Meningitis is the inflammation of the dura mater, arachnoid, and pia mater, the layers that cover the brain and the spinal cord. There are two types of meningitis, the aseptic that is the most familiar form and the bacterial. In the United States, the incidence of meningitis is 1.3 to 3 cases per 100, 000 persons, more than 1 million cases annually worldwide and approximately 135,000 cases of deaths globally. It affects both male and female from the neonates to the geriatric patients (Ferri, 2018).
Incidence & Prevalence
Bell’s palsy is a condition when one side of the face becomes paralysis for unknown reasons (Winland-Brown & Keller, 2015). It occurs suddenly in otherwise healthy people. It affects sexes equally with the median age being 40 (Ferri, 2018). The main people being affected are people less than 70 years old and pregnant woman usually in the third trimester or first week postpartum (Ferri, 2018). It also can affect more people with diabetes or has had an upper respiratory infection or flu affecting 40,000 Americans each year (National Institute of Health [NIH], 2017).
The most commonly encountered cause of nutritional anemia is iron-deficiency anemia, is found in infants, the elderly, and middle-aged women. Iron is a nutrient found in food which when ingested is absorbed in the duodenum and upper jejunum. From the digestive system iron is then transported to: 1) the bone marrow for hemoglobin synthesis, 2) Needy tissues such as muscle for myoglobin synthesis, and 3) Reticuloendothelial cells in the Liver to be stored as ferritin and hemosiderin until released for use in the bone marrow to form new RBCs (Eckman et al, 2013).
Iron is an essential part of hemoglobin, myoglobin, cytochrome, and peroxidases due to its role in the structure of heme; hemoglobin stores about 1.5-2.5 g of iron. Iron absorption occurs in the duodenum and is regulated strictly to avoid toxic iron accumulation or deficiency. Oxidation and reduction reactions are necessary for iron to be absorbed, transported, and metabolized. The daily need of an adult is about one milligram of iron, which is satisfied by the daily intake of iron salts and the intake of up to about 10-20 mg iron. The type of food, for example, meat, is an important factor affecting the bioavailability of iron. Other factors include promoters, acidity increases iron absorption or inhibitors (Alaliwi et al., 2018).
Pathophysiology of Osteoarthritis
Osteoarthritis (OA) is primarily a disease of cartilage. Cartilage is a tissue with viscoelastic and compressive properties. It is predominantly composed of type II collagen and proteoglycans. In a normal condition the extracellular matrix undergoes a dynamic remodeling process in which low levels of degradative and synthetic enzyme activities are balanced. When OA is present, the matrix degrading enzymes will become overexpressed. This results in loss of collagen and proteoglycans from the matrix (Ling & Bathon, 2012). Once the articular cartilage breaks down, the progressive formation of osteophytes (bone spurs) protrude into the joint space decreasing joint movement. Some factors that may cause OA may include mechanical injury, genetic and hormonal factors or previous joint damage. Risk factors may include older age, sex, obesity, and bone deformities.
Clinical manifestations of OA usually consist of pain, stiffness and functional impairment. Movement or exercise may aggravate the joint pain. The affected joint may have a decreased range of motion and may appear enlarged. OA often occurs in weight-bearing joints such as hips, knees, cervical and lumbar spine although the interphalangeal and distal interphalangeal joints may also be involved.
Barbara Carper (1978) “Ways of Knowing”–there are four ways that nurse understand practice situations, and they are: