Acute Infection

For backfill purposes, Urgent Care Department will need the following Ancillary FTE's to support 2017 anticipated membership growth and improve department budget status: 2.1 LVN's. Per November's YTD Budget Report department is overbudget by $2,431.443. Part of overbudget costs included replacing LVN's that were on medical leave, vacation,

Acute renal failure is when the kidneys suddenly are unable to filter the blood of the waste products. Acute renal failure is alternatively called acute kidney failure or acute kidney injury. The causes of acute renal failure are divided into three categories based on their point of origin: prerenal, intrarenal, and post renal. The most common type of acute renal failure is prerenal, which can be described as a sudden drop in blood pressure or an interruption in blood flow to the kidneys. The common causes of prerenal AFR include hypovolemia, reduced renal perfusion, and septic shock. "Prerenal AFR is generally reversible when renal perfusion pressure is restored" (Liu, pg.98). Intrarenal, or intrinsic, acute renal failure is caused by acute tubular necrosis, renal artery obstruction, renal vein obstruction, interstitial nephritis, and glomerulonephritis. Postrenal occurs between the kidney and the urethral meatus. The major causes to postrenal AFR are tubular precipitation, urethral obstruction and bladder obstruction. Acute renal failure has four phases: onset, oliguria, diuresis and recovery. Onset begins with onset of the event and lasts for hours to days. The oliguria stage doesn't always occur in certain patients; however it lasts for 8-15 days. Oliguria deals with multiple acid-base balance diseases. The diuresis stage begins when the kidneys start to recover

The article seemed to imply that the parasite naturally occurs within the feline population. The article does not mention

Thirty to 50 percent of the 400,000 to 500,000 cases of sepsis in the United States each year are fatal, emphasizing the seriousness of this public health concern [2]. Recent research into possible alternative treatment options indicates that patients being treated with statin therapy are less likely to develop sepsis from a serious infection, die from sepsis or develop serious complications due to sepsis; however, the mechanism of action is unknown and therefore is the focus of this study [2, 6, 10-12]. Possible mechanisms of action include a direct interaction of the statin with the sepsis-causing organism, an interaction between the statin and the host immune system or a combination of the two [9, 14, 16-17]. Additionally, recent studies indicate that statins may have a direct antimicrobial effect and has suggested that statins may diminish the replication and infectivity of some pathogens responsible for sepsis [11, 14, 16-17]. Thus, we hypothesized that statins could benefit septic patients by

Under the Core measures, Sepsis is one of the problem-focused trigger for systemic infection and if untreated which can lead to death. In United States, it is the 11th leading cause of death and consumes the large amount of costs about $20.3 billion in 2011 (Jones et al.,2016). According to Centers for Disease Control and Prevention (CDC), more than 1.5 million people diagnosed with sepsis, and at least 250,000 patients die from that yearly (CDC, 2017). The evidence-based research revealed with results of certain pre existing conditions, pathophysiological studies, preventive measures and sepsis bundle for treating and preventing sepsis to save the life of the patients.

Assessment Although a patient in severe sepsis may be transferred to the intensive care unit (ICU), medical-surgical nurses must be able to recognize early signs and symptoms of sepsis to ensure prompt treatment before the patient requires ICU admission. Severe sepsis Severe sepsis occurs when a patient with documented sepsis goes on to develop acute organ dysfunction with hypoperfusion and tissue hypoxemia. Simple prevention strategies Without proper assessment and early identification, patients with sepsis can deteriorate quickly, suffering compromised tissue oxygenation and organ dysfunction for many hours. Be aware that although blood pressure readings are crucial in assessing and planning care for the septic patient, mean arterial pressure

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

According to the authors, Bernstein & Lynn (2013), “A common and devastating condition, sepsis has significant healthcare implication worldwide.” The authors elaborate on the different types of sepsis and the complications that arise from them along with the pathophysiology and risk factors. Bernstein and Lynn emphasized the importance of a proper nursing assessments, recognition of septic progression and nursing interventions.

Upper respiratory tract infections (URTI), including acute otitis media (AOM) are the most common cause of ambulatory physician visits and antimicrobial prescriptions in children1,2. The most common bacterial causes of URTI are Streptococcus pneumoniae and Haemophilus influenzae, though the majority of cases are caused by viral pathogens 3–10. Distinguishing between viral and bacterial URTI can be difficult. Reports on quality of antimicrobial prescriptions have shown a 30-50% of all out-patient prescriptions due to (upper) respiratory tract infections to be inappropriate2,10,11. In Europe the quality of prescription is higher in the north of the continent, including Iceland compared to in the south12. Conversely, many factors contribute to the overuse of antimicrobials2,13–15, which in turn results to increase in antimicrobial resistance16,17. Contributing factors cited by by physicians to cause over-prescription include uncertainty of diagnosis, fear of disease complications, lack of perception of harmful effects of antimicrobials, not perceiving their own prescription practices to be a problem, pressure by patients, limited time, fear of damaging doctor-patient relationship in addition to language, cultural and educational barriers2,13–15. Antimicrobials were long a mainstay treatment against AOM in fear of rare, but dangerous complications, which have later been found to be unfounded, asnd

Kacey, thank you for provide your insight on the framework for praxis discussion. Kacey, we have same phenomenon of interest (POI), which is sepsis prevention. Kacey, as you had stated that sepsis is a major issue in the emergency rooms (ERs). However, sepsis is also a major factor for the medical-surgical units and intensive care units (ICUs). Sepsis within the United Stated represent 2 % of patients admission to the hospitals, additionally, 10% of those admissions are treated in the ICUs. (Kleinpell & Schorr, 2014).

Once ingested, the egg turns into a tachyzoite, which rapidly multiplies and settles in throughout the host’s body (most alarmingly, in the brain). The parasite quite brilliantly assures its proliferation and spread by making cats more appealing to the carrier; in fact, mice infected with toxoplasma gondii even demonstrate sexual arousal at the smell of cats! We can speculate that “cat ladies” carrying toxoplasma gondii would be more inclined to adopt more felines, thus increasing their risk for infection. Most infected by toxoplasma gondii (nearly 30% of the entire population, by some estimates) will never know they carry it. But studies demonstrate a link between carrying toxoplasma gondii and having nearly double the risk of developing

Millions of oocysts are shed for if three weeks after the infection. Oocysts become infective within a few days in the environment. The oocysts are found in feces of domestic and wild cats. In the gut, oocysts transform into tachyzoites and they travel to other parts of the body through the bloodstream and develop into tissue cysts. They can remain in the skeletal muscles, brain, and eyes for decades”. (www.parasitesinhumans.com)

The parasite has one or two stages of life cycle in animals including humans, a proliferate form which can be singly or within host cells in small groups or in the other stage which is found intra- or extracellularly, the cyst (Sheffield 2012). In pro life form the organism is surrounded in a two-layered membrane (pellicle), lateral to the nucleus a micropyle in the membrane (Sheffield 2012). Long club like paired organelles posteriorly from the comoid area (a cone shaped structure) is located at the anterior end where the nucleus and golgi zone are in the posterior half of the organism (Sheffield 2012). The cytoplasm is filled with the mitochondrial, granules, vesicles, and ribosomes. (Sheffield

Toxoplasma gondii is one of the most interesting parasites known to date. It has a facultative heteroxenous life cycle and it can infect all warm-blooded animal including mammals, birds and humans. T. gondii is prevalent in most countries of the world and is of medical importance, because it may cause abortion or congenital disease in its intermediate hosts (Tenter et al. 2000). In its intermediate host, T. gondii undergoes two phases of asexual development. During the first phase tachyzoites multiply in different types of host cells. The last generations of tachyzoites initiate the second phase of development, which results in the formation of cysts in the intermediate host. Within the cyst, bradyzoites multiply rapidly and these cysts readily form in the neural and muscular tissues of the host. However, they may also be found in visceral organs such as the lungs and liver( Tenter et al. 2000). These cysts are immediately infectious to the intermediate host. In many intermediate hosts the cysts may persist for the life of the host giving rise to a latent infection. If the cysts are ingested by a definitive host, the bradyzoites initiate another asexual phase, which consists of repeated endopolygeny in epithelial cells of the small intestine (Tenter et al. 2000). Then comes the sexual phase of the lifecycle. Oocyst formation takes place in the epithelium of the small intestine and unsporulated oocysts are released into the intestine and passed out with defecation. Sporogony

Consider the life cycle of the parasite, (Figure One) and all of the factors are associated with such, as it plays a role in the involvement of invasion. Once a sporozoite invades a hepatocyte, creates a vesicular body, and undergoes asexual development, the parasite