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Biomedical subjects

Beatrice B Turkoski

Publications and source records attributed to Beatrice B Turkoski.

18 recordsLinked to original sources
PubMed2005

Ethical support for culturally sensitive health care.

This month's column presents a case study of a Muslim patient and the considerations for culturally sensitive care that one nurse implemented. The interventions resolved potential cultural conflict and involved several departments within her agency. A brief review of the deliberations and decisions of the Institutional Ethics Committee identifies the supporting ethical arguments and the recommendations for developing cultural sensitivity within its healthcare organizations.

Adult↗
PubMed2003

Ethical dilemma: is this elder abuse?

Elder abuse, neglect, and exploitation are major problems today (Marshall, Benton, & Brazier, 2000). Most elder abuse occurs at home and is committed by spouses, children, or other family members. Abuse may go undetected until observant professionals intervene ( AOA, 1998). Sometimes the abuse is a continuation of existing dysfunctional family dynamics. More often, however, the abuse is a result of changes brought about by an older person's growing dependency and need for increased care.

Aged↗
PubMedDate not supplied

Induction or inhibition: the complexity of cytochrome P450 enzymes and their impact on drug interactions.

Drug interactions are a major concern for health care professionals, the pharmaceutical manufacturing industry, the FDA, and the general public. Today we know that one of the primary causes of drug interactions is the cytochrome P450 enzymes. However, our knowledge about the complexities of these drug-metabolizing enzymes and the part they play in drug interactions is often limited. The actions and effects of P450 enzymes will be addressed in this article. Examples of induction and inhibition of P450 enzymes will illustrate how these enzymes can, in some instances, render a drug less potent and at other times more toxic. By understanding the unique actions of these enzymes, health care professionals may better anticipate, identify, explain, and manage individual responses to pharmacotherapeutic regimens.

Cytochrome P-450 Enzyme System↗
PubMedDate not supplied

Tired blood. Part 1.

"Tired blood" is a common term used to describe anemia because of the association between fatigue, often the first sign of anemia, and the idea that it has "something to do with blood." Today, millions of people have diagnosed anemia, and millions more with chronic diseases are at risk for developing anemia. Anemia is not a specific disease; rather, it is an indication that something has either disturbed the maturation of essential red blood cells or interfered with the oxygen carry capacity of red cells. In this two-part series about tired blood, the etiology and pathophysiology of selected forms of anemia are discussed and pharmacotherapy designed to address the condition of anemia is identified. Part 1 addresses anemia related to red blood cell development, and Part 2 explores the physiology of hemoglobin-related anemia and inherited anemia.

Anemia↗
PubMedDate not supplied

Tired blood. Part 2.

Anemia, "tired blood," with all the accompanying symptoms, such as fatigue, dyspnea, dizziness, muscle weakness, altered brain function, decreased gastrointestinal function, and cardiac stress, is not a disease. Rather, anemia is a sign that something has interfered with the red blood cell transport system that carries hemoglobin-containing oxygen to all bodily tissues (National Anemia Action Council [NAAC], 2002). In part 1 of this discussion (May/June issue of Orthopaedic Nursing), anemias related to interference with red blood cell development were addressed. In this section, anemias related to hemoglobin abnormalities (microcytic hypochromic anemia) and anemias related to premature erythrocyte destruction (hemolytic anemia) are discussed. Treatment approaches and selected pharmacological interventions are identified.

Anemia, Hemolytic↗
PubMedDate not supplied

An ounce of prevention. Drugs used to treat hyperlipidemia (Part 1).

My grandmother used to caution me. "An ounce of prevention is worth a pound of cure." That saying is certainly applicable to coronary heart disease (CHD). CHD remains a major cause of death in the United States today despite modern medical technology. The primary results of CHD, myocardial ischemia and myocardial infarct, when not deadly, often mean a seriously impaired lifestyle. However, since the 1960s, we have known that there were identifiable risk factors related to CHD. One of the major modifiable risk factors is an elevated lipoprotein level (e.g., hyperlipidemia), and today, we have an armament of lipid-lowering medications that are one means of preventing CHD for many individuals. In this article, the major classes of medications with lipid lowering effects are examined. Some of these medications are not new, but with the knowledge that the earlier they are used the more effective they may be, increasing numbers of people are now using nicotinic acid, bile acid-binding resins, fibric acid derivatives, or reductase inhibitors. As a result of the increased focus on lipid-lowering medications, nurses caring for middle-age and older adults are seeing and will continue to see larger numbers of their patients with prescriptions for these drugs. Nurses who are knowledgeable about the many antilipidemics on the market today will be more prepared to answer patient's questions and educate patients about reducing risk of CHD. A brief overview of the physiology of lipid metabolism, the pathophysiology of atherosclerosis, and risk factors for CHD make the rational for using these medications more understandable. Recommendations for early identification of individuals at risk for CHD are identified. In this Part 1 of a two-part series, two of the four major classes of lipid-lowering drugs are examined by looking at the mechanism of action and possible side effects of selected drugs in these classes. In Part 2 (May/June 2004), the other two classes of antilipidemic drugs will be examined and the recommendations of the National Cholesterol Education Program for clinical management of high blood cholesterol will be reviewed.

Fenofibrate↗
PubMedDate not supplied

Fighting infection: an ongoing challenge, part 1.

Since the beginning of time, infections have been a major cause of disability and death of humans in every part of the world. For centuries, little was known about what caused infection, how to prevent infection, or how to cure infection. With the discovery of sulfa and penicillin in the 1930s, the ability to fight infection became reality. During the next six decades, antimicrobials were developed to fight bacterial, fungal, and viral infections. It truly seemed as if the battle against infection was won, until the rapid and global spread of drug resistance began to threaten the effectiveness of all currently available antimicrobials. A new phase of the war against infection began, and the search for methods of reducing the spread of drug resistance began. Today, it is apparent that identifying the agents of infection, understanding how antimicrobials are targeted against specific infectious organisms, and practicing the judicious application of antimicrobials will help reduce the threat of continued escalation of antimicrobial resistance. Part 1 of this three-part series will provide an overview of how antimicrobials are designed to target specific agents of infection and how drug resistance develops. Parts 2 and 3 will examine individual antibacterial, antifungal, and antiviral agents and the recommendations for their appropriate use.

Anti-Infective Agents↗
PubMedDate not supplied

Fighting infection: an ongoing challenge, part 2--antibacterials.

In Part 1 of this three-part series, an overview of how antimicrobials, the "silver bullets" of modern medicine, are designed to target specific agents of infection was given. The worldwide concern regarding antimicrobial resistance and the need for a more judicious approach to using antimicrobials was addressed. In this section, the focus is on those specific antimicrobial agents used to fight bacterial infections. Discussion addresses bacterial cell wall inhibitors (penicillins and cephalosporins), protein synthesis inhibitors (macrolides, tetracyclines, and aminoglycosides), and nucleic acid inhibitors (sulfonamides and quinolones). Examples of agents in each class are identified, with a look at the specific use, action, and potential for adverse effects. A general overview of patient teaching for antibacterial use is included.

Ambulatory Care↗
PubMedDate not supplied

Fighting infection: an ongoing challenge, part 3-antimycobacterials, antifungals, and antivirals.

The first part of this series provided a brief overview of how antimicrobials, the "silver bullets" of modern medicine, are designed to target specific agents of infection. The second part addressed several classes of antibacterials: bacterial cell wall inhibitors (penicillins, cephalosporins), protein synthesis inhibitors (macrolides, tetracyclines, aminoglycosides), and nucleic acid inhibitors (sulfonamides and quinolones). This third section focus on those drugs used to treat mycobacterial infections (Mycobacterium tuberculosis), fungal infections (Candida species, Aspergillus species), and viral infections (herpes, hepatitis, and influenza). Selected agents in each classification are identified, with a look at the specific use, action, and potential for adverse effects. A brief comment about the challenges for future development of antimicrobials is included.

Antifungal Agents↗
PubMedDate not supplied

Unraveling the mystery of HIV medications.

Today, millions of people around the globe are infected with human immunodeficiency virus (HIV). This retrovirus attacks and renders ineffective the human immune system and leads to acquired immunodeficiency syndrome (AIDS), which leaves those with AIDS open to a variety of fatal infections. HIV knows no racial, gender, or age distinctions, and there is, as yet, no cure for HIV. However, after 25 years of research, there are three classes of medication that in various combinations may significantly slow the progress of HIV, thus improving and prolonging the life of infected individuals. Nurses in any practice arena will inevitably care for patients who are infected with HIV. With an understanding of HIV and the therapeutic benefits of antiretroviral medications, informed nurses have the opportunity and responsibility to educate infected persons in the appropriate use of antiretroviral drugs and the importance of preventing transmission of HIV to uninfected persons.

Anti-HIV Agents↗
PubMedDate not supplied

Diabetes and diabetes medications.

There are more than 20 million people in the United States who have diabetes; 14 million are diagnosed and an estimated 6 million who are unaware that they have diabetes. Thus, nurses in every setting are interacting with patients who have diabetes. Those nurses who are knowledgeable about diabetes can play a major role in reducing the damage that diabetes causes by educating patients and helping them identify the important aspects of managing their disease. In this article, a brief overview addresses the two major types of diabetes and the serious implications of uncontrolled diabetes. A review of selected antidiabetic medications identifies the mechanisms of action and potential side effects pertinent to each medication. Laboratory tests used to identify and monitor diabetes are also addressed.

Biguanides↗
PubMedDate not supplied

Managing insomnia.

Sleep is a vital part of normal health and wellness for everyone. It is also an important factor in recovering from the physiological and emotional stress of any hospitalization or illness. Insomnia--the lack of adequate period of sleep--has a profound impact on society and public health in many ways. Chronic insomnia contributes to injury and illness and may have adverse effects on cognitive functioning, interpersonal relationships, concentration, the ability to handle stress, and productivity. Nurses who are knowledgeable about the possible causes of insomnia, the different types of insomnia, and various therapeutic interventions will be able to identify those who have insomnia or are at risk of insomnia and will be able to counsel these patients about healthy sleep habits and the safe use of pharmacotherapeutic therapies used to treat insomnia.

Behavior Therapy↗