...Com 155 Nicole Thompson Week 7 Essay Draft Restrictive vs. Obstructive Lung Disease Breath in with the weight of a thousand elephant’s, Heart pounding, feeling all is lost, Breath out with the strength of hundreds, Chest throbbing, Wishing nothing more than for the pain to stop, and both are a wasted effort. Feelings of hopelessness, No one can imagine the suffering you are feeling. This is what people go through everyday with restrictive or obstructive lung disease, while both are different they are very much the same and they are deadly however they are treatable as well as preventable. Restrictive lung disease as known as restrictive ventilator defects is where the disease causes the lung to restrict its expansion which makes it los lung volume. Which in other words the lung its self as lost its ability to expand due to lose of tissue or cell stiffening due to invasive environmental factors. Having a restrictive lung disease can make it very hard to breath and impairs the body’s ability to transfer oxygen into the body’s bloodstream. Without having the proper amount of oxygen in our blood our bodies can begin to shut down. Now obstructive lung disease is the opposite, obstructive lung disease is where the lung cannot exhale all the air in the lungs. This can be cause by damage or narrowing of the airways as well as blocked or inflamed airways. We exhale carbon dioxide and not being able to exhale all the...
Words: 1426 - Pages: 6
...Airway/Breathing (Oxygenation) Pneumonia/Chronic Obstructive Pulmonary Disease Clinical Reasoning Case Study STUDENT Worksheet JoAnn Walker, 84 years old Overview 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. Principles of spiritual care are also naturally situated in this scenario to provide rich discussion of “how to” practically incorporate this into the nurse’s practice. Concepts (in order of emphasis) I. Gas Exchange II. Infection III. Acid-Base Balance IV. Thermoregulation V. Clinical Judgment VI. Pain VII. Patient Education VIII. Communication IX. Collaboration I. Data Collection History of Present Problem: Pneumonia-COPD JoAnn Walker is an 84-year-old female who has had a productive cough of green phlegm 4 days ago that continues to persist. She was started 3 days ago on prednisone 60 mg po daily and azithromycin (Zithromax) 250 mg po x5 days by her clinic physician. Though she has had intermittent chills, she first noticed a fever last night of 102.0. She has had more difficulty breathing during the night and has been using her albuterol inhaler every 1-2 hours with no improvement. Therefore she called 9-1-1 and arrives at the emergency department (ED) by emergency medical services (EMS) where you are the nurse who will be responsible for her care. Personal/Social History: JoAnn was widowed...
Words: 2774 - Pages: 12
...makes it hard for you to get air into your lungs. Symptoms of chronic bronchitis include a cough that produces mucus or sputum, trouble breathing and the feeling of tightness in your chest (FamilyDoctor.org, 2014). This form of bronchitis is considered chronic because it can last for a long time. Cigarette smoking is most likely the reason for you getting chronic bronchitis also if you have been exposed for a long time to other things that irritate their lungs, such as chemical fumes, dust and other substances, can also develop chronic bronchitis (FamilyDoctor.org, 2014). If chronic bronchitis does not get the treatment needed it can turn into emphysema and the two diseases form together to be called Chronic Obstructive Pulmonary Disease or COPD. It is common that the signs of Chronic Bronchitis can be ignored and most likely recognized when it worsens. The longer you wait to get treatment, the worse your lungs are get. After doing research, I found that Chronic Bronchitis alone is neither primary, secondary, nor tertiary but is actually described in each form. Primary prevention is accomplished by elimination of exposures that cause these diseases. Secondary prevention involves early detection and intervention among asymptomatic persons. Tertiary prevention is the management of symptomatic disease (NCBI, 2011). Since this disease is widespread, a lot of education as well as social groups have been created to help manage things that can lead up to chronic bronchitis. Counseling...
Words: 860 - Pages: 4
...Chronic Obstructive Pulmonary Disease (COPD; Emphysema) Pathophysiology Abakyereba Kwansemah June 4, 2014 Abstract D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and tiredness. His vital signs (VS) are 162/84, 124, 36, 102° F, SaO2 88%. Admitting diagnosis is chronic emphysema with acute exacerbation. Admitting orders includes: diet as tolerated; out of bed with assistance; oxygen (O2) to maintain SaO2 of 90%; maintenance IV of D5W at 50 ml/hr.; intake and output (I&O); arterial blood gases (ABGs) in AM; CBC with differential, basic metabolic panel (BMP), and theophylline (Theo-Dur) level on admission; chest x-ray (CXR) q24h; prednisone 60 mg/day PO; doxycycline 100 mg PO q12h x10 days, azithromycin 500 mg IV piggyback (IVPB) q24h x2 days then 500 mg PO x 7 days; theophylline 300 mg PO bid; heparin 5000 units SC q12h; albuterol 2.5 mg (0.5 ml) in 3 ml normal saline (NS) and ipratropium 500 mg by nebulizer q4-6h;...
Words: 6939 - Pages: 28
...Final exam study guide: Cancer: Know the difference between Benign and Malignant tumors. Classification of tumors Benign neoplasm Well differentiated Usually encapsulated Kidneys have their own capsule so is easier to catch Expansive mode of growth Characteristics similar to parent cell Metastasis is absent. Rarely recur Classification of tumors Malignant neoplasm May range from well differentiated to undifferentiated Able to metastasize Infiltrative and expansive growth Frequent recurrence Moderate to marked vascularity Rarely encapsulated Becomes less like parent cell Check Moles and Freckles Shows differentiation Hair growing = blood supply = no differentiation = CANCER * Know the warning signs/clinical manifestations of cancer. * CAUTION: * Change in bowel or bladder habits * A sore that does not heal * Unusual bleeding or discharge from any body orifice * Thickening or a lump in the breast or elsewhere * Indigestion or difficulty in swallowing * Obvious change in a wart or mole * Nagging cough or hoarseness Know the different staging, grading and classifications of cancer. Clinical staging classifications * 0: Cancer in situ * 1: Tumor limited to tissue of origin; localized tumor growth * 2: Limited local spread * 3: Extensive local and regional spread * 4: Metastasis * 0 – enclosed extremely localzed * 1 – only in tissue...
Words: 2889 - Pages: 12
...1. The first thing that we would ask the patient is about his sleeping habits. How many hours a night are you sleeping? How often do you get up during the night? Do you have any medical conditions or take any medications? By obtaining a complete health history on the patient we will be better equipped to make a nursing diagnosis. VS and O 2 saturation Pertinent medical history: lung diseases such as asthma or emphysema, diabetes mellitus, hypothyroidism Environmental factors: wood-burning stove, animals in the home (especially birds and cats) Pertinent nasal problems: deviated septum, chronic sinusitis Allergies: particularly airborne particles such as animal dander, dust mites, cockroach droppings Medications he is currently taking: opioids, modafinil (Provigil), amphetamines (prescribed and illegal), OTC drugs, and herbals 2. The two main types of sleep apnea are Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). OSA is the more common type and is usually a result of obesity. Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue. When the muscles relax, your airway narrows or closes as you breathe in, and you can't get an adequate breath in. This may lower the level of oxygen in your blood. Your brain senses this inability to breathe and briefly rouses you from...
Words: 1908 - Pages: 8
...I have learned that too much of anything is bad for you so you always have to keep a moderation of anything and everything. We need saturated and unsaturated fats but we have to understand the common misconception between them. “While it is well known that there are saturated and unsaturated fats, fewer people are aware that unsaturated fats are further classified into two other groups:monounsaturated fats and polyunsaturated fats.” (Saturated Fats vs Unsaturated Fats) There is a third type of fat known as a trans fat. Trans fats are actually a kind of unsaturated fat, but they stand out from other types of fat because they very rarely occur in foods naturally. There is a third type of fat known as a trans fat. Trans fats are actually a kind of unsaturated fat, but they stand out from other types of fat because they very rarely occur in foods...
Words: 1630 - Pages: 7
...NURSING PROCESS PAPER Student Name: Date of Care: 10/14/09 Date of Admission: 10/10/09 I. HEALTH STATUS | Admitting Dx: COPD Exac/Chest Pain | Pt. Init.D.R | Rm No.353 | Age60 | SexM | RaceCaucasion | ReligionCatholic | OccupationDisabled | Surgery: Medical Treatment: Back Surgery/ Coronary Artery Bypass Grafting COPD Exac/Chest Pain | Chief Complaint/Reason for Hospitalization & Hx. of Present Illness (with 1-8 critical characteristics, Jarvis pg. 85) Chest Pain | | 1.Location: Midsternal chest pain radiating to left arm. 2. Quality/characteristics: Squeezing, tightening, felt like chest was going to explode. 3. Quantity: 8 on a scale from 1-10 4. Setting: at rest 5. Associative factors: SOB and nausea 6. Aggravating/relieving factors: Aggravated by activity, unable to relieve in any position 7. Timing (Onset, duration, frequency): Sudden and constant pain 8. Patient perception: Thought he was having a heart attack. | Other illness or conditions & year of onset. | | AllergiesNKA | COPD- 2004 Deep Vein Thrombosis -2002Anxiety-2000Depression-1998Lumbar/Cervical Spondylosis-1982HTN- 19XX-Patient cannot recall exact year | | Immediate Teaching Needs | | Hospital safety- Reminded patient to call for assistance, call light within reach, non skid footwear for reduction of falls. Talked with patient regarding fall safety. Teach non-pharmachological...
Words: 3350 - Pages: 14
...Table of Contents Executive Summary………………………………………………………………………………………...…3 Situation Analysis Market Summary……………………………………………………………………………………..4 SWOT Analysis……………………………………………………………………………………....5 Competition………………………………………………………………………………………....10 Macro-environment……………………………………………………………………………….....11 Target Markets……………………………………………………………………………………....11 Reference Page……………………………………………………………………………………………....12 Executive Summary In this marketing plan I look at Walgreen’s as a company. I analyzed the market as a whole including the demographics, needs, trends, and growth. The strengths, weaknesses, opportunities, and threats are all listed for Walgreen’s and is also compared to some of their competitors. I looked into the macro-markets for Walgreen’s and also the target markets to wrap the entire marketing plan up. I found that Walgreen’s is a very successful company and has done well with their research as far as their customers go. Situation Analysis Market Summary Market Demographics- The market demographics for retail pharmacy are very broad. The market includes all age groups from newborn babies to seniors. The demographics also include all races and genders as well as individuals of all income levels. There are long-term care patients and short-term care patients. There are patients who need health tests, help with choosing an insurance plan, immunization and travel consultations and so much more. Market Needs- The market needs for retail pharmacies...
Words: 3334 - Pages: 14
...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
Words: 72133 - Pages: 289
...Care: 2/9-2/13/15 Facility: Cottonwood Room #: A08 Pt. Initials: Pt. Age: 68 Pt. Gender :M Allergies: Adhesive, Amitriptyline, Hydromorphone, Zolpidem-tartrate, Clindamycin Ethnicity: Cauc. Religion: Protestant Social Support: Wife in Dgo, Education: Police academy Occupation: Retired police Admit Date: 01/26/15 Present Diagnosis: Rehabilitation procedure NEC, Orthopedic aftercare NEC, Depressive disorder, Chronic pain NEC, Hypertension NEC, Insomnia NOS, Alcohol cirrhosis liver. Stump is still draining, swollen (2/19) Code Status: I (full) Reason for admission to Facility: Rehab for AKA (Above the Knee Amputation) Past Medical History (from chart):Chronic pain, traumatic blindness right eye, COPD, Asthma, restless leg syndrome, obstructive sleep apnea, AFIB, sick sinus syndrome, HTN, venous insufficiency, cirrhosis(liver),esophageal varices with bleed. Admitting/ Attending Physician: Dr Andreas/ Burnside Diet ordered:Regular Activity Ordered: Up as tolerated/PT Transfer Assistance: 1-person Toileting:Assist Isolation: No Oxygen: 3 L/min Finger Sticks: NA Vital Signs from Previous Shift: T:98.2f P:84 R:18 BP:129/83 Height: 6’1” Weight:232lbs. BMI:30.6 IV Site: none IV Fluids: none Last 24 hrs intake: na Output: na Patient Introduction (2-3 sentences):RM is a a 68 year old male. A former Los Angeles police sergeant (25 yrs), and most recently a Redi-Mix concrete driver, RM is...
Words: 2041 - Pages: 9
...3 studies and a wave of successful IPOs. Looking to 2014, we think the fundamental backdrop is very similar with 1) beatable revenue growth expectations (2014e: +16% vs. 2012/2013: +12%) including several high-profile drug launches, 2) many pivotal studies set to read out and 3) a stable/favorable regulatory and reimbursement environment. Notably, these factors should continue to make biotech attractive to generalist investors, who played a major role in the 2013 outperformance. Our bias is to stick with large caps as well as mid-caps with approved products; revenue/EPS/cash flow forecasts for 2015 and beyond look broadly beatable, in our view. In contrast, we suspect that “pure pipeline” or tech platform small caps could be more volatile in 2014. We continue to believe that the biotech industry is in the early innings of an innovation cycle with many labelexpansion opportunities and novel agents in phase 2 or 3 trials that are largely unaccounted for in Street models. Hence, we are bullish on the group for 2014. Please join us for a call today at 11am ET to discuss our sector outlook/favorite names (US dial-in: 888-889-1309; OUS: 773-756-0161; Passcode: BIOTECH). Large-cap biotech: We don’t believe that a strict assessment of P/E multiples accurately addresses the nuances of the sector (2014e – Biotech: 22x vs. S&P 500: 15x). In our view, large caps are poised for an inflection point in revenue growth over the next two years, driven by significant drug launches in major therapeutic...
Words: 13041 - Pages: 53
...1 NUR 201 DRUG CARD Student: ________________________ Generic Name: Bupropion hydrobromide________ Trade Name(s): Wellbutrin, Aplenzin, Zyban_ Classification: Antidepressant – atypical (heterocyclic), Aminoketone_____________________________ Administration Routes: PO _√_ SQ ___ IM ___ IV ___ Transdermal ____ Ophth_____ Action: Mechanism of action is not known; the drug does not inhibit MAO, and it only weakly blocks neuronal uptake of epinephrine, serotonin, and dopamine. However, its action is believed to be mediated by noradrenergic and/or dopaminergic mechanisms. Exerts moderate anticholinergic and sedative effects, but only slight orthostatic hypotension. Indications: (1) Treatment of major depressive disorder (immediate-release and extended-release). (2) Major depressive episodes in those with a history of seasonal affective disorder (Wellbutrin XL only). (3) Aid to stop smoking (Zyban only); may be combined with a nicotine transdermal system. Contraindications: Hypersensitivity to bupropion or any ingredients. Seizure disorders; presence or history of bulimia or anorexia nervosa due to the higher incidence of seizures in such clients. Concomitant use of an MAOI. Use in clients undergoing abrupt discontinuation of alcohol and sedatives, including benzodiazepines. Use in clients who have shown an allergic response to bupropion or other components of the various products. Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Zyban all contain bupropion; do not use together. Lactation...
Words: 5771 - Pages: 24
...Impact of the economic recession on the pharmaceutical sector February 2010 I.M. Buysse (UU) Supervised by: R.O. Laing (WHO) A.K. Mantel (UU) WHO COLLABORATING CENTRE FOR PHARMACOEPIDEMIOLOGY & PHARMACEUTICAL POLICY ANALYSIS Impact of the economic recession on the pharmaceutical sector Table of contents Executive summary ................................................................................................................................. 3 Introduction ............................................................................................................................................ 6 Background ............................................................................................................................................. 8 History of recessions ............................................................................................................................................................. 8 Asian Crisis 1997-2000 .......................................................................................................................................................... 9 Economic crisis 2008-2009.................................................................................................................................................. 12 WHO involvement in assessing the impact of the recession .............................................................................................. 14 Hypotheses ...................
Words: 25253 - Pages: 102
...DO NOT delegate what you can EAT! E - evaluate A - assess T - teach addisons= down, down down up down cushings= up up up down up addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia No Pee, no K (do not give potassium without adequate urine output) EleVate Veins; dAngle Arteries for better perfusion A= appearance (color all pink, pink and blue, blue [pale]) P= pulse (>100, < 100, absent) G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent) TRANSMISSION-BASED PRECAUTIONS: AIRBORNE My - Measles Chicken - Chicken Pox/Varicella Hez - Herpez Zoster/Shingles TB or remember... MTV=Airborne Measles TB Varicella-Chicken Pox/Herpes Zoster-Shingles Private Room - negative pressure with 6-12 air exchanges/hr Mask, N95 for TB DROPLET think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19 P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus Private Room or cohort Mask 1 CONTACT PRECAUTION MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis SKIN INFECTIONS VCHIPS ...
Words: 7137 - Pages: 29
