...Health Assessment Case Study Introduction The focus of this case study is to examine further focused assessments that should be undertaken after Mr S's initial presentation of acute exacerbation of asthma. Reasoning for recommended focused assessments will be discussed with consideration of Mr S's presentation of symptoms, history, pathophysiology and risk factors for asthma exacerbation. Research on current asthma assessment protocols will guide recommendations, and assessment parameters will be described. Follow up care and self-management options for Mr S will also be explored. Asthma Asthma is a chronic inflammatory disease of the lungs. It is characterised by airflow obstruction and lung inflammation (Johnson, 2010). Asthma symptoms include wheezing, chest tightness, shortness of breath and cough (Johnson, 2010). Potential triggers for asthma include allergens, viral respiratory infections, irritants, stimuli such as cold air or exercise and gastro-oesophageal reflux (Estes et al, 2013). Airway obstruction in asthmatics is variable and reversible. However poorly managed asthma can leave lasting structural changes in the cells and tissues of the lower respiratory tract, resulting in airway remodelling and permanent fibrotic damage (Kaufman, 2011). There is currently no cure for asthma, therefore the disease needs to be managed (NACA, 2014). Pathophysiology and assessment parameters It is important to understand the underlying pathophysiology of Mr Saunders’ presentation...
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...Six-Year Old Asthma Case Study Week 2 Jacqueline Norton South University October 4, 2014 Advanced Pathophysiology NSG5003 Faculty: Rhonda Johnston CASE STUDY: A 6-year-old boy is being readied for discharge from the hospital. He was hospitalized with asthma for four days and will be using a nebulizer and metered dose inhaler at home. Develop a discharge plan that focuses on patient education, the use of the metered dose inhaler, and when the patient should use the nebulizer. You must include substantive rational for your answers using the readings and interjecting the pathological process resulting from the asthma and how the interventions stop the pathological process. (Grossman, 2013) defines asthma is a chronic disorder of the airways that causes...
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...Asthma Case Study Lisa, a four-year-old with status asthmaticus, is admitted from the emergency room via a wheelchair to a medical pediatric unit. She is accompanied by her parents who both have anxious, tense facial expressions. Lisa’s vital signs are T-36.9° C, P- 140 (apical, regular), R 38 (regular but shallow), BP 118/78. She is pale but has no evidence of cyanosis. Her breath sounds are normal in upper lobes, with inspiratory and expiratory wheezing and scatter crackles in all lobes. Breath sounds in lower lobes are diminished. She has moderate intercostal retractions, some nasal flaring, and an occasionally loose, productive cough. Lisa has thin, whitish nasal discharge and tears are dried on her cheeks. She is irritable and appears frightened. Other significant data include: Wt 19 kg, Hemoglobin 12.5, Hematocit 37.3, theophylline level 10.5 mg/dl before treatment in ER. The chest x-ray films show that her lungs are hyper inflated with some infiltrates but no atelectasis or consolidation. Three days ago, Lisa came home from the day care center with the sniffles. By evening, she had rhinorrhea and a cough but no fever. This developed into a head cold. Two days ago, she helped her father rake leaves and then played in the leaves pile with a friend. About noon today, the day care center called Lisa’s mother because she said she couldn’t catch her breath and was tired. At home, Lisa’s mother gave her an Albuterol treatment, which helped for about 30 minutes...
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...had at Cotabato Regional and Medical Center opened the door of opportunity to experience things that broadened our knowledge and enhanced our skills. We were exposed to different cases of various clients. We became accustomed with the routines in the hospital and interacting with our patients, even with their watchers. We encountered some difficulties and struggles, yet that didn’t hinder us in giving our best to do our job. That exposure gave us an opportunity to handle different cases. With all those we’ve encountered, we chose one to be the subject of our case study. We are presenting to you Bronchial Asthma which is the case of our patient at Medicine Ward Room C whom we will call Mr. Theodore for the purpose of confidentiality. Bronchial asthma is a disease caused by increased responsiveness of the tracheobronchial tree to various stimuli. The result is paroxysmal constriction of the bronchial airways. Bronchial asthma is the more correct name for the common form of asthma. The term 'bronchial' is used to differentiate it from 'cardiac' asthma, which is a separate condition that is caused by heart failure. Although the two types of asthma have similar symptoms, including wheezing (a whistling sound in the chest) and shortness of breath, they have quite different causes. Bronchial asthma is a disease of the lungs in which an obstructive ventilation disturbance of the respiratory passages evokes a feeling of shortness of breath. The cause is a sharply elevated resistance...
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...However, previous studies have shown some association between outdoor air pollution and increasing symptoms, acute exacerbations, hospital admissions, and mortality in patients with pre-existing COPD (Ko & Hui, 2012). A study of hospital admissions related to heart and lung disease observed that there was a 2.5% increase in COPD admissions for a 10 µg/m3 increase in PM10 (Zanobetti, Schwartz, & Dockery, 2000). Another study regarding COPD and hospital admissions found that 10 µg/m3 increase in PM2.5 occurring at lag 0 and 1 day was associated with a risk of approximately 0.9% for COPD hospitalizations (Dominici, et al., 2006). Regarding mortality, a six-city study conducted by Harvard found that adjusted mortality due to cardiopulmonary diseases appeared to increase in areas that had the highest past levels of fine particles and sulphates (Sunyer, 2001). The cities included in the study were Boston, MA, Knoxville, TN, Portage, WI, St. Louis, MO, Steubenville, OH, and Topeka, KS (Sunyer, 2001). Even though there is limited evidence to suggest a causal relationship between urban air pollution and COPD, harmful health effects due to air pollution continues to be an issue (Ko & Hui,...
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...diagnosis in these patients. However, studies have indicated that many physicians treat bronchitis with antibiotics. These drugs have generally shown to become ineffective in patients with complicated bronchitis. A patient satisfaction with their treatment of bronchitis is related to the quality of the physician-patient interaction rather than to the prescription of an antibiotic. Bronchitis Bronchitis is an inflammation of the membrane that lines the air passages, or, bronchial tubes, of the lungs and results in the narrowing of these air passages. This disorder may be of either an acute or chronic type. Irritation of mucus-producing glands within the membrane results in the production of excess bronchial secretions. The main symptoms of bronchitis are cough and increased expectoration of sputum, with or without associated wheezing and shortness of breath. Men are more of a target to bronchitis then most women, men out numbering them 10 to 1 for reasons that are unclear. Acute bronchitis is a self-limited infection of the lower respiratory tract causing inflammation of the bronchi. Acute bronchitis is an acute illness lasting less than three weeks with coughing as the main symptom, and at least one other lower respiratory tract symptom such as wheezing, sputum production, or chest pain. Most coughing, which is a common symptom of acute bronchitis develops in any attempt to expel the excess mucus from the lungs. Other common symptoms of acute bronchitis can include a:...
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...NRSG240 Final Test note CARDIAC NURSING 4 AMI 4 Definition (3marks)- very detailed needed. 4 Clinical manifestations of AMI. (5marks) 4 Nursing Interventions and Rationale for Managing a patient with Acute Chest pain(6marks) 4 and Ineffective Tissue perfusion (6marks) 5 Acute chest Pain 오류! 책갈피가 정의되어 있지 않습니다. 1. PQRST questions to evaluate MI- intensity, location, radiation, duration, precipitation & alleviating factors, in order to accurately evaluate, treat and prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 2. Semi-Fowler’s position & O2 therapy 2L via Hudson Mask in order to increase oxygenation of myocardial tissue & prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Administer medications- Morphin (normally 2.5-5mg) & anginine 600mcg (given every five minutes; maximum 3 tablets in order to relieve/prevent pain & ischemia to decrease anxiety & cardiac workload. 오류! 책갈피가 정의되어 있지 않습니다. 4. 12-lead ECG & monitor in order to check hypotension & bradycardia, which may lead to hypoperfusion. 오류! 책갈피가 정의되어 있지 않습니다. Ineffective tissue perfusion 오류! 책갈피가 정의되어 있지 않습니다. 1. Monitor vital signs (Hourly) and saturation oxygen to determine baseline and ongoing change. 오류! 책갈피가 정의되어 있지 않습니다. 2. Administer oxygen by Hudson’s mask (6-10L/min) and monitor the effectiveness to increase oxygenation of myocardial tissue and prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Monitor respiratory status for sysptoms of heart failure to maintain appropriate levels of oxygenation...
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...Washington Western Governor’s University A1. Description SARS is a viral disease caused by a coronavirus, a viral subgroup that causes of many instances of the common cold. Although SARS’ precise origin isn’t definitively known, all current data points to small mammals know as civets as the most plausible source of human transmission. The outbreak of SARs started in November of 2002 in the Mainland Chinese Province known as Guangdong, where the civets were viewed as a delicacy. In a misguided attempt prevent panic, the Chinese government failed to inform the World Health Organization of the initial outbreak for nearly four months. Subsequently the virus was contracted by 8098 people between November 2002 and June 2003. 774 of these cases proved fatal worldwide. (Trivedi, 2013) The 3 primary factors that enabled SARS to spread so far and so fast were a lack of early reporting by Chinese officials, lack its high virulence, and international flight paths. Early awareness of SARS was severely by attempts at secrecy within the Chinese government in an attempt to prevent panic. This secrecy delayed awareness reaching both the WHO and healthcare staff, who were unaware of SARS virulence and potency. As mentioned, the SARS outbreak originated in the Guangdong Province in China. SARS was easily spread to healthcare staff who in-turn infected their friends, family, colleagues, and other patients. Also, family members would sick patients, and then transport the virus back out...
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...It is devastating to think about not having the right supply of air to help me to breath. How many times we have been told to take care of our body and lungs, and fell to do so. I have learn, not maintaining a healthy way of living dealing with your lungs will led to major problems in the long haul. The disease I will discuss is Chronic Obstructive Pulmonary Disease {COPD}. COPD is the resistance to airflow as a result of airway narrowing. Airway obstruction may result from accumulated secretions, edema, swelling of inner lumen of airway, bronchospasm, or destruction of lung tissue. There three cystic fibrosis that is related to COPD and they are Emphysema, Chronic bronchitis, and Asthma. Chronic Obstructive Pulmonary Disease has a major impact on both physical and psychological well-being {Donna R. Falvo, 420.} Realizing that this is a life-changing condition, with one cure and treatment [makes you think] ‘what does that mean?’ A pulmonologist told me, “That any person that is face with COPD would have to have a lung transplant to get rede of the disease.” The etiology of Chronic Obstructive Pulmonary Disease {COPD} is that cigarette smoking is the number one reason in developing COPD and is ten times likely to develop this disease. Secondhand smoke exposure can also cause COPD. When this happen hyperplasia in our cells produce more mucous, reduced airway due to hyperplasia, reduce ciliary activity that bring up foreign bodies to cough things up. Cigarette smoke will cause...
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...large portions of the population to become very sick, and only killing a small number of those infected. One such communicable disease outbreak was the SARS outbreak from 2003. Analysis of SARS SARS is an acronym for severe acute respiratory syndrome. It was caused by the virus SARS-CoV and was first reported in Asia in February 2003. It then spread to over 20 countries in North America, South America, Europe, and Asia. It was successfully contained in 2004, and there have not been any other cases reported since then. In 2012 the National Select Agent Registry Program declared that the SARS virus is a select agent, which means that it has potential to become a serious threat to public health and safety (Severe Acute Respiratory Syndrome (SARS). 2013). Epidemiological Indicators There are many epidemiological indicators that are associated with SARS. It is important to understand the indicators so that the virus can be correctly identified in possible future outbreaks. The indicators that will be discussed are the incubation period, period of communicability, mode and risk factors for infectious agent transmission, and the significance of animal reservoirs. The incubation period for SARS ranged anywhere between one day and 14 days. Most cases had an incubation period of between four and five days (Kutsar, K. 2004). Most patients started experiencing symptoms around 14 days. As a standard, the World Health organization, or the WHO, has recommended that the maximum...
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...Thesis Statement Writing Tuesday, Jun. 8th 2010 Before you familiarize yourself with thesis statement writing, you need to know what the statement is in the first place. This sentence basically sums up your main objective for writing the term paper, creates a simple guide for the reader and provides the basis for your argument. All in all thesis statement writing is quite simple, as long as you keep some tips and techniques in mind. The first thing you need to do is put together one question which is only possible if you compress the entire thesis. A great way to do this is examine the main topic and create a question out of it. It will give you a basic idea of what the statement should look like and how you should answer that question. The first sentence should introduce the topic and the objective and the next few should spell out how you plan to support your argument. Thesis statement writing, therefore, is about asking yourself the fundamental question that forms the essence of your paper. When you are done writing the statement, step back and examine in from another point of view to determine whether it is strong or weak. A strong statement is one which sparkles with confidence and focuses on one and only one aspect of the issue. This means that you can’t be vague or off-hand about the topic. If you have selected a theme, you should be ready to stand up for it- now is not the time to be diplomatic or meek. In addition to that, it should also spell out the basis for...
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...ASTHMA in Adolescents and Adults ASTHMA in Adolescents and Adults Susan Corbridge and Thomas C. Corbridge ASTHMA in Adolescents and Adults Many individuals suffer from a respiratory condition known as asthma and experience the acute and sometimes chronic effects of this disorder. This disorder often presents itself in an individual exhibiting the hallmark signs and symptoms of breathlessness, wheezing and coughing, due to the airway wall being inflamed and smooth muscle bronchospams. At this time it is imperative to assess the situation and take the appropriate action. Research shows that there is various causes to why inflammation and bronchospasm obstruct the airway, making it difficult to pin point any one cause. This article states that atopy has been identified as a risk factor, as well as exposure to allergens can increase or induce an asthma attack (GINA: the Global Initiative for Asthma, Global strategy for asthma management and prevention). There are many factors that can affect any one person with this condition, such as heredity, obesity, smoke, exercise, upper respiratory tract infections, perfumes and certain occupations can trigger respiratory distress with an asthmatic episode. There are other treatment considerations that evaluate and treating other conditions...
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...Historical Perspectives of the Diagnosis of Asthma in Children 1. Introduction: The causes of Asthma: Looking at some recent reports of asthma disease, most of the acute exacerbation because cold and phlegm caused by dysfunction of the lungs which occurred in sputum of asthma. Chronic repeatedly patients mostly offset organs function. Its complex etiology occurs due to some reasons of genetic, physical fitness, diet, environment, age, and other factors related to work and rest, and emphasize internal and external consistency due to infestation. Asthma patients in the onset of the disease is often accompanied by an abnormal increase in serum IgE, IgE is the primary antibody of Ι type hypersensitivity, when its binding to the antigen, mast cells and basophils release of large amounts of biologically active substances, causing a series Asthma disease symptoms, but also by the synthesis of IgE Ts cell regulation (Huang Zhiying 2011). The physiological basis of Asthma: There are many different causes of bronchial obstruction, which is the synonymous of asthma, such as bronchospasm, abnormalities, new growths, swelling of the bronchial mucosa and so on. Some causes may result in mechanical obstruction by new growth, foreign bodies and congenital abnormalities. There are also some secondary obstructions such as mucous secretions, bronchial mucosa swelling and bronchospasm. The reaction of bronchi to irritation with a kind of inside defense mechanism by human body. To antagonize...
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...Communicable disease outbreak occurs when there is a larger then expected incidence of a disease. It can affect a small group or thousands of people in a region. In some instances even just two independent cases can lead to an outbreak, eventually leading to an epidemic, or pandemic which refers to a global outbreak. Measles is a communicable disease that is highly contagious according to the World Health Organization (WHO). The good news is that it is a preventable disease, because there is a vaccine that is available to prevent people from contracting it. One complication that arises is when some people refuse to immunize their children, (sometimes due to religious reasons or other beliefs) then the risk of an outbreak certainly increases. Another complication is when false information circulates, (for example there was a case where someone claimed that a particular immunization could cause Autism), then people tend to jump to conclusions and are quick to blame others, rather than do their due diligence. Additional complications arise in poor countries where immunization is not readily available, and in cases like these an outbreak is more highly possible. Measles has the following epidemiological indicators which show that it is considered a highly infectious, acute viral illness that is typically confirmed via lab tests. Typically a rash will develop which is known as maculopapular, and will typically last more than three days, in conjunction with a fever of greater...
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...Pediatric Chiropractic Care: Scientifically Indefensible? Published by Sam Homola under Chiropractic,Science and Medicine Comments: 37 In a paper published in 2008, two academic chiropractors offered this observation: “The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions.”1 Despite lack of support by the medical and scientific community, chiropractic treatment of children is growing in popularity, and more chiropractors are specializing in “chiropractic pediatrics.” The International Chiropractic Association offers a post-graduate “Diplomate in Clinical Chiropractic Pediatrics” (DICCP) and publishes a “peer reviewed” Journal of Clinical Chiropractic Pediatrics. The diplomate syllabus is a 30-module, 360+ hours classroom course during weekends over a three-year period. There is no hospital training and no contact with diseased or injured children — only a “mandatory observational/training weekend at a chiropractic center for special needs children under multi-disciplinary care.”2 A post-graduate certification in chiropractic pediatrics (CICCP) can be earned after 180 hours of classroom instruction. In a June 2008 joint press release, the American Chiropractic Association’s (ACA) Council on Chiropractic Pediatrics and the Council...
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