Thank you for referring Lauris Dniprowskij, a 67 year-old retired private investigator. Lauris is and ex-smoker of approximately 50 pack years and he ceased this habit eight years ago. She currently has four chickens at home and is looking at acquiring other animals having recently moved to another farm. As you are aware, Lauris has been aware of exertional dyspnoea for at least seven years and this has progressed over time. She is now reaching a point that walking any more than 20-30m will induce symptoms. She is also limited by back and left hip pain relating to arthritis. Lauris reports no chest pain, chronic cough or wheeze, but does report occasional orthopnoea and paroxysmal nocturnal dyspnoea. Aside from pneumonia at the age of 21, she has not experienced any significant chest infections and I note is up to date with both the Fluvax and Pneumovax. Lauris reports being assessed by thoracic surgeon, Julian Gooi, and respiratory physician, Barton Jennings, a number of years ago with regards to endobronchial valves, but was not deemed to be a candidate at the time. She was commenced on Ultibro and has had some benefit with this. She spent a brief period using a combination of Spiriva and Symbicort and found that this led to increased symptoms. Other regular medications are Crestor and …show more content…
At this stage, I have suggested that Lauris continue with Ultibro but I may look and adding on an inhaled corticosteroid if there is any evidence of bronchodilator reversibility. Her oxygen levels are borderline, and although he is limited by back pain, I have suggested that it would be worthwhile to have an oxygen assessment and I have referred her on The Northern Hospital accordingly. I have also referred her to enrolling her in their pulmonary rehabilitation
R.S. has been using the recommended treatment for his condition, which inlcude inhaled short-acting Beta-2 agonist and Theophylline, a bronchodilator, to control his respiratory disease.
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.
Following subsequent investigations, she was diagnosed with bilateral pneumonia and empyema, and was admitted. Once stabilized, she underwent a left thoracotomy with decortication. As a result 2 drains were inserted, with each draining serosanguinous fluid. The plan is to remove these once they have drained < 20 ml in 24 hours.
Growing up with a best friend who has been smoking since middle school, I have seen many of the negative effects it has on a person. Football was a passion and way of life for Andy; however, smoking caused him to struggle with breathing while running up and down the field. He would cut down on his daily amount of cigarettes before and during the season, but cutting down was little help for him. Not only was his breathing affected by smoking, but he also had yellow teeth, smoker’s cough, and would get “the shakes” when in need of a smoke.
...llen S. “Dysphagia and Aspiration Pneumonia in Older Adults.” Journal of the American Academy of Nurse Practitioners 22 (2010) 17-22 *
Glen Carver is a 56 year old male who was admitted unto the cardiovascular care unit 48 hours ago with the diagnosis of heart failure. Mr. Carver went to see his primary care provider with complaints of dyspnea on exertion, a nonproduction cough, decreased activity intolerance, and general fatigue all of which have been worsening over the past two months. The primary care provider found Mr. Carver to have lower extremity swelling, profound ...
Using medication will decrease all the pressure that is caused by fluid going around the lungs and heart. Pulmonary edema may be life-threatening, especially without urgent medical treatment and professional assistance. Curing this problem may also be follow the steps of supplement oxygen and medicine. The patient should then follow a low sodium diet to prevent this from being an occurring health problem. Oxygen therapy on a three to five-day treatment will cut down on the chances of having this health condition attacking the Pulmonary system. Follow -up appointments scheduled by a patient that had been diagnosed with Pulmonary edema is critical. Just based off the studies that this wet lung disorder is a chronic build up that is to be controlled and not necessarily cured. Controlling possible risk factors such as salt intake, smoking, cholesterol consumption and taking the prescribed medications will eventually help minimize symptoms and future episodes of edema. On the other hand, it is important to understand that a lot of treatment resolutions can come from self-care which include a low sodium diet and also supportive care which consists of an oxygen therapy treatment. Nevertheless, with a low sodium diet, this a type of diet that restricts salt and other types of sodium. With the oxygen treatment, patients with pulmonary
conducted using a sample of French smokers (36 F, 60 M) and non-smokers (23 F,
Smoking Smoking is an addicting habit on the rise worldwide. Smoking across the globe has many different forms from cigarettes and cigars to pipes and shisha’s. There are many different reasons for smoking whether it is for medicinal reasons or recreational use. Smoking has been around for a very long time and in this essay I will discuss the origins of smoking, the serious health risks, economical burdens, the addicting materials as well smoking among teenagers. Despite efforts from governments and organizations to bring awareness to people across the globe of the serious dangers and implications of smoking, the number of smokers worldwide generally remains on the rise. Brief History Of Smoking Smoking in one form dates back to as early as 5000 BC. It was used in shamanistic rituals to allow the users to achieve a state of trance and connect with the spirit world. Cannabis smoking quickly spread through Africa and the Middle East almost 3000 years ago. Smoking was sighted in England as far back as 1556 and then spread to France in 1560. Tobacco was then brought into Africa by French traders in the early 1600’s. Tobacco at that time was chewed or smoked. Around that time many religious leaders banned smoking and considered it immoral and even blasphemous. The first machine made to produce cigarettes was made by James Bonsack in 1881 after the civil war. The negative effects of smoking were brought to public attention in 1929 by the paper published linking cancer and smoking. During the Great Depression and in Nazi Germany, Hitler viewed smoking as unnecessary and a waste of money and also that woman who smoked as unsuitable to be mothers and wives. After the Second World War, anti-smoking groups lost popularity and smoking increas...
Cardiovascular System: He does not experience any chest pain or palpitation. He does not have dyspnea or leg swelling.
Secondhand smoke, we have all heard of it and know at least one person that smokes. Throughout the history of smoking, many researchers have found that secondhand smoke is more dangerous than the actual smoking of cigarettes. Many people know that there are dangers to smoking and secondhand smoke, but many tend to avoid the advice given to them. Secondhand smoke is very harmful to people of all ages. It destroys the inside and outside of one’s body. Secondhand smoke is not only dangerous indoors but as well as outdoors. On average every year there are many death results found. As humans should want to live a healthier life and come together to prevent smoking in the future.
VandenBranden, S. L. (Dec 2010). ‘The role of the nurse practitioner in the case of children with chronic respiratory disorders’. Pediatric Annals, 39 (12), 800-803.
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...
Everyone was starting to notice that I had a problem. My wife would ask, 'Are you O.K.?' as I hacked and coughed every morning. My friends would joke about how I would run short of breath just from walking to the car. My wallet was really talking to me! Somehow I managed to lose five or six dollars a day somewhere between home and the convenience store. But the only voice I would heed had to come from within myself. Finally one day it did.
Smoking rates are very high in the community we are living in and there are some implications to the smokers and the people living around the environment so it compelled me to search and find the reasons for these high rates of smoking and how and what can be done to reduce or even stop smoking of tobacco.