Chronic Obstructive Pulmonary Disease Case Study

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.

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).

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).

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

History of Present Illness: Ms. Manock is a very pleasant 60-year-old woman with a history of severe COPD. She was previously seen by Elvira Aguila, MD. Her last office visit was in February 2015. Since that time, she states that over the last few weeks, she feels her dyspnea has worsened which is a result of increased humidity, which is normal for her. She has had a stable cough over the last six months, which is intermittently productive of sputum. She is using her supplemental oxygen at 2 L/minute with exertion and with sleep. She also notes postnasal drip, which is related to seasonal allergies.

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.

Have you ever known a person who smokes and has a hard time doing every day activities, due to difficulty of breath, or constantly coughing. He or she may have Chronic Obstructive Pulmonary Disease, or COPD. COPD is a progressive and treatable lung disease that causes shortness of breath due to obstruction of air way (COPD, 2013). Progressive means that is gradually gets worse over time. It is a combination of chronic bronchitis and emphysema (Causes,2014). Chronic bronchitis is inflammation of the bronchioles, which causes mucus build up (Davis,2016). Emphysema is when the air sacs get enlarged (Smoking, 2016). Since the disease does not have a cure yet it is important to know pathology (path of disease), epidemiology (who is effected in a population), ethology (who is effected genetically), manifestation (symptoms), treatment, and outcome.

c. 34 years old male who complained of shortness of breath. He was obese and had a history of COPD. He was on two liters nasal cannula. After admitting at the ER, he was tranfered to med-surge floor for further evaluation.

2. Patient is experiencing acute pain r/t coughing and deep breathing aeb wheezing in the right and left upper lobes of the lungs.

The information collected in the history was highly suggestive of COPD. One of the best predictors of airflow obstruction was the patient’s smoking history (Qaseem, et al., 2011, pp. 181). According to Qaseem, et al. (2011), the presence of the patient’s smoking history and wheezing on physical examination is indicative of airflow obstruction (pp. 181). Additionally, the patient’s presenting complaint was dyspnea on exertion, which is one of the most commonly presenting complaints in patients with COPD (Boardman, 2013, pp. 446). The chronic nature of the patient’s cough and slow progression of symptoms are consistent with a diagnosis of COPD rather than asthma. Finally, the diminished breath sounds on auscultation is indicative of airflow obstruction and considered to be a reliable finding in the diagnosis of COPD (Boardman, 2013, pp. 447). In addition to the new diagnosis of COPD, the patient also had current diagnoses of hypertension, hyperlipidemia, and osteoarthritis.

This is 51 year old AAF. Patient is here complaining of several issues as listed. Patietn reports for the past several days she had increased SOB at rest, non-productive cough, adiouble wheezes. Patient denies chest pain, N/V/ D. Patient is a current tobacco user wit 20 pack year hisotyr. Denies use of alcohol or illicit drug use. Denies depressive moods, current pain 3/10.

The patient is a 61-year old female who has a history of Chronic Obstructive PulmonaryDisease (COPD), hypertension, Coronary Artery Disease (CAD), and anxiety. The patient is familiar with the diagnosis and illnesses that have been contracted over the years and is knowledgeable about the disease processes, medications, and signs and symptoms of each disease. The patient came into the emergency department presenting with dyspnea, chest pain, weakness, and severe wheezing. The patient was diagnosed with an onset of a COPD exacerbation. During the hospital, stay chest x-ray and respiratory panel was done, showing positive for pneumonia. The patient continued to stay at the hospital until oxygenation status improved and the course of IV antibiotics

“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

A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right

There are multiple questions that can be drawn from this case study; chronic obstructive pulmonary disease (COPD) clients, will always have multiple readmissions as oppose to other patients with diagnosis. “If all readmissions were counted regardless of diagnosis, one out of five index admissions for COPD (20.5 percent) were followed by a readmission within 30 days (Elixhauser, Au, and Podulka, 2011). Mary’s history of diabetes; the sole care taker of her ailing husband and an untimely recommendation of transitioning to a skilled facility, put her at risk for some kind of psychosocial issue, for example depression. Also, her days are stressful, and she has no family support. Care givers do need to take a break periodically, or they will