Evaluate the effectiveness of health and social care practitioners and agencies working together to deliver the care pathway for one of the chosen physiological disorders

7 July 2016

The two physiological disorders I will be talking about in this assignment is hypertension and Diabetes. Pulmonary hypertension Pulmonary hypertension is a lung disorder. The arteries that carry blood from the heart to the lungs become narrowed, making it very hard for the blood to get through the vessels, this then causes the pressure in the arteries to increase more than usual (high blood pressure). Scientists think that the procedure starts with injury to the layer of cells that line the small blood vessels of the lungs.

This injury, which occurs for unknown reasons, may cause changes in the way these cells interact with the smooth muscle cells in the vessel wall. As a result, the smooth muscle contracts more than normal and narrows the vessel. The high pressure then puts more pressure on the right ventricle of the heart, causing it to get bigger. This then causes the right ventricle gradually becomes weaker and loses its ability to pump enough blood to the lungs stronger than usual. Pulmonary hypertension comes in people of all ages, races, and ethnic backgrounds although it is much more common in young adults and is twice as common in women as in men.

Evaluate the effectiveness of health and social care practitioners and agencies working together to deliver the care pathway for one of the chosen physiological disorders Essay Example

It is known to be inherited in a small number of people. Usually if members of a family suffer from it, it can be carried down in generations and could prevent long-term damage from happening. Signs and Symptoms Symptoms of pulmonary hypertension do not usually happen until the condition has been going on for a long time. The first symptom of hypertension is usually shortness of breath within doing simple activities such as climbing the stairs. Feeling exhausted, dizzy, and faint can also be some of the symptoms.

Some signs can be swelling in the ankles, abdomen and legs; bluish lips and skin, and chest pain may occur as strain on the heart increases. Everyone is different so some people may not get some of the symptoms but others might. Long-term the process gets worse and it may even stop you from doing the simplest day-to-day activities. Some symptoms may be heart palpitations, which can be stronger than usual, racing pulse, even when relaxed, passing out from dizziness and more shortness of breath in activities.

It is known that pulmonary hypertension can be caused by some medical problems such as “chronic liver disease and liver cirrhosis; rheumatic disorders such as scleroderma or systemic lupus erythematous (lupus); and lung conditions including tumors, emphysema, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis. ” Scientist believes that it can be caused by other problems such as Thromboembolic disease; this is a blood clot in a large pulmonary artery and other problems such as Low-oxygen conditions, lifestyles, obesity, and sleep apnea can also lead to pulmonary hypertension. Diagnosis

It is stated that pulmonary hypertension can be caused by a lot of problems so it is essential to literally have a full medical history, a physical exam and a full description of signs and symptoms from yourself and other family members, it is important to include family members because they may see things you don’t so it is essential. During the physical exam, the general practitioner or doctor will listen to certain body parts such as the heart, they would be hearing out for irregular heart beats and sounds, a systolic murmur of tricuspid regurgitation or a gallop due to ventricular failure.

They will also check the abdomen, legs, and ankles for fluid retention. Also strangely look at nails and lips for bluish tints. “Other tests can be done such as a blood test: Complete metabolic panel (CMP): Examines liver and kidney function Autoantibody blood tests, such as ANA, ESR, and others: Screens for collagen vascular diseases Thyroid stimulating hormone (TSH): A screen for thyroid problems HIV: A screen for human immunodeficiency virus Arterial blood gases (ABG): Determines the level of oxygen in arterial blood.

Complete blood count (CBC): Tests for infection, elevated hemoglobin, and anemia B-type natriuretic peptide (BNP): A marker for heart failure” other intense tests can be done to make the diagnosis much clearer such as Doppler echocardiogram, this uses sound waves to show the function of the right ventricle to measure the blood flow through the heart valves, and then calculate the systolic pulmonary artery pressure. There is also an X-ray, this is done on the chest.

This can show any increase or decrease in size of the right ventricle and arteries. A simpler test such as the 6-minute walk test, this controls exercise patience level and blood oxygen saturation level during exercise. There is also a Pulmonary function test, this seeks for other lung conditions such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis compared to others. Also there is a ‘Polysomnogram or overnight oximetry’, this monitors sleep apnea (results in low oxygen levels at night).

Also a right heart catheterization, this measures various heart pressures ( inside the pulmonary arteries, coming from the left side of the heart), the rate at which the heart is able to pump blood, and finds any leaks between the right and left sides of the heart. There’s also other scans such as a ventilation perfusion scan, this looks for blood clots along the pathway to the lungs. Other tests such as a Pulmonary angiogram, this is similar to the ventilation perfusion scan because it looks for blood clots, this is slightly different because it looks for the blockages in the pulmonary arteries instead.

Also similar to these, there is a Chest CT scan, this also looks for blood clots and other lung conditions that may be contributing to or worsening pulmonary hypertension. how is pulmonary hypertensions treated? It is vital and essential for the diagnosis of the problem to be stated and made sure before looking for any treatment, there are some cases that have gone wrong because they didn’t actually have hypertension. Treatment varies on the individual, it’s based on the different fundamental causes but generally includes taking medications; making lifestyle and dietary changes; having surgery, if necessary; and seeing your doctor regularly.

There are lots of different medications that are available to treat pulmonary hypertension. Treatment choices, such as those listed below, depend on the strictness of pulmonary hypertension, the likelihood of progression, and individual drug tolerance. Oxygen — replaces the low oxygen in your blood. Anticoagulants or “blood thinners” such as warfarin sodium, this decreases blood clot configuration so blood flows more freely through blood vessels. Diuretics or “water pills” such as furosemide, spironalactone this removes extra fluid from the tissues and bloodstream, which reduces swelling and makes breathing easier.

Potassium, this replaces potassium (an essential nutrient) that may be lost with increased urination when taking diuretics. Inotropic agents (such as digoxin) this improves the heart’s pumping ability. Vasodilators or — lowers pulmonary blood pressure and may improve the pumping ability of the right side of the heart. Bosentan, this helps block the action of endothelin, a substance that causes narrowing of lung blood vessels. These medications require monthly lab work to monitor liver function. Epoprostenol, this dilates pulmonary arteries and helps prevent blood clots from forming.

Sildenafil, thisrelaxes pulmonary smooth muscle cells, which leads to dilation of the pulmonary arteries. Surgical therapies “Pulmonary thromboendarterectomy. ” This is where a large clot in the pulmonary artery may be surgically removed to improve blood flow and lung function. “Lung transplantation” Currently, this is the only cure for primary pulmonary hypertension. Transplantation is reserved for advanced pulmonary hypertension that is not responsive to medical therapy. The right side of the heart will generally return to normal after the lung/lungs have been transplanted.

“Heart and lung transplantation” This type of double organ transplant is very rare but is necessary for all patients who have combined lung and left heart failure. M1- assess possible difficulties involved in the diagnosis of the disorders from their signs and symptoms. Diagnosing someone can be very difficult and is a very long process. It all starts off with referral. Self referral, this is when an individual notices something about themselves or it could be another member of the their family/friends and they take themselves to their doctor.

In some cases people can be quite stubborn about their case and not want to go to the doctor, they may be putting themselves at serious risk. another referral leading from that is a professional referral, this is the individual’s doctor. the doctor then examines them then and there and makes a diagnosis but it most cases sees them over a period time to monitor them, for example the doctor might want to see the patient every couple of weeks to check their blood pressure, this is potentially putting them at risk because it could be getting worse and worse.

however some individuals that are well off can afford private health insurances such as ‘Bupa’ and could be seen within that day. another point about professional referral is that you can’t always get an appointment with the doctor straight the way, in some cases, it takes a week, this makes it severely difficult to diagnose somebody because their situation may have gotten a lot worse and could of lead to something more serious.

There is then a third-party referral, i did mention this before how families and friends of the individual can spot something off with them and then they advise them to see the doctor, this is very important because the individual who is ‘ill’ may not even have a clue what’s going on with their selves. hypertension is dangerous because it can increase your risk of heart attack, stroke, and other illnesses. Unfortunately, however, hypertension has few, if any, early warning signs. A simple, painless test, a physical exam, and a few medical history questions are a start.

Generally, doctors do not diagnose a patient with high blood pressure based on one set of readings, because there are many factors that can artificially raise a patient’s blood pressure. A patient may have rushed to the doctor’s and may still have high adrenaline levels. Seeing a new health care provider for the first time can make a patient nervous and raise blood pressure. “White coat hypertension” is experienced by some patients whose blood pressure is higher when measured by the doctor than when measured by another health care provider.

Pulmonary hypertension is hard to diagnose early because it’s not often detected in a routine physical exam. Even when the disease is more advanced, its signs and symptoms are similar to those of other heart and lung conditions. There are also factors of an individual that may influence the development of hypertension. for example inherited traits. As we get older and as the time of generation gets better everyone gets more aware quickly that disorders in the family can be passed down in the generations. hypertension is known to be to be inherited by other family members.

If an individual does to the doctor for a clinical diagnosis, they happen to have some symptoms of ‘hypertension’ but it doesn’t run in the family this could lead to an issue, because the doctor may think it could be something else. this could automatically put the individual at risk because the doctor is putting the patient on hold. for example the doctor may think the problem may their diet or their birth control pill. so the doctor may consider them to changing their diet or pill, as this process is happening the individual’s ‘problem’ could be getting worse and this is putting them at risk.

another factor could be lifestyle choices. this could be something like diet or social outings. The risk is also greater among individuals who have a high salt intake and those with a higher body mass index (BMI), which is a measure of body fat based on weight and height. Other factors such as employment can make it hard to diagnose hypertension. If someone who works in an industry which is manual labor, their risk of hypertension is a lot higher then someone who has a more ‘chilled out’ job such as working as a receptionist however everyone is different so sometimes this may not be the case.

There are serious complications when diagnosing hypertension because it’s the lead to serious diseases such as cardiovascular and kidney diseases because they all have the same symptoms and signs. cardiovascular diseases could be: stroke: occurs when the blood supply to part of the brain is cut off heart attack: happens when the supply of blood to the heart is suddenly blocked embolism: occurs when a blood clot or air bubble blocks the flow of blood in a vessel aneurysm: occurs when a blood vessel wall bursts causing internal bleeding

It is very surprising that these serious diseases have the same signs and symptoms as hypertension, especially for the fact that hypertension is known to be a silent killer. This is a big factor because if someone has been diagnosed with hypertension they might even have lung or heart failure without knowing so its so important that its taken seriously by health professionals. P1 P2 P3 Explain the nature of two named physiological disorders Explain the signs and symptoms Describe the investigations that are carried out to enable the diagnosis. Breast Cancer

“Breast cancer is the most common cancer in the UK. About 48,000 women get breast cancer in Britain each year. Most (eight out of 10) are over 50, but younger women, and in rare cases, men, can also get breast cancer. ” (1) A woman’s breasts are made up of fat, connective tissue and thousands of tiny glands, known as lobules, which produce milk. If a woman has a baby, the milk is delivered to the nipple through tiny tubes called ducts, which allow her to breastfeed. Our bodies are made up of billions of tiny cells. Normally, cells grow and multiply in an orderly way.

New cells are only made when and where they are needed. In cancer, this orderly process goes wrong and cells begin to grow and multiply uncontrollably. Breast cancer can have a number of symptoms but usually shows as a lump or thickening in the breast tissue (although most breast lumps are not cancerous). If cancer is detected at an early stage, it can be treated before it spreads to nearby parts of the body. There are several different types of breast cancer, which can develop in different parts of the breast. Breast cancer is often divided into non-invasive and invasive types. Non-invasive breast cancer

Non-invasive breast cancer is also known as cancer or carcinoma in situ. This cancer is found in the ducts of the breast and has not developed the ability to spread outside the breast. This form of cancer rarely shows as a lump in the breast and is usually found on a mammogram. The most common type of non-invasive cancer is ductal carcinoma in situ (DCIS). Invasive breast cancer Invasive cancer has the ability to spread outside the breast, although this does not mean it necessarily has spread. The most common form of breast cancer is invasive ductal breast cancer, which develops in the cells that line the breast ducts.

Invasive ductal breast cancer accounts for about 80% of all cases of breast cancer and is sometimes called ‘no special type’. Other types of breast cancer Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget’s disease of the breast. It is possible for breast cancer to spread to other parts of the body, usually through the lymph nodes (small glands that filter bacteria from the body) or the bloodstream.

If this happens, it is known as secondary or metastatic breast cancer. The first symptom of breast cancer most women notice is a lump or an area of thickened tissue in their breast. Most lumps (90%) are not cancerous, but its always worth getting it checked by the doctor. The lump or area of thickened tissue in either breast, it act upon it quickly its always vital women take regular checks on the breast by slightly rolling the palm of the breast. usually you would see a change in the size or shape of one or both breasts.

another symptom is discharge from either of your nipples (which may be streaked with blood) this is very unusual for this to happen so it would be so vital to see the doctor in any of these cases. because the lymph nodes are connected from the armpit to the breast you could find a lump or swelling in either of your armpit. dimpling on the skin of your breasts is also a common sign followed by a rash. also a change in the appearance of your nipple, such as becoming sunken into your breast and pain in either of your breasts or armpits not related to your period.

If the individual has had close relatives who have had breast cancer or ovarian cancer then they have a higher of developing breast cancer. However, as breast cancer is the most common cancer in women, it is possible for it to occur more than once in the same family by chance. Most breast cancer cases do not run in families. However, particular genes, known as BRCA1 and BRCA2, can increase your risk of developing both breast and ovarian cancer. It is possible for these genes to be passed on from a parent to their child.

A third gene (TP53) is also associated with increased risk of breast cancer. The risk of developing breast cancer increases as you get older. Breast cancer is most common among women over 50 who have been through the menopause. Eight out of 10 cases of breast cancer occur in women over 50. All women between 50 and 70 years of age should be screened for breast cancer every three years as part of the NHS Breast Screening Programmed. Women over the age of 70 are still eligible to be screened and can arrange this through their GP or local screening unit.

Currently, there are ongoing pilot studies looking at widening the screening age range to 47-73 Unfortunately if an individual has had previously had breast cancer or early non-invasive cancer cell changes contained within breast ducts, you have a higher risk of developing it again, either in your other breast or in the same breast again. It is vital that if anyone gets any symptoms of breast cancer they go and see the GP or doctor. The GP will examine the person and, if they think their symptoms need further assessment, refer them to a specialist breast cancer

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