Chronic Kidney Disease Free Essay Example, 2000 words

Pathophysiologic changes Chronic Kidney disease affects the normal functioning of the body. According to National Kidney Foundation (NKF), the kidney is responsible for production of hormones called erythropoietin (EPO), which signals the body to make red blood cells (NKF, 2008). When one has kidney disease, the body may not be able to make EPO and this leads to reduced red blood cells which may lead to anemia. Since a combination or a group of cells of the same kind and which perform similar function makes a tissue, the effect of chronic kidney disease on cells affects formation of tissues. An arrangement of tissues of different types forms an organ. Chronic Kidney Disease affects production of red blood cells, a situation that leads to lose of blood. All organs in the body require blood for their operation. For example, the circulatory organ supplies blood from the heart to all parts of the body and lack of blood due to kidney failure may lead to total failure of body organs and lead to death. Clinical symptoms and complications Clinical manifestation on kidney failure shows that between stages 1 to 3 where glomerular filtration rate (GMF) is greater than 30 mL/min/1.73m2, patients with chronic kidney disease do not show symptoms of the disease (Arora, 2013). We will write a custom essay sample on Chronic Kidney Disease or any topic specifically for you Only $17.96 $11.86/pageorder now When clinically tested for loss of GMF, they do not show water or electrolyte imbalance or metabolic disturbance symptoms. These symptoms turn clinically manifest with chronic kidney disease at stage four to five where the GFR is less than 30 mL/min/1.73m2. However, people with other conditions associated with positive symptoms of the disease turn vulnerable at earlier stages. Clinical manifestation in patients with the disease shows them to accumulate multiple toxins with unknown identity and spectrum. At the fifth stage also problems in metabolism show malnutrition of protein energy, muscle weakness and lean body mass loss. There are also changes in water and salt handling by the kidney, which cause peripheral edema and high blood pressure (Arora, 2013). Other clinical manifestations include pericarditis, encephalopathy, peripheral neuropathy, and gastrointestinal symptoms, among others. Complications with their underlying pathophysiology The possible complications of chronic kidney disease are anemia, which is a result of low hemoglobin levels. This limits the amount of oxygen that reaches many parts of the body (Nordqvist, 2013). The disease can also affect the central nervous system, which controls all body organs.

The American Dream - 1011 Words

Brie Alford HNRS 195H (01) Fall 2015 Short Essay #1 We, as humans, are meant for â€Å"something more than mere survival† (FDR Economic Bill of Rights). We are meant for complex ideas, groundbreaking inventions and technological advances, a sense of community, and a place where freedom and opportunity run rampant throughout the streets. We are meant for the American Dream. I fear, however, that as time has passed, America has lost sight of the true ideals entrenched in the idea of the American Dream. Americans seem to believe that because of their mere presence in America they should be clothed in the finest silk and own a house the size of Texas. We seem to believe that our freedom of speech inherently grants us the right to degrade others. We seem to believe that because we live in America, everything should be handed to us on a silver platter. We, as a nation, seem to have forgotten the men who â€Å"[pledged their] Lives, [their] Fortunes, and [their] Sacred Honor† in exchange for this dream, and the responsibility we have, as Americans, to respect and appreciate the opportunities that have been given to us; namely the right to freedom, opportunity, and the pursuit of happiness (Declaration of Independence). The American Dream grants the right to freedom. I perceive freedom as the right to be, act, and do as I please, so long as my actions do not infringe upon another’s rights. As Lyndon Johnson explained, The American Dream does not guarantee â€Å"the right to holler fire in aShow MoreRelatedImmigrants And The American Dream1362 Words   |  6 PagesImmigrants and the American Dream In the article â€Å"The American Dream†, by James Truslow Adams in The Sundance Reader book, he stated that the American dream is that dream of a land in which life should be better and richer and fuller for everyone, with opportunity for each according to ability or achievement. It is a difficult dream for the European upper classes to interpret adequately, and too many of us ourselves have grown weary and mistrustful of it. It is not a dream of motor cars and highRead MoreThe American Dream By Kimberly Amadeo1637 Words   |  7 PagesNowadays, a large number of people migrate to the United States to work and achieve the American Dream. According to the Article â€Å"What is the American Dream?† by Kimberly Amadeo, â€Å"The American Dream was first publicly defined in 1931 by James Truslow Adams in Epic of America. Adam’s often-repeated quote is, ‘The American Dream is that dream of land in which life should be better and richer and fuller for everyon e, with opportunity for each according to ability or achievement.’† There are many peopleRead MoreAnalysis Of The Movie The American Dream 754 Words   |  4 Pages Nyreel Powell Ms. Jones American Literature 1 June 2015 The American dream in A Raisin in the Sun Have you ever had a dream and it didn’t come how you wanted it to be? Have you ever had accomplishments that you wanted to achieve but people were getting in the way of them? The four main characters in this book all have good dreams but there are people in the way of getting to those dreams or their dream is too high to accomplish. A Raisin in the Sun a play written by Lorraine Hansberry, andRead MoreSister Carrie and the American Dream1618 Words   |  7 PagesThe American Dream is surely based on the concept of â€Å"Life, Liberty and the Pursuit of Happiness† but it is above all, a matter of ambition. James Truslow Adams, an American writer and historian, in 1931 states: life should be better and richer and fuller for everyone, with opportunity for each according to ability or achievement†, which not only points towards a better standard of living for Americans but also denounces a degree of greed in the US society. Ambition not only â€Å"killed the catâ₠¬  butRead MoreGrapes Of Wrath And The American Dream1644 Words   |  7 PagesThe idea of the American Dream is ever changing depending on the person and the time of life that person is in. Although the main ideas of the American Dream remain the same to be educated, economically sound, healthy, to have a family, and equal rights. Many great films and works of literature were created to show case all the different ideas people have for their American Dream. The film â€Å"Grapes of Wrath† directed by John Ford and the poem â€Å"I Will Fight No More Forever† by Chief Joseph, both depictRead More Destruction of the American Dream Essay2145 Words   |  9 PagesDestruction of the American Dream I’ve talked about it in the past, the destruction of the American Dream. Always, there have been papers, writings, and thoughts that quantify a particular section of its ultimate demise, be it due to money, education, or sexuality. Maybe the destruction cannot be viewed as a singular event or cause. Perhaps instead it must be examined as a whole process, the decay and ultimate elimination of a dream. Self destruction, if you will†¦ Mr. Self Destruct Read MoreSuccess As One Of The American Dream1137 Words   |  5 PagesApril 2015 Success as One of The American Dream When we hear the word â€Å"success†, we often think of wealth and money. To some people, the embodiment of being success is earning a lot of money. In fact, the concept of success is primarily based on how much money a person earns. However, each person views the definition of success differently. One way to define success is something that has more to do with flash than it does with substance. John Wooden, an American basketball player and coach viewRead MoreJim Cullen And The American Dream2081 Words   |  9 Pages The American Dream, as defined by Cullen, is starting your goal off with a little and ending with more; it s like a business, you invest in it in order to gain more money. Usually, people will define the American Dream as being able to achieve your goal because everyone is offered opportunities. Cullen does acknowledge that people are born with different opportunities, so he talks about the good life. The good life describes different factors that determine your opportunities. Throughout the otherRead MoreFactors Influencing The American Dream1834 Words   |  8 Pagesindividual to succumb or to not succumb to the seductions of crime. These three factors are brilliantly portrayed in the television show, Breaking Bad and the novel, The Stick Up Kids. The American Dream is what many American citizens strive for. However, not all of those citizens are able to achieve the American Dream through a legal pathway. The reason an indivudal may not being able to do so is because of his or her background factors. It is important to note that background factors are a fractionRead MoreShark Tank And The American Dream1755 Words   |  8 PagesShark Tank and The American Dream The TV show Shark tank embodies everything the American dream represents. The show obtains successful Entrepreneurs ready to invest their own money into other Americans wanting to be just like them, reaching the American dream and become a successful entrepreneur. The show presents entrepreneurs working towards the goal of creating a business to not only gain wealth but also change the way we live today. The show is to keep the American dream alive and well while

Why I should go to the promotion board Free Essays

Here are a couple of reasons why I believe I should be go to the promotion board. First, I’m ready to further my career as a Non Commissioned Officer. Being the best I can be is all I’ve ever wanted and I’m ready to take the next step in the Army with being promoted to Staff Sergeant. We will write a custom essay sample on Why I should go to the promotion board or any similar topic only for you Order Now Secondly, I’m ready to take on more responsibility as that shows that I’m becoming a better leader because with more rank comes more responsibility. I feel that I am more than qualified to attend the promotion board. I have more than enough experience as an NCO that this would be a prominent move In the right direction. In these current times I feel that by going to the promotion board upon passing It I will be able to Impose my will as a Staff Sergeant and lead more soldiers to becoming great leaders themselves. I am deserving of this opportunity and have been waiting my chance for a great while now. This is the time and this is the season or a break through. In closing, I’m not asking for too much but to be afforded the opportunity to at least have a chance to attend the promotion board. I will be well prepared and motivated to do my best at the board. This will be a great step towards my career progression. My family would be proud of me, and this would be one of my most recent accomplishments, among many. I want to do so much more for the Army, but I feel limited at the level I am at this moment. I would greatly appreciate this opportunity ND once I’ve gone to the board, you will understand why I feel the way I feel about why I should go to the board. Thank you. Why I should go to the promotion board By AP_daddy SST Phillips, Antennae. Can be is all Vive ever wanted and I’m ready to take the next step in the Army with than enough experience as an NCO that this would be a prominent move in the right passing it I will be able to impose my will as a Staff Sergeant and lead more soldiers and once Vive gone to the board, you will understand why I feel the way I feel about. How to cite Why I should go to the promotion board, Papers

Nursing Case Study Accute Heart failure

Question: Discuss about the Nursing Case Study for Accute Heart failure. Answer: Explain the pathogenesis causing the clinical manifestations with which Mrs. Brown Presented. The heart failure mostly occurs when the heart is unable to pump sufficiently the blood in the body to meet its needs. Mrs. Brown was diagnosed with an acute heart failure. The acute heart failure constitutes a clinical syndrome known as heterogeneous, in which the pathophysiology is very complex and it is not completely understood. Nonetheless, based on the diversities of the clinical presentations, there are various types of the pathophysiological mechanisms along with some factors that trigger the circulatory decompensation to be involved. Therefore, acute heart failure can be defined as the heterogeneous syndrome of the various signs and the symptoms, which exhibit on the onset rapidly and then worsen the heart failure, which may entail an urgent therapy. (Valente, Voors, Damman, Veldhuisen, Massie, Connor Davison, 2014) The acute heart failure often develops in either days or hours that can be life threatening. During the heart failure, there is a drastic drop in the cardiac ou tput. On the case of Mrs. Brown, her case was an exacerbation of a chronic disease. Various conditions that have led to the chronic heart failure include the high blood pressure, inherited heart defects and coronary disease or the inflamed heart. It is important to note that the heart failure and the cardiovascular disease in general can be genetic. Sometimes one of the chronic conditions can lead to an event of acute. (Valente, Voors, Damman, Veldhuisen, Massie, Connor Davison, 2014) The major causes that may associated with the acute failure are a blood clot in the lungs, an infection; there are severe irregular heartbeats, an allergic reaction and an infection. There are also aspect of the risk factors that can lead to the heart failure and a combination of these factors can increase the heart failure. These are a high blood pressure, having an irregular heartbeat, the sleep apnea which the problem breathing while sleeping. Some of these problem were exhibited by Mrs. Brown like she had arbor normal heart beat, severe dyspnea and her pulse rate was high. (Deedwania, 2012) The pathogenesis causing Mrs. Brown manifestation was systolic failure in which there was a dysfunction on the left ventricle. This was mainly caused by any of the multiple disorders that may damage on the left ventricle on its contractile functions. Some factors that may have caused this condition were insufficient ejection fraction, there was reduced cardiac output on the patient, and there was reduced blood pressure and a fluid retention on the patient. (Valente, Voors, Damman, Veldhuisen, Massie, Connor Davison, 2014) On the reduced cardiac output, the body is not able to compensate for blood that is pumped for the needs of the body. The cardiac output is caused by the inability of the heart to generating enough output, which may lead to the reduced flow of the blood to the brain, and some of the other vital organs. The symptoms may include fatigue, and the low urine output. She also exhibited dyspnea where she had exertional breathlessness where there is an increased pressure on the left ventricle, which may be due to the nocturnal fluid that has been redistributed and enhanced on the renal reabsorption. Explain two high priority-nursing strategies to manage on Mrs. Brown case and provide evidence based rationale for the strategies. One of the strategies the nurse could employ would be an ongoing monitoring and management of the patient. The management of the acute breathlessness can be carried out simultaneously with the diagnosis. When the diagnosis of the acute heart failure are made there should be administering of the diuretic in order to relieve dysponea. Moreover, the dose that is administered should be low to reduce on the fluid congestion and thus balance on the positive action to any of the potential negative effect on the functions of renal. (Gardner, McDonagh Walker, 2007) There is need for the close monitoring of the renal functions, the output of the urine and the balance of the fluid. The ongoing monitoring of the response to the treatment and the cardiopulmonary status is important by the nurses in order to close monitor on the key parameters of haemodynamic. This would help the patient in that there is no under treatment or prevent the underlying condition do not deteriorate further. A warning score that is allocated to the vital signs is outside the pre-agreed ranges. These point are then summed together to provide a single composite score. If the score increases it would identify the patients that would benefit from escalation of the monitoring or even treatment. (Deedwania, 2012) Nonetheless, the escalation and the alterations in the management are made in accordance with the score. The use of the close monitoring strategy entail provision of a care environment where the nurses have adequate time and provide the expertise to be able to identify and respond to any changes that are exhibited on the physiological data. There is recognition between the adaptation between the competences of the nurses and the quality of the care they have provided. Therefore Mrs. Brown would receive an in patient care on the specialized cardiology ward and she would be cared by a nursing staff that have specific expertise in the management of the needs care. Moreover, the nurse would identi fy on the exact model to adapt on her conditions Patient Education strategy The hospital is also an ideal time for provide education in regards to the heart failure the monitoring and the management. In some hospitals on admission are preventable if the heart failure worsening is detected early enough. Some patients families wish to get involved in the self-care in order to monitor on their conditions. There should be introduction of these concepts during the stay in the hospital of the patients. In most of the case there can be a mismatch that exists between ta patients understanding on their management of the heart failure and the information, which is often provided by a health professional. In a survey done it showed that the patients only recalled approximately 45% of advice given on self-care. The study also elaborated that the adherence to the medication was majorly associated with the beliefs of the patient on their medication. (Deedwania, 2012)The ability of the patient to learn and be able to retain the information may be reduced while at the hospi tal due to the high levels of anxieties and the cognitive dysfunction. It is important for the nurses to use the admission of the hospital to provide the patient with the verbal information, which is supported by material that are written. The nurse on the case of Mrs. Brown can use teach back technique where they may ask her to repeat using their own words the information they have provided them. This help to confirm on their understanding and helps the nurse to reparse the information they have not understood. The time spent between the nurse and the patient provide benefits in regards to knowledge retention rate and may be much useful when interacting with individuals who have low education level or the health literacy. 3 a). Effects of IV furosemide and glyceryl trinitrate drugs in relation to the underlying pathogenesis The glyceryl trinitrate drug provides a rapid and a steady therapeutic concentration of the nitrates during the continuous infusion. This drug caused the venodilation when given in low doses, but when given on high doses it dilates both the arteries and the veins. The hemodynamic effect of the drug is to decrease the blood pressure in the preload- this is on the left ventricle when it is filling the pressure. It also determines afterload and decreases the oxygen demand in the myocardial. The IV furosemide drug is an anthranillic acid derivate that is often used as a diuretic. The drug is used to treat the excessive accumulation of the fluid, which may be caused by congestive heart failure. The drug is used to control the hypertension and some of the side effect of the drug are thirst, urination. The dosage is essentially determined by the physician depends to how much fluid is there are how fast it should be removed. These two drugs were used on Mrs. Brown because she had acute heart failure. b) Discuss how to monitor for the respond of the adverse effects of these drugs The physician carefully determines the level of the administration of these drugs. The doctors use the therapeutic monitoring method, which they use to check the effectiveness of the drugs taken the individuals with the heart failure. (Gardner, McDonagh Walker, 2007) Monitoring entails looking at the side effects on the drug like severe vomiting, dizziness, the blood pressure level. The doctors are able to keep the record of the patients in regards to the drugs the patients is taking the side effects and if the medication is working effectively. They also need to get the right balance of the drug and control the side effect of the drug and if they are severe change the medication. C) How to evaluate on the therapeutic effect of the drugs The best diagnostic evaluation of the side effects is to carry a complete history of the symptoms that are exhibited. (Gardner, McDonagh Walker, 2007) It is important for a physician to know when they started, how long they have lasted, how severe they have become and whether the patient had them as before. Moreover, the doctor should ask about the history of the patient on the family member history. The treatment outcome of the side effects depends on the evaluation that is done. The therapeutic doses of these drugs will tend to reduce the systolic, diastolic and arteries pressure. The concentration of these drugs should not be mixed to the other drugs. References Deedwania, P. C. (2012). Heart failure. Philadelphia, PA: Saunders Gardner, R. S., McDonagh, T. A., Walker, N. L. (2007). Heart failure. Oxford: Oxford University Press McMurray, J. J., Adamopoulos, S., Anker, S. D., Auricchio, A., Bhm, M., Dickstein, K., ... Jaarsma, T. (2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. European journal of heart failure, 14(8), 803-869. Nieminen, M. S., Bhm, M., Cowie, M. R., Drexler, H., Filippatos, G. S., Jondeau, G., ... Rhodes, A. (2005). Executive summary of the guidelines on the diagnosis and treatment of acute heart failure. European heart journal, 26(4), 384-416. Selby, V. N., Teerlink, J. R. (2013). Whats new in the treatment of acute heart failure?. Current cardiology reports, 15(9), 1-9. Valente, M. A., Voors, A. A., Damman, K., Van Veldhuisen, D. J., Massie, B. M., O'Connor, C. M., ... Davison, B. (2014). Diuretic response in acute heart failure: clinical characteristics and prognostic significance. European heart journal, 35(19), 1284- 1293.