...ongoing and progressive disease, and studies are showing that hidden damage may be happening as early as birth. Having a proactive CF care plan in place can help you manage the disease. Get involved with a CF Center to be sure that you have access to experts. Locate the CF Center in your area and make an appointment to find out more. You will be able to get aCF Care Team, which may improve the quality of your CF care. It's possible that your CF management plan will have multiple aspects. Here are some examples of things that might be a part of your plan: * Oral antibiotics, which may be swallowed * Intravenous (IV) antibiotics, which may require a hospital stay * Inhaled antibiotics, which may be an aerosol or mist * Airway Clearance Techniques (ACTs), which may include postural drainage and percussion, as well as special equipment, such as a vest * Inhaled medications, which may require a nebulizer. Nebulizers vary, so you should talk to your CF Care Team about which is FDA approved for use with your medicine. Indication and Usage Daily administration of Pulmozyme® (dornase alfa) Inhalation Solution along with standard therapies is indicated in the management of cystic fibrosis patients to improve lung function. In patients with a forced vital capacity (volume of air exhaled with maximum effort and speed) greater than or equal to 40% of predicted, daily administration of Pulmozyme has also been shown to reduce the risk of respiratory tract infections requiring...
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...I. Introduction This is a case of a 74 year old woman who was diagnosed with Community Acquired Pneumonia. Pneumonia is an inflammation or infection of the lungs most commonly caused by a bacteria or virus. Pneumonia can also be caused by inhaling vomit or other foreign substances. In all cases, the lungs' air sacs fill with pus , mucous, and other liquids and cannot function properly. This means oxygen cannot reach the blood and the cells of the body. Most pneumonias are caused by bacterial infections.The most common infectious cause of pneumonia in the United States is the bacteria Streptococcus pneumoniae. Bacterial pneumonia can attack anyone. The most common cause of bacterial pneumonia in adults is a bacteria called Streptococcus pneumoniae or Pneumococcus. Pneumococcal pneumonia occurs only in the lobar form. An increasing number of viruses are being identified as the cause of respiratory infection. Half of all pneumonias are believed to be of viral origin. Most viral pneumonias are patchy and the body usually fights them off without help from medications or other treatments. Pneumococcus can affect more than the lungs. The bacteria can also cause serious infections of the covering of the brain (meningitis), the bloodstream, and other parts of the body. Community-acquired pneumonia develops in people with limited or no contact with medical institutions or settings. The most commonly identified pathogens areStreptococcus pneumoniae, Haemophilus influenzae, and...
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...Disease-Cystic Fibrosis Candace Tiley GCU RN-BSN Health Assessment NRS-434V Kathy Karlberg August 01, 2013 Adult Client with Childhood Disease-Cystic Fibrosis CLC GROUP ASSIGNMENT-SPEAKER NOTES Candace Tiley #1- A clinical description and definition of the disease Definition: Cystic Fibrosis is one of the major life-threatening disorders that affect vital organs such as the lungs, pancreas, liver, and intestines. It is a genetic disorder of the exocrine glands, also called the secretory glands, which are the glands that produce and secrete mucus and sweat. CF affects all races but primarily affects Caucasians of European descent. This disease affects about 30,000 people in the United States and 70,000 people worldwide. In the U.S. nearly 5% of the population carries the defective CFTR gene. There are a high number of asymptomatic carriers. (Scott, 2013) Cystic Fibrosis causes severe damages to cells of the body that produce mucus, sweat, and digestive juices. Under normal conditions, these secretions from the body are usually thin and slippery. However, in people diagnosed with CF, the defective gene causes the secretions to become thicker and stickier. This leads to a plugging up of tubes, ducts and passageways, particularly in the lungs, sinuses, pancreas, intestines, hepato-biliary tree, and the vas deferens. (Hopkin, 2009) Cystic Fibrosis is characterized by abnormal movement of chloride and sodium ions across the epithelial membrane. This leads to the formation...
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...Asthma Case Study Lisa, a four-year-old with status asthmaticus, is admitted from the emergency room via a wheelchair to a medical pediatric unit. She is accompanied by her parents who both have anxious, tense facial expressions. Lisa’s vital signs are T-36.9° C, P- 140 (apical, regular), R 38 (regular but shallow), BP 118/78. She is pale but has no evidence of cyanosis. Her breath sounds are normal in upper lobes, with inspiratory and expiratory wheezing and scatter crackles in all lobes. Breath sounds in lower lobes are diminished. She has moderate intercostal retractions, some nasal flaring, and an occasionally loose, productive cough. Lisa has thin, whitish nasal discharge and tears are dried on her cheeks. She is irritable and appears frightened. Other significant data include: Wt 19 kg, Hemoglobin 12.5, Hematocit 37.3, theophylline level 10.5 mg/dl before treatment in ER. The chest x-ray films show that her lungs are hyper inflated with some infiltrates but no atelectasis or consolidation. Three days ago, Lisa came home from the day care center with the sniffles. By evening, she had rhinorrhea and a cough but no fever. This developed into a head cold. Two days ago, she helped her father rake leaves and then played in the leaves pile with a friend. About noon today, the day care center called Lisa’s mother because she said she couldn’t catch her breath and was tired. At home, Lisa’s mother gave her an Albuterol treatment, which helped for about 30 minutes...
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...Chronic Obstructive Pulmonary Disease | INTRODUCTION We are doing a case study on medical, nursing, pharmacological management of COPD (Chronic Obstructive Pulmonary Disease). We took a COPD patient and assessed the patient for clinical manifestation, the medical, nursing, pharmacological care given to the patient. In our case study we will include the care Hawwa is receiving now and the care we can add to daily routine to help her recover faster. Hawwa Ismail is admitted to Medical ward with diagnosis of COPD. She is 145cm tall, slim, with dark complexion. She is 79 years old. She said that she has difficulty in breathing, she cannot sleep in night time ,she do not feel like eating food and she was having cough. Physical assessment revealed BP 138/47mmHg right arm in lying position, pulse 84 regular and strong, and breathing pattern was irregular labored, tachypnic at 40 breathes per minute,SpO2 99% in room air and temperature 360C (96.80F).Her facial color and lips are ruddy, but nails are clean ,pale and clubbed. She has a little barrel chest, uses accessory muscle to breathe. She has prolonged expiration. While auscultating lungs, diminished breath sound in most of the lower lobes and a small wheezing sound in right lower lobe was noted. PERSONAL DETAILS PATIENT NAME: Hawwa Ismail ADDRESS:Iruvaige/R.Inguraidhoo GUARDIAN: NAME: Abdul HameedHussain CONTACT NO: 7772099 AGE: 79yrs SEX: female NATIONALITY: Maldivian LANGUAGE: Dhivehi RACE: Asian ...
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...differentiate it from 'cardiac' asthma, which is a separate condition that is caused by heart failure. Although the two types of asthma have similar symptoms, including wheezing (a whistling sound in the chest) and shortness of breath, they have quite different causes. Bronchial asthma is a disease of the lungs in which an obstructive ventilation disturbance of the respiratory passages evokes a feeling of shortness of breath. The cause is a sharply elevated resistance to airflow in the airways. Despite its most strenuous efforts, the respiratory musculature is unable to provide sufficient gas exchange. The result is a characteristic asthma attack, with spasms of the bronchial musculature, edematous swelling of the bronchial wall and increased mucus secretion. In the initial stage, the patient can be...
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...Cystic fibrosis, also known as mucoviscidosis, is an autosomal recessive disorder.1,2,22 It is the most common inherited disease in the Caucasian population affecting 1 in 3000 children in Western Europe.3 It is a multiorgan disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, which is located on the long arm of chromosome 7 and encodes for a special chloride ion channel.4,5 The vast majority of mutations involve three or fewer nucleotides and result in primarily amino acid substitutions, frameshifts, splice site, or nonsense mutations.11 Of more than 800 identified CFTR mutations, the 3 base pair deletion of phenylalanine at position 508 is found worldwide in 70% of cystic fibrosis sufferers, therefore making F508 CFTR the most common deadly mutant in the Caucasian populations.6 Since cystic fibrosis has a genetic origin the opportunity to treat by replacing the defective gene with a normal healthy gene (gene therapy) offers a ‘novel therapeutic approach’ for sufferers.7 The estimated survival age of cystic fibrosis sufferers is 33.4 years (Fig 1). In this essay we will discuss the aetiology and symptoms of cystic fibrosis and the current available treatments, with particular emphasis on gene therapy and furanones, which prevent the build up of bacterial biofilms and thus reduce lung infection. Mutations in the CF gene can disrupt CFTR function within epithelial cells in different ways, ranging from complete loss...
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...expiratory airflow limitation that does not significantly fluctuate. Within that broad category, the primary cause of the obstruction may vary; examples include airway inflammation, mucous plugging, narrowed airway lumina, or airway destruction. The term COPD includes chronic bronchitis and emphysema. Although asthma also involves airway inflammation and periodic narrowing of the airway lumina (hyperreactivity), the condition is the result of individual response to a wide variety of stimuli/triggers and is therefore episodic in nature with fluctuations/exacerbations of symptoms. Asthma: Also known as chronic reactive airway disease, asthma is characterized by reversible inflammation and constriction of bronchial smooth muscle, hypersecretion of mucus, and edema. Precipitating factors include allergens, emotional upheaval, cold weather, exercise, chemicals, medications, and viral infections. Chronic bronchitis: Widespread inflammation of airways with narrowing or blocking of airways, increased production of mucoid sputum, and marked cyanosis. Emphysema: Most severe form of COPD, characterized by recurrent inflammation that damages and eventually destroys alveolar walls to create large blebs or bullae (air spaces) and collapsed bronchioles on expiration (air-trapping). ------------------------------------------------- Diagnostic Studies * Chest x-ray: May reveal hyperinflation of lungs, flattened diaphragm, increased retrosternal air space, decreased vascular markings/bullae (emphysema)...
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...ASTHMA BRIEF BACKGROUND OF THE STUDY Asthma is a chronic disease of the respiratory system in which the airway occasionally constricts, becomes inflamed, and is lined with excessive amounts of mucus, often in response to one or more triggers. These episodes may be triggered by such things as exposure to an environmental stimulant (or allergen), cold air, warm air, moist air, exercise or exertion, or emotional stress. In children, the most common triggers are viral illnesses such as those that cause the common cold. This airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators. Between episodes, most patients feel well but can have mild symptoms and they may remain short of breath after exercise for longer periods of time than the unaffected individual. Signs and symptoms In some individuals asthma is characterized by chronic respiratory impairment. In others it is an intermittent illness marked by episodic symptoms that may result from a number of triggering events, including upper respiratory infection, stress, airborne allergens, air pollutants (such as smoke or traffic fumes), or exercise. An acute exacerbation of asthma is referred to as an asthma attack. The clinical hallmarks of an attack are shortness of breath (dyspnea) and either wheezing or stridor. Although the former is "often regarded as the sine qua non of asthma," some patients present primarily with coughing...
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...NRSG240 Final Test note CARDIAC NURSING 4 AMI 4 Definition (3marks)- very detailed needed. 4 Clinical manifestations of AMI. (5marks) 4 Nursing Interventions and Rationale for Managing a patient with Acute Chest pain(6marks) 4 and Ineffective Tissue perfusion (6marks) 5 Acute chest Pain 오류! 책갈피가 정의되어 있지 않습니다. 1. PQRST questions to evaluate MI- intensity, location, radiation, duration, precipitation & alleviating factors, in order to accurately evaluate, treat and prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 2. Semi-Fowler’s position & O2 therapy 2L via Hudson Mask in order to increase oxygenation of myocardial tissue & prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Administer medications- Morphin (normally 2.5-5mg) & anginine 600mcg (given every five minutes; maximum 3 tablets in order to relieve/prevent pain & ischemia to decrease anxiety & cardiac workload. 오류! 책갈피가 정의되어 있지 않습니다. 4. 12-lead ECG & monitor in order to check hypotension & bradycardia, which may lead to hypoperfusion. 오류! 책갈피가 정의되어 있지 않습니다. Ineffective tissue perfusion 오류! 책갈피가 정의되어 있지 않습니다. 1. Monitor vital signs (Hourly) and saturation oxygen to determine baseline and ongoing change. 오류! 책갈피가 정의되어 있지 않습니다. 2. Administer oxygen by Hudson’s mask (6-10L/min) and monitor the effectiveness to increase oxygenation of myocardial tissue and prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Monitor respiratory status for sysptoms of heart failure to maintain appropriate levels of oxygenation...
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...6. Emerging and Re-emerging Diseases Chapter 8 Disease is not constant • Emerging Diseases – are recently “discovered” diseases, or diseases that have become increasingly important. • Some are old diseases just discovered – like Hepatitis C • Some are truly new like HIV • Many are taking advantage of some niche – like air conditioners in large buildings – Legionella pneumophila • Diseases moving to new parts of the world – West Nile Virus • Re-emerging Diseases – are diseases that became less important, but are again increasing in importance. • Tuberculosis is an old disease that is again rapidly increasing in some populations. 1 2 Health Science Microbiology David L. Beck, B.S., A.M., Ph.D. FYI Emerging Diseases - Examples FYI Re-emerging Diseases - Examples 3 4 Known Species The Tip of the Iceburg • How many species are there? • 1980 there was 1,792 described species • 1990 there was 3,393 species (173 new per year) • 2000 there was 6,386 species (299 new per year) • 2010 there was 12,926 species (654 new per year) • Oct 2011 there was 13,563 species (Yikes!!!) (Most of these we know nothing about other than their name.) WE KNOW VERY LITTLE 80% of bacteria are unculturable – what you do not know about can hurt you! 61% of the known 1415 species infectious (and counting) to man are from animals (zoonoses) • • • • 5 Want to know the current number of described species? See: http://www.bacterio.cict.fr/number.html Updated daily. 6 Normal...
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...Acknowledgement First, the proponents would like to thank our beloved Professor, Mrs. Jasmine Fontanilla in giving us this opportunity to make this feasibility study. We really learned a lot in this study especially when we are having our brainstorms, we enjoyed it so much. Great thanks to our parents who give their support to us in doing this study. They give us the financial support, accommodation and inspiration in doing this study. The proponents would also like to acknowledge the respondents that respond to the questionnaires, the JSJ goat farm, Central Luzon State University – small ruminants. And to others that assists us. We appreciate it so much. Of course, we also want to thank all the people who help us in this study. We want to give our deepest gratitude to them. To our panel members, Mrs. Jhonnel Panlilio and Mrs. Winnie Fe for giving us advice and additional information about our project, for the corrections and some suggestions to improve this feasibility. Above all, we would like to thank our Almighty God in guiding us while we are doing this study especially when we are travelling around Central Luzon to get information. This study won’t be possible and successful without the guidance of our Almighty God. The Proponents INTRODUCTION The agricultural sector of Tarlac City contributes approximately 18% to the overall GDP generated by the municipality, constituting a slightly larger proportion of the economy on a local level than for...
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...disorders: endometriosis, ovarian cancer, PID, UTIs. • male-specific disorders: testicular cancer, benign prostatic hyperplasia, prostate cancer • nongender-specific problems: STIs, urologic obstructions 2. the relationship between key aspects of normal renal function and the pathophysiology involved in select renal conditions, including: • hydronephrosis. • glomerulonephritis • acute kidney injury (AKI; previously known as ARF—acute renal failure) and chronic kidney disease 3. signs and symptoms related to above pathological conditions, including significance of diagnostic test results used to evaluate and monitor renal and genitourinary function, such as: • PSA • BUN, creatinine, urinalysis, creatinine clearance 4. basic treatment modalities of the above pathologies....
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...DO NOT delegate what you can EAT! E - evaluate A - assess T - teach addisons= down, down down up down cushings= up up up down up addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia No Pee, no K (do not give potassium without adequate urine output) EleVate Veins; dAngle Arteries for better perfusion A= appearance (color all pink, pink and blue, blue [pale]) P= pulse (>100, < 100, absent) G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent) TRANSMISSION-BASED PRECAUTIONS: AIRBORNE My - Measles Chicken - Chicken Pox/Varicella Hez - Herpez Zoster/Shingles TB or remember... MTV=Airborne Measles TB Varicella-Chicken Pox/Herpes Zoster-Shingles Private Room - negative pressure with 6-12 air exchanges/hr Mask, N95 for TB DROPLET think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19 P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus Private Room or cohort Mask 1 CONTACT PRECAUTION MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis SKIN INFECTIONS VCHIPS ...
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...DO NOT delegate what you can EAT! E - evaluate A - assess T - teach addisons= down, down down up down cushings= up up up down up addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia No Pee, no K (do not give potassium without adequate urine output) EleVate Veins; dAngle Arteries for better perfusion A= appearance (color all pink, pink and blue, blue [pale]) P= pulse (>100, < 100, absent) G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent) TRANSMISSION-BASED PRECAUTIONS: AIRBORNE My - Measles Chicken - Chicken Pox/Varicella Hez - Herpez Zoster/Shingles TB or remember... MTV=Airborne Measles TB Varicella-Chicken Pox/Herpes Zoster-Shingles Private Room - negative pressure with 6-12 air exchanges/hr Mask, N95 for TB DROPLET think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19 P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus Private Room or cohort Mask 1 CONTACT PRECAUTION MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis SKIN INFECTIONS VCHIPS V - varicella zoster C - cutaneous diphtheria H -...
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