Urine Protein Test - Research Paper Example

 Question 1: Urine Protein Test As indicated by its name, a urine protein test entails the detection and measurement of protein in urine samples. In addition to this, the test also encompasses monitoring and evaluating kidney function as well as detecting and diagnosing kidney complications, disease and damage. When it comes to urine protein testing, semi-quantitative tests are the most common method of going about the procedure (Strasinger & Lorenzo, 2008). Of all semi-quantitative tests, the dipstick urine protein is the most reliable and therefore is extensively used in almost all instances cases where urine protein is tested. It forms part of the general urinalysis process, and involves the screening of the whole population for any signs of protein in the urine (Mundt & Shanahan, 2011). Results and Implications of the Test In the medical field, it is widely accepted and recognized that for a random urine sample, the normal protein level should range between 0 to 20mg/Dl (Mundt & Shanahan, 2011). In cases where one’s urine protein levels surpass the 20mg/Dl mark, there has to be cause for concern because there may be a strong possibility of kidney damage. Diseases and conditions that may set the alarm bells ringing may include the following: kidney infection, kidney failure, glomerulonephritis, diabetes, hypertension, cardiovascular diseases, malaria, arthritis, leukemia, amyloidosis, sickle cell anemia, multiple myeloma, urinary tract infections, Good pasture’s syndrome, bladder cancer, heavy metal poisoning, polycystic kidney disease and pregnancy. It is important to note that in instances where kidney damage is suspected, the amount of protein detected is directly proportional to the severity of the damage, and therefore when the levels of protein are elevated over a period of time the damage to kidneys becomes more extensive and severe (Parker, 2010). Other indications may include a transient increase as a result of medication (certain drugs may trigger a rise in urine protein levels), physical or emotional stress and even vigorous physical activity. It is also worth noting that if kidney and urinary tract infections are the primary factors behind an elevation in urinary protein levels, they usually normalize once the two conditions have been cured (Parker, 2010). Question 2: Viral Hepatitis and Health Care Workers (HCWs) Out of all the known strains of hepatitis, hepatitis B is the most prevalent worldwide, with both its mortality and infection rates being the highest (Freedman, 2009). It is commonly referred to as HBV, meaning hepatitis B virus. According to a report published by the World Health Organization, hepatitis B is a very critical occupational hazard for all health workers when compared to hepatitis A (HAV) or C (HCV), which also occur among health workers. The same report also backs up previously stated claims that HBV is more infectious (about 50-100 times more) than HIV/AIDS, but states that vaccination is the best way of preventing it (Gerety, 2009). Transmission Hepatitis B and C are often transmitted via blood contact, contamination and use of unsterilized needles or equipment. HCWs that come into contact with blood products, human blood or bodily fluids that are potentially infectious are more susceptible to HBV and HCV. Over the years, it has also been established that some spheres of healthcare represent more risk, with orthopedic services, surgery and gynecology leading the list (Horn, 2005). Treatment and Prevention CDC requires and recommends that all emergency personnel, HCWs and other people who are regularly exposed to bodily fluids and blood at work must be vaccinated against HBV (Freedman, 2009). This vaccine guarantees a lifetime protection against HBV. Since a vaccine is yet to developed for HCV, it is highly recommended that universal precautions are strictly adhered to in addition to employing safe and simple techniques with the aim of avoiding exposure. All HCWs must follow these precautions to the latter in order to protect not only themselves but also their colleagues and patients (Horn, 2005). For individuals who are unvaccinated but who think that they may have been exposed to and contracted HBV, they should be put under post exposure prophylaxis (PEP) as soon as possible. If testing reveals that they are positive for HBV, they must be vaccinated against the disease. In this regard, they receive an initial dose of the vaccine, followed by a single dose of hepatitis B immune globulin (HBIG) not more than 24 hours after the confirmation of positive results (Gerety, 2009). This is often followed by 2 doses of the vaccine that are administered 1 and 6 months from the first dose. It is also recommended that such individuals go for testing 1 or 2 months after the completion of the vaccine series, so as to determine whether protective antibodies have been developed. However, if the source’s HBV status is not known and the individual who has been exposed to the virus has not yet been vaccinated then the vaccine series for HBV should be initiated with immediate effect (Horn, 2005). In cases where HCV is suspected, there are therapies that HCWs can be put under in order to enable them lead normal lives and carry out their duties as normally as possible. Question 3: HIV and BMETs HIV is transmitted through a number of ways, including unprotected sex, blood and bodily fluids contamination and contact, use of contaminated equipment like needles, blood transfusion and mother to child transmission (Johanson, 2008). Out of these, BMETs stand a higher risk of contracting HIV from contaminated equipment and contact with infected blood and bodily fluids (Baker & Pacela, 2009). Preventing HIV among BMETs Owing to the fact that medical examination and history cannot be wholly relied on in the identification of all BMETs that are infected with HIV, precautions associated with both blood and bodily fluids must be applied consistently for all BMETs. This approach is also known as the “universal precautions” or the "universal blood and body-fluid precautions", and should be employed in the care of all BMETs (Baker & Pacela, 2009). It is made up of the following precautions: a) All health-care workers including BMETs should consistently use relevant barrier mechanisms to avoid mucous-membrane and skin exposure when they anticipate contact with bodily fluids and blood of anybody in their line of work. These mechanisms include wearing gloves and changing them, wearing face shields, protective eyewear or masks and also wearing aprons or gowns depending on the situation at hand. b) Washing hands and other parts of the skin thoroughly and immediately when contaminated with bodily fluids or blood. The washing of hands should be done as soon as gloves and other protective clothing are taken off and one is ready to leave the laboratory (Baker & Pacela, 2009). c) Taking precautions to avoid injuries brought about by scalpels, needles and other sharp devices or instruments during procedures or when disposing, cleaning or handling such instruments or devices. Puncture-resistant containers should be used to store large-bore reusable needles when transporting them to areas where they are reprocessed. d) Resuscitation bags, mouth pieces and other ventilation equipment should be made available in cases where resuscitation is necessary in order to reduce the need for mouth-to-mouth at any cost. e) BMETs with weeping lesions or dermatitis should not be allowed to handle equipment used in patient care until their conditions resolve. f) Pregnant BMETs who develop HIV during pregnancy should be made aware of precautions meant to prevent the transmission of HIV to patients, colleagues and their infants (Johanson, 2008). g) Proper disposal and decontamination of equipment and materials that have been used in the laboratory and have come into contact with blood or bodily fluids. h) Proper decontamination of work surfaces in the laboratory by using appropriate germicides whenever bodily fluids and blood have been spilled and laboratory work is complete. i) Syringes and needles should only be used when there is no alternative, and all precautions aimed at preventing injuries resulting from syringes or needles should be followed. j) Mouth pipetting should never be done when manipulating any liquids. Mechanical pipetting instruments must be used in this case (Cunningham, 2009). k) Safety cabinets (Class I/II) should be employed in procedures in which there is a high probability that droplets may be generated. These include vigorous mixing, sonicating and blending. l) All specimens of bodily fluids and blood must be stored in well-built and appropriate containers with tight or secure lids that prevent any leakages during transportation. When collecting specimen, caution should be exercised so as to avoid the contamination of either the outside of containers or even laboratory forms that usually come with specimen (Cunningham, 2009). Question 4: Myocardial Infarction Myocardial infarction is also known as heart attack or MI, and is a condition in which there is blockage of one or more of the coronary arteries that take oxygen to heart muscles, resulting in death of heart muscles (Chazov, 2006). How it Occurs Either a coronary artery or one of its tinier branches is blocked suddenly and the section of the heart muscle that is serviced by this artery is denied blood and oxygen supply. If the blockage is not undone quickly, this muscle stands the risk of dying. Infarction actually refers to the death of any tissue as a result of a blocked artery that inhibits the flow of blood to that tissue (Cohn, 2010). Anatomy of an MI The heart has four chambers: left atrium, right atrium, left ventricle and right ventricle. The 2 tiny atria form the top, while the 2 big ventricles form the heart’s bottom (Cohn, 2010). The right atrium supplies blood to the right ventricle, while the left ventricle is serviced by the left atrium. A wall referred to as the septum separates the right ventricle and right atrium from the left ventricle and left atrium. Blood flow through the heart is illustrated as follows: the right atrium receives oxygen-deficient blood from the body and then takes it to the right ventricle via the tricuspid valve; the right ventricle takes blood to the lungs via the pulmonic valve. In the lungs it acquires more oxygen; the left atrium receives blood rich in oxygen from the lungs and then takes it to the left ventricle via the mitral valve; the left ventricle takes blood to the body via the aortic valve; the blood takes oxygen to the body and the cycle is repeated (Ruttner, 2007). Coronary Arteries These take oxygen to heart muscles, and there are 3 main ones: the right coronary artery that services the right ventricle, the left coronary artery that services the left ventricle and the posterior circumflex artery that services the posterior part of both ventricles (Cohn, 2010). Cardiac Conduction System According to Ruttner (2007), muscle fibers in the heart are stimulated to contract by an electrical impulse. This impulse travels through the heart systematically, such that the contraction of the atria precedes that of the ventricles. The impulse travels as follows: it originates from the sinoatrial node (this regulates the heart beat) that can be found in the right atrium’s wall; it travels through the atria and causes them to contract; the atrioventricular node slows the impulse before it reaches the ventricles, and this momentary delay allows blood to fill the ventricles prior to contraction; after the delay the impulse moves to the ventricles triggers their contraction (Chazov, 2006). Physiology and Patho-physiology of an MI This entails the whole process of the causes of an MI and how it finally occurs. The most prevalent etiological aspect that triggers an MI is the presence of atherosclerotic plaque around or in the area of coronary arteries. Plaques large enough to result in atherosclerosis require a number of years to build up, and despite the fact that plaque erosion caused by metalloproteases may lead to thinning, its thickness is still enough to cause obstruction of arteries (Cohn, 2010). . This results in a disruption in blood flow to the heart muscles from coronary arteries. It is important to note that the degree of block is usually determined by the actual size of a thrombus, and this degree of block is what decides the amount of damage the heart muscles suffer. If blood flow to the heart is decreased for a long time, it results in a condition called ischemic cascade; this cause death of heart muscles that are supplied by the blocked artery because of hypoxic necrosis. In and around the dead muscles a collagen scar develops and permanently destroys that part of the heart. This scarring makes the patient highly susceptible to cardiac arrhythmia since a section of the heart will be unable to pump out sufficient blood as demanded by the body (Ruttner, 2007). The fundamental basis of MI patho-physiology can be found in the fact that scarred heart tissue conducts impulses (electrical) at a much slower rate compared to normal tissue (Ruttner, 2007). The main basis of myocardial infarction patho-physiology lies in the fact that injured heart tissue conducts electrical impulses at a rate that is much slower than normal heart tissue. This difference can trigger arrhythmias (with the most serious being ventricular fibrillation) that may even lead to death. References Baker, S. A., & Pacela, A. F. (2009). Occupational biohazards affecting clinical engineers & BMETs. Brea, Calif., U.S.A.: Quest Pub. Co. Chazov, E. I. (2006). Myocardial infarction (Rev. from the 1971 Russian ed.). Moscow: Mir Publishers. Cohn, P. F. (2010). Silent myocardial ischemia and infarction (4th ed.). New York: Dekker. Cunningham, K. (2009). HIV. Greensboro, N.C.: Morgan Reynolds Pub. Freedman, J. (2009). Hepatitis B. New York: Rosen Pub. Gerety, R. J. (2009). Hepatitis B. Orlando: Academic Press. Horn, L. W. (2005). Hepatitis. Philadelphia: Chelsea House. Johanson, P. (2008). HIV AIDS. United States: ReadHowYouWant.com. Mundt, L. A., Graff, L., & Shanahan, K. (2011). Graff's textbook of routine urinalysis and body fluids (2nd ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. Parker, J. N. (2010). Urine protein a medical dictionary, bibliography, and annotated research guide to Internet references. San Diego, CA: ICON Health Publications. Rüttner, J. R. (2007). Myocardial infarction. Basel: S. Karger. Strasinger, S. K., & Lorenzo, M. S. (2008). Urinalysis and body fluids (5th ed.). Philadelphia: F.A. Davis. Read More