Case Study of Janet Jackson-Free-Samples -Myassignmenthelp.com

Question: Discuss about the Case Study of Janet Jackson. Answer: Introduction In the presented case study, Janet Jackson is diagnosed with uterine fibroids. Uterine fibroids are growths of the uterus which are noncancerous and are usually experienced during the childbearing years in the lifetime of a woman. A contraction of uterine fibroids increases the chances of being infected by cancer of the uterus. Uterine fibroids vary in size from as small as seedlings which are not noticeable by the naked eye to enormous masses which can lead to permanent distortion and enlargement of the uterus. The disease can expand the uterus to the extent of reaching the rib cage in extreme cases. In as much as the exact cause or causes of uterine fibroids have not been proved yet, scientific literature articles now contain information of significant size informative of the epidemiology, hormonal aspects, genetics and molecular biology that can give enough information regarding the causes.(Lee, 2012) These factors are divided into four categories namely: effectors, predisposing, initiators, and promoters. Risk factors involve those conditions that which have been generally identified through epidemiologic studies. Through such knowledge, the etiology of the tumors responsible for uterine leiomyomas as well as the preventive measures can be sought. The initiators of uterine leiomyomas are known which more consideration given to genetic aberrations. Despite the massive and in-depth investigations done, no clear information can be presented regarding the primary or secondary characteristics of the changes of these genes and their effect on promotion and/or initiation of uterine leiomyomas tumors. The ovarian hormones estrogen and progesterone are found to be playing a significantly greater role in the promotion of the growth of uterine leiomyomas tumors(McKay, 2012). This is a proof that has been developed through clinical and laboratory experiments. Risk factors associated with uterine leiomyomas Age: An increase in age is a promoter of uterine leiomyomas especially during the reproductive years of an individual. The increase is found, through studies, to be rapid among women when they are in the age bracket of the forties(David R. Gambling, 2013). This increase in prevalence can be associated with increased growth of already existing fibroids besides an increased willingness of women in the later reproductive years to undergo gynecologic surgery. Obesity: Studies that show a strong correlation between obesity and the prevalence of uterine leiomyomas. The correlation is such that for every 10-kg increase in the weight of an individual, there is an estimated 21% increase in the risk. This applied to the body mass index as well. An increase in the adult BMI corresponds to an increased uterine leiomyomas risk besides an associated risk of gain in weight. The correlation between uterine leiomyomas risk and obesity can be linked to the hormonal factors which are associated with obesity. Still, other pathologic factors can as well be involved in this course(Lee, 2012). The conversion of adrenal androgens to estrogen with the help of adipose tissue is a major hormonal activity that increases the risk factor for uterine leiomyomas(David R. Gambling, 2013). More unbound and physiologically active estrogen is produced as a result of the hepatic production of sex hormones. Menopause: The absence of stimulations of the hormones due to menopause increases the risks of uterine leiomyomas(Lombardi, 2012). Uterine leiomyomas among postmenopausal patients can be reduced through selection bias resulting from the tendency of a clinical approach that is more conservative as well as nonsurgical. Diet: An association has been found to exist between the consumption of ham and red meat among them beef and the risk of the prevalence of uterine leiomyomas. On the contrary, consumption of foods that are rich in green vegetable has a reverse effect and is found to reduce the risk. Beef and ham are foods rich in fats which in turn increase the bioavailability of progesterone and estrogen hormones(Goldman, 2015). Uterine leiomyomas known for being a tumor which is responsive to hormones will then be promoted to grow and multiply. Smoking: The correlation between smoking and uterine leiomyomas has been found to be inverse with current smokers found to be having a 50% risk reduction as compared to past smokers(Foundation, 2010). The more cigarettes individual smoke per day, the lower the risk of the attack by uterine leiomyomas. This correlated has been attributed to the effect of smoking which has been found to be anti-estrogenic. Still, there have been numerous derangements of steroid metabolism which have been noticed in smokers(Foundation, 2010). These metabolisms have been found to decrease the bioavailability at tissues that are targeted by estrogen. At the same time, inhibition of aromatase by nicotine reduces the rate of conversion of androgens to estrone. Other risk factors include menarche, parity, exercise, and use of oral contraceptives etc. therefore, taking a back reflection of the case of Janet Jackson, numerous factors can be alluded to the cause of her uterine fibroids condition such as smoking and age(Tulandi, 2013). She is at her childbearing years hence the high risk of infection by uterine fibroids. A surgical operation is the most recommended treatment for uterine fibroids. It is important to consider the size of the growth before the operation is carried out to ascertain the extent of destruction and expansion the disease has done to the uterus(Goldman, 2015). The treatment aims at reducing or completely relieving the patient of the pain she is experiencing. In this case study, Janet undergoes a surgical operation so as to remove the growth in her uterus that is causing her a lot of pain. The most appropriate nursing management for postoperative hysterectomy is that which aims at reducing the pain would be undergoing through(Stoelting, 2014). Being a surgical operation, the process must be accompanied by pain that requires proper care and maintenance to help the patient gain her self-worth even after undergoing the process. A surgical intervention is the best option in handling the case of Janet as in will minimize pain as well as increasing the quality of her life. Upon completion of the surgical operation process, Janet is transferred to post anesthetic recovery unit in which she undergoes close monitoring before she is further transferred to the general ward. While in the PARU, anesthetist informs the nurse of the general conditions of the patient, the type of anesthesia used for the operation and the operation type performed. The anesthetist also informs the nurse of any complications experienced during the operation process. In the comparison of Janet's baseline observation regarding the given case with the observations taken before the surgical operation, her blood pressure when she was transferred to the PARU was 90/50 mmHg which is a considerably low since the normal adult systolic blood pressure should range between 100-120 mmHg with the diastolic pressure ranging 60-80 mm Hg. She does not experience any pain and a normal body temperature. She experiences a high pulse rate of 130 bpm above the normal rate which ranges from 60-100 beats a minute. This may be attributed to anxiety and depression. The lowered blood pressure of Janet can be attributed to the use of a general anesthesia during the operation of Janet which caused a diminution of her sympathetic nervous system culminating into considerable levels of blood loss. Janet Jackson was also found to be having a respiratory rate higher than that of a normal adult. Her respiratory rate was 30 rpm which is way above the normal range which is 12-20 rpm(McKay, 2012). A high respiratory rate shows respiratory depression which is one of the side effects of uterine fibroids. The PARU nurse is tasked with the role of conducting a detailed assessment of the airway of the patient, the heart rate, temperature among other conditions of the body. The nurse does this by assessing the health conditions of the patient at intervals of 15 minutes. The nurse should conduct a cardiovascular assessment so as to monitor the heart rate and blood pressure. Monitoring of the blood pressure levels and the heart rates is important for the case of Janet since the hysterectomy operation led to side effects such as depression(Glaser, 2013). It would also be important to monitor peripheral circulation in case the extent of the uterine fibroids attack was extreme and reached the rib cage. This would have effects on level and degree of mobility. The nurse should also be continuously conducting the orientation to the patient on strategies on how to reduce depression and anxiety levels. Plans of discharge usually begin as soon as the patient conditions begin to stabilize. During discharge, the family and the patient may be stressed over fears of the patient not being able to get back to normal. Upon the patient gaining stability, the family may be informed on any surgical and medical appointments(Tulandi, 2013). They will also be educated on how to take care of the patient in a way that helps in improving the quality of her life(David R. Gambling, 2013). In order to manage the pain, the patient can be put on the most appropriate analgesia depending on the level of pain. From the given case, Janet did not report any pain from the hospital hence did not necessarily need any pain relieving drugs. Instead, she only needed advice and education on how to manage and care for her wound, any symptoms, and signs that she may need to report to the hospital. An assessment should as well be conducted by a multidisciplinary team consisting of occupational therapists, social worke rs, and continence nurses. Occupational therapists team: This is a team of experts that would assist the patient with movement. Janet having undergone surgical operation may develop problems and challenges with moving from one place to another(Page, 2016). Occupational therapists would assist Jane with improving her ability with doing tasks that would be associated with her daily life. Such assistance will help the patient improve her skills and movement when doing such activities as cooking, dressing, and bathing. Social workers team: Diseases and disease conditions usually come with challenges that may not only affect the patient but also the family(Miller, 2009). Social workers are known for conducting the psychological functioning of the patients and then establish important interventions that would help the patient adjust to the challenges and conditions that she could be facing. Conclusion The complicated nature of medicine makes the treatment of the diseases of patients as just one of the ways of caring for patients. At times it may require a team of professionals who are working in collaboration in order to fully address the needs of a patient. Such needs include emotional issues, pain management, rehabilitation as well as treatment. The field of medicine encompasses adverse healthcare specialists and professionals with each professional having a different and distinguished role to play. An understanding of the role of each of the medical practitioners is important in ensuring proper coordination and appropriate service delivery to patients. References David R. Gambling. (2013). Obstetric Anesthesia and Uncommon Disorders. Cambridge: Cambridge University Press. Durham, R. (2013). Maternal-Newborn Nursing: The Critical Components of Nursing Care. Chicago: F.A. Davis, Foundation, F. H. (2010). International Abstracts of Surgery, Volume 21. Chicago: Franklin H. Martin Memorial Foundation. Glaser, o. P. (2013). Health Care Information Systems: A Practical Approach for Health Care Management. New York: John Wiley Sons. Goldman, M. A. (2015). Pocket Guide to the Operating Room. Washington: F.A. Davis. Lee, J. B. (2012). The ... Year Book of Obstetrics and Gynecology. New York: MD Consult (Online service). Lombardi, D. N. (2012). Handbook for the New Health Care Manager. Salt Lake: John Wiley Sons. McKay, R. S. (2012). The Medical Age, Volume 20. New York: .E. G. Swift,. Miller, R. D. (2009). Miller's Anesthesia: .... 1. London: Elsevier Health Sciences. Page, A. (2016). Keeping Patients Safe: Transforming the Work Environment of Nurses. London: National Academies Press. Stoelting, R. K. (2014). Stoelting's Anesthesia and Co-existing Disease. Oxford: Elsevier Health Sciences. Tulandi, T. (2013). Uterine Fibroids: Embolization and Other Treatments. Cambidge: Cambridge University Press. Waugaman, W. R. (2012). Principles and Practice of Nurse Anesthesia. Manchester: Appleton Lange.