血压。如果舒张压和收缩压读数属于不同的分类，则使用较高的分类。为了对高血压进行临床诊断，在两次或多次就诊中获得的两个或多个血压读数必须属于特定类别（但不是在急性疾病或疼痛期间）。
Continue reading “Hypertension 高血压 (reading & sharing) #1”Breast cancer refers to both in situ and invasive carcinoma of the breast. Breast cancer can be of either ductal or lobular types. Breast canceris nearly exlusively the disease of women, with only 1% of breast cancers occuring in males. It is the most frequently diagnosed cancer in women and leading cause of death due to cancer in women 20-59 years old. More than 50% occurs in women over age 61.
Risk factors include hormone exposure, family or personal history, lifestyle factors, exposure to radiation; smoking; obesity; early menarche; late menopause; postmenopausal hormone therapy; excessive alcohol use; nulliparity; 5% to 6% are associated with a genetic mutation.
Continue reading “Breast Cancer – Carcinoma of the Breast (Reading & Sharing)”Palliative care is available to acutely ill patients, may be provided along with disease-specific, life-prolonging treatment. Meticulous attention to be prevention and relief of pain and other burdensome symptoms is a basic part of quality palliative care. Yet, comprehensive palliative care includes much more. Psychosocial and spiritual care, counseling, and guidance in choosing among treatment options, and assisting with practical support for patients and caregivers are all equally fundamental components of comprehensive palliative care. It is critical to stress that palliative care should be provided from the time of diagnosis of a serious, debilitating, or life-limiting illness. Palliative care should be an integral part of healthcare aimed to achieve best possible outcomes including optimal quality of life, function, and opportunities for personal growth across the life span. Palliative care can and should be provided along with any disease-modifying treatments. And, yes, for some people with advanced illness, palliative care may be the main focus of care.
寧養服務適用於任何人——無論什麼年齡, 種族, 文化, 背景或宗教, 而且大多數服務是免費的。您可以在病情的任何階段使用寧養服務，這並不僅僅是為生命即將到達終點的人而設。使用寧養服務並不意味著生命沒有希望，您已經“放棄”或您的家庭不在乎您。您可以在接受寧養服務的同時繼續治療。
Continue reading “Palliative Care (宁养服务)”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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