... coronary arteriosclerosis, abdominal aneurysm, and lung cancer. The patient was forced to use a ventilator against his wishes. A ventilator was needed to help him breathe or he would have not lived as long as he had. The ventilator was attached by a tracheostomy. “Mr. Bartling entered Glendale Adventist on April 8, 1984, for treatment of his depression. A routine physical examination, including a chest X-ray, was performed, and a tumor was discovered on Mr. Bartling's lung.” (LexisNexis, 1994.) There was a biopsy performed by inserting a needle into the left lung, which caused the lung to collapse. The physicians had to insert tubing through his chest and nasal passage to try and inflate. The lung was unsuccessful in being inflated due to the fact that the patient had previous history of emphysema. By this time, Mr. Bartling is put on a ventilator to keep him alive. The patient asked multiple times to have the ventilator removed but the facility denied his request. He also had tried taking the ventilator out himself. The facility then had to restraint Bartling from hurting himself even more. The patient’s wife and daughter had brought in William’s living will and his wishes. In his will it stated, "If at such time the situation should arise in which there is no reasonable expectation of my recovery from extreme physical or mental disability, I direct that I be allowed to die and not be kept alive by medications, artificial means or heroic measures." (LexisNexis, 1994.) The patient...
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...McClellen The Dangers of Gastric Bypass and Lap-Band Procedures As with any surgery, gastric bypass and lap-band procedures pose potential health risks. One danger with the gastric bypass procedure is a condition known as “dumping syndrome”, this is where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. This undigested food draws excessive fluid into the small intestine causing nausea, cramping, diarrhea, sweating, feeling faint and fast heart rate. In addition people with this syndrome often suffer from low blood sugar or hypoglycemia. Blood clots in the legs can be another danger: In some cases they travel to the lungs and lodge in the arteries which could cause a pulmonary embolism, a serious condition that damages lung tissues and can even lead to death.(“Gastric Bypass Surgery” ,2007) The lap-band procedure also has dangerous risks, one being: Infection of Surgical wounds, or deep abdominal infections because of manipulation of the bowel and organs with the added potential of damaging of bowels and releasing contaminated contents into the stomach. Another risk is the slipping of the band from its original position, if this were to occur then the surgical procedure would be necessary to be performed again. (Chrisholm, 2011) 2 References Mayo Clinic (2007, Oct 5). Gastric Bypass Surgery: What to expect? Retrieved July 17, 2013 from CNN Health website: http://www.cnn.com/health/library/gastric ...
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...quite difficult, and so he came in to the emergency room, was found to be in congestive heart failure with cardiac irregularity, and was admitted to the hospital for further care. The rest of his history can be obtained from his previous record. On physical examination the patient does appear older than his stated age of 69 by at least five years. His blood pressure is 186/80, his pulse is 100 to 178, and he has runs of paroxysmal atrial tachycardia, frequent premature ventricular contractions, and he has had a couple of short runs of ventricular tachycardia. During one of his runs of PAT, I gave him 5 mg of verapamil intravenously, and this reduced the rate dramatically. His neck veins are distended. He has moist rales over both lungs. The heart is at the midclavicular line in the fifth interspace, and there is a systolic murmur at the apex. His abdomen is soft. No masses can be felt. He has 2 + edema in the lower extremities. Both of his knees have bruises from a previous fall. I did not do a rectal exam because of his respiratory difficulty. It is my impression that he has a combination of arteriosclerotic and hypertensive cardiovascular disease with mild cardiomegaly, probably left ventricular hypertrophy, and congestive heart failure with functional classification of III. He also has pulmonary emphysema secondary due to his smoking, with chronic obstructive pulmonary disease. I have taken the liberty to discontinue the Theo-Dur for the present because I do not...
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...The Case of the Coughing Housewife Homework, up to 30 points. Read clinical case. Provide the definitions for terms in bold on the second page. Save file on your hard drive as “your_name.doc”, NOT as docx or any other format! Submit it as assignment similar as you would send an attachment via e-mail. Jessica, a fifty-nine year old mother of four, moved from a ranch in Colorado to Los Angeles, after the death of her husband, to be closer to her oldest son and his family. She has been in Los Angeles for 18 months and has noticed that she is experiencing shortness of breath which has worsened over the last six months, and sleep apnea. For the last week, she has been coughing and bringing up yellow mucus. She also noticed edema in her ankles so she decided to visit a physician about her condition. Jessica's family and medical history include a negative history of asthma or allergies, lack of occupational or home exposure to asbestos, a previous smoking history (one package of cigarettes per day between the ages of 16 and 52), episodes of bronchitis and bronchopneumonitis, treated with antibiotics on an outpatient basis, and a positive history of pancreatitis (father at 52) and meningomyelitis (brother at 56). Jessica has no history of serious illness, including heart disease, and her weight is within five pounds of her "desired" weight. She usually coughs in the morning to "clear her throat", but there is usually only a small amount of white mucus. Her nurse practitioner conducts...
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...a few hours. Depending on the amount of THC, Marijuana use can increase the heart rate as much as 50 percent. It can cause chest pain in people who have a poor blood supply to the heart. Long-term regular users of marijuana may become psychologically dependent. They may have a hard time limiting their use and may need more of the drug to get high. Also, they may develop problems with their jobs and personal relationships and the drug can become the most important aspect of their lives. Compared to cigarette smokers, marijuana users often inhale the unfiltered smoke deeply and hold it in their lungs as long as possible. As a result, the smoke is in contact with lung tissues for long periods of time, which irritates the lungs and damages the way they work. Marijuana smoke contains some of the same ingredients in tobacco smoke that can cause emphysema and cancer. Inspection of human lung tissue that had been exposed to marijuana smoke over a long period of time in a laboratory showed cellular changes called metaplasia, that are considered to be precancerous. In laboratory test, the tars from marijuana smoke have produced tumors...
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...Case Study April 6, 2010 Primary Diagnosis Lung CA with acute mental status change secondary to underlying pneumonic process. Abstract On April 3, 2010 a 61-year-old white female, suffering from a pancoast tumor, presented to the emergency room with altered levels of consciousness and confusion. The patient had gone through her fifth cycle of chemotherapy when she became very confused today. She was then brought to the emergency room where she was evaluated and had testing done. A CT scan of the patients head showed no signs of acute abnormalities. The chest x –ray re-demonstrated the pan coast tumor with possible underlying infection. Sinuitis also was noted on the CAT scan. The patient was admitted to the floor because of her shortness of breath and level of confusion. Antibiotics were administrated for the pneumonic process and Neupogen was given. The patient was put on oxygen therapy and aerosol treatments and later was transferred to the ICU because of respiratory failure. The patient was placed on a mechanical ventilator when sent to ICU with the new status of DNRCC-A and was extubated on 3/6/10 and died. Past Medical History The patient has a history of depression and acute mental status change. The patient has a surgical history of an A-port insertion. History of Present Illness The patient came into the emergency room complaining of confusion and weakness after her fifth cycle of chemotherapy was done earlier that day. Physical Exam on Admission Vital...
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...is accepted as medical use; however this is not true. In my eyes, marijuana is illegal for extremely powerful reasons, and it should stay that way. Marijuana usage had a bad effect on one’s body. When people use marijuana they may not know what is happening inside of them. But however, there is a strong negative effect to the whole body. For one thing Marijuana increases heart rate by 20–100 percent shortly after smoking. In one study, it was estimated that those who use marijuana have a four point eight fold increase of a heart attack in just one hour after smoking the drug. Not only does this drug affect the heart, but it also greatly affects the lungs of a person. Many studies have showed that marijuana smoke carcinogens and to be an irritant to the lungs. They also show deregulated growth of epithelial cells in a person’s lung tissue. When people smoke marijuana they don’t understand the pain they put themselves in. When any one uses marijuana there is a chance of them becoming addicted. In some cases it may be a very low chance but in others there is a high. Usually a person becomes addicted if they cannot control their urges to seek out and use marijuana. Once a person is addicted it affects heir family relationships, school performance, and recreational...
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...different parts of body most commonly the lungs, lymph nodes, eyes and skin. It is believed sarcoidosis is the result of the body's immune system response to an unknown substance, most likely something inhaled from the air. There is no cure for sarcoidosis. Sarcoidosis often goes away on its own. However, signs and symptoms of sarcoidosis may last for years and often leads to organ damage. The exact cause of sarcoidosis is unknown. Some people appear to have a genetic link to developing the disease, which can be triggered by exposure to certain bacteria, viruses, dust or chemicals. Research is still trying to identify the genes and predisposing substances associated with sarcoidosis. Many factors may play a role in triggering the disease. I interviewed a current patient with this disease process and viewed a video titled Living with Sarcoidosis on the National Heart, Lung and Blood Institute website. Signs and symptoms of sarcoidosis vary, depending on which organs are affected. Sarcoidosis sometimes develops gradually and produces symptoms that last for years. Other times, symptoms appear suddenly and then disappear just as quickly. Many people with sarcoidosis have no symptoms, so the disease may be discovered only when you have a chest X-ray for another reason. For many people, sarcoidosis begins with these signs and symptoms: fatigue, fever, swollen lymph nodes, and weight loss. Almost everyone who has sarcoidosis eventually experiences lung problems, which may include: persistent...
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...Disease (COPD) is a progressive lung disease that makes it hard for someone to breath by limiting the airflow of oxygen in and out of the lungs. COPD is a deteriorating disease that worsens as time goes on that affects over 12 million people in the United States (U.S.). It is characterized by inflammation and severe limitation of airflow in and out of the lungs. COPD is an umbrella term used to describe a group of breathing conditions. Most people age 40 and older with a history of smoking (either current or former smokers) are more likely to suffer from COPD, although in some cases one out of six people with COPD have never smoked. (GICOPD 2001) The most common types of COPD are Chronic Bronchitis, Asthma, and Emphysema. Many people diagnosed with COPD may have two types Chronic Bronchitis and Emphysema while a few may only have Asthma. COPD is the third most common cause of death in the United States. Of the major causes of death in the U.S., it is the only to have risen in numbers since the year of 2007 while the leading causes (Heart Disease and Cancer) numbers have slightly gone down. COPD is also the second leading cause of disability in the U.S. In 2010, the cost to the nation for COPD was projected to be approximately $49.9 billion, including $29.5 billion in direct health care expenditures, $8.0 billion in indirect morbidity costs and $12.4 billion in indirect mortality costs. ((COPD) Fact Sheet 2014) In a set of normal functioning lungs, air is inhaled and travels through...
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...Signature Assignment: Chronic Obstructive Pulmonary Disease Case Study Case Study R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2= 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist and Theophylline to manage his respiratory disease. At this clinic visit, it is noted on a chest x-ray that R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia 1) What clinical findings are likely in R.S. as a consequence of his COPD? 2) How would the consequences of the COPD of R.S. (identified in question 1) differ from those of emphysematous COPD? 3) Interpret R.S.’s laboratory results. How would his acid-base disorder be classified? What is the most likely cause of his polycythemia? 4) What is the rationale for treating R.S. with Theophylline and a ß2 agonist? 5) What effects would his respiratory disease have on his cardiovascular function? ANSWERS: 1) 1. And 2. He is likely to have diminished breath sounds. He may or may not have wheezing depending upon the degree of bronchoconstriction and will almost certainly have crackles and bronchial breath sounds over the RLL. Since he is polycythemic and has hypoxemia, he...
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...4/20/15 AP 2630 Unit 5 Case Study 1 Cari’s Story A. The infection in Cari’s nasal passages and pharynx was able to spread into her sinuses due to the sinuses being a drainage area for the nasal passages. B. The cough reflex is used to clear sputum and irritants that are in the nasal passages and pharynx. There are cilia in her trachea that is moving mucous up from the lungs. When the mucous becomes more abundant it triggers the cough reflex. C. There a macrophages found in the terminal bronchioles and alveoli that normally would protect Cari’s lungs from infectious pathogens and particulate matter. D. The excess mucous and fluid in the lungs would raise the resistance of Cari’s airways because of the small diameter the buildup would cause. The fluid would have some of alveoli under water where they could not function properly and there would also be more friction from the buildup. E. Cari’s lung compliance would increase from trying to force gases into and out of the alveoli. Those are filled with fluid due the the pneumonia. F. The fluid in Cari’s lungs would lower her total lung capacity by not allowing the space that is taken up by the fluid to be filled with air. G. The elevation in her respiratory rate would alter her minute ventilation by raising it. Minute ventilation is determined by multiplying respiratory rate by total volume. H. The clinical finding of 90% oxygen saturation level and Po2 of mmHg would show that the arteries are having...
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...new system developed by Veran Medical Technologies that, with the help of computed tomography, can aid physicians in efficiently and accurately locating, diagnosing, and treating lung cancer. Before SPiN Drive was accessible, solitary pulmonary nodules were almost inaccessible. If they could be located, it was sometimes very difficult to reach the pulmonary nodules located deep within the lung to take a biopsy. This left patients on “’watchful waiting’ protocols of repeat CT scans for multiple years causing patient anxiety and significant costs added to the US Healthcare System” (“Veran medical technologies”, 2009). Not only did this increase the time it took to diagnose the patient, but it also significantly increased a person’s...
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...Black lung disease has impacted the lives of more miners in West Virginia and elsewhere than originally thought, according to a new study. The authors of the study say the disease is a "real phenomenon." For the study, researchers from the University of Illinois examined government benefits claims filed by black lung patients dating back to 1970 and identified over 4,600 severe cases of the disease. More than 50 percent of the cases were filed within the past 16 years. Further, they found that black lung cases increased significantly each year in central Appalachian states, with West Virginia experiencing a 30 percent increase. Kentucky and Virginia each experienced 16 percent increases. The study's findings are a revelation. Previous estimates...
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...In order to maintain balance and avoid unnecessary destruction of tissue, protease inhibitors such as alpha-antitrypsin exist in the body (Leischner, n.d.). The main pathologic process in emphysema is caused by a combination of injury by irritant substances and a deficiency of protease inhibitors. Irritants affect protease inhibitors by hampering their protective function of the lung tissue and causing inflammation that ultimately destroys the tissue (Prendergast, 2010). The most common irritant that causes emphysema is cigarette smoking, but there are others such as occupational dust and chemicals, pollution, second hand smoking, and combustion fumes (McPhee et al.,...
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...Nursing interventions for Tachypnea: 1. Assess respiratory quality, rate, depth, effort and pattern. Rationale: Flaring of the nostrils, tachypnea are signs of severe distress that require immediate intervention. 2. Assess for mental status changes. Rationale: Confusion, restlessness can be early signs of cerebral hypoxia. 3. Administer supplemental oxygen Rationale: Early supplemental oxygen is essential in all trauma patients since early mortality is associated with inadequate delivery of oxygenated blood to the brain and vital organs. 4. Position patient in a semi-fowler’s position. Rationale: promotes better lung expansion and improved gas exchange. 5. Assess changes in vital signs Rationale: Tachycardia and hypertension occur with increasing work of breathing. The types of respiratory disease are asthma, allergies, COPD, emphysema, lung cancer, sinusitis. Factors contributing to one having tachypnea are chronic obstructive pulmonary disease, asthma, and or heart attack, stress and...
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