Assessment of infection in older adults. Signs and symptoms in four body systems.

Emerging infections and increased antibiotic resistance are growing concerns within the health care community. Nurses play an important role in the early recognition of clinical manifestations of infection in older adults. Atypical presentation in older adults, the presence of comorbid conditions, and altered immune status all present challenges to both diagnosis and effective treatment in this population. The purpose of this article is to review common infections seen in older adults, with an emphasis on the integration of the effects of physiological changes of aging on patient presentation and nursing assessment.

The effect of culture on symptom reporting: Hispanics and irritable bowel syndrome.

PURPOSE: To explore whether the symptoms reported by Mexican-American patients with irritable bowel syndrome (IBS) meet the current diagnostic criteria. DATA SOURCES: A retrospective review of charts of Mexican-American patients diagnosed with IBS at three large medical centers in central California was performed. Demographic information was extracted, and descriptive statistics were used to determine how symptoms were reported and whether the described symptoms met the Rome II criteria. CONCLUSIONS: Only 63% of the Mexican-American patients in this study reported symptoms that met any of the nine Rome II criteria. There was no significant difference between patients who were English dominant and those who were monolingual Spanish in the concordance of their presenting complaint and the current diagnostic criteria. In addition, there was no significant gender difference in the rate at which symptoms met the Rome II criteria. IMPLICATIONS FOR PRACTICE: Assessment of illness and its symptoms requires that the practitioner have a clear understanding of what the illness means to the patient in order to develop an accurate diagnosis and an appropriate and timely plan of treatment. This study highlights the necessity of revising the symptom-based criteria for diagnosing IBS to include a wider array of reported complaints, taking into account the impact of culture on the perception and description of symptoms.

The effect of demographic variables on achievement in and satisfaction with online coursework.

Although an ethnically diverse health care workforce is considered necessary to meet the needs of our multicultural society, little attention has been given to the effect of language in distance-delivered coursework. A population of ethnically diverse nurse practitioner and physician assistant students at three institutions was studied to determine the effect of demographic variables, such as native language, gender, and prior computer experience, on both successful completion of and satisfaction with online coursework. No significant difference was found in academic achievement of native and non-native English speakers, nor in course satisfaction between these two groups. In addition, neither gender nor prior computer experience affected either academic achievement or course satisfaction.