...Exposure to or not enough exposure to “triggers: • Exposure to environmental tobacco smoke • Air pollution Asthma is more common in families where someone already has the condition. If one parent has asthma, the chance of their child developing asthma is approximately double that of children whose parents don't have asthma. We also know that a mother has a greater risk of passing on asthma than a father, though the reasons are not clear. Environmental Tobacco Smoke is the #1 trigger of asthma, but also studies have shown that exposure to ETS can cause the onset of the disease of asthma. Having a plan and goals of asthma management is the next step that should be taken for children and adults after being diagnosed with this chronic respiratory disease. Goals for Asthma Management • What brings on your asthma symptoms • How to avoid triggers and reduce exposure • What medicines to take and when to take them • Knowing when to seek medical help There are many different “triggers” to asthma and it is best to know what sets you off so that you can avoid any attacks if possible. Cockroaches – how are we allergic to...
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...A Critical Incident of Occupational Health Learning Development: Fit Testing of Respiratory Protective Equipment Face Masks Introduction On my second day of my Occupational Health placement, I was given the opportunity to be part of a meeting with the Occupational Health Manager, two Ward Managers and and one Modern Matron to discuss fit testing of respiratory masks. During discussions, it was felt that there were not adequate numbers of staff trained as this could leave the Trust at risk in terms of staff protection. I decided that this would be my critical incident. This critical incident would follow Rolfe’s et al. (2011) model of reflection, including aspects of education and opportunistic learning. The importance of this incident has reinforced the point that one of my Learning Objectives would not only further my knowledge in Occupational Health skills, but will work with others to protect the public’s health, and wellbeing from specific risks (PGDip SCPHN Handbook,2014). As this challenge was prompted by a critical issue, good communication skills with resilient working relationships were utilised if to incur change. Further actions would entail task structuring and team and individual management. These are reflections of Action Centred Leadership (Adair, 1973). Names and places were excluded to maintain confidentiality as required by the Nursing Midwifery Council Code of Conduct (NMC, 2008). During the week, an acute care unit experienced what they perceived...
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...Respiratory Therapy is a health profession that specializes in Cardio Pulmonary functions and health. Respiratory therapists help with prevention, assessing patients, treatment, diagnostic evaluation, education, and care. They treat patients from all ages, from babies to the elderly. The requirements in becoming a Respiratory Therapist are taking Human Anatomy, Chemistry, Pharmacology, Microbiology, and Mathematics at a high school or college level. To begin the Respiratory Therapy Program out of high school you have to have a C or better in Chemistry, Anatomy, Algebra 2 minimum, and English. If these courses were not taken in high school, they would need to be taken at the college level to complete the prerequisites to apply for the Respiratory Program. The Program Certification may be obtained with an Associate’s Degree. Having a Bachelor’s Degree in Respiratory Therapy show more knowledge about your profession and chances are better at achieving a job right out of college and working about anywhere. The reasons why someone would want to become a Respiratory Therapist is helping patients with Lung Disease, Heart Disease, and Neuromuscular Disorders to improve the patients quality of life. Respiratory Therapists are people-oriented, dependable, flexible, honest, compassionate, caring, and courteous. In addition, the successful Respiratory Therapist must be able to handle the physical and emotional outcomes of what can be a very stressful job. Last, the successful...
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...sits on the ears -Watch for complications -Periodically check o2 delivery device to ensure that the prescribed concentration is being delivered -Monitor the effectives of 02 therapy( pulse ox, ABG’s) to evaluate patient response to therapy -Observe for signs of o2-induced hypoventilation because this occurs with carbon dioxide nacrosis -Position to minimize respirator efforts ( HOB elevate and provide overbed table for patient to lean on) -The person with COPD who retains CO2 should be treated with low rates of 02 with careful monitoring of ABG’s to avoid hypercarbia. 3. What are nursing management issues related to obstructive disorders? Assessment- Subjective health information past health history and medications, functional health patterns, general objective data with integumentary, respiratory, cardiovascular, gastrointestinal, musculoskeletal and diagnostic findings. * Objective- Debilitation, restlessness, assumption of upright position, cyanosis, pallor, poor skin turger, thin...
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...Chronic Obstructive Pulmonary Disease (COPD; Emphysema) Pathophysiology Abakyereba Kwansemah June 4, 2014 Abstract D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and tiredness. His vital signs (VS) are 162/84, 124, 36, 102° F, SaO2 88%. Admitting diagnosis is chronic emphysema with acute exacerbation. Admitting orders includes: diet as tolerated; out of bed with assistance; oxygen (O2) to maintain SaO2 of 90%; maintenance IV of D5W at 50 ml/hr.; intake and output (I&O); arterial blood gases (ABGs) in AM; CBC with differential, basic metabolic panel (BMP), and theophylline (Theo-Dur) level on admission; chest x-ray (CXR) q24h; prednisone 60 mg/day PO; doxycycline 100 mg PO q12h x10 days, azithromycin 500 mg IV piggyback (IVPB) q24h x2 days then 500 mg PO x 7 days; theophylline 300 mg PO bid; heparin 5000 units SC q12h; albuterol 2.5 mg (0.5 ml) in 3 ml normal saline (NS) and ipratropium 500 mg by nebulizer q4-6h;...
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...Diseases caused by Smoking * Chronic Bronchitis * Emphycema * Lung Cancer Signs and Symptoms Lung Cancer * Chronic Cough - A cough that you have had for a month is chronic. This is an important early symptom. It tells you something is wrong with your respiratory system. * Shortness of Breath - Shortness of breath that doesn’t go away after exercising, or that you have after little or no exertion, is not normal. Labored or difficult breathing – the feeling that it is hard to breathe in or breathe out - is also a warning sign. * Chronic Mucus Production - Mucus, also called sputum or phlegm, is produced by the airways. It is a defense response to infections or irritants. If your mucus production has lasted a month, this could indicate lung disease. * Wheezing - Noisy breathing or wheezing is a sign that something unusual is blocking your lungs’ airways or making them too narrow. * Coughing up Blood - If you are coughing up blood, the blood may be coming from your lungs or upper respiratory tract. Whatever the source of the blood, it is a sign of a health problem. * Chronic Chest Pain – Unexplained chest pain that lasts for a month or more – especially if it gets worse when you breathe in or cough – can also be a warning sign. Choronic Bronchitis * Chronic bronchitis, a long-term inflammation of the bronchi (large airways), is characterized by coughing productively over a long period of time. Emphycema ...
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...fourth leading cause of death in the United States and is rising. Chronic obstructive pulmonary disease is treatable but currently there is no known cure and it is a major cause of morbidity and mortality. COPD causes reduction in airflow during the ventilation cycle due to the loss of air way elasticity, narrowing of the airways, chronic airways inflammation and over active mucous production (Frace, 2008). Known risk factors for development of COPD include tobacco use (including second hand smoke), air pollution, dust and exposure to chemicals used in the production of coal, cotton and grain. There are many complications of COPD, the most common are pneumonia, pneumothorax, cor pulmonale, atelectasis, and in severe cases there maybe respiratory insufficiency and failure (Bare, Cheever, Hinkle, & Smeltzer, 2010). Nursing management for a patient with chronic obstructive pulmonary disease begins with assessment; gathering information from the patient including detailed medical history, present symptoms and evaluate findings of diagnostic tests. Symptoms vary with each patient, but may include chronic cough, clubbing of the fingers, chest tightness, weight loss, cyanosis, difficulty breathing with a higher rate of respirations and difficulty sleeping (Weber, 2008). It is common for patients suffering from difficulty breathing to use their accessory muscles to promote more efficient breathing which in turn causes weakness and fatigue. Patients further along in the disease...
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...Definition: Tachypnea is the medical term for an increase in the rate of respiration. The normal respiratory rate is between 12 to 20 for adults. Anything over that is considered tachypnea. Also known as rapid breathing, tachypnea is common in people who have emphysema, are trying to "blow off" excess carbon dioxide which is a waste product of metabolism which has built up in their blood due to inadequate expulsion of inhaled air. Tachypnea is commonly associated with dyspnoea, or shortness of breath and are common symptoms of emphysema (COPD) Tachypnea (WHO) i. New-born to 2 months old: 60 breaths per minute ii. Infant 2 months old to 1 year old: 50 breaths per minute iii. Preschool Children 1 year old to 5 years old: 40...
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...Respiratory sounds can also define as breath sounds or lung sounds. It is generated through the turbulence of airflow in our respiratory tract. The air breath in and out are transmitted through air, liquid and solid and to the chest wall. Each properties of substance that the air attenuated lead to different degree and intensity of breath sounds (Jones, 1995a). Breath sounds can divided into three type, normal, abnormal and diminished (Alexandra Hough, 2001). Breath sound is useful in diagnosing or monitoring respiratory disease and airway abnormalities, such as asthma, Chronic Obstructive Pulmonary disease (COPD), pneumonia and so on. It can be auscultate across chest wall with a stethoscope. A physician can auscultate breath sounds to detect...
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...assessing an individual’s breathing. Some of these can be measured quantitatively such as respiratory rate, depth and rhythm and pulse oximetry. While others are more qualitative such as the assessment of the patient’s cough, colour and level of pain. These observational skills when used with interview and listening skills assist the nurse in gaining the patient’s history and what is normal for them. Breathing is the activity of living which involves moving air in to and out of the lungs. The act of breathing is usually subconscious, meaning we are not normally aware of it, and is important for the function of our other activities of living and the functioning of the body systems (Holland et al, 2008 and Marieb & Hoehn, 2010). When assessing an individual’s breathing the first thing the nurse will do is assess respiratory rate. This involves counting the number of complete breaths the patient takes in one (1) minute. The therapeutic range of respiration rate will be different for each stage of life. For example, a child aged 10 respiration rate should be within14-26 breaths per minute (Bonafide et al 2013) whereas an adult should be within the range of 12-20 breaths per minute (Crisp & Taylor 2009). The nurse should take care to ensure the patient is unaware of this assessment as they may alter their rate of breathing. (Crisp & Taylor, 2009). When assessing the respiratory rate, the nurse should also be assessing the rhythm and depth of breathing. Depth of breathing...
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...body with symptoms including, depression, anxiety, cirrhosis, and heart failure, it is vital that researchers strive to find better treatment options, and legislation continues to protect the public from its devastating consequences. Alcoholism and Health Complications Physiology Alcoholism has reached epidemic proportions in the U.S. According to the Center for Disease Control and Prevention (2014), alcohol abuse contributed to 88,000 deaths in this country from 2006-2010. The health-related consequences can be short-term, including traffic accidents, alcohol poisoning, minor injuries, or sexually transmitted diseases. Many alcoholics, however, will suffer long-term chronic health conditions (Center for Disease Control and Prevention, 2014). In the cardiovascular system, excessive consumption strains the heart which may lead to irregular heartbeat, inflammation, and weakening of the heart muscle which puts the individual at risk for deterioration of the liver. High blood pressure as the result of a magnesium deficiency affects blood flow and may lead to stroke. Because alcohol passes the blood-brain barrier, the central nervous system is affected which may cause cellular damage such as neuropathy or dementia (School of Public Health, 2014). Every organ of the digestive system is at risk for inflammation and cancer including the tongue, stomach, esophagus, intestines, and pancreas. One of the most common chronic...
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...Clinical Case Study Assignment 2014 Jennifer Ahonen Cambrian College a00050951 BSN 2144: Nursing Practice Frances Carvalho & Jillian Smythe March 21, 2014 Clinical Case Study Assignment 2014 The purpose of this paper is to utilize the data collected in the Gordon’s Functional Health Patterns Assessment Tool (Appendix A). After data collection, it will be analyzed and a priority nursing diagnosis will be used to make a care plan (Appendix B). Patient X is an 82 year old male, who presented to the emergency department from his home at Extendicare York with a fever of 38.9 degrees Celsius, a blood pressure of 75/40 mm Hg, blood glucose level of 3.7, diaphoretic and a three day history of diarrhea, nausea and generalized weakness. The admitting diagnosis for this 82 year old male was Pneumonia. Pneumonia is an acute inflammation of the lower respiratory tract due to an infectious agent that impairs gas exchange due to alveolar edema and congestion (Thiem, Heppner, & Pientka, 2011). There are many factors that predispose individuals to pneumonia; however, in the case of this patient the predisposing factors are age and the presence of chronic diseases. The patient’s complete history and demographics can be found in Appendix A. The classic clinical manifestations of pneumonia consist of a temperature above 38 degrees Celsius, diaphoresis, cough, and shortness of breath, chest pain, tachycardia, purulent sputum, fatigue, nausea, vomiting, and diarrhea (Thiem, Heppner...
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...CI#: Not available. Synonym: 2-Hydroxy-1,2,3-propanetricarboxylic acid Chemical Name: Citric Acid International CHEMTREC, call: 1-703-527-3887 For non-emergency assistance, call: 1-281-441-4400 Chemical Formula: C6H8O7 Section 2: Composition and Information on Ingredients Composition: Name CAS # % by Weight Citric acid 77-92-9 100 Toxicological Data on Ingredients: Citric acid: ORAL (LD50): Acute: 5040 mg/kg [Mouse]. 3000 mg/kg [Rat]. Section 3: Hazards Identification Potential Acute Health Effects: Hazardous in case of eye contact (irritant), of inhalation (lung irritant). Slightly hazardous in case of skin contact (irritant, sensitizer), of ingestion. The amount of tissue damage depends on length of contact. Eye contact can result in corneal damage or blindness. Skin contact can produce inflammation and blistering. Severe over-exposure can produce lung damage, choking, unconsciousness or death. Potential Chronic Health Effects: Slightly hazardous in case of skin contact (sensitizer). CARCINOGENIC EFFECTS: Not available. MUTAGENIC EFFECTS: Not available. TERATOGENIC EFFECTS: Not available. DEVELOPMENTAL TOXICITY: Not available. The substance may be toxic to teeth. Repeated or prolonged exposure to the...
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...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 & Observe for signs of pulmonary oedema. 오류! 책갈피가 정의되어 있지 않습니다. CORONARY ANGIOGRAM 5 Nursing responsibilities and rationale pre angiogram 5 CORONARY ARTERY BYPASS GRAFT 6 Definition (3marks) 6 ANTICOAGULANT THERAPY 7 Nursing Responsibilities 7 APTT. (3marks) 7 WOUND MANAGEMENT 8 DISCUSS MOIST WOUND –HEALING ENVIRONMENT 8 DEFINE 5 DIFFERENT TYPES OF EXUDATES 9 NEUROVASCULAR...
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...Health Assessment Case Study Introduction The focus of this case study is to examine further focused assessments that should be undertaken after Mr S's initial presentation of acute exacerbation of asthma. Reasoning for recommended focused assessments will be discussed with consideration of Mr S's presentation of symptoms, history, pathophysiology and risk factors for asthma exacerbation. Research on current asthma assessment protocols will guide recommendations, and assessment parameters will be described. Follow up care and self-management options for Mr S will also be explored. Asthma Asthma is a chronic inflammatory disease of the lungs. It is characterised by airflow obstruction and lung inflammation (Johnson, 2010). Asthma symptoms include wheezing, chest tightness, shortness of breath and cough (Johnson, 2010). Potential triggers for asthma include allergens, viral respiratory infections, irritants, stimuli such as cold air or exercise and gastro-oesophageal reflux (Estes et al, 2013). Airway obstruction in asthmatics is variable and reversible. However poorly managed asthma can leave lasting structural changes in the cells and tissues of the lower respiratory tract, resulting in airway remodelling and permanent fibrotic damage (Kaufman, 2011). There is currently no cure for asthma, therefore the disease needs to be managed (NACA, 2014). Pathophysiology and assessment parameters It is important to understand the underlying pathophysiology of Mr Saunders’ presentation...
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