Chronic Obstructive Disease: Article Analysis

Chronic Obstructive Pulmonary Disease also known as COPD, is one of the third leading cause of death in the United States (National Heart Lung and Blood Institute [NHLBI], 2013a). According to the Centers for Disease Control and Prevention (CDC) (2015) approximately 15 million Americans are affected by COPD, with a morbidity rate of 6.8 million. Data from the CDC from 2011 states that 6.3% of the U.S population suffer from this disease; Florida has the COPD prevalence rate of 7.1% with the highest percentage going to Kentucky with a rate 9.3% as summarized by the COPD foundation (2015). CDC calculated the cost of having COPD as $32.1 billion in 2010 and they expect it to rise to $49 billion by 2020, all for a disease that could be prevented. Additionally CDC has stated the mortality rate has decreased in men in the United States from 57.0 per 100,000 to 47.6 per 100,000 from 1999 to 2010. However, regarding the rate for women, there has not been much change during the same time period. The rate shifted from 35.3 per 100,000 to 36.4 per 100,000 (CDC, 2014).

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

R.W. appears with progressive difficulty getting his breath while doing simple tasks, and also having difficulty doing any manual work, complains of a cough, fatigue, and weight loss, and has been treated for three respiratory infections a year for the past 3 years. On physical examination, CNP notice clubbing of his fingers, use accessory muscles for respiration, wheezing in the lungs, and hyperresonance on percussion of the lungs, and also pulmonary function studies show an FEV1 of 58%. These all symptoms and history represented here most strongly indicate the probability of chronic obstructive pulmonary disease (COPD). COPD is a respiratory disease categorized by chronic airway inflammation, a decrease in lung function over time, and gradual damage in quality of life (Booker, 2014).

* COPD: Chronic obstructive lung disease decreases the lungs ability to exchange carbon dioxide for oxygen. As the disease progress the patient has to work harder and harder to breathe often feeling as if they are suffocating. These disease are often link to a lifetime of smoking but be due to environmental factors.

Chronic obstructive pulmonary disorder, or COPD, is a relatively common chronic illness that is treatable, however there is currently has no cure. COPD is an illness that encompasses two major illnesses these illnesses are chronic bronchitis and emphysema. Both of these illnesses wreak havoc on the lungs of the affected person by causing mucus to build up in the bronchioles henceforth reducing the effectiveness of the alveoli which impairs gas exchange. According to the American Lung Association, “COPD is the third leading cause of death in the United States. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it” (American Lung Association [ALA], n.d.). As this data from the American Lung Association shows, in the United States alone we may have a total of 35 million people (almost one tenth of the American population) living with COPD. QSEN, which stands for Quality and Safety Education for Nurses, has developed six competencies related to nursing care. These competencies are Patient-Centered Care, Teamwork and Collaboration, Evidence-Based Practice, Quality Improvement, Safety, and Informatics. These aforementioned QSEN competencies break down how nurses should be treating patients and working with the health care team.

Chronic obstructive pulmonary disease (COPD) is in the top five principal cause of death in the U.S. The disease is an abnormal inflammatory reaction in the lungs with limited airflow. COPD characteristically arises around the age 35. Smoking continues to be the main source of COPD, but is not the only known root cause. In many studies, smoking explanations for at least three fourths of COPD cases ("Chronic obstructive pulmonary disease | University of Maryland Medical Center," n.d.). Stopping smoking has been known to improve lung capabilities and help to prevent death from COPD. Genetic conditions and introductions to airborne toxins, irritants and gasses are correspondingly involved in the growth of the illness. A complete treatment plan could comprise of lifestyle changes, one or more medications, patient education, oxygen therapy respiratory rehabilitation, and surgery ("Chronic obstructive pulmonary disease | University of Maryland Medical Center," n.d.).

COPD is a disease that depletes a person of air. This disease is the fourth top cause of death in the United States. COPD describes several lung diseases including emphysema, chronic bronchitis, refractory asthma, and other forms of bronchiectasis. There is no average case, as every case is different from the next. This disease is long term but treatable.

One of the main and most frightening symptom in COPD is breathlessness. The sensation of being unable to catch ones breath is uncomfortable and painful. It can increase over time and patients may also suffer with acute exacerbations.(Ek et al. 2010; Sculliion & Holmes, 2011) The actual feeling of breathlessness has been described as being similar to an anxiety attack, but is exacerbated by the patients fear and worry that their next breath will be their last. (Ek et al. 2010) The secondary effects of breathlessness can be quite similar to feelings experienced in the grieving process (Kubler-Ross, 1969) in that the

Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992).

During the second week of my clinical rotation, I had the privilege of being with the respiratory department, as a result of that my research of the Continuity of Care topic will be based on the topic of COPD (Chronic Obstructive Pulmonary Disease). COPD patients are usually readmitted due to acute exacerbations also known as (AECOPD). (Laverty et al., 2015). In this paper, we explore the COPD discharge care bundles which have been developed by different authors. The care bundle consists of a short list of certain evidence-based practices to be utilized or implemented before discharge for all patients who have been admitted with COPD, based on reviewing national guidelines, evidenced based practices, expert opinion, other relevant literature, peer-reviewed journals and patient consultation. (Hopkinson et al., 2012).

Quitting cigarette smoking: The most effective and important treatment for COPD is to quit cigarette smoking. Patients who continue to smoke will have rapid deterioration in lung function in comparison to those who quit. The aging process itself can cause a very slow decline in lung function. Cigarette smoking can result in a

COPD is chronic obstructive pulmonary disease is an “advanced” heart disease that makes it hard to breathe.” Advanced” means the disease get worse over the time. COPD affect the lungs, the air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes or airway. This airways and air sacs are elastic, when you breathe in; each air sac fills up with air like a small balloon and when you breathe out, the air sacs collapse and the air goes out. The air you breathe in is oxygen and the air you breathe out is carbon dioxide. In COPD, less air flows in and out of the airways because of one or more of the following reasons:

The main characterizing feature of Chronic obstructive pulmonary disease is that there is limitation of airflow because the smoke of cigarette directly damages the epithelial cells of the

Chronic Obstructive Pulmonary Disease, also known as COPD, is the third leading cause of death in the United States. COPD includes extensive lungs diseases such as emphysema, non-reversible asthma, specific forms of bronchiectasis, and chronic bronchitis. This disease restricts the flow of air in and out of the lungs. Ways in which these limitations may occur include the loss of elasticity in the air sacs and throughout the airways, the destruction of the walls between air sacs, the inflammation or thickening of airway walls, or the overproduction of mucus in airways which can lead to blockage. Throughout this paper I am going to explain the main causes, symptoms, diagnosis, and ways to reduce COPD.

“Teaching patients about promoting, maintaining, and restoring their health is a required nursing skill that most often results in a positive outcome, enhancing the patient 's quality of life” (Lewis et al., 2014, p.52). The intent of this analysis is to educate patients with chronic obstructive pulmonary disease on means that can enhance their quality of life and avert the progression of their disease. More specifically, it will focus on the aspect of teaching Mrs. N, a patient, how to effectively handle certain symptoms experienced with techniques like pursed-lip breathing and also, to upsurge the client’s awareness on preventative measures to abate the possibility of acute exacerbations. Mrs. N is a 100-years-old woman of Canadian and Arabic background. In mid-September, she was rushed to the hospital after experiencing worsening dyspnea and a fever. The doctors deduced a diagnosis of pneumonia and therefore, she was transferred to the medical unit at the Lakeshore hospital in order to be treated with intravenous antibiotics. Mrs. N has a past medical history of chronic obstructive pulmonary disease, hypertension, anemia, deep vein thrombosis and mixed dementia. Mrs. N is a retired widow with two daughters, who come and visit her on a daily basis at the hospital and encourage her to mobilize and eat because she has an extremely poor appetite on most days. She’s well cared for by a team of care workers in the nursing home where she lives and her daughters and