Explain the pathophysiology behind the signs and symptoms of COPD

 Explain the pathophysiology behind the signs and symptoms of COPD

Bronchitis and emphysema are both classified as a chronic obstructive pulmonary disease (COPD). These chronic illnesses obstruct airflow (McCance & Huether, 2019). Because of the elevated mucus in the airway, COPD allows it to close. As a consequence of cilia dysfunction, mucus causes narrowing, which causes shortness of breath, coughing, and difficulty clearing secretions. The obstruction is caused by a narrowed airway, which makes it impossible for oxygen to reach the lungs and prevents CO2 from exiting the lungs, resulting in hypercapnia (Santus et al., 2020). Ventilation-perfusion imbalance is caused by hypercapnia and hypoxia.

Individuals with COPD develop symptoms such as barrel chest and clubbing of the fingers over time as a result of trapped CO2 (also known as air trapping). Distention of the alveoli occurs as a result of air trapping, which may lead to failure. Excessive work of breathing and puffing causes weight loss in some people, especially those with emphysema. Understanding and recognizing the signs and symptoms of COPD are critical for establishing care and management strategies.

What relationship do you see with Mr. Brown’s vital signs – 26 RR, 91% oxygen saturation, temp: 37.8, HR: 93 BP: 150/70

As a result of hypoxia and hypocapnia, Mr. Brown’s respiratory rate has increased. As a result of the faulty gas exchange, the patient is out of breath and has to work hard to breathe in order to expel CO2. Bad oxygenation is caused by mucus blockage and bronchial narrowing, resulting in a decrease in SPO2. Inflammation and infection are the causes of fever. Mr. Brown’s heart rate has risen as a result of a compensatory process in response to the reduced oxygen and increased CO2 levels. As a result of the ventilation-perfusion imbalance, blood pressure rises.

Describe the goals of care for Mr. Brown. Make sure to use the COPD gold standards of carehttps://goldcopd.org/wp-content/uploads/2018/02/WMS-GOLD-2018-Feb-Final-to-print-v2.pdf (Links to an external site.) (Links to an external site.)for your plan.

The plan of care’s main aim is to prevent COPD exacerbations, keep symptoms under control, and avoid/prevent going to the emergency room. It is possible to use both pharmacological and non-pharmacological treatments. Bronchodilators may be used as preventative medicine or to relieve an exacerbation for a brief period of time. Inflammation may be treated with corticosteroids. Pulmonary rehabilitation, oxygen therapy, and lifestyle changes are examples of nonpharmacological treatments. It is important to have education on how to avoid irritants and adhere to treatment plans. Also, recommendations on the use of peak flow meters to assess the degree of obstruction, participating in smoking cessation, avoid cold weather, and restoring optimum ventilation and oxygen exchange should be the top priorities for the target of treatment.

How would you follow up on your proposed plan of care?’

Mr. Brown should return for a follow-up appointment in 1 to 2 weeks to see if his symptoms have changed, and to re-evaluate the lungs, and a chest x-ray may be taken. Mr. Brown may benefit from instruction on how to use the reward spirometer and pursed-lip breathing to alleviate shortness of breath and keep the airway clear. To avoid COPD exacerbations, I will also educate the patient about how to reduce their exposure to chemical irritants and air pollution.

CODING

SOAP Note 1

Maria Rodriguez

Age: 25 y.o.

Ethnicity: Hispanic

Past Medical history: None

Past Surgical History: Tonsillectomy age 7

Medications: none

Family history: Mother Diabetes, Father Hyperlipidemia

Employment: works as a phlebotomist full time

S: Maria is an established patient who presents to office today for birth control. Pt is in a monogamous relationship with her current boyfriend of 4 months and is using condoms 100% of the time. Pt would like to start a more reliable form of birth control. Menarche 12 y.o menses: every 28 days and lasts for 5 days, patient denies cramps or irregular menses history. Patient is a non-smoker and does not use any substances. Last pap was 6 months ago negative for cytology. Gonorrhea and Chlamydia culture 6 months ago was neg/neg. HPV vaccine completed.

O: 5 feet 6 inches 140 pounds 98.4-80-16-122/76

General: Healthy appearing Hispanic woman in no apparent distress

Skin: No skin lesions identified

Head: Normocephalic, good hair distribution, no alopecia no nits

Eyes: Symmetrical with no erythema or discharge. Vision grossly normal

Ears: Symmetrical with gross hearing intact

Nose: midline, no septal defect, no discharge

Mouth: good dentition, moist mucous membranes

Cardiac: HR 80 normal sinuses rhythm, no S3 or S4, no arrhythmias noted

Lungs: Clear to auscultation bilaterally A & P, no use of accessory muscles

Abdomen: flat, soft, non-distended. Bowel sounds active in all 4 quadrants, tympanic throughout, no hepatosplenomegaly, no rebound or guarding.

A: Contraception Counseling

P: Diagnostics up to date

Education: During the 20-minute face-to-face visit, I discussed with patient the various forms of contraception including barrier, hormonal, non-hormonal, abstinence and natural family planning. Discussed efficacy, cost, risks and benefits of each method, using the Birth control option handout. Discussed timing to start method and how to use method to ensure efficacy. Patient decided to start oral contraceptives. Discussed Sunday start, daily dosing, missed pills, common side effect and major side effects, such as ACHES and when to call.

Continue Condom use for STD prevention

Pharm: Ortho-Tricyclen 28 day, 1 pill every day to start on Sunday after first day of menses. 3 refills

Referrals: none

Follow- up: 3 months

Module 09 Discussion – Pediatric Safety

This assignment will address the current issues in pediatric healthcare related to safety. Growth and development is an important factor that should be considered along with safety in many areas of pediatric health alterations. Many times the health alterations experienced by children can be prevented if safety education is provided.

Competency

Prioritize nursing interventions when caring for pediatric clients with health disorders.

Instructions

This discussion will focus on the importance of teaching a chosen safety concern in the pediatric population. You will present your response in the discussion addressing the following questions: (discussion should be 300 words).

Initial Post:

  1. Determine the age and developmental stage and how that impacts the child related to the safety concern.
  2. Describe why you believe the safety education you chose will benefit the pediatric population. Who do you believe is the target age range for this specific educational teaching?
  3. Describe at least three nursing diagnoses related to the incident you are providing teaching to prevent. Support your choices with rationales citing 1-2 scholarly sources.

CASE STUDY: Active Labor: Susan Wong

Instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA format.

CASE STUDY: Active Labor: Susan Wong

Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy.

She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information.

Reflective Questions

1.  As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?

2.  How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?

3.  With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?

MSN 5550 Health Promotion: Prevention of Disease Case Study Module 8 Instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA format. Deadline: Due by Sunday at 23:59 p.m.

CASE STUDY: Active Labor: Susan Wong Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information. Reflective Questions

1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?

2. How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?

3. With the influence of the recent Human Genome Project and the possibility of predicting open

spinal defects earlier in pregnancy, how will maternity care change in the future?