(Skidmore-Roth, 2017) By combining these bronchodilators, DuoNeb “improves their effect and decreases the risk of adverse effects” (Lewis, Bucher, Heitkemper, & Harding, 2017). In COPD, the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Estimated to be the third leading cause of death by 2020. Powerpoint slides for COPD with the given case study by using CRC. It is the aim of this case study to analyse the holistic care of a patient with severe COPD. This LABA increases levels of cAMP, which relaxes pulmonary smooth muscle. Her blood oxygen level is chronically low which is compensated by her body increasing the amount of red blood cells in an attempt to carry more oxygen. Chronic obstructive pulmonary diseases (COPD) Adult Case Study Explain the role of smoking in the pathogenesis of COPD. *You can also browse our support articles here >. The patient is still within normal BMI range at 19 but has lost 4kg (8.8lbs) in three months. If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! Air becomes trapped in the lungs which creates gas exchange abnormalities, and an increased volume of residual air, making passive expiration arduous. Cigarette smoke comprises of extremely high concentration of … Other risk factors include reoccurring respiratory tract infections in childhood, tuberculosis, asthma, aging, gender, and genetics. 12th Feb 2020 Patient is dyspneic with diminished lung sounds in the bases and diffuse rhonchi and some faint, expiratory wheezing. COPD case presentation Prepared by: Sara Abudahab, Ala’a Alhayek and Amani Almani Supervised by: Dr. Abla Albsoul Jordan UniversityFaculty of pharmacy 2. She uses BiPAP ventilatory support at night when sleeping and has requested to use this in the emergency department due to shortness of breath and wanting to sleep. Search. Administer medications (Solu-medrol and DuoNeb) to promote airway patency and gas exchange. In a study conducted by Kollert et al, they confirmed the high prevalence of anemia of 14.9% and it’s association with reduced survival of COPD. The patient’s pH is low at 7.25 which indicates acidosis. This drug can cause paradoxical bronchospasm with dyspnea, wheezing, and chest tightness. A 65-year-old man with a 60-pack-year history of cigarette smoking presents with worsening exertional dyspnea. COPD case presentation by Amnah AlLail 1. The patient reports an increasing use of oxygen in the home over the past five years and is requiring at least 2L/min continuously over the last year. COPD case presentation 1. A 74-year-old causation male with a diagnosis of pulmonary emphysema ,he was seen in the emergency department with a … There is minimal consolidation in the right upper lung. Digital Edition: Diagnosis and management of COPD: a case study 04 May, 2020. Potassium depletion, cardiac symptoms, mental status, BP every 4 hours, I&O ratio, adrenal insufficiency& infection, Stevens-Johnson Syndrome, hepatotoxicity, severe and fatal immune-mediated endocrinopathies and enterocolitis, hepatitis, pancreatitis, n/v/d, urticaria, cough, dyspnea, toxic epidermal necrolysis, paradoxical bronchospasm, tremors, anxiety, insomnia. State your rationale. Please print the questions out with your answers … The patient is also on supplemental oxygen via nasal cannula at 3L/min and IV fluids of normal saline at 80 mL/hr. Monitor the effectiveness of this therapy via ABGs and pulse oximetry to evaluate the patient response to therapy. “The main function of ATT, an α₠-protease inhibitor, is to protect normal lung tissue from attack by proteases during inflammation related to cigarette smoking and infections. Late in COPD, pulmonary hypertension may occur as a result of thickening of the vascular smooth muscle. Provide the patient with printed information on nutrient dense foods to promote adequate nutrition. Summary of in-patient admission: Susan M. is being discharged today following a 6-day ICU and step-down admission for acute exacerbation of COPD … Radiography is also used to monitor for complications. “The primary causes of [COPD] exacerbations are bacterial or viral infections” (Lewis, Bucher, Heitkemper, & Harding, 2017). This intervention was developed to meet the health needs of COPD patients “such as the need of a better understanding of the sustained symptom burden, physical limitations, and psychological impact of COPD” (Weldam, Lammers, Zwakman, & Schuurmans, 2017). The patient states that she, “only smokes a little to calm her nerves” though her husband still continues to smoke in the home. Medical-Surgical Nursing Assessment and Management of Clinical Problems. Infection is the … a. Patient’s ability to self-medicate. If increased Oâ‚‚ therapy of more than 35-50% is ordered, use a humidification or nebulization device to prevent drying secretions and mucous membranes. Nursing Essay View professional sample essays here. No plagiarism, guaranteed! Avoid OTC medications. CASE STUDY 2 COPD Case Study Case Mr. H.B is a 68-year-old African American widower. Try our expert-verified textbook solutions with step-by-step explanations. This will also increase the patient’s FEVâ‚ level. Ms Aaliyah Abimbola. St. Louis: Elsevier. It works by inhibiting acetylcholine at receptor sites of bronchial smooth muscle, resulting in decreased cGMP and bronchodilation. Auscultate breath sounds, noting areas of decreased or absent breath sounds and adventitious sounds to obtain ongoing data on patient’s response to therapy. CNS depression, paresthesia, chest pain, increased heart rate, dry mouth, blurred vision, glaucoma, vomiting, abdominal pain, constipation, dyspepsia, urinary difficulty, rash, angioedema, cough, upper RTI, candidiasis, flulike syndrome. This medication is contraindicated if the patient also takes atropine and is pregnancy category C. This medication is not for immediate relief of breathing problems. She had similar symptoms approximately 1 year ago with an acute, chronic obstructive pulmonary disease (COPD) exacerbation requiring hospitalization. Teach and encourage pursed-lip breathing to prolong exhalation thereby preventing air trapping and to slow the respiratory rate. Encourage slow, deep breathing; turning; and coughing to promote effective breathing techniques and secretion mobilization. The patient is scheduled for follow up radiography in 24 hours. Home: The patient takes Spiriva Respimat (2.5 mcg/actuation), 2 inhalations once daily. Assess for co-morbidities such as osteoporosis, cardiovascular disease or psychologic problems to ensure patient comprehension and safe management of disease. Study for free with our range of nursing lectures! Store at room temperature. Free resources to assist you with your nursing studies! This study also found that “a pattern of particular patient and nursing care behaviors were identified in the nurse caregiver stories and constituted what we have designated as a COPD-illness template” (Bailey, Colella, & Mossey, 2004). Recommend the patient to a pulmonary rehabilitation clinic and/or a support group to promote smoking cessation. Immediately report allergic reaction, rash, severe abdominal pain, yellowing of skin and/or eyes, tingling in the extremities or change in bowel habits. This case study explains the symptoms, causes, pathophysiology, diagnosis and management of chronic … Weldam, S., Lammers, J.-W., Zwakman, M., & Schuurmans, M. (2017). Drug-drug interactions with oral contraceptives, estrogens, diuretics, St. John’s wart. Tiotropium is a long-acting anticholinergic (muscarinic antagonist), and bronchodilator. Adult inhale 50 mcg (1 inhalation as dry powder) every 12 hours. DuoNeb is a combination of ipratropium and albuterol. (Lewis, Bucher, Heitkemper, & Harding, 2017), COPD is a progressive disease and clinical manifestations develop slowly. His … Severe ATT deficiency leads to premature bullous emphysema in the lungs” (Lewis, Bucher, Heitkemper, & Harding, 2017). Assess the patient’s ability to perform ADL’s and offer alterations to activities to prevent exacerbations. The result of the culture will also determine if antibiotics are necessary and what type of antibiotic is appropriate for treatment. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date. Over time, this injury-and-repair process causes scar tissue formation and narrowing of the airway lumen. Decreased lung markings are due to the enlarged air spaces. Avoid smoking. The patient needs to be monitored for signs and symptoms of pneumothorax such as decreased movement of the chest wall and hyperresonance to percussion. hospital for 3 days with an acute COPD exacerbation and will be discharged tomorrow. Do you have a 2:1 degree or higher in nursing or healthcare? If the patient is having trouble expectorating, teach and promote airway clearance techniques such as huff coughing to loosen secretions and promote expectoration. These are all physical manifestations of COPD as aforementioned in the pathophysiology of COPD. She has been in the. St. Louis: Elsevier. This case study incorporates a common presentation seen by the nurse in clinical practice: community acquired pneumonia with a history of COPD causing an acute exacerbation. The patient’s hemoglobin level is also increased. If this complication were to occur, it is most frequently treated by inserting a chest tube with drainage. Find answers and explanations to over 1.2 million textbook exercises. (Bailey, Colella, & Mossey, 2004) However, this study also indicated that the nurses believed anxiety to be the cause of the breathlessness, not that difficulty breathing caused anxiety. 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