How Can A Nurse Life Care Planner Help Your Medical Related Case

If you have a client who has sustained a catastrophic injury, future health care and medical equipment needs can be very costly.   A certified nurse life care planner can research and estimate these costs based on his or her injury and life expectancy. This is an individualized plan and is a living and modifiable document depending on how your client's needs change as he or she ages.

In putting the life care plan together, the nurse first reviews the client's medical records, employment records, and school records (for children). Then a visit to the injured client's home is scheduled to evaluate the family and home status.  This includes gathering information on caregiver, safety, home modifications, and other home care needs. Here the client is observed during his or her daily activities.  Then based on record review, observation, interview, extent of injury, and life expectancy the nurse formulates the plan.

The certified nurse life care planner collaborates with other professionals involved in the client's care such as physicians, physical/occupational therapists, speech therapists, vocational experts, caregivers, suppliers of durable medical equipment (DME), and home modification builders. Any costs associated with the DME would also include replacement and maintenance costs.

Life expectancy is determined after establishing factors such as age at the time of injury, extent of the injury, and any pre-existing conditions.  All of these costs included in the life care plan are estimated from the date of injury to the predicted age of death.

Life care plans benefit those at any age with catastrophic injuries, such as traumatic brain injury (TBI), major burns, amputations, toxic exposures, spinal cord damage, chronic pain, and other chronic illness.

A certified nurse life care planner is a licensed registered nurse with at least 3 years of experience, has taken an accredited education program to learn how to prepare a life care plan, and has passed the national certification examination administered by the International Commission on Health Care Certification (ICHCC).

Next time you have an injured client, put a medical professional on your team. A nurse life care planner can do the work for you of determining future care and costs associated with an injury.

        

    

Trans Fats

We need a certain amount of fats for energy and health.  But not all fats are good for us.  Trans fats are a type of fat that has recently come to the public's attention.


Some fats are needed in our diets to maintain good health and absorb essential nutrients such as carotenoids and Vitamins A, D, E, and K.  Fats should make up roughly 25% of our daily calories.  But one type of fat, called Trans Fat should be limited in the diet.


Harvard School of Public Health researchers estimate that industrially produced trans fats in the diet cause 72,000-228,000 heart attacks and about 30,000-100,000 heart attack fatalities annually.  The United States Food and Drug Administration (FDA) has concluded that, gram-for-gram, trans fats are more harmful than saturated fats.  Saturated fats and trans fats together should make up no more than 7% of our daily calories.  Trans fats raise the level of LDL (bad cholesterol) lower the HDL (good cholesterol) in the blood. 


The American Medical Association (AMA) recommended a ban of all trans fats used in restaurants and bakeries.  The FDA estimates that the average American eats about 4.7 pounds of trans fats annually. 


Trans fats are formed when hydrogen is added to vegetable oil (called hydrogenation).  This makes the liquid vegetable oil solid and is used to extend the shelf life of certain foods.  The majority of cakes, crackers, cookies, pies and bread (the goods that we like so much) have high levels of trans fats.  Some animal products have trans fats, although their levels are not as high.  Surprisingly enough, many energy and nutrition bars also have trans fats.


In order to figure out how much trans fat is in a product, look at the Nutrition Facts label.  As of January 2006, the FDA has required all food manufacturers list trans fat content on their product labels.  They can be found listed with the saturated fat content.


It is best to choose foods that contain monounsaturated and polyunsaturated fats.  Monounsaturated fats are found in foods such as vegetable oil, avocado, nuts and seeds.  These aid in lowering LDL levels in the blood.  Polyunsaturated fats can be found in foods such as salmon and trout.  These also aid in lowering LDL levels in the blood.  When dining out, ask for foods that are not made with trans fat.  Remember, we need certain fats in our diet.  Make sure to choose the right kind.

Health Benefits of Calcium and Vitamin D

Every body needs calcium and vitamin D to maintain bone health. We need to consume it daily as our bodies do not manufacture it.

Reasons For Consuming Calcium

Calcium is a major mineral, an essential nutrient we need, especially during infancy and the growing years when we are building our bones and teeth. The highest calcium absorption is in infants (60%). Thirty percent is absorbed during adolescence and 25% in adulthood. If the diet lacks calcium, bone loss (osteoporosis) occurs and can cripple us as adults. Calcium is also essential for healthy nerve transmission, muscle contraction including the heart, vasodilation to help keep the blood pressure normal and as an aid in blood clotting.
A national cancer institute study showed that calcium may reduce the incidence of colorectal cancer but has no effect on other cancers. There were no protective effects of calcium found against breast and prostate cancers.

Storage And Use Of Calcium

Calcium is lost daily through the skin, nails, hair, sweat, urine and feces. The skeleton stores about 99% of what we consume. For the many other bodily processes that require calcium, it is taken from the bones. If it is not replaced, the bones become brittle and break. The more calcium that is ingested, the more that is stored. However, the smaller the amount absorbed.

Sources Of Calcium And How Much Is Needed

The diet is the best source of calcium with dairy products having the highest content. Milk is the best source of bioavailable calcium. This is what is left for the body to store and use after digestion. The food sources with the highest calcium content are milk, yogurt, calcium fortified orange juice and tofu. Adults should get 1000-1200 mg daily. Adolescents should get about 1300 mg daily. Children should get 500-800 mg daily.
Oxalates inhibit the absorption of calcium. These are found in foods such as beans, rhubarb, chocolate and almonds.

Consequences Of Inadequate Calcium Intake

Inadequate calcium intake is a major factor in causing osteoporosis. According to the World Health Organization, bone mineral density that is 2.5 standard deviations below normal is defined as osteoporosis. "Osteo" means bone and "porosis" means porous (thin). A bone density scan can assess bone density. If bone density decreases, you are prone to falls and fractures.

Vitamin D And Calcium

Vitamin D is essential for the absorption of calcium by the body. The best source of Vitamin D is exposure to sunlight. It is then made by the skin. Milk also is now fortified with Vitamin D. In large amounts, Vitamin D can build up and become toxic which can lead to diarrhea, headaches, nausea and calcium deposits in the organs which can lead to death.
A Vitamin D deficiency can lead to brittle bones and deafness. Children should get 2.5-10 micrograms daily. Adults and adolescents should get no more than 2.5-5 micrograms daily. Supplements may be needed if exposure to sunlight is not available. For those who do not consume dairy products, alternate sources of calcium should be considered.

first published in Suite101.com
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Article published in Pediatrics for Parents

Is Whooping Cough Only a Baby's Disease

by Sandra Gardner, RN

In the past year there have been reports of whooping cough outbreaks in middle and junior high schools. So what is whooping cough? Whooping cough, also called pertussis, is an illness caused by a bacteria called Bordetella pertussis.

It usually begins with symptoms much like the common cold: low-grade fever, runny nose, and cough. This progresses into the second stage, which is characterized by sudden attacks of forceful coughing. At the end of each coughing episode, a long inspiratory effort is made to get air into the lungs which is accompanied by a 'whoop' sound. Vomiting may also occur. This stage may last up to ten weeks. The third stage, recovery, may take up to six weeks or longer, during which time the cough disappears.

Whooping cough is highly contagious and is transmitted person to person by inhaling droplets coughed or sneezed into the air by an infected person. If antibiotic therapy is given during the coughing stage, it is only to limit the spread of the disease. In order for the drug therapy to get rid of the illness, it must be given during the first stage of the illness. Because of the high communicability of whooping cough, antibiotic prophylaxis should be administered to all household contacts and other close contacts of the infected person.

Sixty years ago, whooping cough was one of the most common diseases in children. Then, in the 1940s, when the first vaccine became available, the incidence of this dreaded disease decreased by more than 98%, and we had all but forgotten about it.

In the last three decades, however, there has been a gradual rise in the number of reported cases. According to data from the Centers for Disease Control and Prevention, in Atlanta, roughly 20,000 cases were reported in 2004 alone. Thirty-eight percent of all these reported cases were in children 10-19 years of age.

But these numbers are somewhat deceiving because classic symptoms of the disease are not always present in older children and may go unreported. A 2005 study published in the New England Journal of Medicine reported that between 13% and 32% of older children and adults with a cough illness of six days or longer would show evidence of whooping cough in laboratory findings.

So what is responsible for these disturbing statistics? Most children receive a series of whooping cough vaccines with a booster around age five. It is now thought that immunity decreases after five years when these children are older, leaving them susceptible.These individuals may unknowingly pass the disease on to vulnerable infants and younger children.

Prior to 1999, there were no booster vaccines available to anyone older than seven years of age. Between 1999 and 2005, booster vaccines were licensed for persons older than seven years outside the United States. On May 3, 2005, the United States Food and Drug Administration approved the first combination vaccine for use in the U.S. It is pertussis combined with tetanus and diphtheria (Td) and is indicated for children 10-18 years. The new vaccine is called Boostrix (Tdap) and is manufactured by GlaxoSmithKline Biologicals (GSK). It can be given as a five-year single dose booster for the series given in childhood. According to Dr. Leonard Friedland, a vaccine research physician at GSK, the goal with the Tdap is to protect those who receive it against tetanus, diphtheria, and pertussis. It is a response to a public health need of getting control of pertussis.

The Advisory Committee on Immunization Practices (ACIP), a group of immunization experts appointed by the secretary of the U.S. Department of Health and Human Services, has formally recommended that Tdap vaccine be given to children ages 11-18 in place of the Td that is currently given.

There is now a way to prevent this devastating disease in infants, older children, and adults. For more information on Tdap, contact your health care provider or visit the following websites: