Blood Pressure Measurement
Everyone doctoral or other nursing student takes their own path and has their own reflections when it comes to their college journey. One of the common facets of nursing and the associated research that nursing students tend to ponder to varying degrees is what is known as evidence-based practice, or EBP. Even with the common sense behind EBP, there are a number of students and even practitioners that are not fully versed in the best practices and such of their job that have come from the EBP. One such nagging habit that many people have is the improper measurement of blood pressure. Indeed, if the measurement of blood pressure is done incorrectly, it can cause shoddy readings and this is something that can be avoided so easily. While it seems like a simple problem to fix, the improper measurement of blood pressure remains a nagging issue that needs…...

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References

Wexler, R. (2010). Ambulatory Blood Pressure Monitoring in Primary Care. Southern Medical

Journal, 103(5), 447-452.  http://dx.doi.org/10.1097/smj.0b013e3181d82404

blood pressure will be affected by drinking a large, caffeinated coffee.
The researcher believe caffeine does have some kind of an effect on a persons' blood pressure, for the reason that we recognize that Caffeine is a drug that is naturally produced in the seeds and leaves of a lot of plants. It's similarly made artificially and added to definite foods. Caffeine is defined as a drug for the reason that it arouses the central nervous system, producing increased attentiveness. Caffeine provides most individuals a temporary energy boost. Which is lactated in coffee, tea, chocolate, numerous energy drinks.

Why was the patient's blood pressure recorded before he drank the coffee?

One of the reasons why it was recorded was because he wanted to measure the blood pressure at various time points using a home blood pressure monitor. It was important to record it before they drank the coffee because that way they…...

calculates the 95% confidence intervals of two data sets, one for the reading of systolic blood pressure and one for the reading of diastolic blood pressure. There was a sample size of 9 total patients included. The steps of reaching the confidence interval are outlined below. Excel was used to find the mean for each data set as well as the standard deviation using the formula provided. From there, the steps were manually calculated.
The confidence interval must be calculated through a number of steps. Some of these were done on excel, while others had to be calculated manually. The first step was to find the average of the data set for each type of blood pressure measured. The systolic average was 131.1 repeating, while the diastolic mean was 75.5 repeating. Next, standard deviation was found using the following formula:

The standard deviation for systolic blood pressure was 23.15407332, while it…...

Introduction Accurate measurement of blood pressure is critical for making appropriate clinical decisions in the management of high blood pressure in order to reduce cardiovascular risk and prevent organ damage. This is important because an inaccurate measurement of blood pressure could lead to a patient being falsely classified as hypertensive or falsely classified as having high normal or normal blood pressure. It could also lead to faulty clinical decisions regarding patient progression in an exercise program (White et al., 2013). This topic is one that is worth examining because blood pressure reading is one of the most inaccurately performed measurements in clinical medicine (White et al., 2013). Efforts are ongoing to increase hypertension awareness, treatment, and control among adults, but the high prevalence of undiagnosed (22%) and uncontrolled (36%) hypertension remains a challenge (White et al, 2013). For that reason, this DNP aims to address that issue.
An assessment of literature regarding…...

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References

Badeli, H., & Assadi, F. (2014). Strategies to reduce pitfalls in measuring blood pressure. International Journal of Preventive Medicine, 5(1), S17-S20. Retrieved from

Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & Emilia, I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies, 52(1), 240-249.

Cooper, L., Andrew, S., & Fossey, M. (2016). Educating nurses to care for military veterans in civilian hospitals: An integrated literature review. Nurse Education Today, 47, 68-73. doi: 10.1016/j.nedt.2016.05.022

Creswell, J. W. (2014): Research design. Qualitative, Quantitative, and Mixed Methods Approach. Lincoln: Sage publications.

Deepak, K. K. (1992). Blood Pressure Simulation Model: A Teaching Aid. Indian Journal of Physiology and Pharmacology, 36, 155-155.

Dichter, M. E., Haywood, T. N., Butler, A. E., Bellamy, S. L., & Iverson, K. M. (2017). Intimate partner violence screening in the Veterans Health Administration: demographic and military service characteristics. American Journal of Preventive Medicine, 52(6), 761-768.

Fallon, N. (2015). The challenge of measuring blood pressure accurately. British Journal of Cardiac Nursing, 10(3), 132-139. doi:10.12968/bjca.2015.10.3.132.

Gillespie, C. D., Hurvitz, K. A., & Centers for disease control and prevention. (2013). Prevalence of hypertension and controlled hypertension-United States, 2007–2010. Morbidity and Mortality Weekly Report Surveillance Summaries, 62(3), 144-8. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/su6203a24.htmhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990924/

For African Americans with Hypertension (P), Does Telemonitoring Blood Pressure Education (I), Compared to Usual Care (C), Improve Blood Pressure Control (O), Within Three Months (T) Abstract
With the advent of technology, telemedicine has gained its popularity over the past few years. Various researches are now being conducted to see whether this emerging trend is effective in controlling diseases remotely. Patients need to be educated about technology, especially for the most common and most complicated chronic disease called hypertension. African Americans are believed to have higher rates of this disease, and data have been collected from numerous scholarly articles in this paper to support whether telemonitoring would be helpful for their hypertension control. A background and significance of the problem are mentioned, and then, an assessment of the phenomenon is provided. To highlight the societal perspective of the problem, details are added for further elaboration of the chosen clinical problem. Incidence and…...

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References

Barton, A.B., Okorodudu, D.E., Bosworth, H.B. & Crowley, M.J. (2018). Clinical inertia in a randomized trial of telemedicine-based chronic disease management: Lessons learned. Telemedicine and e-Health, 24(10), 742-748. DOI: 10.1089/tmj.2017.0184

Buis, L.R., Dawood, K., Kadri, R., Dawood, R., Richardson, C.R., Djuric, Z., Sen, A., Plegue, M., Hutton, D., Brody, A., McNaughton, C.D., Brook, R.D. & Levy, P. (2019). Improving blood pressure among African Americans with hypertension using mobile health approach (the MI-BP app): Protocol for a randomized control trial. JMIR Research Protocols, 8(1), e12601. DOI: 10.2196/12601

Buis, L., Hirzel, L., Dawood, R.M., Dawood, K.L., Nichols, L.P., Artinian, N.T., Schwiebert, L., Yarandi, H.N., Roberson, D.N., Plegue, M.A., Mango, L.C. & Levy, P.D. (2017). Text messaging to improve hypertension medication adherence in African Americans from primary care and emergency department settings: Results from two randomized feasibility studies. JMIR mHealth and uHealth, 5(2), e9. DOI: 10.2196/mhealth.6630

Centers for Disease Control and Prevention. (2020, September 8). Facts about hypertension. Retrieved

Champoux, E., Price, R., Cowdery, J.E., Dinh, M., Meurer, W.J., Rehman, N., Schille, C., Oliver, A., Brown, D.L., Killingsworth, J. & Skolarus, L.E. (2020). Reach out emergency department: Partnering with an economically disadvantaged community in the development of a text messaging intervention to address high blood pressure. Health Promotion Practice, 21(5), 791-801. https://doi.org/10.1177/1524839920913550

Skolarus, L.E., Cowdery, J., Bailey, S., Baek, J., Byrd, J.B., Hartley, S.E., Valley, S.C., Saberi, S., Wheeler, N.C., McDermott, M., Hughes, R., Shanmugasundaram, K., Morgenstern, L.B. & Brown, D.L. (2018). Reach out churches: A community based participatory research pilot trial to assess the feasibility of a mobile health technology intervention to reduce blood pressure among African Americans. Health Promotion Practice, 19(4), 495-505. DOI: 10.1177/1524839917710893

https://www.cdc.gov/bloodpressure/facts.htm

Quantitative and Qualitative Study about Blood Pressure 1 a.
The process of conducting a qualitative research study about blood pressure first begins with the design of the study. As the method is qualitative, the approach is what next needs to be decided: what exactly is to be studied and how will data be collected and analyzed? For example, in the qualitative study by Bergdall et al. (2016), the researchers used a telemonitoring intervention, using focus groups and the interview method of collecting data. The qualitative process requires researchers to obtain information on the subjective experience of a phenomenon in most cases. The process is based on the notion that the researcher is seeking to understand what variables are impactful in a given scenario. There is no emphasis on testing variables; instead, the emphasis is on understanding what the variables are that make a difference among the population studied. A population then needs…...

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References

Bergdall, A. R., Sperl-Hillen, J. M., O\\\\'Connor, P. J., Asche, S. E., Crabtree, B. F., Smith,

E. A., ... & Trower, N. K. (2016). Qualitative Data from a Trial of Home Blood Pressure Telemonitoring and Pharmacist Management. Journal of Patient-Centered Research and Reviews, 3(3), 182-183.

van Dipten, C., van Berkel, S., de Grauw, W. J., Scherpbier-de Haan, N. D., Brongers, B.,

van Spaendonck, K., ... & Dees, M. K. (2018). General practitioners’ perspectives on management of early-stage chronic kidney disease: a focus group study. BMC Family Practice, 19(1), 81.

Woolsey, S., Brown, B., Ralls, B., Friedrichs, M., & Stults, B. (2017). Diagnosing

hypertension in primary care clinics according to current guidelines. The Journal of the American Board of Family Medicine, 30(2), 170-177.

Endocrine control of BP
Hormonal Control of Osmotic pressure: Stimulation

Arterial blood pressure (BP) is under tight control by the mammalian nervous system, cardiovascular system, kidneys, and endocrine system (Vivas et al., 2014). The VII, IX, and X cranial nerves conduct peripheral taste, osmo-sodium, volume, and baroreceptor information to the solitary tract, while the distinct bundles of neurons in the lamina terminalis respond to changes in plasma and cerebral spinal fluid sodium levels, osmolality, and angiotensin II levels. The information thus received is transmitted to the median preoptic, supraoptic, paraventricular, lateral parabrachial, and dorsal raphe nucleus for integration. The neurotransmitter systems involved include angiotensin, vasopressin, oxytocin, and serotonin.

The overall response to reductions in BP and electrolyte content of bodily fluids is to trigger the sympathetic nervous system, endocrine system, and appropriate behavior to correct the deficiency (Vivas et al., 2014). The most important arm of BP control is the renin-angiotensin-aldosterone system, which…...

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References

Chopra, S., Baby, C., & Jacob, J.J. (2011). Neuro-endocrine regulation of blood pressure. Indian Journal of Endocrinology and Metabolism, Suppl. 4, S281-8.

Duka, A., Duka, I., Gao, G., Shenouda, S., Gavras, I., & Gavras, H. (2006). Role of bradykinin B1 and B2 receptors in normal blood pressure regulation. American Journal of Physiology, Endocrinology and Metabolism, 291(2), E268-74.

Farrao, F.M., Lara, L.S., & Lowe, J. (2014). Renin-angiotensin system in the kidney: What is new? World Journal of Nephrology, 3(3), 64-76.

Vivas, L., Godino, A., Dalmasso, C., Caeiro, X.E., Macchione, AF., & Cambiasso, M.J. (2014). Chapter 9: Neurochemical circuits subserving fluid balance and baroreflex: A role for serotonin, oxytonin, and gonadal steroids. In L.A. De Luca Jr., J.V. Menani, & A.K. Johnson (Eds.), Neurobiology of body fluid homeostasis: Transduction and integration (pp. 141-166). Boca Raton, FL: CRC Press.

Introduction The renin-angiotensin-aldosterone system (RAAS) plays a very important role in the regulation of systemic vascular resistance and blood volume. Its role helps ensure hemodynamic stability when the body loses water, salt, and blood. The baroceptor reflex always corrects these imbalances in a short-term window while the RAAS helps keep the balance when the imbalances are chronic. The RAAS is made up of three main compounds: angiotensin II, aldosterone, and rennin (Weir & Dzau, 1999). The three compounds help in the elevation of blood pressure when renal blood pressure decreases and when there is a decrease in the delivery of salt to the distal convoluted tube. It also increases arterial pressure during beta-agonism. Its characteristics and functions make it possible for the body to regulate blood pressure for long periods of time. While it is mainly linked to the kidneys, its functions also have effects on the adrenal glands, blood vessels,…...

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References

Carey, R. M. (2015). The intrarenal renin-angiotensin system in hypertension. Advances in chronic kidney disease, 22(3), 204-210.

Fountain, J. H., & Lappin, S. L. (2018). Physiology, Renin Angiotensin System. Treasure Island Florida, StatPearls Publishing.

Macia-Heras, M., Del Castillo-Rodriguez, N., & Navarro González, J. F. (2012). The renin-angiotensin-aldosterone system in renal and cardiovascular disease and the effects of its pharmacological blockade. J Diabetes Metab, 3(171), 2.

Otte, M., & Spier, A. (2009). The renin–angiotensin–aldosterone system: Approaches to cardiac and renal therapy. Compendium: Continuing Education for Veterinarians,, 31.

Weir, M. R., & Dzau, V. J. (1999). The renin-angiotensin-aldosterone system: a specific target for hypertension management. American journal of hyper

Technology in Medicine: Distant Medical Surveillance Technology for Diabetics in the Less Developed Area of Texas
An estimated 26 million Americans live with diabetes. When not properly treated, diabetes could be fatal as it occupies the seventh position on the list of major mortality causes and it is also a strong causative factor of renal failures, sight damage and clinical limb removals among Americans. Diabetes occurrences are approximately 17% higher in less developed areas. Ethnicity and race are also major factors in determining the risk of suffering from the disease as it affects the smaller factions more. Distant medical surveillance can be very helpful in acquiring daily data about a diabetic's sugar levels, dangerous signs, feeding habits and therapy devotion. This method could help patients take their medications appropriately. Even though certain patients could decide not to adhere to their treatments and thus render this technology useless, the group who…...

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References

Balamurugan, A., Hall-Barrow, J., Blevins, M. A., et al. (2009). A pilot study of diabetes education via telemedicine in a rural underserved community -- opportunities and challenges: A continuous quality improvement process. The Diabetes Educator, 35(1), 147 -- 154.

Greenwood, D. A., Young, H. M., & Quinn, C. C. (2014). Telehealth Remote Monitoring Systematic Review: Structured Self-monitoring of Blood Glucose and Impact on A1C. Journal of Diabetes Science and Technology, 8(2), 378 -- 389.

Hale, N. L., Bennett, K. J., &Probst, J. C. (2010). Diabetes care and outcomes: disparities across rural America. Journal of community health, 35(4), 365-374.

Helseth, C. (2014). Diabetes Management in Rural Areas Takes Holistic, Community Approaches, Rural Health Information Hub. Retrieved from   on February 18, 2017https://www.ruralhealthinfo.org/rural-monitor/rural-diabetes-management/ 

blended study, both qualitative and quantitative in nature. The blend between numbers-based data and analysis and more abstract and conceptual work is necessary because of the totality of what is being looked at and how the research will be done (Lund, 2012).
ationale for Study Type Selection

While the before and after results of hypertension of patients in this case will be strictly numerical and statistical in scope, the formulation and tracking of the interventions, education and so forth that will form the control for the experiment will certainly be based more on concepts, evidence-based practice and the ostensibly proper ways to enforce and impose interventions on patients (McDonald & Blackwell, 2006). After all, the behaviors and changes under way are not something more detached and simple like whether a medication is take or not or whether a therapy is administered. The people involved will be instructed on what to do…...

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References

Hanley, J. A. (2017). Correction of Selection Bias in Survey Data: Is the Statistical Cure Worse

Than the Bias?. American Journal of Public Health, 107(4), 503-505.

doi:10.2105/AJPH.2016.303644

Lund, T. (2012). Combining Qualitative and Quantitative Approaches: Some Arguments for Mixed Methods Research. Scandinavian Journal Of Educational Research, 56(2), 155-

heories of Crowding: hree main models (Evans and Lepore 1992) are behavioral constraints, control, and overload arousal. Behavioral constraints happen when one has difficulty completing a task due to crowding. he control theory holds that either a condition in the environment or a predisposing variable explain crowding. Stress models, including overload/arousal models see a bombardment of the senses as contributing to the feeling of being crowded, and therefore causing stress. Although the control model fits under both the moderator and mediator designations, the other two models fit either the moderator or mediator designation. Negative outcomes are explained by both the constraint and the overload/arousal models.

Practical Effects of Crowding: It is important to keep in mind that short-term effects of crowding do not necessarily correlate to long-term effects of crowding. Although there are a plethora of short-term studies, there have been no conclusive multigenerational studies. Crowding can result in physical symptoms…...

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Theories of Crowding: Three main models (Evans and Lepore 1992) are behavioral constraints, control, and overload arousal. Behavioral constraints happen when one has difficulty completing a task due to crowding. The control theory holds that either a condition in the environment or a predisposing variable explain crowding. Stress models, including overload/arousal models see a bombardment of the senses as contributing to the feeling of being crowded, and therefore causing stress. Although the control model fits under both the moderator and mediator designations, the other two models fit either the moderator or mediator designation. Negative outcomes are explained by both the constraint and the overload/arousal models.

Practical Effects of Crowding: It is important to keep in mind that short-term effects of crowding do not necessarily correlate to long-term effects of crowding. Although there are a plethora of short-term studies, there have been no conclusive multigenerational studies. Crowding can result in physical symptoms such as sweating, sickness, and increased heart rate and blood pressure. In some situations men are more sensitive, and in others women are more sensitive. Children are more susceptible than adults, and lower income children are most effected.

Conclusions: Most studies have failed to address long-term results of crowding. The definition of crowding is not concrete. The social density concept is used to explain crowding even though it is known that there are other mitigating factors such as one's culture or predisposing factors which may change one's perception of feeling crowded. Most theories stress mediator or moderator effects to explain crowding. Competition increases the feeling of being crowded, causes intolerance of others, and causes people to treat their environment with less consideration.

Airway Pressure on Cardiovascular Performance
HEART-LUNG CONNECTION

The Influence of Mean Airway Pressure on Cardiovascular Performance

reathing, also known as pulmonary ventilation, is the basic connection between the heart and lungs (Williams & Whitney, 2006). The connection allows air between the lungs and the atmosphere and the exchange of gases between the air and the alveoli in the lungs. ody receptors can detect changes involved in the movement of air and the pressure that accompanies it. These receptors can either increase or decrease breathing rate. They encourage slower breathing when blood pressure rises and faster breathing rate if the blood pressure goes down. Meanwhile, an exchange of gases between body tissues and capillaries is needed to maintain life. It brings in the gases living tissues need for survival. lood carries oxygen molecules when leaving the heart and distributes it throughout the body. Very small capillaries coordinate in the flow and distribution of…...

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BIBLIOGRAPHY

Byrd, R.P. And Mosenifar, Z. (2010). Mechanical ventilation. Medscape: WebLLC.

Retrieved on August 18, 2011 from  http://emedicine.medscape.com/article/304068-overview 

Daoud, E.G. (2007). Airway pressure release ventilation. Vol 2 (4) Annals of Thoracic

Medicine: Pub Med Central. Retrieved on August 12, 2011 from  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732103

Airway Pressure
THE EFFECTS OF AIRWAY PRESSURE RELEASE VENTILATION AND HIGH FREQUENCY OSCILLATION VENTILATION ON THE HEART - SPECIFICALLY WHEN THE PATIENT HAS CONGESTIVE HEART FAILURE.

MECHANICAL VENTILATION

CONGESTIVE HEART FAILURE

AIRWAY PRESSURE RELEASE VENTILATION (APRV)

APRV & CONGESTIVE HEART FAILURE

HIGH FREQUENCY OSCILLATION VENTILATION (HFOV)

HFOV & CONGESTIVE HEART FAILURE

MECHANICAL VENTILATION

Mechanical Ventilation refers to the process of helping the normal breathing process of an individual when his breathing patterns are compromised due to either a pathology within the lung or due to a collective collapse of the related organs. Mechanical ventilation can be of two types: negative pressure ventilation where the air is made to suck into the lungs or positive ventilation where air is forced into the lungs through the airway. During the process of providing ventilation to the lungs it becomes important to "secure the airway" which means that the air should go through the airway passages namely trachea, bronchi and then to lungs…...

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Bibliography

Calzia E, R.P. (1997). Airway pressure release ventilation and biphasic positive airway pressure:a 10-year literature review. Clinical Intensive Care, 8:296-301.

Cartotto R, E.S. (2004). High frequency oscillatory ventilation in burn patients with the acute respiratory distress syndrome. Burns, 30(5):453-463.

Dickstein K, C.-S. A. (2008). "ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Hear. Eur. Heart J., 29(19):2388-442.

dorland's medical dictionary . (2009).

The picture to the left depicts the various elements that are responsible for thermoregulation in human skin. The illustrations shows the various layers of skin along with the veins, arteries and capillaries of the circulatory system that assist in insuring that the thermoregulatory system works properly. The sweat glands are responsible for selectively removing materials from the blood the sweat glands then concentrates or alters these toxins, and secretes them for elimination from the body. The perspiration or sweat is then removed through the sweat pore. This has a twofold purpose: to remove toxins and thermoregulation (in this case cooling the body).

Thermoregulation involving perspiration is brought about by both internal and environmental heat and exercise. As it relates to the latter, there have been many studies related to exercise and thermoregulation. According to Marino (2004)

"thermoregulatory effector responses of humans and concluded that temperature regulation during exercise is dissimilar to temperature…...

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Works Cited

Caterina MJ, Schumacher MA, Tominaga M, Rosen TA, Levine JD, Julius D. The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature. 1997;389:816-824.

Dugan SA, Powell LH, Kravitz HM, Everson Rose SA, Karavolos K, Luborsky J (2006)

Musculoskeletal pain and menopausal tatus. Clin J. Pain 22: 325 -- 331

Deecher, D.C.K. Dorries (2007)Understanding the pathophysiology of vasomotor symptoms

pressure? How respo
There was a time when I was under extreme duress to get to work on time. Although I can look back on the situation fondly now and apply the lessons learned, back then it could have had serious negative ramifications for my career. I had recently moved and was beginning a new nursing position. I was supposed to fly in on the Friday before I started the following Monday, but I missed the flight and had to catch the next one. By the time I arrived, I barely had a chance to get a full night's rest in my own bed, let alone plot the route from my new residence to my job. I remember feeling so pressured as I drove around the downtown streets which all looked alike since I had just moved. At the time, the last thing I wanted to do was start a…...

Cor Pulmonale is pulmonary heart disease, which causes failure of the right ventricle. This comes as a result of high blood pressure within the lungs. Pulmonary edema is fluid accumulation in the lungs, often as a result of congestive heart failure. Both diseases would be unfortunate and difficult to deal with, but pulmonary edema would be preferable. There are medications and treatments that can be used in order to reduce the fluid in the lungs and keep the congestive heart failure at bay. The Cor Pulmonale, though, will damage the heart\'s right ventricle, and there is nothing that can be....

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Looking for the best practices on endotracheal suctioning often involves determining whether open or closed suctioning is better.  Open suctioning requires disconnecting the patient from the ventilator, while closed suctioning allows the patient to remain connected to the ventilator.  While closed suctioning is generally preferred, it is not always the best practice, but the research investigated looked specifically at closed suctioning because of the research question presented.   

In 1999, Kinloch ran an observational study that compared oxygenation in patients that either had normal saline instilled at the start of endotracheal tube suctioning or did not have saline instilled.  Until....

1. The Role of Exercise in Preventing Cardiovascular Disease in Men: A Comprehensive Examination

Introduction: Highlight the prevalence and impact of cardiovascular disease (CVD) among men and emphasize the role of exercise as a preventive measure.

Body:
Discuss the physiological mechanisms by which exercise improves cardiovascular health, including increased blood flow, improved blood pressure regulation, and enhanced lipid profiles.
Explore the specific types and intensities of exercise that are most effective in reducing CVD risk.
Review evidence from clinical trials and observational studies demonstrating the association between regular exercise and lower incidence of CVD events.

Conclusion: Summarize the key findings supporting the protective....