Interstitial Lung Disease

Acute bronchitis is one of the most common diagnoses encountered in a primary care setting. It affects millions of individuals resulting in significant impact on health of patients and health care industry. Studies have shown that 90% of times acute bronchitis is caused by a virus, yet health care providers are failing to treat or manage these patients with appropriate therapies (Knutson & Braun, 2002). The focus of this paper is to review the guidelines for treatment of acute bronchitis after differentiating acute bronchitis from other common respiratory disease in terms of epidemiology, pathophysiology, clinical features, diagnosis, differential diagnosis, complications and patient education. Understanding the evaluation and treatment guidelines, nurse practitioners can provide evidence-based practice for patients with acute bronchitis.

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Data: Pulmonary function testing dated 2010 showed moderately severe obstruction with positive bronchodilators response. Normal lung volumes. Evidence of air trapping. Severely reduced diffusing capacity for carbon monoxide.

History of Present Illness: Ms. Babula is a very pleasant 76-year-old woman who was previously seen in this office by Elvira Aguila, MD for moderate COPD by pulmonary function testing in 2010. She is currently on monotherapy with Atrovent p.r.n. and she has not used her bronchodilators for quite some time. She does have some stable dyspnea on exertion, which does not limit any of her activities. She does take care of an 18-month-old child as well. She denies any cough, though she does feel that she has some chest congestion in the morning. She denies any chest pain or wheezing.

The Gulf War Syndrome has over 20 symptoms that have been reported by the veterans of the Gulf War. According to Stephen Straus in the journal The Lancet, over 50,000 troops returned as changed men. Reports showed of vascular instability, hyperventilation, bacilliuria, and other physiological and laboratory anomalies in the Gulf War veterans. When the problem began to exist, the US alone funded $ 115,000,000 for targeted research on the unknown syndrome. Four thousand gulf war veterans and men who also served in Bosnia were mailed questionnaires about deployment, exposures, symptoms, and illnesses. The main finding was that the Gulf War

BB, 86, presented to EMCH with pneumonia and a history of COPD and heart failure. The chief complaint for admission was shortness of breath and chest pain. She was put on many medications to help her conditions. A patient with COPD has weakened lungs already so getting control over her pneumonia was that much more important. General overall health is key to preventing infections in COPD patients (Faris, 2012).

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.

Due to the extent of combat warfare that soldiers endure, “military personnel are sustaining TBIs at unprecedented rates due to the style of warfare” such as explosives, which is only the beginning of the problem (Wolf et al., 2012). The main concern related to the soldiers who sustain TBIs is the extent of their physical and

Conscription leads to many health issues. During the War on Terror and Iraqi Freedom, many countries sent their troops to the middle east. The large military’s had limited training on desert survival due to the large military’s, this lead to a large number of heat strokes and heat exhaustion. Multiple gas chemicals were also used by these military’s to give them the upper hand, but this lead to a number of birth defects and

The World Health Organization (WHO) (2006A) defines COPD as a disease state characterized by airflow limitation that is not wholly reversible. The airflow limitation is usually both progressive and associated with abnormal inflammatory response of the lungs to noxious particles or gases. John's chronic bronchitis is defined, clinically, as the presence of a chronic productive cough for 3 months in each of 2 successive years, provided other causes of chronic cough have been ruled out. (Mannino, 2003). The British lung Foundation (BLF) (2005) announces that chronic bronchitis is the inflammation and eventual scarring of the lining of the bronchial tubes which is the explanation for John's dyspnea. The BLF (2005) believe that when the bronchi become inflamed less air is able to flow to and from the lungs and once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced. This increased sputum results from an increase in the size and number of goblet cells (Jeffery, 2001) resulting in John's excessive mucus production. The lining of the bronchial tubes becomes thickened and an irritating cough develops, (Waugh & Grant 2004) which is an additional symptoms that john is experiencing.

Bronchiolitis is defined by the textbook as, “a diffuse, inflammatory obstruction in the small airways or bronchioles occurring most commonly in children” (Heuther & McCance, 2012). It is an acute inflammatory disease of the lower respiratory tract that occurs most commonly in infants and is caused by infection with seasonal viruses such as respiratory synctial virus (RSV) (Zorc & Hall, 2010). Bronchiolitis often results from an obstruction of the small airways. It is the leading cause of infant hospitalization in the United States (Zorc & Hall 2010) and is arguably the most common significant medical illness of childhood, with at least “1 in 7 normal infants developing symptomatic bronchiolitis in his or her first year of

Military recruits are uniquely susceptible to respiratory infections. This is largely attributed to factors associated with a shared, closed environment, greater than usual social proximity, as well as physical and mental stress during

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.

While obstructive and restrictive respiratory diseases both present with the same main symptom of a shortness of breath with physical exertion (David Ebner, 2016), they are mechanically different. An obstructive lung disease encompasses the respiratory conditions where, after a full exhalation, a significant amount of air remains in the lungs. This remaining air cannot be exhaled owning to narrowed pulmonary airways (The Lung Institute, 2016). Common obstructive lung diseases include chronic obstructive pulmonary disease (COPD) and asthma (Harpreet Ranu et al., 2011). A restrictive lung disease, however, describes conditions where the total lung capacity is abnormally low (Klaus-Dieter Lessnau, MD, FCCP et al., 2016). Pulmonary fibrosis (the diagnosis of RL) is a common example of a restrictive lung disease (Harpreet Ranu et al., 2011).

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity