...Obstructive Pulmonary Disease also referred to as COPD is the name that identifies a group of lung diseases. These diseases consist of bronchiectasis, chronic bronchitis, emphysema, and refractory asthma. An individual can have COPD for years and not know it. When the disease is in the early stages the symptoms are not completely mature and are barely discernible. As the disease matures and progresses the symptoms become more noticeable. Although millions of individuals are living with COPD, this disease is the fourth leading cause of death in the United States; and smoking, second-hand smoke, air pollutants, occupational dust, chemicals, and genetics are factors that can cause the disease for which there is no cure; however numerous treatments are available to help live an active and healthy life (COPD Foundation, 2010). Many people who have COPD are undiagnosed with the disease. Undiagnosis could derive from several reasons, which may include no health insurance, afraid to seek medical attention, or belief that the symptoms are of another illness such as a cold that will not go away. However, most cases of COPD are undiagnosed because of a lack of education concerning the disease. Many communities and employers fail to educate the public concerning diseases like COPD.I was surprised to find that the Dobbins Heights Community, Hamlet North Carolina in, which I reside, has no existing education program concerning COPD. The only source of COPD education and awareness offered to the public...
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...Obstructive Pulmonary Disease also referred to as COPD is the name that identifies a group of lung diseases. These diseases consist of bronchiectasis, chronic bronchitis, emphysema, and refractory asthma. An individual can have COPD for years and not know it. When the disease is in the early stages the symptoms are not completely mature and are barely discernible. As the disease matures and progresses the symptoms become more noticeable. Although millions of individuals are living with COPD, this disease is the fourth leading cause of death in the United States; and smoking, second-hand smoke, air pollutants, occupational dust, chemicals, and genetics are factors that can cause the disease for which there is no cure; however numerous treatments are available to help live an active and healthy life (COPD Foundation, 2010). Many people who have COPD are undiagnosed with the disease. Undiagnosis could derive from several reasons, which may include no health insurance, afraid to seek medical attention, or belief that the symptoms are of another illness such as a cold that will not go away. However, most cases of COPD are undiagnosed because of a lack of education concerning the disease. Many communities and employers fail to educate the public concerning diseases like COPD.I was surprised to find that the Dobbins Heights Community, Hamlet North Carolina in, which I reside, has no existing education program concerning COPD. The only source of COPD education and awareness offered to the public...
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...Current diagnosis COPD/Emphysema. Patient XX was diagnosed with COPD in 2009. COPD is a progressive disease with presence of airflow obstruction, which may be cause by chronic bronchitis or emphysema. Emphysema is a pathological condition caused by the destruction of alveolar walls and a consequent permanent enlargement of the alveolar sacs. According to the National Institute of Health (NIH), a diagnosis of COPD is made based on the patient’s signs and symptoms, medical and family history, and results of diagnostic tests. Common signs and symptoms of COPD include cough, dyspnea, wheezing, and chest tightness. Most patients are older than 50 years. They present with major complaints of severe dyspnea and require the use of accessory muscles...
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...was an acid imbalance occurs in the body. During gas exchange, the exchange of gas is impaired and results in excess carbon dioxide (CO2) being absorbed into the blood stream, initiating the formation of an acid, making the blood more acidic (Porth & Matfin, 2009). The PH drops as there is little ventilation of the alveolar, and compensation results in the production of hydro carbon dioxide (HCO2) (Farrell & Dempsey 2005). Respiratory acidosis may be caused by injury to the respiratory centres, diseases of the lungs, blockage of the airway and respiratory disorders (Porth & Matfin, 2009). b.) Provide two possible reasons for the ABG’s based on Derek’s history and presentation. The cause for Respiratory acidosis in Derek could have been caused by a respiratory disorder such as COPD which he has been diagnosed with since 1997, and was asked to cease smoking but up to date he has continued to smoke 20-30 cigarettes per day. Porth and Matfin, (2009) explain that conditions of the respiratory system may cause impairment of gas exchange. Respiratory acidosis could also have been caused by poor diet intake. Derek has hypercholesterolemia and type 2 diabetes mellitus, he lives close to convenience stores and often consumes take away foods. The proximity of these stores and the distance from the nearest train station probably encourages him to take fast food. These foods are high in carbohydrates...
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...maintaining a healthy way of living dealing with your lungs will led to major problems in the long haul. The disease I will discuss is Chronic Obstructive Pulmonary Disease {COPD}. COPD is the resistance to airflow as a result of airway narrowing. Airway obstruction may result from accumulated secretions, edema, swelling of inner lumen of airway, bronchospasm, or destruction of lung tissue. There three cystic fibrosis that is related to COPD and they are Emphysema, Chronic bronchitis, and Asthma. Chronic Obstructive Pulmonary Disease has a major impact on both physical and psychological well-being {Donna R. Falvo, 420.} Realizing that this is a life-changing condition, with one cure and treatment [makes you think] ‘what does that mean?’ A pulmonologist told me, “That any person that is face with COPD would have to have a lung transplant to get rede of the disease.” The etiology of Chronic Obstructive Pulmonary Disease {COPD} is that cigarette smoking is the number one reason in developing COPD and is ten times likely to develop this disease. Secondhand smoke exposure can also cause COPD. When this happen hyperplasia in our cells produce more mucous, reduced airway due to hyperplasia, reduce ciliary activity that bring up foreign bodies to cough things up. Cigarette smoke will cause lung damage, which can lead into COPD over time. Smoking harms the cilia that line the airways. Damage cilia can’t sweep mucus and particles away. Some of the cilia are destroyed. This damage makes the problem...
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...screening? Week 2: Question 1= Choose an FDA-approved prescription medication and discuss the pharmacokinetics and pharmacodynamics of the medication, including any differences that would be expected based on the patient's age, a condition of pregnancy, or lactation. Address any adverse effects the medication may have based on age, pregnancy, or lactation. Question 2= Active acquired immunity can be achieved through the use of childhood immunizations. Many parents voice concerns regarding the safety of vaccinations. What is your opinion on the current use of vaccinations? How would you educate parents regarding the safety and effectiveness of vaccinations? Defend your answers with evidence-based research. Week 3: Question 1= Share a case study of an electrolyte imbalance from your practice or from the...
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...Airway/Breathing (Oxygenation) Pneumonia/Chronic Obstructive Pulmonary Disease Clinical Reasoning Case Study STUDENT Worksheet JoAnn Walker, 84 years old Overview This case study incorporates a common presentation seen by the nurse in clinical practice: community acquired pneumonia with a history of COPD causing an acute exacerbation. Principles of spiritual care are also naturally situated in this scenario to provide rich discussion of “how to” practically incorporate this into the nurse’s practice. Concepts (in order of emphasis) I. Gas Exchange II. Infection III. Acid-Base Balance IV. Thermoregulation V. Clinical Judgment VI. Pain VII. Patient Education VIII. Communication IX. Collaboration I. Data Collection History of Present Problem: Pneumonia-COPD JoAnn Walker is an 84-year-old female who has had a productive cough of green phlegm 4 days ago that continues to persist. She was started 3 days ago on prednisone 60 mg po daily and azithromycin (Zithromax) 250 mg po x5 days by her clinic physician. Though she has had intermittent chills, she first noticed a fever last night of 102.0. She has had more difficulty breathing during the night and has been using her albuterol inhaler every 1-2 hours with no improvement. Therefore she called 9-1-1 and arrives at the emergency department (ED) by emergency medical services (EMS) where you are the nurse who will be responsible for her care. Personal/Social History: JoAnn was widowed...
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...patients admitted to ICCU were taken up for study. A detailed history physical examination &laboratory work up was done in all patients. Results: 100 Patients of acute myocardial infarction were included in this study. They consisted of 77 male and 23 female patients. The youngest patient was a 23 year old male and the oldest patient was an 84 year old male. Out of 100 patients with myocardial infarction 80 were males & 20 were females. Out of 80 males 37 had rhythm disturbances with a percentage of 46.25 & out of 20 females 9 had rhythm disturbance with a percentage of 45. 8 patients had previous ischemic heart disease prior to present episode. Of these 4 developed rhythm disturbances. All female patients were postmenopausal. 6 patients had COPD and 3 developed rhythm disturbances. Out of 100 patients 25 patients had Intraventricular block, of these right bundle branch block was common with an incidence of 10. Keywords: Acute Myocardial Infarction, Rhythm Disturbances, Intraventricular Conduction Block Introduction: It is defined by either electrocardiogram or echocardiography. It is an important independent risk factor roughly doubling the risk for cardiovascular death in both men and women (1). Left ventricular hypertrophy is associated with obesity, excessive salt intake, advanced age and heredity (2).Several studies have found that Angiotensin converting enzyme inhibitor reduces left ventricular mass by 12%, calcium channel blockers by 11%, beta blockers by 5% and diuretics...
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...Community Health Nursing Case Study Mr. Evans is a new patient to this nurse. This is the first home visit and upon presentation the patient has tachycardia and presumably newly diagnosed Atrial fibrillation, for which he takes Digoxin. According to records last Digoxin level was two months ago. Respiration are increased and adventitious breath sounds are noted. Patient states that this is his baseline. Patient has COPD and takes Proventil PRN and Theo-Dur twice a day. Patient reports he had a hospitalization for “congestion in his heart” and is currently on Lasix 40 BID. Patent denies any acute distress, home health aid reports recent weight loss, loose stools and complaint of nausea. This nurse in the field would interview the patient and his wife after the clinical assessment. I would ask about any anorexia, loose stools, nausea and or vomiting. Patient does take a stool softener daily. After assessing attend skin turgor and sign if dehydration, this nurse would investigate when the patient takes his medication, and if he has been missing any doses of meds. This nurse would ask when his next cardiology follow up is and when he is due for any labs including a BMP since 40 mg of Lasix twice a day is a higher dose, and for a current digoxin level. This nurse would ask how the patient is sleeping and how often he is using his rescue inhaler for shortness of breath and wheezing. This nurse would ask when his next follow up with oncology is and how long...
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...uses Information and Communication Technologies to overcome geographical barriers, and increase access to health care services. This is particularly beneficial for rural and underserved communities in developing countries – groups that traditionally suffer from lack of access to health care. Uses of telehealth Clinical uses | Non-clinical uses | * Transmission of medical images for diagnosis (Store and forward telehealth) | * Distance education including continuing medical education, grand rounds, and patient education | * Groups or individuals exchanging health services or education live via videoconference (Real-time telehealth) | * Administrative uses including meetings among telehealth networks, supervision, and presentations | * Transmission of medical data for diagnosis or disease management (Remote patient monitoring) | * Research on telehealth | * Advice on prevention of diseases and promotion of good health by patient monitoring and followup | * Online information and health data management | *...
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...nosocomial infection in the United States and is associated with high mortality and morbidity (Seymann, 2008). Higher rates of hospital-acquired pneumonia (HAP), functional decline, pressure ulcers, and falls are a few factors that leads to prolonged bed-rest . HAP Iis a pneumonia that begins within 48 hours after hospitalization and does not incubate at the time of admission. Because individuals with hospital-acquired pneumonia usually have underlying illnesses and are exposed to more dangerous bacteria, it tends to be more deadly than community-acquired pneumonia (Seymann, 2008). Those at risk include patients with a compromised immune system, are HIV positive, have been hospitalized for more than two days, reside in a nursing home, have COPD, diabetes, heart failure, are elderly, alcoholics or have other underlying disorders (Smeltzer, et al). A new report regarding the high death rate due to hospital acquired pneumonia was a an issue that could not be ignored by congress in light of the fact that it was published days before President Barack Obama convened a Health Care Summit in Washington last week (Zigmond, 2010). Goals/learner outcomes for the lesson. One of the main educational needs determined in the hospital is infection control. According to the U.S. National Library of Medicine National Institutes of Health (2011) “infectious diseases kill more people worldwide...
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...Abstract Pneumonia Introduction: I will not be looking too deep into this severe case of Community Acquired Pneumonia. My objectives in this case study will basically be to determine whether hospital admission for intravenous antibiotics are necessary. This will be done by using clinical scores and other in-hospital diagnostic criteria to determine prognosis and severity. The relevance to this case study with be treatment regime and a ventilator strategy you may not have heard of. Case study: 67 year old female of colored ethnicity from wellington, transferred from Paarl hospital intubated, ventilated will host of problems including Chronic Obstructive Pulmonary Disease grade ii , Community Acquired Pneumonia (CAP) , Gastro Intestinal Tract bleed which occurred just before transferring from Paarl, also history of smoking, one packet year, and ethanol (ETOH) abuser. Conclusion: Diagnostic criteria, is clinical presentation and chest x-ray. The simplest of all clinical scoring system is CURB-65 using 5 prognostic variables to determine the severity of Pneumonia, instead of 20. Much easier and practical can be applied at patient bedside. Inverse ratio ventilation to aid and improve filling of non-compliant...
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...CASE STUDY 1 Acute coronary syndrome Patrick Gallagher Case outline Peter Brown is a 58-year-old gentleman who has experienced an episode of crushing central chest pain while at work. Peter works as a taxi driver and a colleague has taken him to the Accident and Emergency Department. On admission, Peter is sweaty, clammy, nauseated and short of breath. He is complaining of chest pain radiating to his left arm. This is Peter’s first presentation to hospital and he has no relevant past medical history. Peter smokes approximately 20–30 cigarettes per day and takes alcohol at weekends only. Peter is anxious and is concerned that his wife and children are informed. He also states his father died suddenly following a heart attack a number of years ago. Peter is immediately triaged and taken to the resuscitation room. You are the receiving nurse. Observations on admission include: Respiratory rate: 18 breaths per minute Oxygen saturations: 95% Blood pressure: 150/90 mmHg Pulse: 94 beats per minute Temperature: 37ºC. On admission to hospital an electrocardiograph (ECG) has been undertaken. Peter has been diagnosed with an anterior ST segment elevation myocardial infarction (anterior STEMI). Blood samples have also been drawn for urea and electrolytes (U&E), full blood picture (FBP) and highly sensitive troponin T. 1 Discuss Peter’s immediate problems and explain these using your knowledge of pathophysiology. A On admission to Accident and Emergency...
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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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...From Chronic to Critical: A Latino Family Confronts End-of-Life Decisions By Karen Peterson-Iyer Gabriela Rivera is an 80-year-old Puerto Rican immigrant, who lives alone in her rent-controlled apartment in New York City. She has lived in the United States for almost 40 years and speaks some English, albeit somewhat hesitantly. Her primary language is Spanish. Although she is now retired, for years Gabriela worked in a factory where she was exposed to a variety of industrial chemicals now considered toxic. Gabriela's husband died four years ago of a massive heart attack. She has six adult children, three of whom now live out of state. Gabriela is a devoted mother, calling her children as often as she can afford and even sending them homemade sweets. She raised her children through their teenage years in the same apartment in which she lives today. She is loath to leave it, although she now pays the rent only with great difficulty and substantial financial help from her children. Gabriela has long suffered from high blood pressure, which she controls with medication. She also has type-2 diabetes. When she was originally diagnosed with diabetes, she met once with a nurse who advised her on diet, exercise, and weight control, but Gabriela has found it difficult to adapt her traditional tastes in food and her lifestyle to the recommendations the nurse offered. Subsequently, Gabriela's doctor prescribed medication to help keep her diabetes under control. She tries to take her medication...
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