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Edema refers to a health condition where individual experiences swellings in the body. It is a medical term used while referring to swelling (In, 2014). Generally, edema is due to excessive accumulation of fluids in the body tissues. More so, accumulation of fluids may be in the interstitial spaces and as well cells. Normally, edema is not a disease but rather acts as a manifestation of an altered physiologic function within the body. Edema as a health concern has different effects on the patient.
Due to the inflammation resulting due to the fluids within the interstitial cells, there is an increase of the diffusion distance of oxygen and other nutrients. This has an effect on the swollen tissues, as it comprises cellular metabolism. In addition, this condition has a similar effect on the by products produced during cell metabolism. This is because it limits the diffusional removal of toxic substances from the swollen cells due to the increased diffusion distance (Porth, 2009).
There are different causes attributed to edema condition in human beings. Edema resulting from an increase in capillary pressure may be due to different reasons. Heart failure is the most common cause of edema. Due to failure in the right ventricle, blood usually backs to the systemic vein circulation system. This on the other hand has an effect of increasing vein pressure and on the other hand increasing capillary hydrostatic pressure. This results to swelling in feet and legs similar with the condition suffered by the 65-year old female (Braun, 2007).
Unlike heart failure, obstruction of flow is another possible cause of edema in the 65-year-old female. This cause of edema takes place due to blockage of drainage fluid in the legs. Once there is the obstruction, the fluid can easily back up within the legs. An example of obstruction of flow is in the occasion of a blood clot in the veins where blood faces a limit of flowing in the veins. On the other hand, this has leads to swelling in the legs.
Lastly, allergic response may be another reason behind the swelling of the patient’s leg. Resulting from allergic reactions in the body, there is an increase in capillary permeability. In addition, there are instances where these capillaries become damaged and leaky. This allows more fluids through them to the interstitial cells surrounding the capillaries (Braun, 2007). As a result, there is swelling in the legs as with the 65-year-old patient. Some of the pathophysiologic changes occurring in the body that results to edema include; heart failure, asthma neurohumoral status and as well, changes in the blood level volumes (In, 2014).
Diabetes insipidus refers to a condition resulting to failure of production of sufficient levels of antidiuretic hormone (responsible for helping the kidneys and the body conserve the correct amounts of water). Normally, this hormone is responsible for controlling the kidneys’ output of urine. Diabetes insipidus as a health condition leads to loss of excessive amounts of water in the urine. Other than insufficient production of ADH hormone, this condition can be because of brain injury, tuberculosis, meningitis and as well family heredity.
Some of the symptoms of the condition are; excessive thirst due to the excessive loss of water, excessive urine production, poor feeding, irritability, failure to grow, fever and as well dehydration. There are different methods used during diagnosis of the condition. Urine test is the most common test carried out on patients with the stated symptoms. More so, patients may undergo blood tests and lastly water deprivation tests (aiming at observing whether dehydration takes place) (Braun, 2007).
There are different treatment methods for patients suffering from diabetes insipidus. Treatment of the condition is dependent on the extent of the disease, age of the child and as well tolerance of the child to some therapies. Treatment include; medication with drugs that stimulate the production of antidiuretic hormone and as well oral and injection administration of modified ADH hormone. More so, adequate intake of fluids (especially water) in the 10-year-old patient is important to maintain the levels of water. Lastly, with the child, there should be great care in monitoring the level of sodium intake in the fluids taken (In, 2014).
Depending on the cause of diabetes insipidus, the condition can be either permanent or temporary. Central diabetes insipidus with the correct medication may lead to fully healthy lives. However, nephrogenic diabetes insipidus, there is a need for early medical care (Porth, 2009).
Hyponatremia is a condition where an individual suffers from low levels of sodium. Sodium is an important mineral in the body for maintenance. It helps in the maintenance of fluid balance, regulation of body pressure and lastly it plays a crucial role in maintaining the healthy functioning of the nervous system. In most cases, the condition results due to excessive consumption of water without replacement of sodium to maintain the healthy balance between sodium and water (Braun, 2007).
There are different causes of hyponatremia in the human body. The main cause of the condition is an imbalance in body hormones. In the kidney, there are different hormones involved during the urine formation process. High levels of antidiuretic hormones in the nephron leads to high reabsorption of water back to the body from the filtrate. Apparently, low levels of aldosterone in the nephron leads to low reabsorption of sodium from the filtrate forming urine. Therefore, the body reabsorbs more water than sodium leading to an imbalance. This cause of low sodium levels in the body may also result to failure of the kidney that may lead to an imbalance of hormones and as well its malfunctioning (In, 2014).
The other possible cause of low sodium levels in the body is the accumulation of excess fluids in the body. Accumulation of excess fluids results from failure of the cells to have a continuous supply of nutrients and as well oxygen. In most cases, this results from low volumes in the blood circulating in the body. More so, this may result from inadequate blood pumped into body cells and as well leakage of some blood in circulation. As a result, the body tends to retain some fluids in the tissues. This result from cognitive heart failure that leads to a reduced pressure of blood pumped to the cells. Pathophysiologic changes that occur in the two causes include cognitive heart failure and as well kidney failure (Porth, 2009).
Porth, C.M., & Matfin, G. (2009) Pathophysiology: Concepts of altered health states. (Eight ed.) Philadelphia, PA
Braun, C. A., & Anderson, C. M. (2007). Pathophysiology: Functional alterations in human health. Philadelphia: Lippincott Williams & Wilkins.
In Grossman, S., & In Porth, C. (2014). Porth's pathophysiology: Concepts of altered health states.
Infectious disease occurring within the United States and in SW Florida
Primary Amebic Meningoencephalitis (PAM)
Primary amebic meningoencephalitis is a disease caused by Naegleria fowleri. Naegleria fowleri is an amoeba that freely lives in the environment. The primary amebic meningoencephalitis is a rare disease that affects the central nervous system. The disease leads to fatal patient conditions in most parts of U.S.A including SW Florida (Garcia, Tanowitz & Brutto, 2013).
This essay evaluates the risk of pulmonary amebic meningoencephalitis in the community. Further, this essay seeks to explain why the disease is of interest to professional public health nursing. Therefore, this essay describes relevant situations to support the need for the disease management proposed program.
Assessment of the Primary Amebic Meningoencephalitis (PAM)
Naegleria fowleri is also called the “brain-eating amoeba.” It is a free-living, single-celled microorganism (Garcia, Tanowitz & Brutto, 2013). The amoeba causes a rare and fatal brain infection called primary amebic meningoencephalitis (PAM). This amoeba is commonly found in wet habits, which include lakes, hot springs and rivers. Further, it also lives in the soil.
The amoeba infects people when they take contaminated water through the nose. Once the amoeba enters the body through the nose, it travels to the brain cells where it causes the primary amebic meningoencephalitis. The infection mostly occurs when people go swimming in warm freshwater places (Garcia, Tanowitz & Brutto, 2013). However, the PAM condition can also result from other contaminated water sources such as poorly chlorinated swimming pool water. Nevertheless, one cannot get infected through drinking contaminated water.
Although the disease is rare, the cases are fatal with few survivors. Since 2000-2013, there have been 132 PAM cases with only three survivors. Most of the reported cases occurred in southern-tier states, half of cases mainly reported in Florida and Texas. Clinicians explain that the distribution pattern of the disease is unclear, but the types of water activities happening in the region may cause the infection cases.
What data is needed to effectively manage the condition?
The likelihood of the amoeba exposure is high; however, the risk of infection is low. According to the Department of State Health Services, the states should educate swimmers on how to lower their risk towards the infection. This education should include tips on where to avoid swimming, mostly in warm fresh water. Further, “no swimming” posts should be set in risky areas. Moreover, swimmers can also be educated on how to use nose plugs while diving in water in order to avoid contaminated water from entering their noses. In addition, open wounds and cuts should be properly dressed to reduce the risk of contamination.
Thus, the main data needed is the target population, population highly susceptible to the contamination risk, and meteorological conditions such as temperature and test runs for the amoeba.
The target population is the people who frequently engage in swimming and diving activities along the warm fresh water bodies such as lakes and rivers. These include children and adults who reside in the risk declared areas. This essay specifically targets the SW Florida population and states within America.
Consequently, the community partners include other states such as Texas and Minnesota. The states surrounding warm fresh water bodies should engage in a community partnership to manage the condition. The government through public health policies should initiate the PAM management program (Lippincott, 2011). Further, state health policies should be used to enhance preventive measures against the disease.
A routine bimonthly water-sampling program can be initiated to examine the disease patterns. These monitoring programs should entail bacteriological test run to test for the amoeba. Further, tests should be done in suspected habitats where the microorganism exists. For instance, in Texas a routine water quality-monitoring program was initiated by the Colorado River Watch Network. The group cited over 200 locations to sample the water quality on a regular basis in order to measure the pathological patterns of the disease. The samples were monitored in terms of quality index. The water quality index varied from excellent, poor, fair and good (Crisp, 2012).
The water quality index has enabled the community to understand the water conditions in their neighboring water bodies. This had enhanced the public health precaution measures employed in Texas. This is a good management program for the PAM condition.
Water quality monitoring program scope of practice
The water-monitoring program should consider the nursing scope of practice regulations. The water quality-monitoring program should collaboratively work with the health sector to ensure the data sampled is accurate. The coalition for patient’s rights mandates all health procedures to be aimed at producing the utmost patient-centered care. Thus, the water quality control program should work with the healthy sector. Further, the program should have legal consent to initiate the water quality program. Legal action mandates all nurses to operate within the law. Thus, a breach of the legal protocol would make the program illegal. The water quality-monitoring program abides by the nursing scoped of profession since government intervention through the public and state health is present (Garcia, Tanowitz & Brutto, 2013).
Water quality monitoring program to manage the PAM condition
The vision of the quality-monitoring program is to enable a safe swimming environment. Further, the water quality- monitoring program aims at reducing other aquatic diseases in the future. The mission of the program is to reduce PAM cases. The program will attract other community partners and the program can be performed in all the PAM risky states. Thus, the goal of the program is to reduce the risk of the PAM condition substantially to create a safe environment. Consequently, the disease is fatal because of redundant survival chances among victims. Therefore, this program will help reduce the prevalence of the disease and other aquatic diseases in the future (Lippincott, 2011).
The water quality-monitoring program engages all the affected states in a bid to create public awareness about the dangers of the disease.
The program should be carried out in key states, where there are highly susceptible habitats for the Naegleria fowleri amoeba. The water-monitoring program should also incorporate educative measures to help the public understand the nature of the disease. For example, mass education is vital to enable children and adults refrain from swimming or diving in cautious environments. Swimming in stagnant waters or playing out in the water after rain can easily predispose little children to the PAM condition. The program will enable the state health programs to make health decision based on regular data samples rather than mere speculation.
The constraint of the program is that the water conditions can change quite more rapid than expected. Thus, this can lead to unexpected risky conditions in the water bodies. However, the regular samples would help detect if there are rapid changes experienced at times.
The Naegleria amoeba enters the body through the nose and it travels via the olfactory nerve to the brain. The disease is not communicable from one person to another. The initial signs of the disease include sudden headaches, nausea, fever, vomiting presence of meningeal signs and stiff neck. The disease can also lead to nasal obstruction and nasal discharge. Furthermore, when the disease develops it leads to photophobia, mental-state abnormalities, loss of balance and other visual disturbances such as seizures and coma. The disease is considered risky because it progresses rapidly and in most cases, it results to death within 3-7 days.
Even though the amebic infection is less severe, the risk posed by the disease is risky. Over the last decade (2000-2010), there have been 30 reported cases of the disease. This indicates a reduction in the disease cases compared to 36,000 cases in the previous decade (1995-2005). It is clear that the low risk of the amoebic condition is caused by the recreational use of warm freshwater lakes, hot springs and rivers (Garcia, Tanowitz & Brutto, 2013). The low numbers of infection cases insinuate an abnormal disease pattern because millions of people use these water bodies for recreational use. This water quality-monitoring program enables health practitioners to understand the pathological adaptations of the PAM condition. Moreover, the water quality-monitoring program will facilitate medical advances towards curing the disease.
The use of volunteers and government resources in the water quality-monitoring program would facilitate the program. Further, the program requires both private and public participation among health practitioners. The data samples require temperature surveys, oxygen samples, pH and other relevant samples. The coalition between expert volunteer hosts in the program and other laboratory officials will facilitate effective data interpretation. The program has already been successful in some states such as Texas, where a group of volunteer hosts through the Colorado River Watch Network (CRWN) have begun carrying out frequent water quality-monitoring programs (Crisp, 2012).
How to measure the effectiveness of the program
The advanced nursing practice enhances collaborative and cohesive working relations among medical practitioners. This simulates that all nursing professions should be centered at providing the best patient care. Nurse administrators should oversee the water quality-monitoring program and clinicians should work with nurse administrators in implementing new health policies. In order for the program to be successful, government intervention is necessary to ensure illegal operations are not carried out during the water-sampling process. The goals of the program should be streamlined at producing patient-centered care. Therefore, the program should achieve qualitative reduction in the number of PAM related cases. Further, the water-monitoring program should also focus on identifying other pathogens in the water such as bacteria.
Consequently, the program should design remedies to improve poor water conditions. Mass education should be carried out to promote mass sensitization towards the best practices to avoid getting infected with the PAM condition.
The water-sampling program is an ideal way to deal with the amebic infection in the long run. It ensures that risk of contaminated water is reduced. This will reduce the PAM related cases because most of these cases arise from recreation activities in contaminated water. The water-sampling program will enable various states to detect the critical areas of contamination, and reduce human recreational activities in these areas. Further, it a good way of initiating a public health assessment tool among nurses in a bid to create patient reported outcomes.
Crisp, M. (2012). River of contrasts: The Texas Colorado. College Station: Texas A&M University Press.
Garcia, H., Tanowitz, H. B., & Brutto, O. H. (2013). Neuroparasitology and tropical neurology.
Lippincott's guide to infectious diseases. (2011). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.
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