Heparin Induced Thrombocytopenia Essay

When an individual has a platelet count less than 150,000 platelets/uL, he or she is considered to have thrombocytopenia. This condition can occur because of genetic predispositions or can be acquired. When thrombocytopenia is seen due to congenital origin, the underlying disease could be TAR syndrome, Wiskott Aldrich syndrome, or a gene mutation. Acquired thrombocytopenia is usually seen in relation to viral infections, mediation use, a nutrient deficiency, , renal failure, or radiation therapy, or cancer (Huether & McCance, 2017, p. 541). Heparin Induced Thrombocytopenia Essay.

Thrombocyopenia can be induced with the use of heparin. Furthermore, this condition is called heparin induced thrombocytopenia (HIT) syndrome. It occurs in result to an immune response to the use of heparin. It is less common when using unfractionated heparin, like Lovenox. The immune response causes IgG antibodies to react against the heparin-platelet factor, which leads to platelet activation. The increase in platelet factor 4 and thrombin production leads to an increase in platelet consumption. Platelet consumption results in low platelet counts which appear five to ten days later after heparin was administered (Huether & McCance, 2017, p. 541).

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With HIT syndrome, the patient will experience venous and arterial clotting, while having low platelets levels. This problem is difficult to manage because the patient is clotting and has a risk for bleeding at the same time. Priority management of the patient’s condition is essential (Krzych, Nowacka, & Knapik, 2015).  Heparin Induced Thrombocytopenia Essay.

Drug Therapy

After HIT syndrome has been identified, it is important to stop the use of heparin and look at other avenues of anticoagulant therapy. There is not a reversal medication to stop HIT from occurring. Managing the patient based on their clinical manifestations is the mainstay of treatment (Huether & McCance, 2017, p. 541). Heparin Induced Thrombocytopenia Essay.

Behavior

Patients with HIT syndrome typically need platelet replacement. Platelets are a blood component and require consent from the patient prior to them being given. Some individuals have religious beliefs, such as a Jehovah witness, in regards to receiving blood products and will refuse platelet therapy. This therapy is patient choice, but refusal of platelets can be detrimental to the patient. It is important to give all patients the option to receive therapy and discuss pros and cons of their decision. Promoting patient decision making is essential as we strive to maintain their autonomy (Edelen, 2014). Heparin Induced Thrombocytopenia Essay.

References

Edelen, A. (2014). Blood products and the Jehovah’s witness: An ethical concern. Kentucky

Nurse, 62(2), 4-5.

Huether, S. E., & McCance, K. L. (2017). Understanding  pathophysiology (6th ed.). St. Louis,

MO: Mosby. Heparin Induced Thrombocytopenia Essay.

Krzych, Ł. J., Nowacka, E., & Knapik, P. (2015). Heparin-induced thrombocytopenia.

Anaesthesiology Intensive Therapy, 47(1), 63-76. doi:10.5603/AIT.2015.0006. Heparin Induced Thrombocytopenia Essay

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Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development.
What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Summarize two initiatives spearheaded by your state’s Action Coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers?

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Question description

Assessing and Planning Care for an Elderly Person

In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the values they hold. Additionally it is important to assess and determine his/her needs and establish appropriate interventions for this individual.

By the due date assigned, choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature.

Download a patient questionnaire. This form should be used as an example.

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment.

Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

1. Tinetti Balance and Gait Evaluation
2. Katz Index of Activities of Daily Living
3. Assessment of Home Safety
4. The Barthel Index

Make sure the older adult is clearly identified on the tools. Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.)

Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem.

Make sure that you integrate personal cultural awareness and cultural competency.

Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper.

On a separate references page, cite all sources using APA format.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
• This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.

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Applying to Graduate School

In the first two modules, you explored your career options and identified available positions related to your interests. You also determined which of these positions requires a master’s or a doctoral degree. For this assignment, research graduate school programs for the selected career using your textbook, the Argosy University online library resources, and the Internet.
Tasks
In the Discussion Area, address the following:

• Select one of the careers that require graduate-level degrees.
• Identify at least three graduate school programs you would consider attending. For example, if you hope to become a licensed professional counselor (LPC), you would first need to earn a master’s degree at the very least. You would want to research programs that provide master’s degrees in counseling. Include research on whether you would fulfill the requirements for licensure in your state of residence if you completed those specific programs. Cover the following:
  • Indicate which license you would seek and which programs would or would not prepare you to be eligible for licensure.
  • If you want to become licensed, ensure that these programs meet your state’s requirements for licensure. For example, if you wish to become an LPC, you would have to review the American Association of State Counseling Boards and locate your state’s licensing board website address.
• For each of the three graduate school programs, research and discuss the institution’s accreditation. You may find that many state licensing boards require programs to be regionally accredited.
  • You might want to review the US Department of Education’s Database of Accredited Postsecondary Institutions and Programs to determine whether the school is regionally accredited.
  • Most states also require a specialized accreditation for licensure as an LPC or a psychologist. For counseling licenses, most states honor programs that have the CACREP designation. For psychology licenses, APA accreditation is usually required. Find programs with the CACREP designation.
• Discuss any concerns you may have about applying to or attending graduate school. List any questions you have about the application or licensure process.
• Provide at least two authoritative references or sources for the information you have discussed. One of these can be the textbook.

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Analyzing an Ethical Decision Essay

To prepare:

Review literature for moral/ethical issues encountered by a PMHNP.

Write a 2-page paper using this article: (copy and paste in browser)

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http://www.psychiatrictimes.com/special-reports/ethical-issues-patients-capacity-make-medical-decision

in which you do the following:

Summarize the moral/ethical issue in the article (no more than 1 paragraph).
Describe the moral and ethical dilemmas surrounding the issue.
Analyze the ethical issue and compare them to the state health laws and regulations in your state.
Outline the process of ethical decision making you would use to address this ethical dilemma.

Please use a minimum of three resources within the last 5 years. Analyzing an Ethical Decision Essay

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