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Discussion

research paper

i have to do a research paper on polio in apa format. can anyone give me any info on this topic? some of the guidelines for my paper are:

causative organism

description of health problems

prevention

treatment

nursing diagnosis with rationale

nursing goals and interventions

here is a copy of what i had started on, keep in mind i am not finished. would like some of your input on this paper.

what is polio?

polio is a highly contagious disease that is caused by a virus that primarily lives in the intestines and human feces. the virus is spread from person to person through oral contact with the feces of an infected person (for example, by changing diapers); it can also be spread through contaminated food or water. it affects children usually at the age of three but it can affect persons at any age and some won't have complications until later in life which is referred to as post polio.

when the virus enters the body it penetrates the intestinal lining and enters into the lymphatic system and blood stream and then it is carried to the central nervous system where it replicates and destroys the motor neuron cells which control the muscles for swallowing, circulation, respiration, and the trunk, arms, and legs. for some people the virus only causes flu like symptoms but for others the virus begins to attack the central nervous system and destroying the motor cells of the spinal cord and brainstem and then infected person will become irritable and develop pain in the back and will have muscle tenderness and stiff neck.

when the virus encounters the nerve cells, the receptors attach themselves to the virus and then the infection begins. once the virus is inside the cells it makes thousands of copies of itself with in hours and the virus kills the cell and then spreads to infect other cells.

health complications

polio can lead to muscle paralysis that results in deformities of the hips, ankles, and feet, but many of these deformities can be corrected with surgery and physical therapy but other complication can also affect the lungs, kidneys, and the heart such as:

  • pulmonary edema - life threatening condition that fills the lungs with fluid and prevents them from absorbing oxygen.
  • aspiration pneumonia - inflammation of lungs that is caused by inhaling stomach contents into the lungs.
  • myocarditis - inflammation of thick muscular layer of the heart that leads to chest pain, abnormal heartbeat, or congestive heart failure.
  • cor pulmonale - heart condition that occurs when the right side of the heart can't pump hard enough to compensate for prolonged high blood pressure in the arteries and veins in the lungs.

there are three phases of polio:

o nonparalytic - this form of the disease doesn't lead to paralysis but will have symptoms that include sore throat, fever, nausea, vomiting, diarrhea, and most people recover within a week.

o paralytic - this is the most serious form of the disease which often begins with flu like symptoms and then leads to an acute flaccid paralysis which causes the limbs to appear loose and floppy, often comes on suddenly and usually affects one side of the body, but sometimes both sides are affected but typically one side is worse than the other.

o post polio syndrome - adults who had polio as a child, usually 30-40 years later will experience muscle weakness and pain in the areas that were previously affected by polio, or they could also develop a new paralysis. other signs and symptoms may include breathing or swallowing problems, decreased tolerance of cold temperatures.

prevention

there is no cure for polio; it can only be prevented by an inactivated vaccine (ipv) through injections.

this immunization schedule can protect a child for life:

  • 2 months
  • 4 months
  • between 6-18 months
  • booster between 4-6 years

adults that need the vaccination:

  • traveling to other parts of the world
  • people who handle the poliovirus
  • healthcare workers

treatment

in the early outbreak of polio, researchers tried to find treatments for the disease. they used a number of therapies which included body casts, and braces to prevent deformities. they also used a chamber like respirator known as "iron lung". it enclosed the whole body except the head and in which alternate pulsations of high and low pressure induces normal breathing movements and forces air into and out of the lungs but current treatment focuses on comfort and preventing complications which include:

  • antibiotics
  • analgesics for pain
  • portable ventilators for breathing
  • moderate exercise
  • a nutritious diet

nursing diagnosis with rational

the diagnosis of polio is based on a neurological exam. the physician may suspect that you have polio if you have fever with limb weakness or paralysis that affects one side of your body. the physician will test your muscle reflexes and look for muscle weakness, abnormal muscle contractions, and decreased muscle tone. throat or stool samples may be used to identify the poliovirus with laboratory tests. blood test may be used to identify antibodies to the virus that are produced by your immune system.

thanks,

connie

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  • Experts

hi, connie!

i almost missed your post because you posted it in the general nursing discussion forums and i seldom look here! i am usually looking for students looking for help with care plans, nursing diagnosis and case studies. your assignment pretty much falls into the category of a case study.

i commend you on the information you found on this disease! i have a lot of references available to me here at home and i had a heck of a time finding any reference to poliomyelitis in any of them! i am a baby boomer, so i was around when the sabin vaccine came out and we were given it in grade school. polio was considered a terrible thing to contract back then. now, you hardly ever hear about it. it is still out in the third world countries, however, and i've given you a weblink below to a site dedicated to it.

here are some links to articles on emedicine that give you the pathophysiology and treatment of this disease. these are articles written for doctors, so you kind of have to read through them slowly to digest the information. however, the information in them covers you on your requirement to present the causative organism, description of health problems, prevention, and treatment. it also gives you the signs and symptoms of the disease which is what you need to help you determine the nursing diagnoses, nursing interventions and goals that you need for the paper. you will find the information on medline plus to be the most informative for your paper, i think.

http://www.emedicine.com/pmr/topic6.htm - acute poliomyelitis (focus is on the physical medicine aspect of treatment)

http://www.emedicine.com/pmr/topic110.htm - postpolio syndrome

http://www.emedicine.com/ped/topic1843.htm - poliomyelitis

http://www.post-polio.org/ipn/index.html - post-polio health international - lot of information for you to explore at this site

http://www.nlm.nih.gov/medlineplus/ency/article/001402.htm - information about polio from medline plus' medical encyclopedia

http://www.nlm.nih.gov/medlineplus/ency/article/002030.htm - information on polio vaccine

a couple of observations about your paper. . .the iron lung was the precursor of the modern day ventilator. today, a person with polio who has respiratory problems due to paralysis of the pulmonary muscles would be given a tracheostomy and placed on a ventilator. that technology wasn't available back then and the "iron lung" was what they used. also, you should have someone review your paper for grammatical correctness. you've got a few grammer errors in there.

now, i want to turn the major part of my post to the last two items you are to present in your paper: nursing diagnosis with rationale, nursing goals and interventions. this is an area that i really know a lot about. first of all, i have to tell you that everything you have written under the heading of "nursing diagnosis with rational" is incorrect. what you have put there is information about medical diagnosis. that belongs in the beginning areas of your paper.

a nursing diagnosis is something that is very different from a medical diagnosis. a nursing diagnosis is also based upon a patient's signs and symptoms, and is geared more toward their response to them. also, nurses can only independently perform certain nursing actions. we cannot diagnose the same way a physician can. to help you understand this idea of nursing diagnoses much better you can read about them in a care plan book, a nursing diagnosis book or you can also look through the posts on these two forum threads:

it will be very important for you to come up with nursing diagnoses, goals and interventions (all with rationales) for this assignment. this will be a major grading point that your instructors will focus on, i do believe, because this is what most nursing programs teach. this business of nursing diagnoses, goals and interventions is a written expression of the nursing process and is called care planning.

so, you begin this process by determining what the patient's abnormal signs and symptoms are. in this case, there are so many. you have to make a decision here. as a nurse what kind of a polio patient are you likely to see? someone who has initially contracted the disease? (not likely) or, someone who is experiencing the initial onset of the paralytic form or someone with postpolio syndrome? (i opt for those.)

symptoms of paralytic polio are: (i'm getting this from medline plus' medical dictionary)

  • fever
  • headache
  • stiff neck and back
  • unilateral muscle weakness that can progress to paralysis
  • muscle pain
  • muscle contraction or spasms
  • abnormal sensations
  • difficulty urinating
  • constipation
  • difficulty swallowing
  • drooling
  • difficulty breathing (this can include paralysis of the muscles, sleep apnea)
  • irritability or poor temper control

from this list you have something to work with to develop some nursing diagnoses. nanda-i (north american nursing diagnosis association, international) has currently defined and described for nurses 172 nursing diagnoses. each nursing diagnosis has a definition, a list of symptoms (they call them defining characteristics) and an etiology, or cause (they call them related factors). your mission, grasshopper, is to figure out which of the above symptoms (and i'm going to elaborate a bit on the symptoms as well) fit with some of these 172 diagnoses. i'll help you out here because i have care plan/nursing diagnosis references at hand.

the first nursing diagnoses to address are the ones that involve breathing since oxygenation of the brain and the tissues of the body are of most importance. the nursing diagnoses most appropriate to use are:

next problems of importance involve nutrition and food.

let's address elimination next. these patients tend to have two problems in this area: constipation and trouble with urinating.

next, address fever. not all will have fever unless they are in the early stages of the disease.

now, we get to one of the biggies--movement.

this immobility also includes all the self-care deficits for the adls (activities of daily living), so:

and finally

there are also what are called anticipatory nursing diagnoses that you could also list. these are problems the patient could develop; things you need to kind of do to prevent them from happening. some nursing instructors don't like students listing those, so you might want to check to see if your instructors are going to have a cow if you bring them up. those are:

  • risk for infection r/t chronic disease [i'm talking about uri and uti here]

let me also mention that i didn't even touch on the safety and self-esteem nursing diagnoses. i am sure that there are a few we could throw in there. certainly, depression and the need for the patient's safety are things to consider. you would be very wise to consider investing in a book of nursing diagnoses or care plans. these books are very good resources for listing nursing interventions, especially when your mind is blanking on what to do for a patient. the weblinks that i gave you for each of the nursing diagnoses above are online companion sites for the following nursing diagnosis books:

  1. nursing care plans: nursing diagnosis and intervention, 6th edition, by meg gulanick and judith l. myers.
  2. nursing diagnosis handbook: a guide to planning care, 7th edition, by betty j. ackley and gail b. ladwig.

this part of your paper will probably be the biggest part of it. after all, you are in nursing school and your focus should be on nursing care. so, you have a lot more work to do on this paper. here are some weblinks to case studies that were done by students on actual patients they took care of. it will give you an idea of how they wrote up their patient case studies to give you some idea of how these things are written. they generally start with a discussion about the patient's disease, it's pathophysiology (how the normal body physiological process is altered by the disease), diagnostic tests done to diagnose the disease, medical treatment ordered including medications and tests and then the nursing diagnoses and nursing care. good luck with the rest of this assignment. please don't hesitate to ask for more help if you need it.

http://learn.sdstate.edu/craigg/ercases.html

http://learn.sdstate.edu/craigg/ersp01.html

  • Author

You have gave me what I needed for my paper and I want to thank you for your time, that was alot of information to give. I don't think I have had anyone help me out like that. Not even my instructor is that helpful.

Thank you

Connie:roll

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