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CHRONIC OBSTRUCTIVE PULMONARY DISEASES
CHRONIC OBSTRUCTIVE PULMONARY DISEASES
CHRONIC OBSTRUCTIVE PULMONARY DISEASES
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Amanda Newton-Brown
Pathophysiology 370
October 1, 2015
Case Study COPD
What clinical findings are likely in R.S, as a consequence of his COPD? Many clinical findings can be a problematic for R.S, due to him having chronic obstructive pulmonary disease, which is composed by two closely related diseases being Chronic Bronchitis and Emphysema. Polycythemia is a prominent consequence of COPD, which is an abnormally increased concentration of hemoglobin in the blood, through either reduction of plasma volume or increase in red cell numbers (Mayoclinic,2015). He has elevated PaCO2 and HCO3 levels, indicating respiratory acidosis partially compensated. R.S, suffers from chronic bronchitis COPD type B, also labeling him as a “blue bloater,” which can cause him to experience symptoms of peripheral edema, elevated hemoglobin, dyspnea, chest tightness, cyanosis, wheezing, and a persistent cough. The symptoms of the dyspnea, cough, cyanosis, and wheezing result from the changes in the smooth muscle in the bronchus and congestion of the alveoli. These patients
Extreme cases of chronic obstructive pulmonary disease can lead to cor pulmonale, increased vascular resistance and right heart failure, accompanied by reduced left ventricular filling, left ventricular stroke volume, and cardiac output. COPD and left-sided heart failure are not directly related. However, the two conditions may influence each other. For example, low oxygen in the blood from COPD may put excess strain on the heart, worsening left-sided heart failure. Excess fluid in the lungs from heart failure can make breathing even more difficult for someone with COPD (WebMd.com). Smoking increases problems for both the heart and the lungs, which is one of the main reasons for patients with respiratory disease to quit smoking because it also affects the
The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
Chronic obstructive pulmonary disease, better known as COPD, is a disease that affects a person’s ability to breathe normal. COPD is a combination of two major lung diseases: emphysema and chronic bronchitis. Bronchitis affects the bronchioles and emphysema affects the alveoli.
Harry Barr is a 66-year-old white male with COPD here for followup. He was initially seen in Pulmonary Clinic 02/17/2016. At that visit most recent spirometry was from 2012 and showed Gold stage III COPD with no bronchodilator responsiveness. He was on an excellent inhaler regimen and recommendations including occluded chest CT for lung cancer screening and assessment of oxygenation for hypoxia. Since that visit, the patient has had significant worsening of his dyspnea on exertion. He also states that he has had two exacerbations over the last year requiring prednisone, but prednisone is problematic because of his diabetes. He continues on the same inhaler regimen of Symbicort, Spiriva, albuterol, and also takes theophylline. He endorses significant nasal symptoms including stuffiness and drainage for which he takes Flonase two sprays in each nostril once daily. He denies any history of childhood asthma.
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
The main symptom of the disease is shortness of breath, which gets worse as the disease progresses. In severe cases, the patient may develop cor pulmonale, which is an enlargement and strain on the right side of the heart caused by chronic lung disease. Eventually, this may cause right-sided heart failure. Some patients develop emphysema as a complication of black lung disease. Others develop a severe type of black lung disease in which damage continues to the upper part of the lungs even after exposure to the dust has ended called progressive massive fibrosis.
This is a follow-up visit for [Name], who is a 9-year 6-month-old young man who brought here today, by his mother, for medication management.
R.G. is a 74 year-old male, and was admitted on 3/16 with shortness of breath and cough, which had been going on for one week. He was previously discharged with aspiration pneumonia, but was readmitted with the same diagnosis for treatment. R.G. was taking Zosyn for antibiotic treatment. He was also diagnosed with acute kidney injury due to medication during his hospital stay. He is currently on hemodialysis with right internal jugular access. While on dialysis his hemoglobin was 6.4 and on 3/26 he received one unit of blood.
“Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body's needs for blood and oxygen” (American Heart Association, 2012, para 3). What this basically means is that the body is functioning in a way that the heart cannot keep up with. Although heart failure can be acute and occur suddenly, it usually develops over time and is a long-term or chronic condition. There are two different types of heart failure, left-sided and right-sided, and they can be caused by other diseases such as diabetes, coronary heart disease, or high blood pressure (National Institutes of Health, 2012). In most cases, both sides of the heart are affected simultaneously.
COPD Chronic Obstructive Pulmonary Disease is the name of a collection of lung diseases. Such as chronic bronchitis, and emphysema. 83% of the deaths caused by COPD are caused by smoking. Lung cancer, coughing, wheezing, and dying? Isn’t that what you think of when you hear smoking? You’re thinking yeah, I hear this all the time, I know what smoking does to you. But it does a lot more than just screw up your respiratory system. It messes everything up. Let’s start with skin, since this day and age everyone is obsessed with outer beauty. Smoking reduces the amount of oxygen that reaches that precious layer of yours. Causing it to become ashen and grey. Speeding up the aging process and increasing the likelihood of you looking like a withering
Chronic Obstructive Pulmonary Disease (COPD) is the obstruction of airflow in the lungs that is not reversible. COPD includes chronic bronchitis, which is the chronic inflammation of the bronchioles where extra fluids are produced as well as a cough, and emphysema, which is larger air spaces in the lungs due to loss of airway walls. About one in every twenty patients will have COPD, with 70% of them being above the age of 45. Typically, the main cause of COPD is smoking, which accounts for nearly 90% of all COPD related deaths. The inhaled smoke irritates the mucosa of the lungs, which causes inflammation that then damages the mucosa and blocks airways. It is not a one-time cause and effect, but happens over periods of time and exposure. The more exposure, the more likely/severe the disease will appear. COPD is characterized by a chronic cough, large amounts of sputum production, and difficulty breathing that gets worse during exercise. There is no cure for COPD, but it is possible to decrease progression by ridding of irritants like by quitting smoking. Inhaled bronchodilators are used to help manage the disease and they help by reducing mucus production and relaxing smooth muscles of the lungs.
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.
Chronic obstructive pulmonary disease, also known as COPD, is a lung disease that block airflow and makes breathing difficult. There are two common condition, emphysema and chronic bronchitis that help make up COPD. There are also about four gold stages; mild, moderate, severe, and very severe. COPD is the fourth leading cause of death in the U.S, the disease typically occurs after age 35.
Breathing in and out is an innate behavior that we are born with; also, it is a behavior that people take for granted. Let’s say, people who smoke think a cough, or a cough with phlegm is a sign that they are about to get a cold, but then again it can be a sign of a potential health problem like emphysema, asthma, or tuberculosis. People smoke for different reasons; nevertheless, it is an addiction that they can recover from. It may take them several tries to quit smoking, but they can quit. People don’t think about the harm that they are putting on their lungs and alveoli when they put a cigarette to their mouth. For example, many long time smokers are diagnose with emphysema every minute. Emphysema is an example of a chronic obstructive pulmonary diseases (COPD) that has causes numerous deaths and disabilities in the United States of America. Also, smoking is the number one causes of death in developed countries.
The purpose of this essay is to explore nursing care priorities for a patient with a common health condition. A common health condition is a disease or condition which occurs most often within a population. The author has chosen scenario 3 for this essay and will describe the nursing assessment and care planning provided to a patient with Chronic Obstructive Pulmonary Disease (COPD). The WHO definition of COPD is a lung disease which has a chronic obstruction of the airways that impedes normal breathing and is not fully reversible (). According to), there are estimated to be over 3 million people in the UK with COPD. It is common in later life and there are approximately 25,000 deaths each year, with 15% of COPD being work related (The identity of the patient will remain anonymous in adherence with the Nursing and Midwifery Council, Code of Conduct on patient confidentiality (). However, the patient will be referred to as Mr B in this essay. The author has chosen the priority of eating and drinking for Mr B. Patients with COPD are at increased risk of malnutrition and nurses must make certain they screen patients and offer advice or refer as necessary (). If this priority is managed well it will have a positive effect on the other priorities (, 2012). In accordance with NICE Guideline 101 (), the treatment and care provided should consider each persons’ individual requirements and preference. Care and treatment should take into account people’s individual needs and choices. To allow people to reach informed decisions there must be good communication, supported by evidence-based practice (). This essay will provide an evidence based discussion on how care will be implemented in relation to Mr B and his eating and drin...