EBA Do depression symptoms predict early hypertension incidence in young adults in the CARDIA study?

I found this article extremely interesting mainly because I relate to the subject. I myself suffered from depression as a teenager and I now have hypertension. Recent analyses of almost 3,000 subjects enrolled in the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study who were followed up for 7-16 years showed that high depressive and anxious symptoms assessed with a standardized measure were significant predictors of hypertension onset. Independent and significant increased risk was found for white subjects aged 45-65 years and for black subjects aged 25-64 years. Hypertension incidence was significantly more elevated in the high and intermediate depressive symptom groups than in the low depressive symptom group for both the full sample and the black cohort. Of the subjects classified as having hypertension, 47% used antihypertensive medication, 51% had a resting diastolic BP higher than 95mmHg, and 1% had a resting systolic BP higher than 160mmHg. Finally, 1% of the subjects met both the diastolic and systolic BP criteria. High depressive symptoms in blacks predicted hypertension better than any other potential risk factor for hypertension. The results of this study shows that depressive symptoms were predictive of later hypertension incidence in young adults. The relation between depression and hypertension is biologically plausible given the increased adrenergic activity in depression that may have a pressor effect on the cardiovascular system. I hope you find this as interesting as I did! 

https://www.researchgate.net/profile/Karina_Davidson/publication/12492546_Do_depression_symptoms_predict_early_hypertension_incidence_in_young_adults_in_the_CARDIA_study_Coronary_Artery_Risk_Development_in_Young_Adults/links/02e7e529551f283665000000.pdf

NUR201 Simulation Lab Reflective Journal

I personal always love when I have simulation day, because I always get to do things you do not normally get to do in the hospital. I had a great group and I feel like we all worked well together. At first it was a little off track, but we eventually got in a grove. When we arrived in our patients room she was not hooked up to her oxygen, and her O2 was dropping fast. I quickly grabbed the ambu bag and hooked it up to oxygen. I then started to give her some rescue breaths, but her O2 continued to fall. As I was trying to do that the other members of the group gathered the supplies to hook her up to oxygen and got her hooked up to the HR monitor and applied the BP cuff. We quickly tried to hook up the oxygen supplies, but we were unsuccessful. One of my team members decided to call respiratory to see if we could get some help. Once respiratory got there they then showed us how to hook up the oxygen, and once we got her hooked up her O2 began to rise. As we started to get ready to suction and draw labs on the patient, who was nonverbal, we noticed her armband was missing. I realized in the middle of all the craziness of trying to get her O2 up we forgot to check the patient. Once we realized her armband was missing we called admissions to retrieve another one. While we waited on that we gathered supplies for suctioning and drawing labs, started our assessment, and charted some, all while making sure the patient was safe and her VS were stable. Once admissions brought the armband we realized it had the wrong date of birth, so we quickly called them again and they brought us a new one with the correct information on it. Once we had that in order, I gathered my supplies to suction the patient. After three suctions I asked the patient if she was okay, and with a head nod she said yes. Once I finished that, we informed her she was going to have to get some labs drawn. As one of my team members began to do that, the other two of us began to gather up her medications and continued to monitor her breathing and O2 status. One of my team members then began to give her her one PO medication, only to find out after we had to suction it out of her mouth that she has a PEG tube. I then checked residual and placement of the tube. Once we confirmed placement, my team member administered her medications via PEG tube.  I feel that the next time I have simulation I will be better prepared. I learned from this experience that no matter how crazy the situation is you always need to identify your patient and do a full head to toe as soon as possible. Also I learned about how to hook up the patient to oxygen properly. While watching my peers I learned that once your patients oxygen tank shuts off you have to move fast or they will decline quickly. I also learned what to do in that type of situation when the patient is declining and what to do in a code situation. My team was the code team so we had to hurry and try to help revise the patient. Over all I really enjoyed me experience at simulation, and I cannot wait to do it again!   

Hi Samantha