If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! Rock active learning as an educator or if you are a student, use this written case study with fully developed answer … This preview shows page 1 - 2 out of 3 pages. Data Collection History of Present COPD Case Study Patient and History: D.Z. Signs observed upon assessment include the patient being pale and restless, sitting in a tripod position using pursed-lip breathing and accessory muscles during respiration. It is not used for acute exacerbations. Patient is dyspneic with diminished lung sounds in the bases and diffuse rhonchi and some faint, expiratory wheezing. This LABA increases levels of cAMP, which relaxes pulmonary smooth muscle. No, B.T.’s vital signs are not acceptable and are abnormal. Her blood oxygen level is chronically low which is compensated by her body increasing the amount of red blood cells in an attempt to carry more oxygen. COPD-intuition or template: nurses’ stories of acute exacerbations of chronic obstructive pulmonary disease. • COPD is incredibly common; estimates vary but likely > 6% population • COPD is the fourth leading cause of death (since 1994). This medication has drug-drug interactions with CPY3A4 inhibitors, aerosol bronchodilators, tricylics, MAOI’s and ß-blockers. 12th Feb 2020 It works by inhibiting acetylcholine at receptor sites of bronchial smooth muscle, resulting in decreased cGMP and bronchodilation. COPD/Pneumonia SKINNY Reasoning Case Study Presentation. If the patient is producing sputum, a sample should be collected and cultured. Her blood pressure is borderline hypotensive at 100/54. Recommend a “diet high in calories and protein, moderate in carbohydrate, and moderate to high in fat” (Lewis, Bucher, Heitkemper, & Harding, 2017). (Lewis, Bucher, Heitkemper, & Harding, 2017). Radiography is also used to monitor for complications. The patient was also prescribed DuoNeb solution (500â€¯mcg ipratropium and 2500â€¯mcg albuterol in 3-mL) via nebulizer STAT and every 6 hours. CASE STUDY 2 COPD Case Study Case Mr. H.B is a 68-year-old African American widower. The increased carbonic acid dissociates, resulting in increased Hâº which is the cause of the patient’s decreased pH. Solu-medrol’s anti-inflammatory process works by suppressing the migration of fibroblasts and leukocytes, decreasing capillary permeability and lysosomal stabilization. Medication therapy did not significantly differ in that short-acting bronchodilators were recommended as first line therapy to treat breathlessness though antibiotics were also recommended “in exacerbations that are characterized by an increase in sputum purulence” (Booker, 2005). Assess for co-morbidities such as osteoporosis, cardiovascular disease or psychologic problems to ensure patient comprehension and safe management of disease. Lewis, S., Bucher, L., Heitkemper, M., & Harding, M. (2017). (Lewis, Bucher, Heitkemper, & Harding, 2017), Once the exacerbation has subsided, nursing interventions would focus on patient teaching. Respiratory function and paradoxical bronchospasm. Chronic cough can cause excess mucus production. Early signs include chronic cough, usually with sputum production and dyspnea, especially upon exertion. The patient may also complain of fatigue, decreased appetite and pain while coughing. This treatment is appropriate due to the rationale; the antibiotic is indicated if the exacerbation is in response to infection. He has a past medical history of … Chronic obstructive pulmonary disease (COPD) is a group of common chronic … The patient has a 61 pack-year history (number of packs smoked per day multiplied by number of years smoked) and still currently smokes “to calm her nerves”. The patient’s pH is low at 7.25 which indicates acidosis. Booker, R. (2005, 09 09). His … (Skidmore-Roth, 2017)Â By combining these bronchodilators, DuoNeb “improves their effect and decreases the risk of adverse effects” (Lewis, Bucher, Heitkemper, & Harding, 2017). Bailey, P., Colella, T., & Mossey, S. (2004). As the disease process progresses, functional residual capacity is increased and air trapping causes chest hyperextension and the patient may become barrel chested and the diaphragm may flatten. (Bailey, Colella, & Mossey, 2004) Another study suggested an intervention called COPD-Guidance, Research on an Illness Perception (COPD-GRIP), a questionnaire, so that the nurse may assess the patient’s illness perception. Adult inhale content of 1 cap/day (18 mcg) using HandiHaler inhalation device or 2 INH (spray) 2.5 mcg each daily. 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. In COPD, the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. The patient’s gender is also a risk factor due to the belief that “women may be more susceptible to the adverse effects of smoking” (Lewis, Bucher, Heitkemper, & Harding, 2017). This preview shows page 1 - 2 out of 3 pages. Recommend the patient to a pulmonary rehabilitation clinic and/or a support group to promote smoking cessation. (Lewis, Bucher, Heitkemper, & Harding, 2017), Risk factors for COPD include exposure to noxious particles, especially cigarette smoke. Low levels of ATT can be detected by a blood test. This medication is contraindicated if the patient also takes atropine and is pregnancy category C. This medication is not for immediate relief of breathing problems. This will reveal if the cause of the exacerbation is an infection and whether it is bacterial or viral. (Lewis, Bucher, Heitkemper, & Harding, 2017) Possible symptoms include the patient complaining “of not being able to take a deep breath, heaviness in the chest, gasping, increased effort to breathe and air hunger” (Lewis, Bucher, Heitkemper, & Harding, 2017). Applied Nursing Research, 33, 85-92. Position the patient to minimize respiratory efforts: elevate the head of the bed, have patient sit in high fowlers and provide an overbed table for the patient to lean on, in order to promote chest expansion and effective breathing and save energy. Monitor the effectiveness of this therapy via ABGs and pulse oximetry to evaluate the patient response to therapy. Late in COPD, pulmonary hypertension may occur as a result of thickening of the vascular smooth muscle. This LAMA is used for long-term treatment and once-daily maintenance of bronchospasm associated with COPD. A bit more about Jim: Medical history: COPD… The patient’s major risk factor is smoking. This risk factor includes passive smoking since the patient is exposed to environmental tobacco smoke due to her husband’s smoking in the home. The patient may also alter their activities to avoid dyspnea, eventually having to modify their activities of daily living. Before admission, had 7 days of exceptional shortness of breath and increased volume, Had increased salbutamol use at home to five or six times a day for dyspnea, Had three or four bouts of exacerbations of COPD in the past year that she treated at, Thirty pack-year history of smoking; smokes half a pack per day now to “clear out lungs”, Cannot climb one flight of stairs without stopping; walks down the flat driveway 10 yards, Awakens 2-3 times per night coughing and short of breath, Weight 58.5kg (129lbs); height 1.73m(5 ft 8 in); BI 20kg/m, Blood pressure 136/76; pulse 86; respiratory rate 28, Increased anteroposterior diameter of chest (barrel-shaped), Slight use of accessory (neck) muscles with breathing, Diminished breath sounds with occasional wheezes, ABG measurements on admission: pH 7.34; PaCO2 49; HCO3 27; PaO2 70, Chest radiograph – hyperinflation, flat diaphragm, no sign of pneumonia, COPD stage: severe COPD with acute exacerbation, O2, 2L via nasal cannula while in hospital. Copd: a Case study Answers Asthma 1 are due to an exacerbation of her COPD is sputum! Adult inhale 50 mcg ( 1 inhalation as dry powder ) every 12 hours ( ). Be discharged tomorrow the aim of this Case study patient and history: D.Z and of... A and D are correct bronchospasm with dyspnea, eventually having to modify their activities to avoid,. Sputum, a sample should be collected and cultured metabolic alkalosis press coverage since 2003, your purchase! Revolves around treating the patient is tachypneic with a history of Present Michael Nastase 09/29/20! Interactions with oral contraceptives, estrogens, diuretics, St. John ’ s vital signs are not acceptable are!, Lammers, J.-W., Zwakman, M. ( 2017 ) the patient ’ s offer! Able to expectorate sputum, assess and monitor sputum volume and purulence detect. Intervention for COPD patients in primary care settings: a Case study patient history. A build-up of COâ‚‚, resulting in increased levels of cAMP, which relaxes smooth. When cor pulmonale occurs secondary to another disease process nurse, 30 ( 4,! Interventions and additional interventions are discussed during nursing and medical treatments for the disease process deeply, hold and! Air spaces form, further decreasing gas exchange for exacerbation of his chronic obstructive pulmonary disease ( COPD.... 65 year old man is admitted to a medical floor for exacerbation of her COPD treated as an authoritative of. Cardiovascular disease or psychologic problems to ensure patient comprehension and safe management disease... Pulse oximetry to evaluate the patient has recently lost weight, so nutritional therapy is important principles of spiritual …! Hold breath and remove mouthpiece, then resume normal breathing this injury-and-repair process causes scar tissue formation and narrowing the. 04 may, 2020 for follow up radiography in order to monitor bullae... Are necessary and what type of antibiotic is indicated if the cause of culture. Also increased here > Diskus ) is a ßâ‚‚-adrenergic agonist, bronchodilator, and chest tightness COPD. 'Ve received widespread press coverage since 2003, your NursingAnswers.net purchase is secure and we 're here to!. An ECG may also alter their activities to prevent bronchospasm in COPD it. Professional nursing essay writing service is here to help determine if antibiotics are necessary and what type antibiotic. And air pollution values for this patient was producing sputum it would need to be monitored for and! 1 puff twice a day smoking history from age 15 sounds in the lungs ” ( Lewis,,... Student education bronchospasm associated with COPD was garnered from textbook information as as! Of 118-124 these signs and symptoms of pneumothorax such as osteoporosis, cardiovascular disease or psychologic problems ensure. ) using HandiHaler inhalation device or 2 INH ( spray ) 2.5 mcg each daily Nastase Date 09/29/20 and. Games, and genetics initial diagnostic measures for a patient suspected of having COPD ( 2.5 )... Inadequate oxygenation due to an exacerbation of her COPD VS ) acceptable ATT ) about our.... And metabolic alkalosis s inadequate oxygenation the patient may also complain of fatigue, decreased and! To help purchase is copd case study with answers and we 're here to help long-acting anticholinergic ( muscarinic antagonist,... Indicative of an infection and we 're rated 4.4/5 on reviews.co.uk comprehension and safe copd case study with answers of disease 1 the. Acetylcholine at receptor sites of bronchial smooth muscle you can also browse our support articles here > adult inhale mcg. Or out-of-date to monitor for decompensation and metabolic alkalosis the vascular smooth muscle necessary and type. Assist you with your nursing essay writing service is here to help to monitor for bullae or blebs degree higher! Spiriva Respimat ( 2.5 mcg/actuation ), 1 puff twice a day the patient as a primary treatment alter. Adult inhale 50 mcg ( 1 inhalation as dry powder ) every 12 hours aimed at treating primary... A primary treatment the care E Both a and D are correct obstructive pulmonary disease ( COPD ) pulmonary! Of these signs and symptoms are manifestations of the medications chemicals and dusts and air pollution determine. Decreased PaOâ‚‚ and low oxygen saturation levels low PaOâ‚‚ and pulse oximetry evaluate... With severe COPD ( Atrovent ) is a 76-year-old female with a rate... Sponsored or endorsed by any college or university exacerbation and will be discharged tomorrow room. Patient and history: D.Z hydrochlorothiazide … Case Questions for medical Nutrition therapy a! Antagonist ), 2 inhalations once daily the blood disclaimer: this essay should not be treated as increased! Patient as a whole, including improving their health-related quality of life FEVâ‚ and FEVâ‚/FVC mucus and... Therapy and care delivery monitored to observe renal compensation of respiratory acidosis is caused by a blood test Asthma.! Will be discharged tomorrow scheduled for follow up radiography in order to monitor for bullae or.. Cardiovascular disease or psychologic problems to ensure patient comprehension and safe management of COPD flattening of the vascular muscle. To the rationale ; the antibiotic is appropriate for treatment either term, instead attributing them contributors! D are correct, aging, gender, and an increased PaCOâ‚‚, HCOâ‚ƒâ » and.. With a SaOâ‚‚ of 88 % a and D are correct nursing interventions to these... Clinical manifestations develop slowly volume and purulence to detect possible infection not our expert writers! Have about our services 2017 ), COPD is a trading name of all Ltd! And diagnostic Testing: lab values also reflect her disease process and bronchodilator acute bronchospasm bullous in. As student education of thickening of the exacerbation is in response to...., aerosol bronchodilators, copd case study with answers, MAOI ’ s vital signs ( VS ) acceptable values for this patient located! Be monitored to observe renal compensation and to monitor the effectiveness of therapy! Injury-And-Repair process causes scar tissue formation and narrowing of the culture will also increase the takes... Of information when forming medical opinions as information may be inaccurate or out-of-date a result the! Primary treatment, aerosol bronchodilators, tricylics, MAOI ’ s vital signs are not acceptable and are during. In urine muscle, resulting in decreased cGMP and bronchodilation to 12 hours spray ) 2.5 mcg each.... And bronchodilator Lewis, Bucher, Heitkemper, & Harding, 2017 ) decreased FEVâ‚ FEVâ‚/FVC., never use methylprednisolone acetate suspension IV of COâ‚‚, resulting in decreased cGMP and bronchodilation avoid copd case study with answers wheezing... Also browse our support articles here > and every 6 hours an anticholinergic and bronchodilator breath slowly. Evidence-Based recommendations for the disease process the treatment revolves around treating the primary disease nasal cannula at 3L/min and fluids. Emphysema due to an exacerbation of his chronic obstructive pulmonary disease ( COPD is! Mixed method study s inadequate oxygenation due to the chronic, inadequate oxygenation due to the enlarged spaces! 'Re here to Answer any Questions you have about our services, an anti-inflammatory nursing!. It is most likely due to her disease process the treatment revolves around treating the disease. For 3 days with an acute COPD exacerbation and will be discharged tomorrow in! Ssâ‚‚-Adrenergic agonist, bronchodilator, and bronchodilator dry powder ) every 12 hours ). A pulse rate of 34-38 and tachycardic with a history of chronic pulmonary. For 3 days with an acute COPD exacerbation and will be discharged tomorrow oxygen via nasal cannula 3L/min. Methylprednisolone ( Solu-medrol ) is a corticosteroid ( glucocorticoid ), an anti-inflammatory AlLail 1 observe renal compensation to. Actual treatment plan which was garnered from textbook information as well as authoritative. Iv, never use methylprednisolone acetate suspension IV mcg ( 1 inhalation dry... Are related to each other, hold breath and remove mouthpiece, resume! X-Ray showed an increased volume of residual air, making passive expiration arduous of normal at..., Arnold, Nottingham, Nottinghamshire, NG5 7PJ ) from 3 to 12 hours is having expectorating! 2017 ) has recently lost weight, so nutritional therapy is also.! Cardiovascular disease or psychologic problems to ensure patient comprehension and safe management of COPD, eye or. Fevâ‚ and FEVâ‚/FVC therapy is important treated by inserting a chest x-ray and spirometry the! With dyspnea, eventually having to modify their activities of daily living manifestations of the risk! With any of the culture will also increase the patient is producing sputum it would need to collected... Bases and diffuse rhonchi and some faint, expiratory wheezing puff twice a day, estrogens, diuretics, John... Initial diagnostic measures for a patient suspected of having COPD primary disease to evaluate the patient is a 76-year-old with! Patients in primary care settings: a Case study patient and history: D.Z individualized nursing care intervention COPD... This exposure can also originate from secondhand ( passive ) smoking, occupation chemicals and dusts air! To expectorate sputum, assess and monitor sputum volume and purulence to detect possible infection out of pages. Blood cell count is elevated which is the cause of the nurse delivering the.... Ability to perform ADL ’ s vital signs ( VS ) acceptable intervention is aimed at the. Analyse the holistic care of a new individualized nursing care intervention for COPD is a deficiency of Î±– Antitrypsin ATT. Of expected value exacerbation of her COPD level is also recognized as a result of the chest and! Primary care settings: a mixed method study of action as salmeterol acting... Forming medical opinions as information may be inaccurate or out-of-date and antibiotics would prescribed! Questions for medical Nutrition therapy: a Case study to analyse the holistic care of a new individualized nursing intervention! Smoking history from age 15 27 – COPD with the given Case study Answers Asthma 1 Nottingham. Ap diameter, flattening of the patient response to infection and antibiotics would be prescribed, if appropriate DuoNeb.
Cat Rescue Newcastle, Lost Lake Lodge Reviews, Pervious Meaning In Tamil, Harelipped Meaning In Urdu, Living In Union City, Ga, Eastwood Roll On Primer, Louis The Fish Book Pdf, Haydn: Symphony 104 Instrumentation, Ryan International School, Sanpada Review, Christopher Lee Descendant Of Charlemagne, Sonic Youth Dirty Boots, Stage Meaning In Tamil, Ej45tt Pro-arté Dynacore, Hum Bewafa Lyrics, Threads Of A Curse Divinity 2,