NR 503 Week 5: Infectious Disease Paper

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NR 503 Week 5: Infectious Disease Paper

NR 503 Week 5: Infectious Disease Paper

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Description of tuberculosis

Tuberculosis (TB) is a contagious, life-threatening infectious disease that primarily affects the lungs and is caused by the mycobacterium germ (Delogu, Sali, and Fadda, 2013). General symptoms are a wracking cough, extreme weakness and fatigue, coughing up blood or phlegm (sputum), marked weight loss, fever and chills, profuse sweating, and severe chest pain while breathing or coughing (CDC: Signs and symptoms, 2016). A skin test or TB blood test are used to determine if a person has tuberculosis.

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The TB mode of transmission occurs when a person with TB coughs, sneezes, speaks, or opens his or her mouth; mycobacterium germs are released into the air and remain for hours— even days (CDC: How TB spreads, 2016). Complications of pulmonary TB include structural, metabolic, vascular, and infectious conditions (Shah & Reed, 2014). An acute complication of TB is sepsis (Shah & Reed, 2014). Chronic complications are pulmonary mycetoma or focal neurologic deficits from tuberculomas; pulmonary complications include hemoptysis (coughing up blood) or pneumothorax (collapsed lung) (Shah & Reed, 2014). TB is treated with or more first-line drugs for 6 to 12 months: isoniazid (INH), rifampin (RIF), ethambutol (EMB), and/or pyrazinamide (PZA) (CDC: Treatment for TB disease, 2016). If the strain of TB is resistant to first-line drugs, second-line group 2 drugs are given (CDC: Treatment for TB disease, 2016). Other TB drugs are categorized as second-line groups 3 and 4, and third-line group 5. The vaccine for TB is Bacille Calmette–Guèrin (BCG) (CDC: Treatment for TB disease, 2016).

Demographic of interest

The global mortality rate for tuberculosis is more than 50 percent in patients who do not receive adequate treatment (Adigun & Bhimji, 2018). The CDC (2018) reports the morbidity of TB as 10.4 million people around the world of which the mortality was 1.7 million (Adigun & Bhimji, 2018). The morbidity of TB cases in the U.S. was 9,547 cases reported in the U.S. in 2015, of which 470 people died; of the 9, 272 TB cases reported in 2016, the CDC has yet to compile mortality rates (CDC, 2017). The incidence rate for TB cases in the United States is 3.0 per 100,000 in 2015 and 2.9 per 100,000 in 2016 (CDC: TB Incidence…, 2017). WHO (2017) estimates the global incidence rate for TB decreases 1.5 percent every year; the prevalence of TB in the U.S. in 2015 was 0.00002974 percent in a population of 321 million; in 2016, the prevalence was 0.0000287058 in a population of 323.4 million people (Adigun & Bhimji, 2018). 

Determinants of health/host, agent, environmental factors

Common TB determinants of health are socioeconomic factors, physical environment, and individual behaviors. Poverty is one of the leading social determinants of TB, as it determines the conditions in which people live. Undernutrition is also another risk factor for developing the disease. Malnutrition leads to secondary immunodeficiency, which amplifies a person’s susceptibility for TB infection (Narasimhan et al., 2013).  Smoking and alcohol abuse also increase a person’s chances of getting TB because these behaviors cause other medical conditions that weaken the immune system. Smoking damages the lungs in many ways, and people who smoke are 40 – 60 percent more likely to develop pulmonary TB, the leading form of the condition (Narasimhan et al., 2013). Excessive alcohol consumption damages the body and interferes with TB treatment drugs. People who have been diagnosed with cancer, diabetes, Crohn’s disease, chronic obstructive pulmonary disease, HIV/AIDS, or other medical conditions that attack the immune system are at great risk to contract TB. These conditions cause an already compromised immune system to become defenseless against TB (Narasimhan et al., 2013).

Host factors for TB are general health practices, attitude about healthcare providers, psychological states, social status, previous exposure to disease, race, genetic diseases. The causative agent for TB is the mycobacterium tuberculosis microbe. Environmental factors that promote TB are poorly ventilated, crowded, filthy home and work environments. Settings that have a lot of air pollution, geographic areas with a high incidence of TB, or work environments with high levels of airborne or released toxins promote growth of the mycobacterium tuberculosis germ. 

Role of the FNP

If FNPs want to effectively help communities eliminate and prevent tuberculosis outbreaks, FNPs must understand and practice current CDC and WHO approved TB screening procedures, treatment guidelines, and community engagement methods. Case finding methods should include retrieving relevant TB source documents from local, national, and state health agencies, such as disease indices and pathology reports that identify reportable cases. FNPs should also go out in the community and collect data about members who have been treated for TB or who can recount stories of interactions with people who have been diagnosed with TB. FNPs can utilize their informatics and research skills to analyze their findings and experiences then compile them into a report. Once these experiences and evidence-based practices have been presented to the right sources, TB resources and clinical care for at risk populations will be more readily accessible.

References

Adigun R, Bhimji SS. (2018 Apr 20). Tuberculosis. In: StatPearls (Internet). Available from: 

https://www.ncbi.nlm.nih.gov/books/NBK441916/

Centers for Disease Control and Prevention (CDC). (2016, March 17). Tuberculosis (TB): Signs & symptoms. Available from https://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm

Centers for Disease Control and Prevention (CDC). (2016, July 26). How TB spreads. Available from https://www.cdc.gov/tb/topic/basics/howtbspreads.htm

Centers for Disease Control and Prevention (CDC). (2016, August 11). Treatment for TB Disease. Available from https://www.cdc.gov/tb/topic/treatment/tbdisease.htm

Centers for Disease Control and Prevention (CDC). (2017, November 13). Reported tuberculosis in the United States, 2016. Available from https://www.cdc.gov/tb/statistics/reports/2016/table1.htm

Centers for Disease Control and Prevention (CDC). (2017, November 13). TB incidence in the United States, 1953-2016. Available from https://www.cdc.gov/tb/statistics/tbcases.htm

Delogu, G., Sali, M., & Fadda, G. (2013). The Biology of Mycobacterium Tuberculosis

Infection. Mediterranean Journal of Hematology and Infectious Diseases, 5(1), e2013070. http://doi.org/10.4084/MJHID.2013.070

Narasimhan, P., Wood, J., MacIntyre, C. R., & Mathai, D. (2013). Risk Factors for Tuberculosis.

Pulmonary Medicine, 2013, 828939. http://doi.org/10.1155/2013/828939

Shah, M., & Reed, C. (2014). Complications of tuberculosis. Current Opinion in Infectious Diseases, 27(5), 403-410. doi: 10.1097/QCO.0000000000000090

fter reviewing the options, I decided to choose the https://www.lgbtqiahealtheducation.org/
link to analysis and educate me on transgendered children and teens.  This population of clients has increased in the inpatient facilities. To my knowledge there are countless sexual orientations in our society.  I became familiar with transgender and non-binary only.  This was because I was afraid of discriminating against individuals.  The national LGBT Health Education Center website has enlightened me in understanding the difference and addressed new concepts that I had no clue on how to approach.  From this reading I know I have much more to educate myself on when it comes to sexual orientations, such as the correct pronunciations and proper treatments for this population. I truly would not want to make any mistakes, causing people to feel discriminated against or just uncomfortable when being treated.  

National LGBTQIA + Health Education Center. (2022). Learning Resources – Learning Modules. Http://www.lgbtqiahealtheducaton.org/resources/type/learning-module

Participation for MSN

Threaded Discussion Guiding Principles

The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.

Participation Guidelines

Each weekly threaded discussion is worth up to 25 points. Students must post a minimum of two times in each graded thread. The two posts in each individual thread must be on separate days. The student must provide an answer to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week. If the student does not provide an answer to each graded thread topic (not a response to a student peer) before the Wednesday deadline, 5 points are deducted for each discussion thread in which late entry occurs (up to a 10-point deduction for that week). Subsequent posts, including essential responses to peers, must occur by the Sunday deadline, 11:59 p.m. MT of each week.

Direct Quotes

Good writing calls for the limited use of direct quotes. Direct quotes in Threaded Discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the Grammar, Syntax, APA category.

Grading Rubric Guidelines

Performance Category 10 9 8 4 0
ScholarlinessDemonstrates achievement of scholarly inquiry for professional and academic decisions. Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisionsEvaluates literature resources to develop a comprehensive analysis or synthesis.Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.Evaluates information from source(s) to develop a coherent analysis or synthesis.Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion. Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.Demonstrates little or no understanding of the topic. Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.Information is taken from source(s) without any interpretation/evaluation.The posting uses information that is not valid, relevant, or reliable No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge -Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;Applies concepts to personal experience in the professional setting and or relevant application to real life. Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.Applies concepts to personal experience in their professional setting and or relevant application to real lifeInteractions with classmates are relevant to the discussion topic but do not make direct reference to lesson content Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real lifeDoes not demonstrate a solid understanding of the principles and concepts presented in the lesson Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.Posts are superficial and do not reflect an understanding of the lesson contentDoes not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignoredNo discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive DialogueReplies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.(5 points possible per graded thread) Exceeds minimum post requirementsReplies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.Replies to a post posed by faculty and to a peerSummarizes what was learned from the lesson, readings, and other student posts for the week. Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate daysReplies to a question posed by a peerSummarizes what was learned from the lesson, readings, and other student posts for the week. Meets expectations of 2 posts on 2 different days.The main post is not made by the Wednesday deadlineDoes not reply to a question posed by a peer or faculty Has only one post for the weekDiscussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments Does not post to the threadNo connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APANote: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.Points deducted for improper grammar, syntax and APA style of writing.The source of information is the APA Manual 6th Edition 2-3 errors in APA format.Written responses have 2-3 grammatical, spelling, and punctuation errors.Writing style is generally clear, focused, and facilitates communication. 4-5 errors in APA format.Writing responses have 4-5 grammatical, spelling and punctuation errors.Writing style is somewhat focused. 6-7 errors in APA format.Writing responses have 6-7 grammatical, spelling and punctuation errors.Writing style is slightly focused making discussion difficult to understand. 8-10 errors in APA format.Writing responses have 8-10 grammatical, spelling and punctuation errors.Writing style is not focused, making discussion difficult to understand. Post contains greater than 10 errors in APA format.Written responses have more than 10 grammatical, spelling and punctuation errors.Writing style does not facilitate communication.The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
 0 points lost       -5 points lost
Total Participation Requirementsper discussion thread The student answers the threaded discussion question or topic on one day and posts a second response on another day.       The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirementper discussion thread The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.       The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Wednesday. Any assignments and all discussion requirements must be completed by 11:59 p.m. MT Wednesday of the eighth week.

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