Name: Allan Jeffrey U. Lorica November 26, 2011 Concept: Nursing Management BSN-4 Area: BJRMH – St.

Francis CI: Zaida Jo, RN, MN

Date: Placement: Criteria: Summary: Reaction: Reference: ________

Use of Gastric Acid-Suppressive Agents Linked With Diarrhea Infection (Press Release)
Use of gastric acid-suppressive therapy, particularly proton pump inhibitors, is associated with an increased risk for an infection that is a significant cause of diarrhea, according to a study in the December 21 issue of JAMA. Clostridium difficile infection, an important cause of nosocomial (taking place or originating in a hospital) diarrhea, has also been reported to be an important cause of diarrhea in the community, according to background information in the article. A British study identified C difficile as the third most common cause of infectious diarrhea in patients aged 75 years and older seen by general practitioners. A French study performed in outpatients to whom antibiotics were prescribed reported an incidence of C difficile–associated disease (CDAD) of 1.5 percent and estimated that up to 920,000 outpatients nationwide could potentially develop toxinogenic CDAD yearly. Recent data suggest that both the rates and severity of nosocomial CDAD are increasing. While the rates of CDAD in the community are much lower than in the hospital setting, the absolute number of cases in the community could be significant. Sandra Dial, M.D., M.Sc., and colleagues from McGill University, Montreal, conducted a study to determine whether the use of gastric acid–suppressant drugs is associated with the risk of communityacquired CDAD. This study consisted of two population-based casecontrol studies using the United Kingdom General Practice Research Database (GPRD). In the first study, the researchers identified all 1,672 cases of C difficile recorded between 1994 and 2004 among all patients registered for at least 2 years in each practice.

“Clostridium difficile–associated disease is becoming an important public health issue.com/020424_diarrhea_infection_commun ity.000 persons in 1994 to 22 per 100.” the authors conclude.000 in 2004. use of H2-receptor antagonists was associated with twice the rate of CDAD. After controlling for certain variables.672 patients. and it is in this context that the contribution of these agents by potentially increasing the pool of susceptible hosts to the increasing rates of CDAD needs to be considered and more completely characterized.The researchers found that of these 1. current use of proton pump inhibitors was associated with nearly 3 times the rate of CDAD.233 (74 percent) had not been hospitalized in the year prior to diagnosis and were considered community-acquired. . an important cause of nosocomial diarrhea. Acid-suppressive agents are among the most frequently prescribed medications in the United Kingdom and North America. During this period. 1.naturalnews. including the exponential increase in the community observed in this study.html#ixzz1ebLE4Jtd Clostridium difficile infection. Reference: http://www. according to background information in the article. Significant increases in number of cases of CDAD in Great Britain since the 1990s have been observed. While the overall rate of CDAD in the GPRD is much lower than in the hospital setting. A British study identified C difficile as the third most common cause of infectious diarrhea in patients aged 75 years and older seen by general SUMMAR Y: . Current use of NSAIDs but not aspirin was associated with a 30 percent increased rate of C difficile. it appears to be increasing significantly even in the face of both our data and another report to suggest that out patient antibiotic prescribing in the GPRD is decreasing. Genetic mutations that may be associated with increased transmissibility and increased severity are also being reported. These factors combined with reports of outbreaks in the United States and the recent outbreak in the Canadian province of Quebec justify considering CDAD as an important public health concern. has also been reported to be an important cause of diarrhea in the community. the rate of prescriptions of antibiotics has decreased and that of proton pump inhibitors has increased. There has been a significant increase in the rate of C difficile cases diagnosed in the community from less than 1 per 100.

difficile or C. M. M.D. surfaces and objects when people who are infected don't wash their hands thoroughly. Sandra Dial. Current use of NSAIDs but not aspirin was associated with a 30 percent increased rate of C difficile. use of H2receptor antagonists was associated with twice the rate of CDAD. current use of proton pump inhibitors was associated with nearly 3 times the rate of CDAD.5 percent and estimated that up to 920. The bacteria produce hardy spores that can persist in a room for weeks or months.672 patients. difficile bacteria are passed in feces and spread to food. If you touch a surface contaminated with C. 1. Acid-suppressive agents are among the most frequently prescribed medications in the United Kingdom and North America. It is really important to do hand washing especially when it comes in eating you really must have to wash your hands and especially after going to the comfort room. often called C. diff. is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.000 outpatients nationwide could potentially develop toxinogenic CDAD yearly.” Clostridium difficile (klos-TRID-e-uhm dif-uh-SEEL). and colleagues from McGill University. REACTIO N: . you may then unknowingly ingest the bacteria.. A French study performed in outpatients to whom antibiotics were prescribed reported an incidence of C difficile– associated disease (CDAD) of 1. difficile. In the hospital almost all the children suffers diarrhea and some in the remote areas in our country dies from severe dehydration not just the children but also some adults that are not conscious of hand washing before handling of foods and so on. No matter what kind of drugs out there can be use to treat and kill this kind of bacteria we must still be careful for us to avoid this from get into us especially the young ones are the most common to be infected by this bacteria because of wrong handling of foods and unsanitary ways of giving meals. The researchers found that of these 1. and it is in this context that the contribution of these agents by potentially increasing the pool of susceptible hosts to the increasing rates of CDAD needs to be considered and more completely characterized. After controlling for certain variables. C. conducted a study to determine whether the use of gastric acid–suppressant drugs is associated with theriskof community-acquired CDAD. Montreal.233 (74 percent) had not been hospitalized in the year prior to diagnosis and were considered community-acquired.Sc..practitioners.

and it is in this context that the contribution of these agents by potentially increasing the pool of susceptible hosts to the increasing rates of CDAD needs to be considered and more completely characterized. The medications are given after we had our drug study with our clinical instructor.” This just means that we must rely on what our doctors prescribed to us and to remember that this drug is still under the study and can add more complications to the patients. The endorsement starts at 3:00pm for the PM shift and went home. MN Date: Placement: Criteria: Summary: Reflection: ________ SUMMARY: I arrived at the school 6:00am for the morning circle lead by one of our clinical instructor Sir Natad. 2011 Concept: Nursing Management BSN-4 Area: BJRMH – St. We CM and PN had our VS monitoring at 8am and prepare our medications to be given at 10am. Name: Allan Jeffrey U. Lorica November 22. REFLECTION: .The author concluded that Acid-suppressive agents are among the most frequently prescribed medications in the United Kingdom and North America. RN. after the circle we had our evaluation for the yesterday’s performance for us to be aware if we improved or not. It starts at 7:00am and ends at around 8:00am. Francis CI: Zaida Jo. VS monitoring again at 12pm and transcribed all the data including the DAR after the last VS monitoring and checked by our clinical instructor. table nurse. 12pm and 2pm. We immediately went to the hospital after the evaluation for us to prepare ourselves for the endorsement. case method and the primary nurse. we had our rounds each group with the head nurse.

I learned that time management is very much important. Thanks to God. He helped me everyday to really become an angel on the sick room. It was one of my worst days in the hospital. calm self is sooths you and helps you think on what will be the right thing to do and especially to be patience because today almost of my patients watchers are very “toxic”. . reprimanding. Francis in Nursing Management concept and I as a case method nurse. I thought that today was much better compared to the days on my first week but then I felt that it was my first time as a case method nurse. On this day.This is our second week of our duty in the BJRMH – St. calm and giving explanation with respect for them to understand things and situation. I struggled in time management but plus the time that we started our rounds and first vs monitoring. and they don’t follow to any instructions especially about the intake and output of their patient. I handle this situation through patience. We nurses have our therapeutic communications and through that it helps me in handling this kind of situation that the watchers are not showing some good manners. they were very demanding.

2011 Concept: Nursing Management BSN . RN.Name: Allan Jeffrey U.4 Area: BJRMH – St. Lorica 26. Francis CI: Zaida Jo. MN Date: November Placement: NURSING CARE PLAN .

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