Each students need to write an initial post to all discussion prompts (7 total). Each student also needs to respond to 3 students TOTAL, under any topic or combination of topics. So at a minimum, we should see a student\'s name 10 times within the entire Discussion Board to receive a Completion grade.
Students are required to include a reference for each initial post, cited in APA format. If your response to a student includes new information that is not your own opinion, it needs a citation as well. These can be from any textbook, journal article (recent, within 5 years), or reputable website.
1) Pick a type of therapy and discuss (appropriate patient population, nursing implications, patient teaching), and include what patient populations or diagnoses these would be utilized in; Heat therapy modalities or cold therapy modalities.
2) Chose one: Discuss Patient Teaching as it pertains to testicular self-examination or breast self-examination.

3) Pick one and discuss: What is the purpose or nursing implication as it pertains to vision, hearing, or spinal screening, and what patient populations does this affect?
4) Discuss Patient Teaching as it pertains to Pre-Op and Post-Op patients. This can include diet changes, pharmacologic expectations, pain management (both pharmacological and nonpharmacological) in patients who are having orthopedic, urologic, and cardiologic surgeries/procedures.
5) Pick one and discuss: What are the nursing implications or patient teaching pertinent to sutures and staples (insertion or removal), wound care considerations for a sacral decubitus, incontinence injuries, or cellulitis.

6) Pick one and discuss: What are the nursing implications or patient teaching pertinent to the care of a patient with a cast, splint, and/or in traction with pins?

7) Discuss the nursing implications of bed baths, bedmaking, hygiene, and/or elimination in the following patient populations: hip fracture, quadriplegia, post-perineal procedure (i.e. episiotomy, hemorrhoidectomy).

Please let me know if u have any questions. write on 1 to 7 Separately with minimum of two source for each using APA format. 

Discussions

Question 1: Heat Therapy Modalities

Heat therapy modalities are types of therapies that help to improve muscle function. The appropriate patient populations to which heat therapy modalities are applied are adult and elderly populations experiencing health conditions that lead to muscle pain. However, it is often recommended for elderly patients with multiple comorbidities (Freiwald et al., 2021). A commonly used type of heat therapy modality is superficial heat therapy. In this type of therapy, heat is applied to patients by either convection or conduction. The types of superficial heat therapies applied by conducting are heat packs, hot water bottles, hot stone therapy, and electric heat pads. Hydrotherapy, hot baths, hot lamps, and stream/sauna use convection to transfer heat to the patient.

An example of a diagnosis that is usually treated with superficial heat therapy is acute or chronic non-specific low-back pain. Low-back pain is commonly diagnosed in adults and the elderly. The effectiveness of superficial heat therapy in the management of low back pain is confirmed by research. In a study conducted by Freiwald et al. (2021), the researchers found that low-level superficial heat therapy applied continuously on the affected areas results in an improvement in muscular strength, enhances flexibility, and promotes pain relief. The nursing implications for using superficial heat therapy in patients with low-back pain include; it facilitates a speedy return of the patient to normal function and it may negate the need to use medications in patients with moderate to severe muscle pain.

Patient teaching promotes the effective use of heat therapies leading to speedy improvement of disease symptoms. Most heat therapy modalities are effective and easy to use. It is important to teach the patient how to apply various modalities properly, emphasizing to them how heat transmission occurs by either conduction or convection (Freiwald et al., 2021). Providing a patient with an educational booklet describing how a particular modality is applied can be very useful.

References

Freiwald, J., Magni, A., Fanlo-Mazas, P., Paulino, E., Sequeira de Medeiros, L., Moretti, B., Schleip, R., & Solarino, G. (2021). A role for superficial heat therapy in the management of non-specific, mild-to-moderate low back pain in current clinical practice: A Narrative Review. Life (Basel, Switzerland), 11(8), 780. https://doi.org/10.3390/life11080780

Kim, K., Ro, B., Damen, F. W., Gramling, D. P., Lehr, T. D., Song, Q., Goergen, C. J., & Roseguini, B. T. (2021). Heat therapy improves body composition and muscle function but does not affect capillary or collateral growth in a model of obesity and hindlimb ischemia. Journal of Applied Physiology (Bethesda, Md. : 1985), 130(2), 355–368. https://doi.org/10.1152/japplphysiol.00535.2020

Question 2: Patient Teaching as it Pertains to Breast Self-examination

Breast cancer is the type of cancer that is commonly diagnosed among women. Screening for breast cancer is the best way to detect early signs of the disease and identify individuals who are at risk of developing the condition. Although it is not recommended as a screening strategy for breast cancer, breast self-examination can provide useful insights that can help with the early detection of the disease (BreastCancer.org., 2022). Many women have limited knowledge about breast cancer examination, a factor that prevents them from engaging in the process and increasing the risk of a delayed diagnosis (Akarsu & Andsoy, 2022). The authors recommend that the best way to increase awareness among women regarding breast cancer examination is through patient teaching.

Patient teaching is associated with increased knowledge and awareness about breast self-examination. Akarsu and Andsoy (2022) conducted a study to evaluate the effect of breast self-examination training among Turkish women. They used a semi-experimental single-group pretest-posttest design to collect data for the study. The researchers found that 81.5% of the women did not engage in regular breast self-examination because they lacked the knowledge of how to complete the procedure. After training, there was an increase in scores of women who reported an increase in awareness of breast self-examination including an increased understanding of breast cancer risks and the need to go for screening. The participants reported an increased understanding of the steps to be followed when performing breast self-examination (Akarsu & Andsoy, 2022). Akarsu and Andsoy (2022) concluded that patient training increases breast self-examination awareness among women. They recommend regular training for renewed knowledge and skills.

References

Akarsu, N. K., & Andsoy, I. I. (2022). Evaluation of breast self-examination training in Turkish women living in Northwestern Turkey. Journal of Preventive Medicine and Hygiene, 63(1), E76–E82. https://doi.org/10.15167/2421-4248/jpmh2022.63.1.2305

BreastCancer.org. (2022). Breast self-exam. https://www.breastcancer.org/screening-testing/breast-self-exam-bse

Question 3: The Purpose and Nursing Implication for Spinal Screening

Spine curving and twisting are common complications in children and adolescents. Scoliosis is the medical term that is used to describe a curved or twisted spine. The purpose of spinal screening or scoliosis screening helps to identify people at risk of developing scoliosis and enhances early detection of the condition (Yaokreh et al., 2022). Although spine deformation can affect people of all age groups, they are highly prevalent in children and adolescents. Girls are at a higher risk of developing spine deformities when compared to boys (Yaokreh et al., 2022).  Spinal screening should be done early when and that is why it is recommended in children and adolescents. A recommendation by the Scoliosis Research Society indicates that spinal screening on adolescents and children should be done annually in order to identify symptoms of spinal deformation early (Zou et al., 2022). Early detection allows the timely initiation of treatment.

Spinal screening is associated with numerous nursing implications. Since scoliosis is a rare condition, affected children and adolescents experience challenges related to healthcare access. The nurse is charged with the responsibility of advocating for enhanced spinal screening in children and adolescents and for increased healthcare access for those diagnosed with the disease (Zou et al., 2022). Again, malnutrition has an influence on the development of spinal deformities in adolescents and children. Essentially, high cases of scoliosis are usually reported among malnourished minors (Karls et al., 2021). The nurse is charged with the responsibility of educating parents about spinal deformities, their risk factors, the need for screening, and the importance of adhering to the prescribed therapeutic regimen.

References

Karls, C. A., Duey-Holtz, A., Lampone, O. A., Dopp, A., Tolo, H., Tassone, J. C., Liu, X. C., Visotcky, A., & Goday, P. S. (2021). Prevalence of malnutrition and its associated outcomes in pediatric patients with scoliosis undergoing elective posterior spinal fusion or spine growth modulation – a retrospective review. Studies in Health Technology and Informatics, 280, 235–240. https://doi.org/10.3233/SHTI210475

Yaokreh, J. B., Yapo Kouamé, G. S., Ali, C., Odéhouri-Koudou, T. H., & Ouattara, O. (2022). Epidemiological and diagnostic characteristics of scoliosis in children in a single tertiary centre in Abidjan. African Journal of Paediatric Surgery : AJPS, 19(3), 171–175. https://doi.org/10.4103/ajps.AJPS_62_21

Zou, Y., Lin, Y., Meng, J., Li, J., Gu, F., & Zhang, R. (2022). The prevalence of scoliosis screening positive and its influencing factors: A school-based cross-sectional study in Zhejiang Province, China. Frontiers in Public Health, 10, 773594. https://doi.org/10.3389/fpubh.2022.773594

Question 4: Patient Teaching as it pertains to Pre-Op and Post-Op patients

A disease diagnosis that requires surgery can cause psychological distress to patients and their families. The nurse has the responsibility of addressing the concerns and uncertainties that the patient might have before and after a surgical procedure. For example, the nurse should work together with a physiotherapist and an orthopedic surgeon to provide pre- and post-operative education to a patient who is undergoing knee replacement (The Cochrane Collaboration, 2022). Pre-operative patient teaching is usually meant to prepare the patient for surgery. On the other hand, the purpose of post-operative patient teaching is to guide the patient through self-care management and the recovery process.

The nurse and other healthcare providers should address key issues and concerns during pre-operative teaching. Although contents of patient teaching usually vary based on settings and patient needs, important things to capture in the discussion include an explanation of the condition, its associated risk factors, clinical manifestations, how the surgery will address the existing complications, and the types of food to eat or avoid before surgery (The Cochrane Collaboration, 2022). Additionally, the nurse should teach the patient about the actual steps that will be followed during surgery, possible stressful scenarios that might arise during surgery, and the precautions to take during surgery to avoid complications during the procedure.

A patient who has undergone knee surgery should be guided through self-care management including the use of pharmacological and non-pharmacological interventions. For example, it is important to teach the patient about drug adherence and the need to keep the surgical site clean using an antiseptic (Blöndal et al., 2022). Other things that a post-operative patient should know include possible complications that might arise, the possibility of fatigue and loss of stamina, pain management, expected time for recovery, and the need to seek help when complications arise.

References

Blöndal, K., Sveinsdóttir, H., & Ingadottir, B. (2022). Patients’ expectations and experiences of provided surgery-related patient education: A descriptive longitudinal study. Nursing Open, 9(5), 2495–2505. https://doi.org/10.1002/nop2.1270

The Cochrane Collaboration. (2022). Preoperative education for hip or knee replacement. https://www.cochrane.org/CD003526/MUSKEL_preoperative-education-hip-or-knee-replacement

Question 5: Nursing Implications Pertinent to Sutures and Staples, and Wound Care Considerations for Incontinence Injuries

Operating room nurses play a key role in helping surgical patients to manage their wounds after surgery. In this respect, it is imperative for these nurses to understand wound closure techniques such as the use of sutures and stapes and how to effectively care for the wound to prevent surgical site infections (Rose & Tuma, 2022). A number of conditions can cause urinary incontinence. Some of these conditions require surgery which must be conducted by a qualified medical professional. An example of a medical condition that needs the attention of nurses is bladder stones. Bladder stones often cause obstruction of the urinary bladder (Julian & Agil, 2021). A surgical procedure to remove bladder stones leaves open wounds which are closed using sutures and staples. The nurse must work closely with the patient to prevent surgical site infections.

An important nursing implication is understanding how to insert and remove sutures and staples following a surgical operation to address urinary incontinence caused by a condition such as kidney stones. Nurses need to know that sutures are most commonly used for wound closure when compared to staples because they bear a low risk of surgical site infection (Kuit et al., 2022). Non-absorbable sutures require removal when the wound is fully closed while non-absorbable sutures do not require removal. It is recommended that the healthcare professional uses the right needle when inserting sutures. Additionally, suture or staple removal should only be done when the wound is fully closed (Rose & Tuma, 2022; Kuit et al., 2022).

The nurse should take appropriate measures to care for the surgical wound to prevent the development of an infection at the surgical site. Some of the interventions that the nurse should implement include cleaning the wound before inserting sutures or staples, covering the wound with a damp bandage after suturing to prevent drying, and cleaning the wound daily with an antiseptic (Lalonde et al., 2019). The nurse should remember to conduct a follow-up when the patient is discharged.

References

Julian, A. S., & Agil, A. (2021). Hanging bladder stone due to misplaced surgical suture several years after hysterectomy: A case report. International Journal of Surgery Case Reports, 89, 106586. https://doi.org/10.1016/j.ijscr.2021.106586

Kuit, A., Krishnan, R. J., Mallee, W. H., Goedhart, L. M., Lambert, B., Doornberg, J. N., Vervest, T., & Martin, J. (2022). Surgical site infection after wound closure with staples versus sutures in elective knee and hip arthroplasty: a systematic review and meta-analysis. Arthroplasty (London, England), 4(1), 12. https://doi.org/10.1186/s42836-021-00110-7

Lalonde, D., Joukhadar, N., & Janis, J. (2019). Simple Effective Ways to Care for Skin Wounds and Incisions. Plastic and reconstructive surgery. Global Open, 7(10), e2471. https://doi.org/10.1097/GOX.0000000000002471

Rose, J. & Tuma, F. (2022). Sutures and needles. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539891/

Question 6: Patient Teaching Pertinent To The Care of A Patient With A Cast

Broken bones and injured or displaced joints can cause pain and discomfort to the affected patients. An orthopedic can fit a splint or a cast to enhance bone protection, reduce pain, and promote healing. Patient teaching ensures that a cast or splint is used properly and ensure that it achieves its intended purpose (Schweich et al., 2021). The nurse plays a key role in helping the patient to minimize the risks of possible complications when on a cast or splint.

The goal of patient teaching is to address issues that the patient should know to maximize safety when using a cast or splint. According to Schweich et al. (2021), patient teaching should include cast care instructions, when to seek help, and resources where the patient can obtain further information. For instance, the nurse should teach the patient that the injured area is likely to develop a mild swelling during the first few days of cast fitting making it feel tight. To minimize the swelling, the nurse should advise the patient to maintain the cast for about 24 or 48 hours above the heart level. An ice bag, covered in a thin towel, can also reduce the swelling when applied for 20 minutes to the swollen area after every two hours during the day. It is also important to remind the patient to take his or her medications as prescribed, keep the cast dry while bathing, keep the cast clean, avoid putting pressure on it, and avoid removing the pad (Schweich et al., 2021). The patient should also remember to stretch the limb where the cast is placed.

The patient should be advised to seek help when he or she develops severe pain, swelling, numbness, or ulcers/sores on the limb bearing the cast. Again, the patient should seek help when the cast becomes seriously soaked. Healthcare providers and the resources they provide are good sources of information regarding cast management (Mayo Clinic, 2022). The nurse should address any concerns that the patient might have after the teaching session.

References

Mayo Clinic. (2022). Cast care do’s and don’ts. https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/cast-care/art-20047159

Schweich, P., Boutis, K., & Ganetsky, M. (2021). Patient education: Cast and splint care (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/cast-and-splint-care-beyond-the-basics#:~:text=Keep%20the%20cast%20clean%20and,Cover%20the%20cast%20when%20eating.&text=Do%20not%20place%20anything%20inside%20the%20cast%2C%20even%20for%20itchy%20areas.

Question 7: Nursing Implications of Bedmaking in Patients with Hip Fracture

Nurses are their patients’ immediate helpers, especially those who have conditions that cause movement challenges. In addition to medication administration, nurses help their patients with activities such as bathing, making beds, maintaining bed hygiene, and repositioning (Jackson et al., 2019). For example, a patient with a hip fracture depend on the nurse to remain clean, eat, and maintain hygiene during their admission to the hospital. The nurse should understand the implications of bedmaking in a patient with a hip fracture.

The nurse should maximize safety and limit pain when making a bed for a patient with a hip fracture. For example, when moving the patient to make the bed, the nurse must be careful to support the joints above or below the fracture site. Again, the nurse should always place the patient on an orthopedic bed (Doenges, 2022). Normal beds can increase the patient’s risk of developing pressure ulcers.

Multidisciplinary care is among the factors that determine success when caring for a patient with a hip fracture. When making the bed, the nurse will always need to either remove the patient from the bed or reposition him or her to the side of the bed (Doenges, 2022). Performing this task alone can be challenging for the nurse and may also subject the pain to pain. Therefore, the nurse should use adequate team members when turning the patient. The nurse must also assess the patient carefully to avoid interfering with the cast or splint. After making the bed, the nurse must ensure that he or she places the patient back to the patients and in a comfortable position. The nurse can use a pillow or a folded blanket to support the site of the fracture (Doenges, 2022). Bedmaking should be a daily routine.

References

Doenges, M. E. (2022). Nursing diagnosis manual: planning, individualizing, and documenting client care. 7^th ed. F.A. Davis Company.

Jackson, K., Bachhuber, M., Bowden, D., Etter, K., & Tong, C. (2019). Comprehensive Hip Fracture Care Program: Successive Implementation in 3 Hospitals. Geriatric Orthopaedic Surgery & Rehabilitation, 10, 2151459319846057. https://doi.org/10.1177/2151459319846057