Friday, November 25, 2016

Evidence based article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913335/



My article is about optimizing the benefits of biologic therapy in patients with ulcerative colitis. The anti-TNF alpha (antitumor necrosis factor alpha), “act by binding to the proinflammatory cytokine TNF alpha.” The drugs that are mentioned in the article as most commonly used are infliximab (Remicade) and adalimumab (Humira). Infliximab is given via infusions in the doctor’s office and Humira is given subcutaneously and is typically given every week to every 2 weeks. Golimumab and vedolizimumab were also mentioned as alternative therapies but the most preferred treatments were infliximab and adalimumab. Patients that received these treatments and did not develop antibodies that required them to quit taking the medication, had a higher incidence of remission and a lower incidence of requiring a colectomy. The ultimate goal of the biologic therapy is mucosal healing and de-escalation of therapy. The physician has to have a good patient history in order to prescribe the correct biologic therapy treatment for the patient with ulcerative colitis. They also need to follow-up with the patient to determine if the treatment has been effective by collecting the proper blood work such as C-Reactive Protein and serum albumin levels. Also following up with the proper testing such as colonoscopies and other endoscopic testing is essential to monitor the effectiveness of the drug therapy.

Wednesday, October 26, 2016

Krysten Wilson Reflective Journal Istan 10/24/16




11. Discuss 4 tasks you completed or tried to complete in simulation lab.
1. Draw labs for CBC, BMP, and digoxin level
2. Put in new orders for Zofran
3. Obtain a new order for acetaminophen for pt to receive acetaminophen suppository when the acetaminophen 650 mg was not in the drawer for PO
4. administer acetaminophen suppository  

 2.  What did you learn most about the situation(s) you encountered in simulation lab?
a.    Digoxin toxicity starts out with high blood pressure and tachycardia.

3. What will you do differently during your next simulation experience?
a.    I will check the allergies again before administering the medication

  4.  While watching your peers’ simulation experience, what are 3 things you learned?
1.   You can give medication even when they say they are allergic to something that looks very similar to what you are administering
2.   You need to call the unit secretary to get the correct patient labels
3.   You should not get someone out of bed unless you have finished with the head to toe assessment first.

5.   What 3 things did you learn in the classroom (didactic) that you put into practice during your simulation experience?

1.   Administering medication (acetaminophen suppository)
2.   Head to toe assessment
3.   Recognizing digoxin toxicity

Monday, September 5, 2016