Medical Nutrition Therapy : A Case Study Approach

Case Study: D.Q. is a 57-year-old male who worked in a water treatment plant for many years. He also smoked heavily for approximately 30 years. He has been diagnosed with COPD. During an extremely hot summer, he arrived at the emergency department in severe exacerbation of the COPD. The patient’s heart rate is 123, blood pressure is 163/90, respiratory rate is 34, oxygen saturation is 86% on 2 L NC, and temperature is 37.5 celsius.

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.

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

There are no cure for this disease. However, there are different treatment to prevent further deterioration of the lungs function in order to improve the quality of life of the patient by increasing capacity of their physical activity. One of the main severe complication a patient with COPD can develop is exacerbation. Increased breathlessness, increased sputum volume and purulent sputum are the signs and symptoms of exacerbation. Early detection of the signs of exacerbation can help keep the condition of the patient from worsening. The treatments of COPD mainly aims at controlling the symptoms of exacerbation such as taking inhalers. Patients who are over the age of 35 and ex-smokers with chronic cough and bronchitis are recommended to have spirometer (NICE, 2004). This is because it is possible to delay or prevent patients from developing severe case of COPD is identified before they lose their lungs functions. Oxygen therapy is another treatment for COPD as the patients with this condition has high

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).

The study began with 32 patients having stages II to IV COPD. They had to meet the criteria pertaining to the Global Initiative for Chronic Obstructive Pulmonary Disease; total lung capacity >120%, (FEV1/FVC) <70%, FEV1 <80%, RV/TLC >140% and >40% of predicted values in stable conditions. Patients were removed from the study if they had asthma, heart failure, orthopedic impairments of the shoulder girdle, recent surgery, past thoracic fractures, pneumothorax, and claustrophobia.

In both groups of patients at the end of treatment showed no improvement in FEV1 FVC parameters (Table. 3). There were no significant differences in the dynamics of the parameters of respiratory function, so there is no correlation between the level of serum blood interleukin IL-6, IL-8, TNF-a, and treatment between the groups not observed (Table. 3).

COPD is the continued tightening of the airways, causing a blockage to the airflow to the lungs, which causes shortness of breath. It chiefly comprises of emphysema and chronic bronchitis. Both are typically caused by smoking, or less frequently, by work-related exposure to dusts or

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).

Diagnosing COPD is multifactorial, as stated previously, an all-encompassing nursing assessment and patient history must be conducted. When these processes are finalized, and subjective evidence points towards COPD, it is necessary to confirm the diagnosis with objective data. The definitive way to do this is by conducting pulmonary function testing (PFT); specifically, spirometry. On top of diagnosing, spirometry, is also pertinent for staging the patients COPD (Corbridge,et al., 2012). In addition to these facets, there are several other radiologic and laboratory tests that are helpful in determining the severity of COPD; they are not so much diagnostic, as they are informative.

As of not long ago, the significant objective of COPD treatment was the diminishment of side effects. Nonetheless, with the acknowledgment that intensifications of COPD are extremely normal, have a noteworthy antagonistic effect on personal satisfaction, and may speed sickness movement, rules and clinical consideration are concentrating on decreasing future dangers, for example, the counteractive action and treatment of intensifications (2013, August 23). In created nations the hospitalization of COPD patients, brought on transcendently by intensifications, represents over half of direct human services

Emphysema is a lung disease that is classified as a COPD. (Chronic obstructive pulmonary disease)

The Lung Pulmonary Function Test measures the amount of air that is inhaled and exhaled with each breath, it also measures the amount of oxygen that blood receives from the lungs. A Chest X-Ray tests the lungs for emphysema, which can be further diagnosed as COPD. A CT Scan can also be used in order to detect emphysema and determine if you’re eligible for surgery. This scan can also show different types of lung cancer that may have developed. The Arterial Blood Gas Analysis is another form of testing that can be used to diagnosis this disease. This test measures how well your lungs bring in oxygen and release carbon dioxide. In order to check for an Alpha-1 deficiency, a Laboratory Test can be performed. Although there are many forms of diagnosing this disease, there is no actual cure. However, there are many ways to reduce the symptoms which include medicines that can help with specific symptoms, an increase of physical activity, prevention of flare-ups, quitting smoking and inhalation of other harmful substances, and pulmonary