Texas Womens University DB Bi

Search current nursing journals for a research study that uses an epidemiological, biologic, or physiologic theories as a framework.

BOOK IF NEEDED CHAPTER 9 McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Lippincott Williams & Wilkins.

RUBRIC-NO NEED TO ADD REPLY

Quality of Initial Post and Replies (60 points)

(60-54 points)

Posts a substantive, well-developed response that fully addresses all aspects of the prompt.

Includes several current (< 5 years old) references in APA format.

Demonstrates analysis of others’ posts; extends meaningful discussion by building on previous posts.(20-18 points)

Contributes to discussion with clear, concise comments formatted in an easy to read style that is free of grammatical or spelling errors.

Clarity and Mechanics (20 points)

(20-18 points)

Contributes to discussion with clear, concise comments formatted in an easy to read style that is free of grammatical or spelling errors

POST 1

One disease causation theory is The Epidemiologic Triangle. This model is used to show the relationship between the host, agent, and environment. A change to any part of this triangle could potentially cause disease. Host factors include age, gender, race, marital status, economic status, state of immunity and lifestyle factors. Agent factors are presence or absence of biologic organisms, exposure to physical factors and chemical factors. Environmental factors include physical elements, biologic elements, and social/economic considerations (McEwen & Wills, 2019). In the article, “Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians” it has outlined four common bacterial infections that need antibiotics that practitioners and physicians are prescribing too often or too long of course. This is causing a worldwide issue known as antibiotic resistance. Using The Epidemiologic Triangle, the article suggests best practice in prescribing antibiotics depending on the host, agent, and environment. The unnecessarily long durations of antibiotic therapy in patients with common bacterial infections, such as acute bronchitis with chronic obstructive pulmonary disease (COPD) exacerbation, community-acquired pneumonia (CAP), urinary tract infections (UTIs), and cellulitis, (Lee, Centor, Humphrey, Jokela, Andrews, & Qaseem, 2021). This article states clinicians should limit antibiotic treatment duration to 5 days when managing patients with COPD exacerbations and acute uncomplicated bronchitis who have clinical signs of a bacterial infection (presence of increased sputum purulence in addition to increased dyspnea, and/or increased sputum volume). For community-acquired pneumonia for a minimum of 5 days. Extension of therapy after 5 days of antibiotics should be guided by validated measures of clinical stability, which include resolution of vital sign abnormalities, ability to eat, and normal mentation. In women with uncomplicated bacterial cystitis, clinicians should prescribe short-course antibiotics with either nitrofurantoin for 5 days, trimethoprim– sulfamethoxazole (TMP–SMZ) for 3 days, or fosfomycin as a single dose. In men and women with uncomplicated pyelonephritis, clinicians should prescribe short-course therapy either with fluoroquinolones (5 to 7 days) or TMP–SMZ (14 days) based on antibiotic susceptibility. In patients with nonpurulent cellulitis, clinicians should use a 5- to 6-day course of antibiotics active against streptococci. This article lays out a foundation of lengths of antibiotics with regards to the host in mind as well as the environmental factors, (Lee, Centor, Humphrey, Jokela, Andrews, & Qaseem, 2021).

Lee, R. A., Centor, R. M., Humphrey, L. L., Jokela, J. A., Andrews, R., & Qaseem, A. (2021). Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians. Annals of Internal Medicine, 174(6), 822–827. https://doi-org.ezp.twu.edu/10.7326/M20-7355

POST 2

The epidemiologic triangle, which includes the three elements of host, agent, and environment, is commonly used to study communicable diseases (McEwen & Wills, 2019). To prevent transmission of disease, exposure to the agent, health of the host, and environmental factors related to susceptibility must be properly managed (McEwen & Wills, 2019). Climate change naturally influences all three of the elements in this triangle and the article I found relating to our practice as nurse practitioners explains this phenomenon on us as providers and the communities we reside in.

According to Smith (2019), changes in our climate will reshape the patterns of infectious disease prevalence in our communities. Without knowledge of these changes, we as nurse practitioners cannot properly manage patients that may present with symptoms of a disease not typically seen during the season we are in. The Centers for Disease Control expressed to our nation that due to climate change we will see an adverse effect on the health of the people (Smith, 2019). These changes could lead to an increase in the emergence and rate of familiar diseases as well as new diseases (Smith, 2019). For us to determine and assess our patients properly, knowledge of the epidemiology and pathophysiology of diseases must be attained (Smith, 2019).

When applying the epidemiologic triangle to this situation it is easy to see it’s effect on each component via changes in the occurrence and spread of diseases (Smith, 2019). An increase in salmonella due to increased temperatures is an example of the effects climate change has on agents (Smith, 2019). With more rain in the environment there is naturally an increase in the amount of water borne diseases and when people, or hosts, interact differently based on such weather this can increase their risk of exposure to certain disease (Smith, 2019). A wonderful example that ties in all three elements given by Smith (2019) includes the spread of chickenpox. The agent, the varicella zoster virus, typically spreads to young children and teenager hosts during times when the environmental temperatures are moderate (Smith, 2019). With climate change and increasing temperatures we may then see an increase in the incidence of this disease.

In order to advocate for our patients, we need to inform them on when and what diseases are spreading through the community. This will give them a chance to prepare whether it be through interactions with each other or attaining immunizations such as the flu shot when the time is right (Smith, 2019). If the timing of these diseases shifts due to climate change, we will need to alter the recommendations to prevent widespread infections. Climate change is something I am passionate about reducing based on all the information provided by not just this article but also every documentary regarding it that has been released in the past five to ten years. The ways it is affecting our planet, society, and vectors for disease will only get worse unless we act now through guiding our patients to better manage themselves and the world they live in.

References:

McEwen, M., & Wills, E. M. (2019). Theoretical Basis for Nursing (5th ed). Wolters Kluwer.

Smith, Ellen. (2019). The Effect of Potential Climate Change on Infectious Disease Presentation. Journal for Nurse Practitioners, 15(6), 405-409. DOI:10.1016/j.nurpra.2019.02.023

POST 3

Stress is the body’s natural response to certain triggers. The General Adaptation Syndrome is a theory by Walter Canon, who developed the concept of “fight or flight” to explain the body’s reaction to emergencies (McEwen & Wills, 2019). The pathological process of the stress response is initiated by the adrenal medulla which produces epinephrine and norepinephrine. Scientist Hans Selye used Canon’s findings to develop a framework that described the body’s response to stress. The framework, the General Adaptation Syndrome (GAS), was built off of his observations of the general signs and symptoms manifested by patients experiencing stress (McEwen & Wills, 2019). The GAS breaks down the effects of stress into three categories: alarm, resistance, and exhaustion. The alarm phase is the body’s initial fight-or-flight response, the resistance phase involves the body’s return to resting phase or chronic resistance, and exhaustion is where the body has over-exhausted itself and organs can show signs of deterioration (McEwen & Wills, 2019).

A study was conducted on Hans Selye’s theory and its application to recent studies on the different factors that stress can have on the body. The study focuses specifically on the relationship between stress and gastroduodenal ulceration. The researchers utilized the “Stress Triad” to focus on the acute ulcers found in Selye’s laboratory studies with rats, and the finding’s relation to recent stress-related ulcers in humans (Szabo, et al., 2017). Selye’s original studies explain how the stress ulcers are caused by the “massive release of glucocorticoids and catecholamines during the alarm reaction; which predisposes the gastroduodenal mucosa to the damaging action of gastric acid” (Szabo, et al., 2017, p. 4032). This historical finding has been verified by clinical observations in humans. The study describes how each process of the triad, originally coined by Seyle, has been clinically proven in current practice. Ultimately, the study found that going back to the basic mechanisms of stress, is beneficial in better understanding its manifestations (Szabo, et al., 2017).

References

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th Ed.). Wolters Kluwer.

Szabo, S., Yoshisa, M., Filakovszky, J., Gyorgy, J. (2017). “Stress” is 80 Years Old: From Hans Seyle Original Paper in 1936 to Recent Advances in GI Ulceration. Current Pharmaceutical Design, 23: 4029-4041. https://doi.org/