The 10 Most Common Reasons for Hospitalization in the USA That You May Encounter as a USRN

As a Medliant USRN you will likely encounter patients who present with one or more of the most common reasons for hospitalization in the USA! While these conditions occur all over the world, the top reasons for hospitalization from country to country will vary. To better prepare yourself for working as a Registered Nurse in the USA, it is important to familiarize yourself with these conditions, including the risk factors, patient teaching and education, and treatments that they each require! Here are the 10 most common reasons for hospitalization in the USA that you may encounter as a Medliant USRN!

10. Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease or COPD is a group of respiratory diseases that causes airflow blockage and breathing problems. According to the Centers for Disease Control and Prevention, 16 million Americans have COPD, which includes emphysema and chronic bronchitis. It is believed that there are millions more who suffer from COPD in the USA that have not yet been diagnosed or treated. There is no cure for COPD, however its symptoms can be treated. COPD is especially prevalent in adults 65 years and older and affects more women than men. Risk factors for COPD include the use of tobacco, exposure to environmental pollutants, and a history of respiratory infections. Those affected by COPD have difficulty completing activities of daily living, working, walking, and require portable oxygen with them at all times. Comorbidities associated with COPD include depression, arthritis, congestive heart failure, diabetes, coronary heart disease, stroke, or asthma.

Common symptoms of COPD include:

• Frequent coughing or wheezing

• Excess phlegm, mucus, or sputum production

• Shortness of breath

• Difficulty taking a deep breath

9. Cardiac Dysrhythmias

Cardiac arrythmias are irregular, or abnormally slow or fast heartbeats and can be life threatening such as with ventricular fibrillation for example. Common symptoms of cardiac arrythmias include having an irregular heartbeat, heart palpitations, lightheadedness or dizziness, fatigue, shortness of breath, and chest pain. Treatment varies depending on the type of cardiac arrythmia, however many affected individuals will require medication to prevent cardiac arrythmias from taking place as well as blood-thinners to prevent clots and strokes from forming. In some cases, surgery may also be indicated. Healthy lifestyle choices should be discussed with those who have cardiac arrythmias to reduce the risk and complications associated with them.

Examples of Cardiac Arrythmias include:

• Atrial fibrillation: rapid, irregular, and disorganized rhythm resulting from chaotic and uncoordinated heart beats from the atria to the ventricles. A severe complication secondary to having atrial fibrillation is experiencing a stroke as 1 in 7 people who have atrial fibrillation will have a stroke.

• Atrial flutter: Rapid circuits of conduction in the atria that typically present as more regular than atrial fibrillation.

• Heart block: A delay or complete block of conduction at any point throughout the normal heart’s electrical pathway from the SA node to the Bundle of HIS or Purkinje Fibers.

• Supraventricular tachycardia (SVT): A fast heartbeat that originates from above (supra) the ventricles. This results in the cardiac chambers not being able to properly fill between contractions, compromising blood flow and oxygenation to the body and its vital organs.

8. Acute Myocardial Infarction (Heart Attack)

Acute myocardial infarction, otherwise known as a heart attack, is a severe and life-threatening condition that is caused by a blockage of the coronary arteries. As a result, tissue that is past the blockage begins to die as it is not being supplied with oxygenated blood. The cause of a heart attack is often associated with high levels of cholesterol, saturated fats, and triglycerides. Those with a high blood pressure, diabetes, obesity, and the use of tobacco are especially at risk in addition to being an older adult and having a family history of heart attacks. 

Symptoms of an acute myocardial infarction include:

• Tightness of the chest

• Shortness of breath

• Sweating

• Nausea or vomiting

• Anxiety

• Coughing

• Dizziness

• Tachycardia

7. Diabetes Mellitus (Type 2 Diabetes) 

Diabetes mellitus is a disease where the body does not produce or can’t sufficiently use insulin to control the body’s blood sugar levels. Diabetes mellitus often develops in adulthood and can be prevented or delayed with maintaining a healthy weight, a proper diet, and exercise. Approximately 34 million people or 10% of the US population lives with diabetes with another 88 million people or 34% of the US population living with prediabetes. If diabetes is not properly managed, circulation is compromised peripherally and can result in the death of tissue in the extremities beginning with the toes and fingers, potentially requiring amputation. Patients are also at risk losing their vision and going blind in severe cases.

Symptoms of diabetes include:

• Increased urination, especially at night

• Increased thirst

• Weight loss

• Blurry vision

• Increased appetite

• Fatigue

• Numbness or tingling of the hands or feet

• Dry skin

• Delayed wound healing

• Higher prevalence of infections

6. Pneumonia

A pneumonia is an infection of the lungs that can affect patients of all ages and is a leading cause of death for older adults. A pneumonia is bacterial or viral in nature, and can be acquired from being in the hospital, especially in long-term care facilities and the ICU, as well as in the community setting. With a pneumonia, the air sacs of the lungs are often filled with purulent matter causing patients to cough and have difficulty breathing. Patients may also present with a fever or chills, sweating, fatigue, loss of appetite, headaches, and chest pain. Over 1.5 million Americans visit the Emergency Department each year with a pneumonia. 

5. Complications of and During Childbirth

Complications associated with childbirth most commonly result in women who give birth after the age of 35 years old, have had an early age pregnancy, poor nutrition during pregnancy, use tobacco/alcohol or drugs during pregnancy, and in pregnancies with multiple babies such as with twins.

Complications of childbirth include:

• Gestational hypertension: often due to a narrowing of the arteries carrying blood from the heart to the placenta.

• Gestational diabetes: occurs when the body cannot process and manage sugar appropriately. This requires dietary management and at times insulin.

• Preeclampsia (toxemia): causes high blood pressure and may affect the kidneys as well. Increased monitoring and an induced labor may be required.

• Preterm birth: a delivery before 37 weeks of pregnancy. Complications can arise as preterm babies may not have had full organ development.

• Miscarriage or stillbirth: a loss of the pregnancy, which is often not preventable. This can occur as a result of problems with the placenta, maternal health concerns, or infections. A miscarriage is a loss of an unborn child before 20 weeks of pregnancy while a stillbirth is a loss after 20 weeks of pregnancy.

Complications during childbirth include:

• Anemia: this can result from a loss of blood.

• Infections: may occur in the form of UTIs, group B streptococcus, CMV, influenza, a yeast infection, or spreading an illness to the newborn such as hepatitis B.

• Positional concerns: an example is if the newborn is breech (feet to be delivered before the head). A cesarean section may be required if the baby is in a concerning position.

• Placenta previa: the placenta is covering the cervix and may require a cesarean delivery.

• Low birth weight: this can result in the newborn being at risk for respiratory infections, learning disabilities, heart infections, or blindness.

4. Osteoarthritis 

Osteoarthritis is the most common form of arthritis and is often considered a degenerative joint disease worsening over time. Most commonly, osteoarthritis affects the hands, hips, and knees where the cartilage within a joint begins to break down. Osteoarthritis can be painful and can cause swelling and stiffness of the joints which negatively impacts an individual’s activities of daily living and ability to work. Affected individuals may also experience a decreased range of motion (ROM) and pain or aches. There are over 32 million Americans living with osteoarthritis today. Risk factors include injury, older age, obesity, and genetics, with more women being affected than men.

3. Heart Failure

Heart failure results when the heart in unable to effectively pump and supply blood to the body which can impair many bodily functions and comprise circulation and perfusion to vital organs. Heart failure is often categorized as either left (congestive) or right sided heart failure. There are over 6 million adult Americans who live with heart failure today. Risk factors include coronary artery disease, diabetes, hypertension, obesity, and valvular heart disease, as well as tobacco and alcohol use, a high fat diet, and a lack of exercise. Treatment may require diuretics to remove excess fluid in the body, inotropes to improve the hearts ability to pump blood and maintain an adequate blood pressure, digoxin to strengthen the hearts muscle contractions and slow the heart rate, as well as other medications such as beta blockers to reduce the blood pressure and workload of the heart.

Types of heart failure include:

• Left sided (congestive) heart failure: the left side of the heart fails resulting in blood back flowing into the pulmonary circulation and the lungs. This results in fluid overload or pulmonary edema, shortness of breath, difficulty breathing, and respiratory distress. Left sided heart failure is the most common type.

• Right sided heart failure: often results following left sided heart failure and causes fluid to back up into the systemic circulation causes edema or swelling in the feet, ankles, abdomen, liver, and GI tract.

2. Septicemia

Septicemia is a serious and deadly infection of the blood that may enter from anywhere else in the body. Without early intervention and treatment, septicemia is fatal. It should be noted that sepsis is not septicemia, rather sepsis is a complication of septicemia. Septicemia often takes place secondary to another infection or surgery having already taken place. Thus, having wound sites or a recent surgery, a compromised immune system such as those taking chemotherapy or steroids, or being on a mechanical ventilator, can significantly increase the risk of developing septicemia. The most common causes of septicemia include UTIs, lung infections (e.g. pneumonia), kidney infections, and abdominal infections. Symptoms may present as fever or chills, tachypnea, tachycardia, a change in level of consciousness, confusion, decreased urine output, cool and mottled or pale skin, and a decreasing blood pressure. Patients with septicemia may develop sepsis, septic shock, or acute respiratory distress syndrome (ARDS). The immediate initiation of broad-spectrum antibiotics and IV fluids are often the first-line treatment in a patient who is suspected of having septicemia, even before blood culture results are confirmed.

1. Liveborn

Each year over 3.7 million babies are born in the USA. With an aging baby boomer population and many American’s choosing to either have less or no kids at all, there continues to be a decrease year after year in the number of births in the USA. Many Americans are also choosing to begin having children later in life due to pursuing post-secondary education or focusing on their careers. The rate of cesarian section births is approximately 30% of all births, which has also seen a gradual decline since 2009. The birth rate for women in their teenage years to age 34 years old has declined, while the birth rate for women aged 35-39 has slightly increased over recent years.

Ready to apply? If you are ready to begin your application to become a US Registered Nurse with Medliant International Healthcare Staffing please reach out to us on our Medliant Website, Facebook (Medliant International Healthcare Staffing), or Instagram (@medliant).

You can also email your resume to nursebrennan@medliant.com to start your application. Let Medliant help you begin making your American Dream come true today!

References:

2018 U.S. National Inpatient Stays. Agency For Healthcare Research and Quality. https://www.hcup-us.ahrq.gov/faststats/NationalDiagnosesServlet Last Updated April 2021. Accessed May 2021.

Atrial Fibrillation. The Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/atrial_fibrillation.htm Last Updated September 2020. Accessed May 2021.

Acute Myocardial Dysfunction. Healthline. https://www.healthline.com/health/acute-myocardial-infarction#diagnosis Last Updated January 2018. Accessed May 2021

Chronic Obstructive Pulmonary Disease. The Centers for Disease Control and Prevention. https://www.cdc.gov/copd/basics-about.html Last Updated July 2019. Accessed May 2021.

Complications During Pregnancy and Delivery. Healthline. https://www.healthline.com/health/pregnancy/delivery-complications#your-doctor Last Updated May 2016. Accessed May 2021.

Diabetes And Data Statistics. The Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/data/index.html Last Updated May 2019. Accessed May 2021.

Heart Failure. The Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/heart_failure.htm Last Updated September 2020. Accessed May 2021.

Osteoarthritis. The Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/basics/osteoarthritis.htm Last Updated July 2020. Accessed May 2021.

Pneumonia. The Centers for Disease Control and Prevention. https://www.cdc.gov/pneumonia/index.html Last Updated March 2020. Accessed May 2021.

Septicemia. Healthline. https://www.healthline.com/health/septicemia Last Updated February 2020. Accessed May 2021.