Conclusion The use of pharmacological interventions against cystic fibrosis has far-reaching implications for nursing care

Conclusion The use of pharmacological interventions against cystic fibrosis has far-reaching implications for nursing care

It is prospective that the patients permit the revelation of confidential information to medical contingent participating in treatment. All data that could reveal the identity of the patient must be protected. The degree of protection should be adequate form of data storage. Patients have a right of accessing medical history as well as all materials regarding diagnosis and treatment. Patient has the right to obtain copies of these materials. However, data concerning the third party should not be available to the patient.

Patient has the right to request correction, additions, improvements, and elimination of personal and medical treatment if they are inaccurate, incomplete, or irrelevant to the justification of diagnosis and treatment.

Any intrusion into matters of personal and family life of the patient is prohibited, except for cases where the patient does not object to this interference and in case the need is dictated by the objectives of diagnosis and treatment.

In any case, medical intrusion in secrecy of the patient, of course, involves consideration for his secrets. Therefore, such an encroachment could be carried out only in the presence of precisely needful for its carrying persons, unless otherwise wish of the patient (Balint 19).

Patients coming in the health care setting have the right to rely on the existence of inventory in this facility and equipment necessary for ensuring the preservation of medical confidentiality, especially in those cases where medical professionals provide care, conduct research and treatment.

There is a ministerial ordinance that sets the regulations for health facilities and health insurance companies in respect of who can sight and obtain personal health information. This law is Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Balint 20).

The chapters of this act consist of several important statements. It ensures patients’ right to dispose of their medical information, including the right to receive copies thereof, validation of health information, and reporting.

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Patient can require providing medical records and other information for reference and copies thereof. If you would like get a copy, then you may have to present their request in writing and pay the cost of copying and postage. In most cases, a copy of your medical information must be provided to you within 30 days. Patient can request correction of any inaccurate information contained in documentation, or make additions if he believes that your health information is incomplete or misses anything.200 words essay about myself For example, if you and your hospital agree that your test results, listed in your documentation, are incorrect, then the hospital administration is obliged to correct this error. Even if the administration of the hospital believes that test results are correct, you have the right to put a mark on disagreement in your medical records. In most cases, medical documentation should be changed within 60 days (Klosek 62).

The law provides the rights for the use and transfer of your medical information for specific purposes not directly regarding your treatment, for example, ensuring quality of this doctors’ work, cleanliness and safety of therapeutic boarding schools, alert influenza epidemics in your region, or reporting required in compliance with state or federal law. In most of these cases patient can get a report on who was transferred to your health information.

As a rule, health records cannot be consumed for objectives not regarding individual treatment directly without authorization. For example, your doctor may not make transferal of health information date to your tenant or use it in trading and advertising without your permission done in writing form. You, probably, have noticed how your medical information may be used during your first visit to the newest provider, or when you switched a new health insurance. However, patient can request a copy notification at any time (Field 268).

Patient can inform health workers and health insurance company if he does not wish his information to be shared. Patient can ask if his health information is not passed to certain individuals, groups, or companies. For instance, you can ask your doctor not to transfer your health information to other physicians or medical staff of the clinic. Patient can also ask health care facility or pharmacy not to transfer to medical insurance company information about medical assistance or taken medications if he or she pays for medical care or medicines in full, and in case medical institution or pharmacy must not receive payment from patient’s insurance company.

Patient can ask to be contacted in certain places or in a certain way. For instance, patient can ask the nurse to call him or her at the job, not home, or send information in the envelope, not on a postcard.

Nevertheless, many people have reverse point of view on patient’s private information. There is a social hypothesis that the best way to solve the problem of medical privacy is to reveal the files and databases, making medical records freely available to all. Since each person has some medical problems, the best way to wash away the blot with the disease is to put them on public display (Field 265). But the problem with the opened access to medical records is personal features of each individual organism. Someone has diabetes, someone has asthma, and someone has inherited genetic disease. Some people have small schizophrenic deviations based on drugs.123 essay Making histories of everyone opened to the public will put people at risk of discrimination or personal attacks, for which there is always a reason. One of the goals of privacy in society is to protect all of us from different social problems that we have not got rid of (Sylvester, Connell, and Reichman 11).

There is one more reason why we should still respect the privacy of the patient. People who were able to cope with their physical or mental illness deserve to be free from various well-wishers, constantly reminding them about it. People deserve to control their medical issues and privacy of medical records.

Summarizing all research information, it should be noted that depending on regulations and ethics, confidentiality in the relationship of medical employee and patient is a principle that creates special atmosphere of trust and helps to provide complex of full rehabilitation in the features of social comfort and safety.

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Cystic Fibrosis: A Brief Insight

In order to understand how nurses should approach some pharmacological treatment strategies for cystic fibrosis, the very nature of the disease needs to be reviewed. According to O’Sullivan and Freedman (2009), cystic fibrosis is the most prevalent lethal genetic disorder among white population. Over the past years, life expectancy for patients with cystic fibrosis has grown from 31 to 37 years, but it is still too early to speak about realistic cures (O’Sullivan & Freedman, 2009). The pathophysiological roots of the disease can be found in the mutation of a gene “that encodes fibrosis transmembrane conductance regulator (CFTR) protein, which can be expressed in many epithelial cells and blood cells” (O’Sullivan & Freedman, 2009, p. 1891). The most problematic aspect of cystic fibrosis in relation to pharmacology is that its symptoms and manifestations can vary considerably between patients (O’Sullivan & Freedman, 2009). Consequently, no pharmacological strategy in cystic fibrosis may be regarded as universally effective. At the same time, nurses should not hope to cure cystic fibrosis: even the most aggressive pharmacological treatment is aimed at achieving and maintaining the optimal lung function in patients over their lifespan.

Pharmacological Management of Cystic Fibrosis

Chronic Pulmonary Treatment

A chronic pulmonary treatment remains the foundational element of the pharmacological strategies used to deal with cystic fibrosis. The purpose of these pharmacological approaches is to reduce the risks of pulmonary exacerbations while improving the patients’ wellbeing and quality of life in a long-term perspective. In this sense, aerosolized antibiotics remain the most common pharmacological solution for cystic fibrosis. The importance of aerosolized antibiotics and their efficacy are justified by the emerging evidence that they can curb an initial infection and suppress a chronic one and related complications (Flume et al., 2007). Tobramycin remains the most common aerosolized antibiotic recommended for patients with cystic fibrosis (Flume et al., 2007; O’Sullivan & Freedman, 2009); it is particularly useful for patients who are older than 6 with mild to severe forms of the disease (Flume et al., 2007). Certainly, nurses can also recommend other inhaled antibiotics, such as colistin. However, the clinical evidence to support its positive effects on the lung function is quite scarce (Flume et al., 2007). Pharmacological strategies to curb cystic fibrosis can also incorporate the use of recombinant human deoxyribonuclease, inhaled hypertonic saline, ibuprofen, and chronic azithromycin too as inhaled beta-agonists (O’Sullivan & Freedman, 2009).

A special attention should be paid to the use of recombinant DNase in patients with cystic fibrosis. It can be used by nurses to “improve the viscoelastic properties of airway secretions and promote airway clearance” (Flume et al., 2007, p. 960). Positive effects of DNase on the patients’ lung function in the short and long runs have been widely established (Flume et al., 2007). Recommendations regarding the dosage and length of administration should be developed basing on the severity of the disease. Hypertonic saline can be used as a supplementary mechanism to facilitate airway hydration, leading to improved mucociliary clearance (Flume et al., 2007). In fact, it is believed to be effective not only in relation to symptoms but also a genetic defect that underlies cystic fibrosis (O’Sullivan & Freedman, 2009).

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Anti-Inflammatory Agents and Corticosteroids

The application of inhaled corticosteroids remains one of the most controversial aspects of pharmacological management in cystic fibrosis. Flume et al. suggest that the application of corticosteroids may be justified by the fact that cystic fibrosis is a disease of inflammatory nature. Excessive inflammatory responses among the patients’ airways are not uncommon. Chronic inflammation is claimed to result in the destruction of airways, leading to the development of an obstructive airway disease (Flume et al., 2007). However, the evidence to confirm the efficacy and safety of corticosteroids against inflammation in cystic fibrosis is far from being sufficient (Flume et al., 2007; O’Sullivan & Freedman, 2009). Nurses should know that the Cystic Fibrosis Foundation recommends against the use of oral corticosteroids in children and adults (Flume et al., 2007). In this context, nonsteroidal anti-inflammatory drugs, such as inhaled ibuprofen, can be used since they increase the patients’ chances to preserve the optimal lung function (Flume et al., 2007). These pharmacological solutions are relatively inexpensive, have few side effects, and are also readily available to patients (O’Sullivan & Freedman, 2009). Nurses should also pay the particular attention to the benefits of macrolide antibiotics, which have proved to be effective in patients with cystic fibrosis. Macrolide antibiotics may be administered to reduce the risks and frequency of pulmonary exacerbations (O’Sullivan & Freedman, 2009). They are known because of their effects on the cytokine production, altering polymorph nuclear cell function and turning into a relevant anti-inflammatory agent (O’Sullivan & Freedman, 2009).

Pulmonary Exacerbations and Infections

One of the biggest problems that nurses face in relation to cystic fibrosis is that it is a multifaceted disease that has many symptoms and signs. As a result, nurses often have to focus on more than one symptom, each requiring a unique pharmacological approach and a treatment strategy. Pulmonary infections and exacerbations require the development of effective pharmacological models. Cystic fibrosis is normally associated with a unique range of pathogens, which are acquired at different stages of the disease (Gibson, Burns & Ramsey, 2003). The pharmacological management of cystic fibrosis necessarily includes sun and rain of appropriate antibiotic therapies targeting bacterial pathogens in a patients’ respiratory tract (Gibson et al., 2003). Antipseudomonal antibiotics can help prevent the risks of Pseudomonas aeruginosa infections in patients with cystic fibrosis (Gibson et al., 2003). Antistaphylococcal antibiotics and their effects on patients with cystic fibrosis raise number of questions. Therefore, nurses should consider the use of alternative non cell active antibiotics with a critical eye (Gibson et al., 2003).

One of the chief concerns about the chronic use of antibiotics in the pharmacological management of cystic fibrosis is the gradual emergence of antibiotic resistance. Unfortunately, today, researchers are not aware of the real risks of antibiotic resistance in cystic fibrosis while the best possible approaches to avoid those (Gibson et al., 2007). George, Jones, and Middleton (2009) speak about some alternative combinations of antibiotic and non-antibiotic agents. Unfortunately, the present-day pharmacological industry focuses predominantly on the development of new antibiotics from the existing drug classes rather than the development of the entirely new drug modes. The existing antibiotics cannot help nurses and physicians to overcome the risks of methicillin-resistant bacterial infections in patients with cystic fibrosis (George et al., 2009). In certain conditions, monotherapy with antibiotics may become a good option for nurses and their patients, but they should not expect that these therapies will do anything beyond the alleviation of symptoms.

Gastrointestinal Manifestations and Emerging Therapies

Some scientists state that “cystic fibrosis is a complex disease that requires more than a single approach to alleviate the causes and symptoms while the complications that accompany them” (George et al., 2009). Therefore, nurses should be prepared to deal with the existing and emerging manifestations of the disease among different patients. For instance, Brodzicki, Trawinska, and Korzon offer some recommendations to manage gastroesophageal reflux in children with cystic fibrosis. The frequency and severity of gastoesophageal reflux suggests that it can readily aggravate a physical and emotional state of children with cystic fibrosis (Brodzicki et al., 2002). In this case, cisapride or a combination of cisapride and ranitidine can be used to reduce the frequency of reflux episodes and their period in children (Brodzicki et al., 2002). The proposed pharmacological treatments have proved to improve the patients’ endoscopic picture (Brodzicki et al., 2002).

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Certainly, not all pharmacological treatments are equally effective. Due to the complexity of the disease, nurses should be aware of the emerging methodologies as well due to the fact factors which can potentially impact the effectiveness of their management propositions. Jones and Helm describe quantity of medications that can be used in the treatment of cystic fibrosis but currently undergo pharmacological tests. These include some dry-powder versions of tobramycin, colistin, and ciprofloxacin as well as the new formulations of amikacin, ciprofloxacin, azteonam, and fosfomycin (Jones & Helm, 2009). In addition, it is not enough to develop a promising treatment strategy. Even more important is to monitor the patients’ compliance with the prescribed regimens. Nurses should remember that cystic fibrosis is a genetic disorder diagnosed early in life. Many children with cystic fibrosis experience difficulties with the adherence to treatment (Modi & Quittner, 2006). The complexity of the disease and its pharmacological implications place nurses into the center of disease management and health maintenance. Nurses should be ready to make fast and grounded decisions that will help patients to quickly attain and maintain an optimal level of health.

Implications for Nurses

Pharmacological management of cystic fibrosis has profound implications for nurses. As mentioned earlier, due to the complexity of the disease, nurses should be ready to deal with its multiple signs and manifestations. Kerem, Conway, Elborn, and Heijerman (2005) specify the general standards of care for nurses working with patients diagnosed with cystic fibrosis. According to Kerem et al. (2005), specialist nurses must advocate for the interests of every patient, be aware of the most recent treatment strategies, develop and maintain the patient’s and family’s liaisons, and provide support and advice to patients. Obviously, most treatments of cystic fibrosis are aimed at alleviating the symptoms as opposed to treating the underlying genetic defect (Flume et al., 2007). However, nurses must ground their pharmacological decisions on the most relevant and valid clinical evidence. More importantly, they should monitor the emergence of new pharmacological treatments and, at the same time, monitor patients’ compliance with the prescribed treatment regimens. Given the ambiguity surrounding many pharmacological treatments, nurses must make a final decision based on the most effective interests of each patient.


The use of pharmacological interventions against cystic fibrosis has far-reaching implications for nursing care. Nurses are expected to play one of the central roles in providing the quality pharmacological treatment to patients with cystic fibrosis. Apart from developing unique pharmacological approaches, nurses must ground their treatment decisions on the clinical and empirical evidence. It should be noted that the pharmacological treatment of cystic fibrosis cannot be simple. Due to the complexity of the disease, nurses often have to focus on more than one symptom of the disease, each requiring a unique pharmacological approach. However, in all situations, nurses must understand that the proposed strategies will simply alleviate the symptoms of the disease. The final decision will have to be made basing on the best interests of every patient.

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At least 700,000 people suffer from stroke each year in America. Stroke is caused by blockage of blood within its system. The blockage results to lack of blood flow in some areas of the brain. The injury of these parts of the brain is referred to as ischemia. In this case, one or more areas within the brain might be damaged. The person affected can lose various abilities depending on the part of the brain that has been injured. These injuries can come in form of a person losing the ability to speak, walk or move one side of the body. The damages might be temporal or permanent, while the functions affected may be lost completely or partially (Berry, 2010). The result is dependent on the severity of the brain damage, enough time the first treatment is administered, among other factors.

Recent research confirms that people have assumed sedentary lifestyles (Caplan, 2006). In addition to the high cholesterol intake, majority of the adults are at high risk of health complications such as VTE. VTE is among the four main causes of death among the Us citizens. a third associated with the VTE patients succumb within thirty days (Hutton, 2005). Among the leading alert medications is the anticoagulant. Hence, there is dependence on patients to be protected against the effects of anticoagulation therapy. The realization has led to the introduction of basics of medication to the nurses.  These essentials form the fundamental rights which include: patient, medication, route, dose and time. If all nurses can stick to these basics of education, then few errors can occur.

Statistics also show that stroke is among the leading causes of lifelong injuries and death (Hutton & Caplan, 2003). Early management of disease together with preventive measures has bore fruit of reducing further brain damage. Treatment is based on the type: the ischemic while the hemorrhagic stroke. Underlying medical problems are viewed as a cause of prolonged treatment of the disease. Platelets are blood components that exist in form of tiny cells. They only clump during bleeding or in abnormal conditions, forming the clotting of blood. Anticoagulants are mostly referred as blood thinners. This is because they act by reducing blood clots within the arteries. Due to their nature, anticoagulants are rarely administered to ischemic patients.

Treatment of Early Stroke

For ischemic patients, treatment involves restoration of blood flow into the brain as quickly as possible. Aspirins, anticoagulants and alteplase are used due to the fact first treatment of stroke (McBane, 2010). Thrombotic therapy (alteplase) involves the use of tissue plasmigen activator (tPA). This treats by dissolving clots which block the flow of blood within the brain arteries. Its benefit lies within the fast coordination of the hospital to offer emergency services with the neurologist available. Previous statistics prove that this medicine has even more benefits than side effects (Davis, 2005). Out of fifteen patients who were administrated with thrombotic therapy, one of them developed excessive bleeding. The statistics further reveals that the result may be fatal. It leads to personal choice of drug consumption. Aspirin is administered when thrombotic drugs cannot be given. It is an early treatment drug against acute ischemic stroke.

Anticoagulant Therapy

This works by interfering with the process of clotting. Frequent indications for the use comprise: treatment of disseminated intravascular syndrome, prophylaxis and management of pulmonary embolism and venous thrombosis (Jennings, 2008). Prevention of thrombo-embolic complications related to vascular and cardiac surgery. Coagulation examination must be carried out before administration of an anticoagulant. It allows any abnormal results to be taken to the physician first. The normal ranges are:

  • Platelets 150 – 400 x 109/ L
  • APPT 30-40 sec.
  • PTT 60-70 sec.
  • PT 11 – 13 sec.
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Prevention of Ischemic Stroke

For patients with history of ischemic, doctors should prescribe drugs that can prevent recurrence of the stroke. The treatment includes anti-platelet and anticoagulant medications. Surgical procedures are at times considered when it is necessary to open up blockages (Skidmore-Roth, 2007). To prevent recurrence of ischemic stroke, anti-platelet therapy is administered. One of these anti-platelet therapies given after an occurrence of a stroke to prevent its recurrence is Dipyridamole. It is given in form of release. The patient takes it two times daily. This drug is mostly combined with aspirin. Common side effects of this drug are stomach upsets diarrhea and headaches. The patient on medication is expected to show improvement after the first one week.

Clopidogrel is an antiplatelet drug also used after a patient has had a stroke. It is useful in preventing any recurrence. Previous studies have proved that this drug is much better than aspirin. Hence, it is highly recommended as an alternative drug to aspirin. In can, however, not be used in combination with aspirin. This is because it increases the chance of brain bleeding. The side effects of this drug are rashes, diarrhea, gastrointestinal bleeding and stomach upset. Aspirin, as an anticoagulant, is effective in higher doses than in smaller doses (Ansell, 2007). It is also very cheap in price compared to dipyridamole and clopidogrel.

Anticoagulant therapy is used in prevention of stroke. The therapy comprises the warfarin and dabigatran. Warfarin is a tablet that is taken orally. It is used in patients who have a high probability of forming clots. Such patients must be monitored closely to prevent further bleeding and to reduce any enlargement of blood clots. Dabigatran is used to thin blood, and it is mainly used by patients with atrial fibrillation of the heart. It is better than Warfarin as it requires little supervision. It is, however, more expensive than Warfarin.

Revascularization refers to the process of restoring flow of blood in part of the brain (Sullivan, 2006). For the stroke patients, it means the surgical procedure of opening the carotid artery. This prevents occurrences of stroke as it increases blood in the brain. In order to know the extent of the blockage, the patient is advised to buy an ultrasound imaging test or the conventional arteriogram. Carotid endarterectomy is a procedure done to open up blocked tubes. Its risks are equal to its successes. Risks are inclusive of stroke, bleeding, brain injury or death. Another alternative is the placement of stent in the tube at the neck. This carries a higher risk than carotid endarterectomy.


Several patients face other problems after they have had stroke. These complications are viewed as risky. This is because majority of deaths caused by stroke are mainly due to complications. Immediately after stroke, the care givers plus the relatives can reduce the risk of many of these diseases. Major complications comprise heart failure, blood clots, pneumonia, and difficulty in taking meals, bed sores, falls, urinary tract infections and bleeding in the digestive system (Jennings, 2008). The majority of the patients of stroke are affected by blood clots. These clots always move along the blood vessels. They can cause blockages anywhere in the body. This leads to difficulty in walking which may further result in paralysis. Such patients are mostly treated with heparin.

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Nursing Implications

After stroke, it can be difficult to know what may happen next. The medical profession should prepare the care givers plus the families about the long term risk and death. It is, however, indispensable to watch and wait. Anticoagulants are used if the patient is bleeding or during menstruation. When brushing their teeth, the patients should use toothbrushes with soft bristles. In addition, they are to use electric razor. These are measures put to reduce chances of bleeding. For side effects of this management to be reduced, patients must be educated to be able to protect themselves from any injury or bleeding. In case they see any bleeding signs in the gums, urine or stool, they should report it immediately to the physician. Patients should also avoid using aspirin, NSAID or steroids since they highly react to the anticoagulants.

There are times when the patients must use anticoagulants. However, caution should be exercised to avoid further bleeding. Aspirin is mainly used to prevent further production of thromboxane A2. The effect of antiplatelet of this anticoagulant lasts for 7 days.  Only patients with a lower risk of stroke can use this drug. Gastrointestinal side effects caused by the use of aspirin may be relieved by reducing the dose given. Warfarin can also be used alongside heparin. It is because warfarin takes longer to react. The drug is, however, necessary because it is used to prevent recurrence of thrombi. A daily dose of about 10 mg is administered until the normal ratio is achieved. Others incorporate the use of vitamin K in to the management. Equally, the doses may be adjusted depending on the age and severity of the problem. Factors such as drug interactions, compliance of the patient, diet and metabolic rate of this drug affect the administration of the drug.

Heparin is also employed to reduce the formation of blood clots. It acts at multiple sites to end the clots from enlarging. It also prevents exchange of fibrinogen to fibrin. Very few patients can use this drug and hence, its dosage is also very specific. Plavix is another antiplatelet agent. It works by inhibiting 1st two phases of platelet aggregation (Jennings, 2008). It inhibits the aggregation that is stimulated by other ADP. Plavix is administered to reduce the threat in critically ill patients. To reduce the gastric side effects, this drug should be administered with food. The drug is mostly prescribed to patients as it does not require consistent monitoring of the blood. Thus, it best suits patients on long term therapy. When administering heparin, complete occult blood and blood count should be studied. Lab tests have to be monitored strictly. To avoid bolus infusions when administering heparin intravenously, the nurse should avoid piggybacks. She should also create a separate line in addition. Ticlid is another drug that is used to inhibit the threat of stroke in patients. To reduce further bleeding in patients, platelet transfusions should be administered. There is dependence on care givers to end the treatment for around five days for patients receiving anticoagulant therapy. This is to prevent early death rate (Huttona & Caplan, 2003).

Caution should be exercised due to the fact dose given might be higher than that of preventive measures. Patients are advised to often move their limbs to prevent any clotting of the blood from taking place. This may require the help of a therapist. a stroke patient may develop dysphagia. This may lead to inhalation of saliva or food into the lungs. Caregivers need to exercise great care as this can result in death. To determine whether a patient is at risk of dysphagia, water should be given to see if they have the ability to swallow. If this test turns negative then no food should be given orally. Instead, nutrition and medication should be given through the vein. Training programs and exercises may be introduced for the patients to swallow without the help of the nerves while the muscles. In addition, additives may be added to the food to make the liquids thick. The use of a catheter is employed to patients who have the difficulty of passing urine. Care givers should eliminate the patient contracting an urinary infection. This can be implemented by using it only when necessary, removing the catheter as soon as possible and changing the catheter.

At times a person loses the ability of recovering from stroke. This increases the chance of long term disability. The main cause of this problem is malnourishment before and after stroke. There should never be a reduction of the nutritional quantity taken in. This should be elevated prior to the patient being discharged. Feeding tube should be placed through the nose to the stomach to ensure the wellness of the patient. Patients who have had severe stroke may most likely have GI bleeding; thus, medication ought to be administered to lower the amount of gastric acid being produced. Heart problems such as irregular heart rhythm are also a common occurrence after stroke. More than 70% of the patients develop this problem later on. Before administration of drugs, other causes associated with the problem need to be ruled out. Tests carried out to ascertain the cause includes ECG and electrocardiogram (ECG). Bed sores are problems that occur because the patient could have lied on one area for so long. The skin injury may take different forms from mild to deep ulcers. This increases the risk of the patient to other infections. Care givers should help the patient turn every two hours. Patients should be placed at different angles to prevent them from exerting pressure on their hip bone. Pillows can be used to elevate the ankles while the knees to reduce pressure at those areas. However, the head of the bed should not be elevated frequently.

In addition to this, exercises need to be carried out. Exercises are to strengthen the muscles and enable the patient walk again. Due to the fact patient is exercising, the risk of falling should be totally eliminated. This is because fall is categorized among the risks to life threatening complications. A care giver should be assigned to every patient to eliminate such risks. If the patient has been discharged, home hazards should be removed. Loose rugs can be kept away from the patient’s path and lighting system can be improved for the sake of the patient. The care giver and relatives should ensure that the patient is well clothed to avoid any loose cloths that may cause falls.


More than 450,000 American citizens are suffering from stroke related illnesses (Aplan 2006). This is because of the form of sedentary lives people have opted for.

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