Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum. Mrs. Jones has a history of COPD. She was already taking albuterol for her illness and it was ineffective when she took it that day. Mrs. Jones had been a smoker but had quit several years ago. According to Chojnowski (2003), smoking is a major causative factor in the development of COPD. Mrs. Jones's primary provider stated that she had a mixed type of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was established to address the growing problem of COPD. The GOLD standards identify three conditions that contribute to the structural changes found in COPD: Chronic bronchiolitis, emphysema, and chronic bronchitis. A mixed diagnosis means that the patient has a combination of these conditions (D., Chojnowski, 2003). Mrs. Jones chronically displayed the characteristic symptoms of COPD. "The characteristic symptoms are cough, sputum production, dyspnea on exertion, and decreased exercise tolerance." (D., Chojnowski, 2003, p. 27). Based on her histor... ... middle of paper ... ...ould be included in this education. This exacerbation of her COPD revealed the need for inhaler re-education. This education holds more importance due to her exacerbation that possibly could have been prevented with proper inhaler use. An education plan should be developed to assess her readiness to learn and to map out a schedule of sessions. Several sessions over an extended period of time with continuous re-evaluations is essential. Research has shown that this approach has better long term outcomes (M., Duerden & D., Price, 2001). References Chojnowski, D. (2003) "GOLD" standards for acute exacerbation in COPD. The Nurse Practitioner,28(5), 26-35. Retrieved from www.tnpj.com on 2/19/04. Duerden, M. & Price, D. (2001). Training issues in the use of inhalers. Practical Disease Management, 9(2), 75-87. Retrieved from www.pdm.com on 2/19/04.
The risk factors that Jessica presented with are a history that is positive for smoking, bronchitis and living in a large urban area with decreased air quality. The symptoms that suggest a pulmonary disorder include a productive cough with discolored sputum, elevated respiratory rate, use of the accessory respiratory muscles during quite breathing, exertional dyspnea, tachycardia and pedal edema. The discolored sputum is indicative of a respiratory infection. The changes in respiratory rate, use of respiratory muscles and exertional dyspnea indicate a pulmonary disorder since there is an increased amount of work required for normal breathing. Tachycardia may arise due to the lack of oxygenated blood available to the tissue stimulating an increase in heart rate. The pedal edema most probably results from decreased systemic blood flow.
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
COPD is Chronic Obstructive Pulmonary Disease and is a major cause of disability. Millions of middle aged-adult and older adults are diagnosed with COPD. “Over the past decades chronic obstructive pulmonary disease (COPD) has become widespread and is now the fourth leading cause of morbidity and mortality on a worldwide basis” (Hellem, Bruugsgaard, & Bergland, 2012, p. 206). This disease is a progressive disease that makes it hard to breathe. As time goes on the symptoms will get worse. Most people with COPD have both emphysema and chronic bronchitis. With emphysema, the walls between many of the air sacs are damaged which reduces the amount of gas exchange in the lungs. With chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken and thick mucus forms in the airways, which makes it hard to breathe.
Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that affects breathing. This disease is one that blocks or obstructs air flow which then affects the way that one breathes. It diminishes the capability of airflow in and out of the lungs. COPD is the term used for a group of different diseases that affect the lungs. The two most common types of COPD are emphysema and chronic bronchitis. Emphysema is a destruction of the small bronchioles in the lungs and chronic bronchitis is an inflammation of the lining of the bronchial tubes. Both emphysema and chronic bronchitis are obstructive diseases that impact breathing in a negative manner. (COPD, 2014)
COPD GOLD Grade A: A bronchodilator (short or long acting), titrating or switching to another as
Although the neutrophils from one of the COPD groups was less responsive to bacterial peptide . This shows that systemic inflammatory signals do not necessarily correspond with the GOLD classification and that inflammatory phenotyping can remarkably add in enhanced diagnosis of single COPD patients . The background is that COPD as i stated earlier is characterized by irreversible airflow limitation , and is a leading cause of mortality and morbidity . Cigarettes as stated in the article is the most important risk factor for the development of chronic obstructive pulmonary disease in the western world . According to GOLD the diagnosis and severity of COPD is assessed using lung function measurements , like FEV1 , FVC . It is well received that these spirometry measurements are insufficient , mainly because spirometry data alone poorly correlate with symptoms and health status . A lot of studies have focused on the identification of disease phenotype in COPD , and have also searched for individual and/or combined biomarkers using the data they collected
One hundred million deaths have resulted from tobacco use in the 20th century, and up to one billion more from tobacco use are predicted for the 21st century. Chronic Obstructive Pulmonary Disease, or COPD, is becoming a global public health crisis.1COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production, and wheezing. It is caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer, and some other respiratory conditions.2 The two most common conditions that contribute to COPD are chronic bronchitis and emphysema.
Chronic Obstructive pulmonary disease (COPD) is a severe public health problem that affects health related quality of life (HRQoL). In COPD patients, limitation of the airway function is generally persistent and patients usually suffer from considerable physical and psychological symptoms, and impairments of functional ability and HRQoL (Vestbo et al., 2013). Common symptoms of COPD include chronic cough, sputum production and exertional dyspnea (Ng & Smith, 2017). These symptoms affect HRQoL, but can they can be managed. The ultimate goals of COPD management are to maintain or improve patients’ functional quality and ability, facilitate patients to better live with the chronic condition with less acute respiratory exacerbations
Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic disease that affect the normal function of lungs. COPD is an obstructive lung disease and the inflammation and thickening of the airway makes breathing very difficult for patients with COPD1. COPD is often preventable and treatable. The severity of COPD depends on patient’s airflow limitation through their airways and degree of symptoms1. According to Global Initiative for COPD (GOLD), air flow limitation in COPD patients is not fully reversible, usually progressive and is normally related with an abnormal inflammatory response of the lungs to harmful particles or gases that are inhaled1. The characteristic symptoms of COPD includes chronic cough, shortness of breath, decreased exercise tolerance and wheezing1. Usually, COPD patients have a symptoms of emphysema1. Emphysema is a chronic lung disease defined as abnormal and permanent enlargement alveoli in the lungs which leads to collapse and destruction of alvoli1. This causes airflow obstruction, increased work of breathing, increased breathlessness, and reduced efficiency of expiratory muscles1.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
Chronic obstructive pulmonary disease (COPD) is characterised by airflow restrictions that cannot be entirely undone once damaged happened. COPD leads to injured lungs, making them narrow and air flow out and into the lungs problematic. It can be produced by environmental or work-related exposure to contamination, dust and smoking. Emphysema and Pneumonia is but 2 of the disease processes that fall below this umbrella of COPD (Mitchel, 2015).
Smarter monitors that display information less but process it more, while interacting directly with ventilators and other devices to modify therapeutic interventions. (4) Increased use of and expertise with noninvasive ventilation, with a corresponding decrease in intubations and complications, in treating patients with acute exacerbations of COPD. (5) Increased use of triage in the intensive care unit, including earlier determination of the appropriateness of maximal supportive intervention. (6) Greater use of protocols in patient assessment and management, in all clinical settings. (7) Increased awareness of, expertise in, and resources for palliative care, with a more active and acknowledged role for respiratory therapists. (8) Accelerating progress in smoking cessation and prevention, and in early detection and intervention in COPD, led by the respiratory care profession. (9) An increasing presence and impact of respiratory therapists as coordinators and care givers in home care. (10) A continued and enlarging role for the journal RESPIRATORY CARE in disseminating research findings, clinical practice guidelines, protocols, and practical educational materials in all areas of the field.
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.
One of the major public health problems facing Australia today is Asthma. It is disturbing that there has been an apparent increase in its prevalence and severity, and increased rates of hospital admissions. (E.J.Comino, 1996) For the diagnosed patient, the degree to which he or she suffers is related to severity of the condition, compliance with recommendations by medical experts, the immediate environment and the effectiveness of education programs.
I really didn’t know very much about COPD. I knew that COPD makes it hard to breathe and that sometimes you need to use oxygen to help you breathe. I’ve never heard very much about it other than my grandpa had it and there are a lot of commercials about it. It makes your life a lot harder and you can’t do daily tasks with the ease we take for granted because you’re lugging around your oxygen tank or, ultimately you just can’t breathe.