Patient dumping essay

Illegal dumping of health care risk waste in the South of Johannesburg, South Africa. In a Healthcare facility setting HCRW is in handle by the health care personnel and waste management personnel this can be the Environmental Health Practitioner.

Patient dumping essay

Patient dumping essay

Causes, management, and patient education Dumping syndrome: Causes, management, and patient education Learn how to identify and manage this under-recognized syndrome. Dumping syndrome is often misdiagnosed. The clinical manifestations of dumping syndrome are categorized as early or late.

Dietary changes are the most effective way to manage dumping syndrome. Phillips, PhD, RN Dumping syndrome DSa well-established yet under-recognized side effect of upper GI surgery, occurs when the body reacts to food moving too rapidly from the stomach into the intestine, resulting in unpleasant symptoms such as a pounding pulse, sweating, dizziness, and nausea.

Its incidence decreased during the 20th century when the discovery of Helicobacter pylori made most gastric surgical interventions to treat chronic gastritis and peptic ulcer disease unnecessary and treatment shifted to medication. But the recent increase in bariatric surgery and gastric or esophageal surgery to treat cancer has led to an increase in the incidence of DS.

In addition, DS Patient dumping essay frequently are misdiagnosed. Nurses and other healthcare providers should understand the etiology, symptoms, and management of DS to educate patients and to improve their health outcomes and quality of life.

DS is a cluster of symptoms that can occur when undigested food moves too quickly into the intestines. The symptoms typically occur after eating a large amount of food or a high-carbohydrate, high-fat meal. The incidence and severity of postsurgical DS corresponds to the type of surgery performed.

See Surgery and DS. DS also has been reported in patients with diabetes, cyclic vomiting syndrome, and Zollinger-Ellison syndrome.

DS can occur after a bolus tube feeding, especially if the formula is high osmolality or a feeding is given in large amounts over a short time.

Pathophysiology and symptoms DS clinical manifestations are categorized as either early or late, depending on how soon they begin after a meal. Symptoms arise when the undigested food moves too quickly into the duodenum, causing fluid to shift from the surrounding tissues into the intestine to aid in the rapid dilution of the concentrated food.

The movement of fluid into the intestine is associated with excessive intravascular fluid loss, resulting in vasomotor symptoms, including diaphoresis, tachycardia, hypotension, and, in some cases, syncope. The rapid movement of carbohydrates into the intestine releases an excessive amount of insulin from the pancreas in an attempt to maintain normoglycemia, but ultimately resulting in hypoglycemia.

The subsequent symptoms are a direct consequence of the hyperinsulinemic response: Most people who experience late dumping also exhibit early dumping symptoms. Another factor that may play a role in the pathophysiology of both early and late dumping is increased secretion of GI hormones, although their exact mechanism is unclear.

Severe dumping can be a precursor to several complications, including malnutrition and weight loss due to nutrient malabsorption and chronic diarrhea. DS also can lead to social impairments and persistent lethargy because of inadequate nutrition.

How is DS diagnosed? Many patients with DS have symptoms similar to irritable bowel syndrome or gastroparesis delayed gastric emptyingwhich can result in misdiagnosis.

Unless the patient reports a history of upper GI surgery, the healthcare provider may have difficulty distinguishing between many of the GI disorders.

Diagnosis typically is based on clinical manifestations and the timing of the symptoms, although a few diagnostic tools can be helpful. The Sigstad scoring system was developed in to aid in the diagnosis of DS.

See Sigstad scoring system. A score above 7 indicates DS; a score less than 4 may suggest a different diagnosis, such inflammatory bowel disease, celiac disease, or bowel obstruction.

For the modified oral glucose tolerance test, the patient fasts for 10 hours, then drinks a solution containing 50 g of glucose. His or her glucose level, heart rate, blood pressure, and hematocrit are measured every 30 minutes. Late dumping is suspected if hypoglycemia occurs 2 to 3 hours after glucose ingestion.

Patients undergoing gastric emptying scintigraphy eat a bland meal containing a small amount of radioactive dye. An abdominal x-ray is then taken every hour for 4 hours after the meal to follow the movement of the dye and measure the rate of gastric emptying.

DS is diagnosed if an accelerated rate of emptying is noted. The Dumping Symptom Rating Scale questionnaire is reliable for detecting the severity and frequency of dumping symptoms. It uses a 7-point Likert scale to grade the severity of 11 DS symptoms along with three questions about foods that may cause symptoms.

How is DS managed? Diet is the most effective way to manage DS. Patient education is particularly beneficial for people with mild to moderate DS symptoms because they respond well to dietary changes; those with more severe DS symptoms may not respond well to dietary changes alone.

General recommendations include eating small, frequent, high-protein meals and snacks; avoiding liquids with meals; avoiding simple carbohydrates cookies, candy, sweetened drinks, and ice cream ; and lying down for 15 minutes after eating.

People with DS should maintain a food journal that includes what they eat, when they eat, and the timing and nature of their DS symptoms.A cancer diagnosis can be overwhelming. Find out about coping with the emotional, practical and physical effects.

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Mar 26,  · Congress passed EMTALA, known as the patient anti-dumping law, in response to national outrage over a surge in community hospitals transferring unstable emergency patients—including women in. Inhale this: A shadowy $10 billion Obamacare agency with zero oversight just awarded first lady Michelle Obama’s pet patient-dumping scheme at the University of .

The Emergency Medical Treatment and Active Labor Act (EMTALA), also known as the “Patient Anti-Dumping” statute, is a Federal statute intended to prevent Medicare-participating hospitals with dedicated emergency departments from refusing to treat people based on their insurance status or ability to pay.

Patient dumping essay
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