Child abuse: Recognizing the injuries

What: Child abuse: Recognizing the symptoms is an article that gives insight into how to identify different kinds of child abuse, including physical, sexual, and emotional abuse.  It gives case studies for several actual incidences of abuse or suspected abuse. 

CRAAP: The author is affiliated with a children’s hospital and the article is from a scholarly journal.  The content is relevant, presented professionally, and with appropriate medical terms.  The article is from 2002, but still relevant content to today. 

So what? It is good for health care providers to be able to recognize when there are inconsistencies in reported histories and physical examination of a child.  The author presents several types of injuries that would not likely occur outside of abuse.  It encourages the health care worker to think critically about the injuries and histories, including the past history of the child’s caretaker.  Caretakers who are isolated, depressed, or who have histories of abusing children or animals may be cause to suspect abuse. 

Now what: Although it is easy for me to want to trust people and the stories they tell to explain a child’s injuries, I think it would always be important for me to consider alternative explanations if any of the injuries or circumstances seemed suspicious.  Recognizing abuse and notifying the proper authorities can serve to protect vulnerable children from further abuse.  It is my duty as a nurse to advocate for the patient, especially when they are at risk for further abuse or death. 

4510 Musculoskeletal Article

Article: The Effect of a Long-Term, Community-Based Exercise Program on Bone Mineral Density in Postmenopausal Women with Pre-Diabetes and Type 2 Diabetes 

What?  This is an article about the effect of exercise on bone density after 32 weeks of being on a regular exercise program for 3 days a week.  The participant’s bone density was compared with that of participants who did not follow any specific exercise routine.  It was a small sample of 10 postmenopausal diabetic or pre-diabetic women.  The result was that there was a significant improvement in bone density with exercise. 

CRAAP: This article was scholarly and peer-reviewed.  It employed scientific and responsible methods of research.  The subject matter is relevant and useful for the population in question. 

So what?  I thought that it was impressive that with a small sample over such a short period of time the results proved significant.  The decline in estrogen after menopause and diabetes (or pre-diabetes) put these women at a greater risk than the general population, making them ideal study participants.  This research result helps to justify interventions that target this patient population specifically. 

Now what?  Now I think it would be important for this research to be announced and for the successful outcome of the participants to be used as encouragement and evidence to influence behaviors.  I think that I would want to know that I could have significantly denser bones in as little as 32 weeks if I were facing the risk or reality of bone loss or fracture related to bone loss. This gives me something to consider mentioning to patients in my own practice if bone loss is a concern.  Perhaps it will really help to motivate my patients to engage in regular exercise and give them hope. 

Journal Entry for Article on Abdominal Conditions

Abdominal Conditions Article

What I learned and CRAAP

The article this week was on colorectal cancer screening.  It is from a scholarly, peer-reviewed source and cites statistics from the US Department of Health and Human Services, as well as US Census data.  The purpose of the article was to show how the cost of campaigning for screenings can be calculated and compared with the benefit or outcome of the campaigns.  Essentially, the article shows that the more people that choose to be screened, the lower the dollar amount spent on campaigning per person will be.  The importance of colorectal cancer screening is also emphasized because it is the second leading cause of cancer deaths, and typically goes undetected until the cancer is too advanced to treat successfully.  Studies like this one help to justify spending for similar campaigns. 

So What?  Lessons learned

I was reminded by this article about how significant the death rate for colorectal cancer is and how it can easily go undetected.  I was also reminded that it is expensive to campaign for screenings, but that there might be small ways that I can help in the effort to encourage people to be screened, which is really a duty of every nurse. 

Now What? How it impacts my practice

This article impacts my practice directly because I work in medical oncology and with patients who have colorectal cancer.  The risk for colorectal cancer is increased for relatives of people who have been diagnosed.  I should educate these family members of their risk and encourage them to be screened to prevent late detection, which carries with it the risk of death. 


4510 Week 7 Article Journal Entry

This week’s article was by Julie Considine, an Australian PhD student of nursing out of Australia, who wrote a literature review on how nurses can prevent adverse events through respiratory assessments.   The major points that stood out to me include the fact that, by definition, adverse events are caused by the health care the person is receiving, and that there are typically observable manifestations of a problem developing for a while before a full-blown adverse event takes place.  The take-home message to me is to be more observant and careful in my assessments of body systems, especially the respiratory system, because we can do a lot as nurses to intervene before a minor problem becomes a major one.  Our own negligence in making careful and frequent assessments is too often the cause of tragic outcomes.  

I find this article to be reliable.  It is from 2004, and therefore not especially current; although the nature of the content covers a principle that is unchanging: the need for a nurse to make careful and frequent assessments.  It is written professionally in an academic, peer-reviewed journal, and cites other professional sources.  The topic is relevant to the course material for this week.   It is also applicable to health care in America even though it is an Australian study.  The data analyzed were from the United States.  The same principles of assessment and tendency for respiratory dysfunction to precede adverse events are not unique to any one country.