Copd Case Study

| 1. corticosteroid 2. bronchodilator 3. ACE inhibitor4. cholesterol 5. benzodiazepine 6. potassium sparing diuretic

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.

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

Furosemide 80 mg is a potent diuretic, which may cause the loss of potassium and magnesium.

D.Z., a 65-year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD; emphysema). He has a past medical history of hypertension, which has been well controlled by Enalapril (Vasotec) for the past 6 years. He has had pneumonia yearly for the past 3 years, and has been a 2-pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 F, SaO2 88%. His admitting diagnosis is an acute

It leads to a reduction in supine and standing blood pressure without a compensatory rise in the heart rate (reflex tachycardia). The effect of a single dose is apparent in 1-2 hours and its peak effect is 3-6 hours. The abrupt cessation of Ramipril does not produce a rapid and extreme rebound increase in blood pressure. Ramipril can be used as a therapy for heart failure as the drug has beneficial effects on cardiac haemodynamics. It results in decreased left and right ventricular filling pressures, reduced total peripheral resistance and increased cardiac

Statins are also another type of medication prescribed if you have a high blood cholesterol level, this lowers cholesterol. This medicine blocks the formation of cholesterol and increasing the number of LDL receptors in the liver, which helps remove the LDL cholesterol from your blood. This helps slow the progression of CHD, and will make having a heart attack less likely. However, not everyone is suitable for this medicine.

Angiotension II receptor blockers-decrease chemicals that narrow blood vessels allowing blood to flow easily and decreases salt and fluid build-up. Antiarrhythmic-treat abnormal heart rhythms. Antiplatelet-prevent blood clots. Aspirin- help prevent strokes and heart disease. Beta-blockers-help reduce hypertension and congestive heart

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).

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

The second system we will cover is the Gastrointestional System. All medications in this system were used based upon the manufacturers intended use as referenced by Davis’s Drug Guide. The first medication she was put on relating to the GI system is polyethylene glycol which was used to draw water into the lumen of the GI tract and aid in the evacuation of the GI tract without causing electrolyte imbalance. The teaching that was given to her for this medication was to take the medication until gone even if she is feeling better, avoid alcohol and products that contain aspirin or NSAIDs and to avoid foods that may cause an increase in GI irritation. She was also told to report any black and tarry stools, diarrhea or abdominal pain immediately. The second medication she was put on relating to the GI system was furosemide which was used to prevent edema and encourage excretion of sodium and water (Valerand, 2013). We informed her that she should not double the doses, and that if she started to get a rash, muscle weakness, cramps, nausea, diaainess, numbness or tingling she needed to contact the physician immediately. The final

Therapeutic measures for a patient with congestive heart failure would be daily weights, dietary sodium restrictions, positioning in high or semi-Fowler’s position, frequent vital signs, oxygen by cannula or mask, medical devices: pacemakers, internal cardiac defibrillator, biventricular cardiac pacemaker, ventricular assist device, medications: digoxin, diuretics, inotropes, nesiritide, beta blockers, surgery: heart valve repair or replacement, coronary

In the case study it discusses a patient, Mrs. Harris, who is a 72 year old and is complaining of fatigue and swelling in her feet. Mrs. Harris also expresses her concern on the swelling, as some days she is unable to put her shoes on despite proper elevation. She also states walking to her mailbox can be challenging because it causes her to feel more tired and to have shortness of breath, also known as dyspnea. Mrs. Harris is currently taking medication for high blood pressure, hypertension; and is also drinking approximately 8-12 glasses of wine a week. While examining Mrs. Harris it’s clear she is a little overweight and has swollen ankles. Upon listening to Mrs. Harris’s breathing, crackles are heard. Therefore, Mrs. Harris seems to have congestive heart failure.

Using effective communication skills and easily understood english with Mrs Smith the enrolled nurse will explain what the drug Frusemide is and how the drug works on the body and precautions that Mrs Smith may not be aware of. Frusemide may have been prescribed for Mrs Smith for her history of cardiac failure and hypertension and is usually given in conjunction with a potassium supplement to counteract potassium loss. Frusemide works on the body by preventing reabsorption of sodium, potassium and chloride in the proximal and distal renal tubules but mainly in the ascending limb of the loop of Henle (Tiziani, 2013, p 694). So, rather than being returned to the body the sodium, potassium and chloride are excreted in the urine and where salt