COPD Exacerbations

I will analyse the prevalence of the condition and what the potential causes may be. My interests have been directed to pre hospital care and community lead treatment packages, which are potentially available to the patient, as this is the acute environment, which I will have contact with in my employment as a paramedic. The initial reading was to understand COPD as a chronic condition, what is COPD? and its prevalence in the population. The (World health organisation, 2000), states that one in four deaths in the world are caused by COPD. In 2010 (Vos T Flaxman etal, 2012), says globally there were approximately 329 million, which is 4.8% of the population who are affected by this chronic condition, In the UK (NICE, 2010), have estimated that 3 million people suffer from COPD, with more yet to be diagnosed. This information about the amount of people living with this condition was surprising, as I little knowledge of its existence. During the early 1960’s (Timothy Q. Howes, 2005), says the term COPD had been designated as a single term unifying all the chronic respiratory diseases. Since then the term COPD, has been sub divided in to three umbrella areas, Bronchitis, Emphysema and Chronic asthma, which are separate conditions, which I have been previously aware of as their individual conditions. The 58 year old patient who we visited,

This is a case study on a 76 year old man.Mr Alan Chari(pseudonym used to protect the identity of a patient),was admitted over night in my department.He is a divorcee who stays with son.He is a retired teacher and his son is permanently employed by a local company as an electrician.He is independent with activities of daily livings but is occasionally limited by his ill health.He used to be a heavy smoker .After realising the burden COPD has on general New Zealand population ,affecting about15% of the adult population over the age of 45 years according to asthmanz( 2010) ,l took this case study to gain in-depth understanding.

How would you describe the pathophysiology of COPD and comorbid heart failure to Charlie, considering that he has no medical knowledge/background?

The effectiveness of Family Support Caregiver in improving the Functional Status of Client with Pulmonary Diseases.

I work as a respiratory therapist and treat patients diagnosed with chronic obstructive pulmonary disease (COPD). Smoking is a leading cause associated with developing COPD. As a professional working in the healthcare field, I have been fortunate and educated about the dangers and consequences linked to cigarette smoking. I have treated and have experience with individuals who have smoked and developed COPD. Also, as an educator, I have tried to help individuals quit smoking to improve overall health. As an educator, I view smoking as an addiction to the drug nicotine and managing cravings will help individuals quit smoking.

The World Health Organization (WHO) recognizes dementia as a major public health priority and a significant cause of disability.[1] With the aging of the Canadian population, dementia as a serious public health issue will continue to grow. Several research reports point to a potential link between COPD and the development of cognitive decline.[2-5] Depending on the population group and methodology, about 10 to 61% of COPD patients have cognitive impairment.[2,6] The literature indicates that cognitive impairment in COPD patients may be associated with increased adverse outcomes such as more prolonged hospitalization, difficulty with the instrumental activities of daily living (IADL),[7,8] and trouble with managing their disease and adherence to treatment.[9-11] Moreover, the cognitive impairment could affect the success of pulmonary rehabilitation[12] and smoking cessation programmes[13] in patients with COPD.

All over the world, chronic obstructive pulmonary disease (COPD) is a very significant and prevalent cause of morbidity and mortality, and it is increasing with time (Hurd, 2000; Pauwels, 2000; Petty, 2000). Due to the factor of COPD being an underdiagnosed and undertreated disease, the epidemiology (Pauwels, Rabe, 2004) is about 60 to 85 % with mild or moderate COPD remaining undiagnosed (Miravitlles et al., 2009; Hvidsten et al., 2010).

Unfortunately, there is currently no cure for COPD, but there are medications that are available to help the symptoms and make it easier for the person to breathe. Bronchodilators are a type of medication that will help open the airways to get better airflow. Short acting bronchodilators are used in emergency situations for rapid relief. Some short acting bronchodilators are Albuterol, levalbuterol (Xopenex), and Ipratropium (Atrovent). They can come in an inhaler or in a liquid that can be inhaled from a nebulizer. There are some side effects to the short acting bronchodilators including dry mouth, blurred vision, tremors, tachycardia, or a cough. Long acting bronchodilators help treat the symptoms of COPD over a longer period of time, so it may take longer to see results. Patients can use long acting bronchodilators once or twice a day depended on how bad the symptoms are, which also comes in inhalers or a liquid that can be put in a nebulizer. Some examples of the medication are Tiotropium (Spiriva), Salmeterol (Serevent, Formoterol (Foradil, Perforomist), Arformoterol (Brovana), Indacaterol (Arcapta), Aclidinium (Tudorza). (Mayo Clinic Staff, 2015). Over time these medications will help if the person takes them continually. Long acting Bronchodilators are not used as emergency or rescue medication. Some of the side effects of these medications are dry mouth, dizziness, tremors, runny nose, an irritated or scratchy throat, allergic reactions, blurred vision, and

Based on a case study for a 76 year old female, Betty White, presenting to a medical ward with an acute exacerbation of chronic obstructive pulmonary disease (COPD), this paper will firstly outline a brief summary of COPD and discuss the associated risk factors. Secondly, the patient’s information will be summarised. From the perspective of the primary Registered Nurse, this paper will detail steps of an initial clinical assessment of the patient. In doing this, the priorities and considerations involved in order to provide best patient care for this scenario will be addressed. A discussion of information and suggested interventions will be integrated as to how the nurse shall develop a plan of care. Furthermore, it will outline

Chronic obstructive pulmonary disease (COPD) is a common problem in the elderly, characterized by obstruction of airflow that cannot be fully reversed with inhaler medications, called bronchodilators. It is characterized by intermittent worsening of symptoms and these episodes are called acute exacerbations, in which approximately half are caused by bacteria including Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae and Chlamydia pneumoniae.

Chronic Obstructive Pulmonary Disorder (COPD) is a progressive lung diseases mainly characterized as having emphysema and chronic bronchitis. It is one of the major cause of death and disability in the US.1 In 2011, it was the third leading cause of death in the US. Prevalence of COPD varies by state and was found to be 6.3% (nearly 15 million) amongst the US adults. Despite such high prevalence, it remains undiagnosed or untreated in nearly half of the population.3 Prevalence rate is higher among people over 65 years old, among females, and among non-Hispanic white population.3 It’s one of the major driver for avoidable healthcare costs. It causes long-term disability, early deaths and is an important issue affecting employee health and work-productivity. In 2010, the estimated direct healthcare costs by the National Heart, Lung, and Blood institute was $29.5 billion, where $13.2 billion accounted for hospital care costs, $5.5 billion were for physician services and $5.8 billion were for prescription drugs. The indirect cost estimated due to COPD was around $20 billion, and the number of productivity days lost due to suffering from COPD was higher than any other chronic conditions. ,

Mclvor et al. state that the epidemiology of this disease will continue to change and the number of cases among women will rise (2010). In 1998, the WHO estimated that COPD was the fifth most common cause of death worldwide. (Mclvor et al., 2010) Also, the Global Burden of Disease Studies estimated that COPD would become the third most common cause of mortality by 2020 (Calverley et al., 2003). COPD presents a personal burden. Sufferers of this disease have reported significant disability and restriction as a result of COPD (Calverley et al., 2003). “Patients tend to be slow to seek medical help and are reluctant to press for more public attention to their problems” (Calverley et al., 2003). This is most likely due to the social stigma attached to being diagnosed with a disease. Under diagnosis of this disease is a major problem. In fact, Decramer, Janssens & Miravitlles state that 60-85% of patients (usually with mild to moderate disease) remain undiagnosed

Asthma is one of the main differential diagnosis in COPD exacerbation because of the similarities in the presenting symptoms. The patient complains of a cough and shortness of breath. These are typically seen in asthma but asthma will be ruled out because the cardinal signs that include; wheezing, an intermittent sensation of chest tightness, non-productive cough and a possible trigger such as exposure to allergens (Jo & Laurie, 2014) were not noted in the patient’s H&P or in the health assessment.

Pathological changes characteristic of COPD are found in the airways , lung parenchyma and pulmonary vasculature .These include chronic inflammation, with increased numbers of CD8 lymphocytes in different parts of the lower respiratory system and structural changes which result from repeated injury . Inflammatory and structural changes increase with disease severity and smoking .(43)

We identified 52,612 records. After excluding duplicates, we screened 39,725 titles and abstracts and retrieved 3,114 articles for full text screening. We included 213 quantitative studies eligible reporting patient values and preferences on COPD related outcomes in the systematic review (See Figure 1. Flow Diagram).