Clinical Application Essay Two: Respiratory Amy Parsons is a 16-year-old female who presents to a primary care clinic with a chief complaint of “I am coughing a lot.” Ms. Parsons reports episodes of coughing and shortness of breath after swimming in the community pool this past summer as well as coughing episodes that were notably worse after swimming in a lake the previous summer. She describes her cough as dry, hacking, and nonproductive. Ms. Parsons reports that she is a competitive swimmer in the fall and winter seasons, during which she reports that the coughing is improved when she is in the pool and becomes worse when she gets out. Occasional wheezes are also reported. Ms. Parsons’ denies any known drug, environmental, or food allergies …show more content…
Parsons’ signs and symptoms are indicative of asthma, a chronic disorder of the airways. Grossman (2014) explains that asthma causes bronchospasm leading to bronchoconstriction, edema of the bronchial mucosa, airway inflammation, and mucus plugging. Risk factors linked to asthma include genetics, allergies, family history, antenatal exposures to pollutions, cigarette smoke, and according to Grossman (2014) recurrent viral respiratory infections can lead to the development of asthma. The severity of asthma one has can be linked with and influenced by genetics, environmental exposures, age at onset, and gastroesophageal reflux disease (Grossman, 2014). Triggers might include environmental changes, viral infections, stress, and exercise. Signs and symptoms of asthma attacks include shortness of breath, non-productive cough, wheezing, chest tightness, use of accessory muscles, moist skin, diminished breath sounds, tachypnea, and anxiety. Respiratory fatigue and failure can occur as the result of a prolonged attack (Grossman, 2014). Diagnosis of asthma is comprised of a focused history, physical examination, and diagnostics such as laboratory testing, chest x-ray, and pulmonary function testing. According to Grossman (2014), the peak expiratory flow (PEF) can help to determine the level of asthma exacerbation. Treatment is typically based on the severity and can consist of pharmacological as well as non-pharmacological …show more content…
Certain “triggers” can cause episodes of asthma. Let’s talk about some of the specific triggers that seem to be affecting you. Temperature change: Breathing cold air or a quick change in temperature can irritate your airways and cause an asthma attack. Keep a towel ready to dry off when you exit the pool. Infections: Lung infections like the colds and URIs you told me about can be a dangerous asthma trigger. Stay away from anyone who is sick and get a flu shot every year. Exercise: You do not have to stop swimming because of your asthma. We will create a safe exercise and medicine plan for you. Make sure not to exercise when your asthma is not well controlled and/or your PEF results are low. Make sure to warm up and cool down so you don’t heat or cool too quickly. Avoid strong odors like elevated chlorine levels in the pool. Relax, stress can trigger
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).
Physician Assistant is a career choice that entails various specialties and flexibilities that attracts many. Those who desires a path to practice medicine as soon as possible, PA 's lateral mobility allows that to happen. Compared to medical school, PA school requires less time and amount less debt. As the population grows and chronic diseases spreads, The future projection of PA is growing faster than the average careers.
Imagine a young child competing with his or her fellow classmates during recess and immediately losing the ability to breathe normally. He or she stops in the middle of the competition and falls to the ground while holding his or her chest trying to find air. When you are young, being able to keep up with your peers during recess and sporting events is very important, however, having asthma restricts this. Asthma has a significant impact on childhood development and the diagnosis of asthma for children 18 years and younger has dramatically increased over the years. Asthma is known as a “chronic inflammation of the small and large airways” with “evident bronchial hyper-responsiveness, airflow obstruction, and in some patients, sub-basement fibrosis and over-secretion of mucus” (Toole, 2013). The constant recreation of the lung walls can even occur in young children and “lead to permanent lung damages and reduced lung function” (Toole, 2013). While one of the factors is genetics, many of the following can be prevented or managed. Obesity, exposure to secondhand smoke, and hospitalization with pneumonia in the early years of life have all been suggested to increase children’s risk of developing asthma.
Exercise-induced asthma is an acute transient airway narrowing that occurs during and most often after exercise. It is objectively defined as a 10% fall in forced expiratory volume in the first second from baseline that may be measured up to thirty minutes following exercise (M&M). Exercise-induced asthma occurs not only in elite athletes and asthmatics, but it can also be found in non-asthmatics. The stimulation of exercise-induced asthma can range anywhere from inhaling allergens to hyperventilation or intense exercise. The management and prevention of exercise-induced asthma is a series of trials to reduce the effects of prolonged bronchoconstriction.
Asthma is chronic inflammatory disorder of the airways characterized by recurring episodes of wheeling and breathlessness. It often exists with allergies and can be worsened through exposure to allergens. In fact, asthma is complicated syndromes that have neither single definition nor complete explanation to the point. In light of its treatment, it is worthwhile to notice that asthma cannot be cured, instead can be only managed by avoiding exposure to allergens and/or by using medications regularly.
I will be relating the implication of developing critical thinking aptitudes in order to practice, safe nursing diagnostic and professional judgment in my daily nursing process. I will also converse the approaches and skills that are required to develop clinical thinking and safe clinical problem solving in the environment I work in. The main focus will be on the responsibilities and
Cough-induced asthma is one of the most difficult asthmas to diagnose. The doctor has to eliminate other possibilities, such as chronic bronchitis, post nasal drip due to hay fever, or sinus disease. In this case the coughing can occur alone, without other asthma-type symptoms being present. The coughing can happen at any time of day or night. If it happens at night it can disrupt sleep.
I chose a career as a medical assistant because of the rewards I knew I would experience on a daily basis. Seeing a patient smile because I have helped them understand, or just making them feel comfortable with their visit, is just one of the many perks of my job. Upon graduating from an accredited college such as The College of Health Care Professions (CHCP), I now work for one of the most reputable hospitals in my area. Within two short years of committed studies, I obtained my associate of applied science degree, and then went on to obtain my certification as a medical assistant. There is nothing I have found more fulfilling, strong, secure, or rewarding then choosing to become a medical assistant,
Asthma symptoms can range from mild to very severe. A person may experience only occasional severe episodes one time and then experience frequents mild episodes. According to the book, Living Well With Asthma, there are four main symptoms of an asthma attack. Since an attack can be so overwhelming and frightening, it may be difficult to know what’s going on inside of a persons body. Here are the major elements of an asthma attack:
As healthcare reform evolves, advanced practice nurses (APNs) will play essential roles in improving health outcomes of diverse populations. APNs should be able to practice fully of education and training. However, barriers exist that limit the APN practice (Hain & Fleck, 2014). Because of known challenges, APNs must be involved in policy changing and be politically competent to effect change. The author will identify steps to advocate for policy change and identify ways to improve political competence.
What is the central component of advanced practice nurses (APNs) direct clinical practice and patient/families?
Clinical social workers in the community strive to enhance and maintain psychosocial functioning of individuals, families, and small groups. They also focus on prevention of psychosocial dysfunction or impairment, including emotional and mental disorders. The perspective of person-in-situation (psychosocial context) is fundamental to clinical social work practice (Austin, Barr, & Coombs, 2006).
The clinical manifestation one may see in patients with chronic bronchitis are chronic cough, weight loss, excessive sputum, and dyspnea. Chronic cough is from the body trying to expel the excessive mucus build up to return breathing back to normal. Dyspnea is from the thickening of the bronchial walls causing constriction, thereby altering the breathing pattern. This causes the body to use other surrounding muscles to help with breathing which can be exhausting. These patients ca...
Throughout my final ten weeks at my placement, I have grown and overcome so many obstacles. I have accomplished a wide range of skills since the beginning and have been improving on them as I gained experience. At my placement as a student nurse, I have gained a lot of confidence, skills, knowledge and experiences that have helped me act and work in a professional way. All the experiences I have had during the ten weeks of my student years have helped me in shaping me into a professional.
Clinical psychology is not just regular psychology. Psychology is typically just concerned with people that do not suffer from many mental illnesses while clinical psychology is a branch of psychology that is concerned with treatment of mental illnesses. Clinical psychologists can work in many different types of places and they are typically in indoor environments. This career also takes a lot of education to be successful in this field. There are many things to consider about clinical psychology. Some of these things include the actual job, education, and what you can do now to prepare.