Principles of spiritual care … Use as prescribed. Store at room temperature. Airflow … Potassium depletion, cardiac symptoms, mental status, BP every 4 hours, I&O ratio, adrenal insufficiency& infection, Stevens-Johnson Syndrome, hepatotoxicity, severe and fatal immune-mediated endocrinopathies and enterocolitis, hepatitis, pancreatitis, n/v/d, urticaria, cough, dyspnea, toxic epidermal necrolysis, paradoxical bronchospasm, tremors, anxiety, insomnia. Oxygen therapy is also recognized as a primary treatment. (Skidmore-Roth, 2017)  By combining these bronchodilators, DuoNeb “improves their effect and decreases the risk of adverse effects” (Lewis, Bucher, Heitkemper, & Harding, 2017). Registered Data Controller No: Z1821391. Notify provider if >4 inhalations are needed. COPD-intuition or template: nurses’ stories of acute exacerbations of chronic obstructive pulmonary disease. Answer: E Both A and D are correct. A 65-year-old man with a 60-pack-year history of cigarette smoking presents with worsening exertional dyspnea. The medical treatment section includes the medication, it’s classification, method of action, dose and frequency, as well as the reason the patient is taking the medication. Patient’s ability to self-medicate. Bullae and blebs can form, further decreasing gas exchange and putting the patient at risk of spontaneous pneumothorax. Journal of Clinical Nursing , 756- 764. The patient’s medications, both those used at home and those ordered in the emergency department, are discussed in the medical treatment section. Dose range, route, adverse effects, patient education, implementation, and assessment for these medications are located in table 2 in the appendix. Suspected in patients with a history of smoking, occupational and … Find answers and explanations to over 1.2 million textbook exercises. Radiography is also used to monitor for complications. Administer medications (Solu-medrol and DuoNeb) to promote airway patency and gas exchange. Infection is the … Amnah al-lail 2. Monitor respiratory and oxygenation status to assess need for intervention and give supplemental oxygen therapy as ordered to increase PaOâ‚‚ and improve Oâ‚‚ saturation levels. Booker, R. (2005, 09 09). All work is written to order. The patient was also prescribed DuoNeb solution (500 mcg ipratropium and 2500 mcg albuterol in 3-mL) via nebulizer STAT and every 6 hours. Weldam, S., Lammers, J.-W., Zwakman, M., & Schuurmans, M. (2017). Rock active learning as an educator or if you are a student, use this written case study with fully developed answer … 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. “The primary causes of [COPD] exacerbations are bacterial or viral infections” (Lewis, Bucher, Heitkemper, & Harding, 2017). (Lewis, Bucher, Heitkemper, & Harding, 2017) Chronic inflammation causes structural deviations in the lungs which leads to airflow limitation and obstruction. Chronic obstructive pulmonary disease is “characterized by chronic inflammation of the airways, lung parenchyma (respiratory bronchioles and alveoli), and pulmonary blood vessels [with] not fully reversible airflow limitation during exhalation” (Lewis, Bucher, Heitkemper, & Harding, 2017). Do not use a spacer. This risk factor includes passive smoking since the patient is exposed to environmental tobacco smoke due to her husband’s smoking in the home. COPD case presentation Prepared by: Sara Abudahab, Ala’a Alhayek and Amani Almani Supervised by: Dr. Abla Albsoul Jordan UniversityFaculty of pharmacy 2. The patient is also on supplemental oxygen via nasal cannula at 3L/min and IV fluids of normal saline at 80 mL/hr. By Keith Rischer March 27, 2018 February 1st, 2019 No Comments. Chronic obstructive pulmonary disease (COPD) is a group of common chronic … The patient’s hemoglobin level is also increased. It is used to prevent bronchospasm in COPD patients and maintains improvement in forced expiratory volume (FEV) from 3 to 12 hours. For evidence of allergic reactions or palpations. Recommend a “diet high in calories and protein, moderate in carbohydrate, and moderate to high in fat” (Lewis, Bucher, Heitkemper, & Harding, 2017). The patient will also have a decreased FEV₁ and FEV₁/FVC. (Lewis, Bucher, Heitkemper, & Harding, 2017), Risk factors for COPD include exposure to noxious particles, especially cigarette smoke. Ms Aaliyah Abimbola. Monitor the effectiveness of this therapy via ABGs and pulse oximetry to evaluate the patient response to therapy. The patient has recently lost weight, so nutritional therapy is important. (Lewis, Bucher, Heitkemper, & Harding, 2017) The patient also has a low PaOâ‚‚ and low oxygen saturation. a 65 year old man is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD). Use only Solu-Medrol IV, never use methylPREDNISolone acetate suspension IV. The patient is tachypneic with a respiratory rate of 34-38 and tachycardic with a pulse rate of 118-124. 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). Decreased lung markings are due to the enlarged air spaces. Free resources to assist you with your nursing studies! Chronic obstructive pulmonary disease (COPD) is a progressive disease state characterized by airflow limitation that is not fully reversible. Additional nursing interventions to increase these abnormal lab values are patient positioning and pursed-lip breathing. 4668 words (19 pages) Nursing Essay. St. Louis: Elsevier. Danielle McGarry Introduction The patient is a 76-year-old female with a history of chronic obstructive pulmonary disease (COPD). The patient reports an increasing use of oxygen in the home over the past five years and is requiring at least 2L/min continuously over the last year. (Lewis, Bucher, Heitkemper, & Harding, 2017). COPD Case Study - Winter 211 From BCP 323-3797 Chandler Bing is a 52 year old male admitted for management of influenza B. Pt is a current smoker with a 4Opkyr history. The patient’s HCO₃⁻ should also be monitored to observe renal compensation and to monitor for decompensation and metabolic alkalosis. Nursing Essay Both of these medications are indicated for COPD, though Albuterol is short acting (SABA) and specifically targets acute bronchospasm. However, the current definition does not include either term, instead attributing them as contributors to the disease process. The patient’s symptoms include patient report that she feels, “anxious, more fatigued than usual with a very poor appetite”, as well as increasing dyspnea described as “really bad now, I can’t breathe”. The patient’s white blood cell count is elevated which is indicative of an infection. When cor pulmonale occurs secondary to another disease process the treatment revolves around treating the primary disease. The patient uses Serevent Diskus DPI (50 mcg/inhalation), 1 puff twice a day. All of these signs and symptoms are manifestations of the patient’s inadequate oxygenation due to an exacerbation of her COPD. If increased Oâ‚‚ therapy of more than 35-50% is ordered, use a humidification or nebulization device to prevent drying secretions and mucous membranes. The patient should also use spirometry to measure their FEV₁/FVC ratio to monitor the effects of the medications. Instructions: Answer the questions below. Immediately report dyspnea after use if  ≥ 1 canister is used in 2 months time. Avoid getting aerosol in eyes. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. hospital for 3 days with an acute COPD exacerbation and will be discharged tomorrow. Assess for co-morbidities such as osteoporosis, cardiovascular disease or psychologic problems to ensure patient comprehension and safe management of disease. Drug-drug interactions. VAT Registration No: 842417633. Outline Patient presentation COPD assessment according to GOLD 2017 Pharmaceutical care plan Smoking cessation Newly approved drugs for COPD … Patient is dyspneic with diminished lung sounds in the bases and diffuse rhonchi and some faint, expiratory wheezing. One study of patients reviewed at 14.5 years after stopping smoking showed … Company Registration No: 4964706. Chronic cough can cause excess mucus production. Case Study Heart Failure with answers.docx. The patient should have continued radiography in order to monitor for bullae or blebs. Not for treatment of acute exacerbations. 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. Auscultate breath sounds, noting areas of decreased or absent breath sounds and adventitious sounds to obtain ongoing data on patient’s response to therapy. Chronic obstructive pulmonary diseases (COPD) Adult Case Study Explain the role of smoking in the pathogenesis of COPD. Low levels of ATT can be detected by a blood test. The results indicated “the nurses described the intervention as a useful, structured and individualized tool to guide COPD patients in living with the consequences of COPD” (Weldam, Lammers, Zwakman, & Schuurmans, 2017). Start studying COPD Case Study. These interventions and additional interventions are discussed during nursing and medical treatments for the disease process. It has the same method of action as Tiotropium, inhibiting acetylcholine at receptor sites on bronchial smooth muscle, resulting in decreased cGMP and bronchodilation. Breath in slowly and deeply, hold breath and remove mouthpiece, then resume normal breathing. Avoid smoking. Applied Nursing Research, 33, 85-92. This medication has drug-drug interactions with CPY3A4 inhibitors, aerosol bronchodilators, tricylics, MAOI’s and ß-blockers. (Lewis, Bucher, Heitkemper, & Harding, 2017) (Skidmore-Roth, 2017) Emergency Department: The patient was prescribed Solu-medrol, 50 mg IV, every 6 hours. View Notes - Unfolding Case Study Pneumonia-COPD Case Study (with answers)(3)(1)(1)(1)(1) (1).docx from NURSING 13 at Riverside City College. Estimated to be the third leading cause of death by 2020. Store at room temperature in a light resistant container. He has 10-year history of hypertension. COPD/Pneumonia SKINNY Reasoning Case Study Presentation. She has been in the hospital for 3 days with an acute COPD … This drug can cause paradoxical bronchospasm with dyspnea, wheezing, and chest tightness. She states that she always removes her nasal cannula before smoking. Her oxygen saturation is low with a SaOâ‚‚ of 88%. The patient needs to be monitored for signs and symptoms of pneumothorax such as decreased movement of the chest wall and hyperresonance to percussion. Provide the patient with printed information on nutrient dense foods to promote adequate nutrition. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date. The patient’s FEV₁ was 40% of expected value. Michael Nastase Date 09/29/20 Asthma and COPD Case Study Answers Asthma 1. 04.37 Chronic Obstructive Pulmonary Disease (COPD) Case Study (60 min) 04.45 Preeclampsia (45 min) 04.11 Emergent Delivery (OB) (30 min) Background information for the assignment. Do you have a 2:1 degree or higher in nursing or healthcare? The inflammatory response occurs throughout the airways, parenchyma, and pulmonary vasculature Because of the chronic inflammation and the body’s attempts to repair it, narrowing occurs in the small peripheral airways. It is not used for acute exacerbations. Some nursing interventions also focus on self-management of COPD exacerbations and “are aimed at helping patients to recognize and respond promptly and appropriately to an exacerbation” (Booker, 2005), though it was also stated that the effectiveness of self-management has not been proven (Booker, 2005). Acidosis is also indicated by the patient’s increased carbon dioxide. Chest x-ray and spirometry are the most appropriate initial diagnostic measures for a patient suspected of having COPD. It is the aim of this case study to analyse the holistic care of a patient with severe COPD. Use the “5 A’s” (ask, advise, assess, assist and arrange) to assess patient willingness to quit smoking. A bit more about Jim: Medical history: COPD… Early signs include chronic cough, usually with sputum production and dyspnea, especially upon exertion. Please print the questions out with your answers … Hypoxemia and hypercapnia may result from decreased gas exchange. Case Questions for Medical Nutrition Therapy: A Case Study Approach 4th ed. Air becomes trapped in the lungs which creates gas exchange abnormalities, and an increased volume of residual air, making passive expiration arduous. It is used to decrease inflammation for management of acute exacerbation of COPD. Oxygen therapy is also used to correct hypoxemia. (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). If cor pulmonale is suspected an ECG may also be used to detect right-sided enlargement and BNP levels can be monitored since increased BNP levels indicate increased stretch.  The lab values should also continue to be monitored. ... Clinical Case Study on COPD. 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