Jack Little is a 59-year-old panel beater with a past medical history of smoking two packs of cigarettes per day for approximately 40 years (80 pack years), chronic bronchitis, and corpulmonale. Jack was on holidays with his wife in the high, mountainous area when became extremely short of breath. His wife took him to the Emergency Department (ED). On presentation to the ED, Jack was agitated and dyspnoeic at rest and had a Glasgow Coma Scale (GCS) of 15. His physical examination revealed the presence of loud wheeze in the mid-lung fields, a temperature of 38.5 " C, SpO2 88% on room air and a respiratory rate of 28 breaths/min. Jack's lips were bluish color, and he complained of new-onset ankle swelling. During the past three days, Jack has had a productive cough and was expectorating thick, tenacious, green sputum in the morning on waking up. Dr. Santorini…… [Read More]
COPD Teaching Plan and Its Contribution to Healthcare:
Nurses not only strive to restore health in sick individuals but they also seek to promote maximum health potential in healthy people. The major way through which nurses achieve this goal is through patient teaching in which these health practitioners assist patients and their families to develop effective health behaviors and lifestyles. During this process, nurses use various teaching plans including Chronic Obstructive Pulmonary Disease (COPD) teaching plan. The need for using this teaching plan is attributed to various factors such as the increase in chronic obstructive pulmonary disease in the past 25 years despite COPD cases being largely underreported or misdiagnosed. The other reason necessitating the use of this teaching plan is the fact that management of COPD is complex as patients need to make changes in their lifestyles as the take medications.
Contribution to the Future of Healthcare:
The contribution…… [Read More]
differential diagnoses for Jane may be congestive heart failure (CHF), which could account for her dyspnea and be associated with her lifelong habit of smoking, exacerbated by a glass of wine in the evenings; it could possibly be treated by surgery, with the addition of eliminating smoking and alcohol. Peak expiratory flow can be measured to distinguish COPD from CHF. A second differential may be Alpha1-Antitrypsin deficiency (AATD), which could be indicated by the sputum, wheezing, and smoking. This is an inherited genetic condition and can be treated similarly to treating COPD (Stoller, Aboussouan, 2012). Bronchiectasis could be a third differential, but the absence of crackles could rule this out, though voluminous purulent sputum could signify it as a possibility; nonsteroidal anti-inflammatory drugs would be recommended for treatment. Pulmonary emboli may be a fourth diagnosis, and anticoagulation measures would need to be adopted to treat (Guyatt et al.,…… [Read More]
COPD Case Study
The author of this report has been prepare a brief report about Chronic Obstructive Pulmonary Disease, or COPD for short. There will be two main foci when it comes to the subject. The first part will speak to the facts and details that pertain to COPD and what is involved in living with and treating the disorder. Further, there will be an explanation of how to implement these facts and details in a clinical setting. There will also be a case study subject selected and scrutinized as part of this report. There will be an explanation of the diagnosis, a comparison between the prior-researched guidelines and the patient's condition and the treatment or management options that exist for the patient based on all of the above. While COPD is a grave diagnosis to run into, it can be managed and quality of life can be maximized post-diagnosis.…… [Read More]
The author of this report has been asked to do a brief report on the disease that has come to be known as COPD. COPD is short for Chronic Obstructive Lung Disease. As part of this report, there will be a brief description of the factors related to COPD and how they influence the development and progression of the disease as defined by the guidelines in the source used. That source is from the Global Initiative for Chronic Obstructive Lung Disease. The publication being used is their latest version of their global strategy for the diagnosis, management and prevention of the disease. The edition in question was published in April 2015.
Within the GOLD guidelines, there is a specific section early in the document that specifically pertains to the development and progression of the disease and that section appears on the fourth and fifth page of the document. When…… [Read More]
family copes with COPD
COPD Nursing Intervention: Patient and Family Coping
The objective of this work in writing is to analyze current literature and apply various nursing approaches to a family experiencing a complex health challenge related to their current clinical practice experience.
Chronic Obstructive Pulmonary Disease (COPD) is a "progressive illness characterized by airflow obstruction and dyspnoea that afflicts over 12 million people and represents a leading cause of death in the United States. Not surprisingly, COPD is often associated with emotional distress and reduced psychosocial adjustment, which can negatively affect physical functioning and impair quality of life. However, the psychosocial consequences of COPD remain largely untreated." (Blumenthal, et al., 2009)
Coping with COPD and Impact on Patient's Family
The Journal of Family Practice article written by Fisher and Weihs (2000) reports that the National Working Group on Family-Based Interventions in Chronic Disease:
"…identified potential mechanisms by which the…… [Read More]
Chronic Obstructive Pulmonary Disorder
COPD Diagnosis, Management, and Exacerbation Prevention
The treatment objectives for chronic obstructive pulmonary disorder (COPD) outlined by the Global Initiative for Chronic Obstructive Lung Disease are two-fold: (1) the immediate relief of symptoms and (2) the long-term management of disease (GICOPD, 2013). Patients will present in the clinic with shortness of breath, a chronic cough, or production of sputum and a complete patient history will often reveal pulmonary exposure to environmental contaminants. A COPD diagnosis is typically made when the FEV1/FVC ratio is less than 0.70 as determined by spirometry. atings of disease severity are based on post-bronchodilator FEV1. The patient should also be evaluated and treated for common comorbidities, such as lung cancer, cardiovascular disease, metabolic syndrome, depression, motor impairment, and osteoporosis.
Long-term management of COPD focuses on the relief of symptoms and treatment of comorbidities (GICOPD, 2013). Smokers are encouraged to enter a…… [Read More]
Scientific literature review on COPD
This review and analysis seeks to show comparisons between the long-acting effects of tiotropium versus ipratropium in the reduction of exacerbation risk and referrals related to COPD in COPD patients. The data in this study was acquired from the General Practice data base for research (GPD). The study shows that patients subjected to tiotropium treatment suffered severe COPD compared to those treated with ipratropium (Griffin et al. 2008). The review also focused on when that medication is administered and the accompanying concomitant application of the inhaler and nebulizer relative to the quality of life, efficacy and symptoms of the patient. A study in which COPD patients of over 50 of age were randomly placed in three groups, i.e. inhaler, nebulizer and concomitant treatment was done. St. George's espiratory Questionnaire was used to assess quality of life. The most significant improvements in the quality of life…… [Read More]
She should take drugs for rapid onset of symptoms only when called for but drugs that keep her level as time goes on should be taken consistently (Brasher, 2012).
The girl needs to not mow the lawn anymore or otherwise expose herself to situations that can lead to attacks (Brasher, 2012).
2. Chapter 6: COPD
The patient should be asked if she is currently smoking, is around someone that is smoking or has a closely-related person (a parent in particular) that does. The patient should be asked if she or anyone in her family has a history of heart issues (due to the ankle swelling combined with the shortness of breath). Should be asked if there have been any notable changes in weight in either direction and whether there is any sputum or other symptoms (Brasher, 2012).
The patient should be asked how long…… [Read More]
According to the text by Sanders (2011), the Venturi Mask is likely to be the most appropriate assistive device in this process. Sanders indicates that this particular apparatus is "advised for patients who rely on hypoxic respiratory drive. This includes, for example, patients with COPD. The main benefit of the Venturi Mask is that it allows precise regulation of the FiO2. It also permits the paramedic to titrate oxygen for the patient with COPD so as not to exceed the patient's hypoxic drive while allowing enrichment of supplemental oxygen." (Sanders, p. 422)
In addition the Venturi Mask which can help to normalize pulmonary activity, the patient is also experiencing a productive cough with thick yellow sputum. The presence of excessive mucus is also likely contributing to Mr. Hay's airway blockages. This would be an appropriate place to use the Yankeur sucker in order to help remove fluids that might be…… [Read More]
M.K., a 45-year-old female who has a history of Type II diabetes mellitus and primary hypertension. In addition to this, M.K. is overweight and persists with a poor diet. The patient has also been smoking for the past 22 years, and has recently been diagnosed with chronic bronchitis. Current symptoms include chronic cough, which tends to be more severe in the mornings and productive with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increase urination at night. The patient is currently on several medications including Lotensin and Lasix for the hypertension, along with Glucophage for the Type II diabetes mellitus. From an analysis of M.K.'s lab results, this report will offer clinical findings and treatment recommendations, as well as suggestions for what other conditions M.K. may be at risk for given her health history, lifestyle, and lab results as follows:
158/98 mm Hg
Glycosylated…… [Read More]
T for Decision Makers in espiratory Care
X for COPD
Craig osebrock, MD, and James Donohue, MD
T for Decision Makers in espiratory Care
Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory-linked condition associated with airflow limitations to the lung tissue of a patient. Numerous disease states can be linked to the condition including asthma, bronchitis, emphysema and triggers associated with the presence of inflammatory inhalants. Epidemiologically, the strongest causative factor in COPD globally is cigarette smoke (Lopez, 2006). The authors present the prescription pharmacological factors associated with COPD treatment focusing on clinical pharmacology, clinical data and meta-analysis data to demonstrate treatment options and effectiveness. The primary recommendation for COPD management is cessation of smoking and avoidance of tobacco and nuisance particles. Following a discussion of smoking cessation, the authors discuss the types and use of pharmacotherapy in treating COPD.
Table 1 within the publication describes the recommendations for managing…… [Read More]
COPD and the Elderly Population
Although discussions about death and dying can be uncomfortable for patients, family members, and healthcare providers, the subject is important - especially for people with severe chronic illnesses (Covinsky, et al., 1994; Schiff, et al., 2000). The issue of a living will is particularly important for people with COPD, who are at risk for being placed on a ventilator (breathing machine) when they are very ill (Schiff, et al., 2000). As a home health nurse, it is easy to discover that many COPD patients do not have living wills and have not made final decisions and arrangements with their families. While it is natural to want to put off the inevitable decline and demise as long as possible, there is no substitute for making appropriate plans in order to determine what will take place in the future (Covinsky, et al., 1994). For purposes…… [Read More]
* The effects on normal aging and metabolism is that after the age of forty, metabolism usually decreases by about 5% every ten years. That does not mean that metabolism cannot be controlled to some extent; it can. Metabolism is loosely defined as the chemical workings within our bodies that help us to maintain a certain level of energy use, calorie burning and general energy (even at rest). As we age, our metabolism rate slows down, meaning that we burn less calories and the ones we do burn are burned at a slower rate. It also means that we may have less energy and our overall health slows as well.
* As individuals grow older their muscle mass is less likely to maintain its composition. Bill Sonnemaker, the 2007 IDEA Health and Fitness Personal Trainer of the year states that building muscle mass at any age provides a number of…… [Read More]
McClure Case Study
Patient Overview -- Patient, Mr. M., is 49 years old and has smoked for 25 years, quit three years ago when diagnosed with emphysema. He indicates he as shortness of breath for the past 48 hours, with sputum so thick he has difficulty coughing it out. Skin is warm and dry with slight clubbing of fingers noted. Lung sounds diminished with crackles and expiratory wheezes and barrel chest. Vitals are 101.8 Temp, pule 110, respiratory 32, BP 150/82. Blood gases show decreased O2 and increased C02 with an increase in red blood cells and twice the normal white cells.
M's risk factors for emphysema are high. Smoking for so long contributed to decrease of long function and is an abnormal dilation and destruction of the alveolar ducts and air spaces in the lungs. It usually occurs in people over 50, so Mr. M is at the lower…… [Read More]
How do cells in a multicellular organism communicate with one another?
Cells communicate by chemical signals. Chemical signals are passed from one cell to another for example saccharomyces cerevisiae, the yeast of bread; wine identifies potential mates by chemical signaling.
Direct contact, cell to cell.
Through formation of connections or cellular junctions to neighboring cells.
By use of receptors whereby signaling molecules bind.
Forming groups' i.e. group together in a colony.
Communicate using light.
Through chemical and physical touch.
Through use of cell junctions, signal transduction pathways and cell to cell recognition.
Communicate with the aid of junctions holding cell firmly together.
Through production and receiving of chemicals and electric signals.
What are the usual physiological changes of aging and how are these differentiated from diseases?
According to Suzanna and Jennifer, (2006) these changes include; sensory changes, digestion, circulation and sexuality.
Diminishing sense of tastes, smell and touch.…… [Read More]
Structure and Function of the Respiratory System
Forty-five-year-old Brad has, ever since the age of 20, been working in the mines in the post of coal cutter. He is happy with his job as he earns a good wage and his father also worked in the very same mine. Akin to several co-workers of his, he suffers from chronic cough. However, Brad has neglected going for yearly health checks as is required for mine workers owing to his fear of being diagnosed with “black lung” (i.e., coal worker pneumoconiosis). This ailment results in fibrosis, lasting dilation of the small airways, and reduced diffusing capability. At more advanced stages of the disease, alveoli, airways and pulmonary capillaries get destroyed.
Chronic obstructive pulmonary disease (COPD)
COPD has been described as a persistent inflammatory lung ailment which obstructs flow of air from the patient’s lungs. Disease symptoms include difficulties in breathing, wheezing,…… [Read More]
new respiratory drugs that have been approved for medical use over the past decade. The paper will highlight the diagnoses of the drugs i.e. when and why it is prescribed, how it is meant to be used and how often, its side effects, the impact for a missed dose or an overdose along with any other relevant information that will add depth to it appropriate use.
The main purpose for the respiratory drugs is to help cure the ailments directly or indirectly related to the functioning of lungs or general breathing of an individual. There are numerous sectors where studies on new respiratory drugs can be carried out and some of the most recent studies to include this particular aspect include allergies, asthma attacks, Acute espiratory Distress Syndrome (ADS), pneumonia and sinus infections.
In this paper we will focus on the following new respiratory drugs: Arcapta, Daliresp, Dulera, Tyvaso, Alvesco,…… [Read More]
Respiratory Issues Complicated by Economic Disadvantage
Socio-economic status, commonly referred to as SES can be describes as the economic or social standing of an individual, and is a measure of the person’s economic or social position in a social group. SES is a composition of different measures such as education, earnings, location of housing or job. According to studies, a lower socio-economic status can be related to unequal access to healthcare in several illnesses. There exists emerging data and information on respiratory diseases such as asthma, COPD, pulmonary hypertension, cystic fibrosis and other pulmonary ailments which suggest a similar observation also noticed in other chronic ailments (Sahni, Talwar, Khanijo & Talwar, 2017).
Asthma is a chronic inflammatory illness that presents permanent condition with varying severity levels all through the life of the affected persons. It affects individuals of all ages and presents its highest frequency in childhood. Latest data gathered…… [Read More]
Advance Nursing Practice
In order to sustain life, the human body has to have oxygen. When a person cannot breathe, or there is not enough oxygen coming into the body through the act of breathing, it is not possible for life to continue. The respiratory system is what provides the person with the opportunity to breathe and take in oxygen. Carbon dioxide is also expelled that same way. If oxygen is not received, the brain cells will start dying, followed by other cells, organs, and tissues. Addressed here is a case study dealing with the respiratory system, conditions it may face, and how those issues can be treated.
Patient Initials: Unknown Age: 65 yo Sex: Female
Client Complaints: The patient complains of a dry cough that is rarely productive. She has had the cough for two weeks, and for the last two days has also been running a…… [Read More]
Cigarette smoking is the major cause of cancers of the lung, mouth, larynx, esophagus, and pharynx. In addition, cigarette smoking is a contributing cause of cancers of the stomach, colon, rectum, bladder, pancreas, uterine cervix, and kidney. Finally, cigarette smoking is a contributing factor in some leukemias. Currently, cigarette smoking is responsible for approximately 180,000 cancer deaths every year. However, quitting smoking immediately can reduce the risk of cancer. Ten years after quitting smoking, an ex-smoker's risk of lung cancer is about half that of a current smokers. Furthermore, quitting smoking reduces the risk of developing cancers of the mouth, esophagus, throat, bladder, cervix, and pancreas within a ten-year period.
Finally, cigarette smoking increases the risk of heart disease. Heart disease is the number one cause of death in America, and smoking cigarettes is the number one risk factor for heart disease. Smoking is the main cause of sudden heart…… [Read More]
he most common progressive chronic lung situations that would require the rehabilitation include interstitial lung disease, chest wall disease, bronchiectasis, and pre and post thoracic surgery. he fourth category of patients to offered pulmonary rehabilitation is those with recent exacerbation of COPD requiring hospitalization, without the anticipated recovery path, and whose functional baseline has changed significantly ("Service Specification," 2012).
Chronic lung diseases have developed to become one of the most common respiratory illnesses across the country. As the diseases have become one of the major reasons for hospitalizations of patients, they usually affect individuals at the age of 35 years and above despite of the fact that these individuals are usually not diagnosed until they are 50 years and above. he growth and rapid increase of chronic diseases is attributed to the tendency of many people with the disease not to get medical assistance. While the conditions continue…… [Read More]
Benchmark-esearch Critique and PICOT statement
This article is a research critique on the paper titled 'Home Telehealth for Patients with Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis' by J. Franek. The research paper under review was published by the Ontario Health Technology Assessment Series.
Although there isn't a direct statement that refers to Problem statement, there is a title that highlights the "Objective of the Analysis." There is an excerpt of the objectives below. The discussion in the objective statement is only centred on the evaluation steps. There is evidence in the literature that the effects of COPD were openly revealed as being core elements of the problem statement in the first place.
"For patients experiencing multiple comorbidities, it is essential to observe routine self-management support. Such support consists of the necessary education to enlighten parents to pick out the symptoms in good time. They will consequently manage their…… [Read More]
Nursing Diagnosis Plan
Assessment Analysis- Patient, CM., is a 60-year-old female African-American, married and a factory worker. CM is complaining about difficulty breathing, dyspnea. She indicates she is completely compliant with her medication regimen, naps and sleeps 7 hours a day. She is active, has a positive attitude, and regularly exercises. She does admit that sometimes she waits to seek medical attention, believing she should trust in God for minor issue. She does not take OTC or herbal medications and her immunizations are up-to-date. She denies use of alcohol, tobacco, or illicit drugs. Her pharmaceutical regimen consists of control of heart issues (aneurysm, artery disease, COPD, vein thrombosis, hypertension, aortic aneurysm; arthritis, seizures, and diabetes). She is emotionally stable, plans to continue working for at least 7 more years, and has a positive attitude.
Areas for Focused Assessment- CM has visited the hospital four times in the last two weeks.…… [Read More]
Pulmonary Disease and Exercise
Exercise may benefit pulmonary patients in a variety of ways. Pulmonary patients however face many unique challenges to exercising that other disease patients do not.
Pulmonary disease may affect the lungs and in a variety of manners. The condition includes respiratory disorders such as emphysema, chronic bronchitis and pulmonary hypertension. In the article "Comparison of Specific Expiratory, Inspiratory, and Combined Muscle Training Programs in COPD" from Chest Journal, Dr. Weiner and his colleagues explore the idea that weakness within the respiratory muscles may actually contribute to shortness of breathe, which in turn may limit the ability of patients with this disorder to exercise regularly at a significant pace (Weiner, 2003). In a second article, "Comparison of Effects of Strength Endurance Training in Patients with COPD, from the American Journal of Respiratory and Critical care, Francisco Ortega and colleagues examined the effects of different exercise modalities as…… [Read More]
respiratory assessment is usually carried out if a patient experiences abnormal breath sound, shortness of breath, cyanosis, nasal flaring, rapid or slow breathing, and restlessness and anxiety among other symptoms. This type of assessment comprises different steps inspection, palpation, auscultation, and percussion. Once these assessment techniques for examining respiratory problems have been carried out, comparison of all findings to baseline is carried out and any changes recorded. The next step in the process is to record the rate and character of the pulse and respirations, evaluation of the patient's mental status, and assessment of other objective changes (Ciocco & Ciocco, 2014, p.74). These evaluations are carried out in consideration of the patient's past respiratory health history. Some of the abnormal findings in a focused respiratory assessment include dyspnea, adventitious breath sounds, and sputum.
Using Incentive Spirometer
An incentive spirometer is a device used for maintaining the health of a patient's…… [Read More]
2008).. This points to the ethical responsibility of nurse educators -- it is not enough to treat the disease, bit one must treat the patient.
Failure to provide the proper level of education to a patient is certainly one way to fail them both ethically and medically, bit the opposite can also be true. That is, it is possible to provide too much care -- what is deemed "medically futile care" -- and this also raises very serious ethical issues in the realm of respiratory illnesses (Sibbald et al. 2007). This particular stuffy found that insufficient communication among the medical team was one of the primary causes for prolonging futile care, which often means increasing and/or prolonging a patient's discomfort without any reasonable expectation of an improvement in their condition (Sibbald et al. 2007).
The ethical choice here, of course, is to end care (with the consent of the patient…… [Read More]
Toward an Effective olution
In principle, the most effective solution to the tremendous problem of cigarette smoking in the U.. would simply be to impose legislation banning the manufacture, sale, or consumption of cigarettes altogether. In fact, it is impossible to justify any logical distinction between the current illegal status of marijuana (at the federal level and in almost all of the individual states) and the fact that a slightly different cultivated vegetation that is empirically linked to almost half a million preventable premature deaths annually is still perfectly legal to market at great financial profits. However, from a practical perspective, the U.. already had experience during the Prohibition era of the 1920s with the difficulties of trying to ban alcohol. In addition to widespread violation by otherwise law-abiding citizens, that ban created such a tremendous opportunity for profit associated with the black market production and distribution of alcohol that…… [Read More]
Echo Valley Council
Case eport: Mr. William Doe
Director, Community Options Program
Proposed Interventions and Treatment Plan for Mr. William Doe
Like other developed Western nations, the elderly in Australia are confronted with numerous challenges to living independently as they grow older, including coping with age-related diseases processes such as dementia and obstructive airways disease as well as adjusting to the loss of a spouse. This case report provides a discussion concerning the application of the overarching and practice functions of the case management model described within the organisational and community contexts. A reflective discussion concerning the proposed approach to practice that focuses on decisions and reasons for practice, the effectiveness of the proposed practice and alternative approaches, skills or techniques that may be required to provide appropriate levels of care for Mr. William Doe who is described further below.
eview and Discussion
Overview of Client: "Mr. William…… [Read More]
Healthcare -- Nursing -- Case Study
I am required to make differential diagnosis, examine health issues and their management, order diagnostic tests and provide health teachings/health promotion for "Ted." Ted is a 55-year-old Caucasian man with general malaise and a 6-day history of a productive cough. During this time he had noticed a gradual accumulation of fluid in his legs and feet. He had not seen a health care professional in 3 years. His social history was significant because he smoked about a pack of cigarettes a week. Ted reported having a dry, hacking cough for years, but he attributed it to 30 years of smoking. The review of systems was unremarkable. Generally he appeared well nourished and in no acute distress. The physical exam showed the following: weight 142 pounds, height 5'8," blood pressure 150/92 mmHg left arm and 158/96 mmHg right arm, temperature 99.2 degrees F, and oxygen…… [Read More]
This particular aspect is what most medical trainers miss when dealing with interns or newly appointed nurses. They found that oxygen use, if below the necessary requirement can be damaging, so can its overuse. In another study, it has been found that using oxygen below the prescribed level can instigate damage in the organs, respiratory structures and can be especially damaging for patients who have chronic obstructive pulmonary disease (Danchin et al., 2009). Hence, the training and instructions that are given must follow be thorough enough to let the health caretakers realize that the monitoring is not merely a game of reading and recording, but it can have serious repercussions if handled carelessly.
Some of the common mistakes, which can be avoided through proper and accurate transference of instructions and training, occur in different medical circumstances. Sometimes nurses tend to miss the monitoring deadline. For instance, if a patient is…… [Read More]
Questions regarding all three aspects should be asked during intake because this disease should be treated holistically meaning that everything should be factored in.
IV. DISEASE Management MODEL
A disease management plan is necessary for the congestive heart failure patient because so many other illnesses are associated with this disease. The plan is designed to improve the patient's health, while at the same time reducing medical costs.
Disease Management Model
To manage as well as reduce congestive heart failure and the illnesses generally associated with it.
Patients who already have congestive heart failure or those who are at risk.
To reduce the chances of developing other illnesses and diseases associated with congestive heart failure.
To cut down on hospital admissions by ensuring patients follow instructions for at home care as well as regular follow up visits.
To cut down on medical costs by monitoring patients at…… [Read More]
nurses deliver evidence-Based care?
Define main ideas within the title supported from the literature
Nurse instructors confront many hurdles in the present healthcare environment. Educational methods, philosophies, and the content of curricula is required to reviewed to cater to the requirements of the professional nurses who would practice in the coming millennium. (Kessenich; Guyatt; DiCenso, 25) Evidence-based practice or EBP has currently emerged to be a remarkable attribute in nursing literature along with a key impetus in restructuring nursing practice. (Elizabeth; Pyle, 64) Evidence-Based Nursing or EBN is the strategy by which the nurses formulate clinical conclusions applying the best available research evidence, their clinical skill and patient prioritization. (Evidence-Based Nursing: University of Minnesota) It could be narrated as the meticulous, unequivocal and judicious application of the current best evidences in formulating decisions about the care of individual patients. When clinicians formulate health care conclusions for a population or group…… [Read More]
Policy Changes in Healthcare Finance
The American Medical Association (2013) developed the Current Procedure Terminology (CPT) codes decades ago in the 1960s. The first edition was published in 1966 and over the subsequent years several updated versions were created. The reasons for developing the CPT code system was to make communications about medical procedures easier between health care providers, help patients and their doctors submit claims for services to insurance providers, create a structure that would facilitate the development of an electronics records system, and create categories that would help researchers collect data on the health care field.
The CPT code system expanded with each subsequent edition and with publication of the second edition the codes were transitioned from a 4 to a 5 digit system (American Medical Association, 2013). This transition was necessary as the services covered by the code expanded beyond medicine, radiology, and…… [Read More]
acial and Ethnic Approaches to Community Health (EACH 2010 Program)
The health objectives for the United States for the 21st century have been described in The Federal Initiative to Eliminate acial and Ethnic Health Disparities and Healthy People 2010. The national interest in the areas of racial and ethnic disparities has been renewed with the public health initiatives with the leadership for the discussion being taken by the Center for Disease Control and Prevention. The overall health of the nation has improved a lot, but the members of the minority groups in the ethnic and racial areas have not been benefited. This includes the African-Americans, Alaska Natives, American Indians, Asian-Americans, Hispanic-Americans and Pacific Islanders.
This segment of our population is more likely to have poor health and premature deaths than the white Americans. During 1992 to 1998, the deaths from breast cancer have come down noticeably, but there are more…… [Read More]
(NHS Institute for Innovation and Improvement, 2008)
The Angiotensin-converting enzyme inhibitors are stated to be "recommended as first-line treatment in all people with left ventricular systolic dysfunction (LVSD) "with or without symptoms of heart failure." (NHS Institute for Innovation and Improvement, 2008) Additionally it is stated that strong evidence exists that ACE inhibitors "...increase life expectancy in people with LVSD and reduce the risk of hospitalization -- the effect is greatest in those with more severe LVSD or more severe symptoms, but benefit occurs for all degrees of severity." (NHS Institute for Innovation and Improvement, 2008)
Prescribed for individuals who are intolerant of ACE inhibitors due to cough are
Angiotensin-II receptor antagonists which provide an alternative to angiotensin converting enzyme (ACE) inhibitors." (NHS Institute for Innovation and Improvement, 2008) There is stated to be evidence that AIIRAs supports life expectancy improvement and symptoms for those with heart failure due to…… [Read More]
If left untreated it may lead to tetany, seizures and decreased mental status. It also decreases coronary blood flow and predisposes persons to refractory arrhythmias. This condition may also cause hypoventilation, leading to hypoxemia and impair weaning from mechanical ventilation. This is also associated with hypokalemia and may precipitate hepatic encephalopathy in susceptible patients.
Third simple acid-base disorder is respiratory acidosis. This is a clinical disturbance due to alveolar hypoventilation. The production of carbon dioxide increases and there is a failure of ventilation, which increases the partial arterial pressure of carbon dioxide. This in turn decreases the HCO3-/PaCO2 and decreases pH. This condition can either be acute or chronic. Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs, whereas, chronic respiratory acidosis may be secondary to many disorders, including COPD. This disorder can be manifested depending on the severity and on the rate of development of hypercapnia. Patients…… [Read More]
He says that if the prices are still too high, the UN should offer subsidies. (oseley, 2003)
2. Rupert ondy - Senior Vice President and General Counsel
He played a key role in the merger between Glaxo Welcome and SmithKline as well as after the merger. ondy developed an efficient post merger legal department and he ensured legal representation to all organizational departments. (Practical Law Company, 2003)
3. John Clarke - President, Consumer Healthcare
Clarke is the main actor on the company's Consumer Healthcare market and it is due to him that oral hygiene, over-the-counter and nutritional healthcare products have been promoted by GlaxoSmithKline. (Forbes Magazine, 2007)
4. Marc Dunoyer - President, Pharmaceuticals Japan
He extensively promoted the anti-allergy Zyrtec drugs in Japan and around the world.
5. Russell Greig - President, Pharmaceuticals International
Greig is in charge of the GSK operations outside the United States, mainly Japan and the…… [Read More]
THE EFFECTS OF AIRWAY PRESSURE RELEASE VENTILATION AND HIGH FREQUENCY OSCILLATION VENTILATION ON THE HEART - SPECIFICALLY WHEN THE PATIENT HAS CONGESTIVE HEART FAILURE.
CONGESTIVE HEART FAILURE
AIRWAY PRESSURE RELEASE VENTILATION (APRV)
APRV & CONGESTIVE HEART FAILURE
HIGH FREQUENCY OSCILLATION VENTILATION (HFOV)
HFOV & CONGESTIVE HEART FAILURE
Mechanical Ventilation refers to the process of helping the normal breathing process of an individual when his breathing patterns are compromised due to either a pathology within the lung or due to a collective collapse of the related organs. Mechanical ventilation can be of two types: negative pressure ventilation where the air is made to suck into the lungs or positive ventilation where air is forced into the lungs through the airway. During the process of providing ventilation to the lungs it becomes important to "secure the airway" which means that the air should go through the…… [Read More]
Cross-Border Acquisitions Acquisition
International cross-border acquisitions: Takeda's acquisition of Nycomed
In May 2011, the Japanese Takeda Pharmaceuticals bought Nycomed, a Swiss pharmaceutical company. Although Asia's largest drug manufacturer Takeda paid 9.6 billion Euros for Nycomed it will be able to operate the company debt-free, primarily because of the strong Japanese Yen's value in relation to the Euro (Harner 2011). Although Japanese companies have been famously insular in the past, doing business abroad at present is so cheap in comparison with the costs of operating domestically, more and more Japanese companies are looking to enhance their value through international cross-border acquisitions.
Nycomed would add considerable value to Takeda. Nycomed "would broaden Takeda's reach in emerging markets and add products for heartburn and smokers' cough. Takeda will focus on medicines for unmet needs and tapping new markets as blockbuster pills become harder to find" (Torsoli, Matsuyama & Ewing 2011). Takeda is concerned…… [Read More]
Management of Chronic and Terminal Illness
For people dealing with chronic or terminal illness, stress levels can be very high. While that is to be expected, high stress levels only make things worse. Accepting the inevitable is easier on a person's emotional well-being, but it may take some time to get to that point (Taylor, 2005). If a diagnosis is new, denial is often the first emotion the person faces. He or she does not want to believe the sickness or the severity of it. After denial, there are other stages that a person usually works through, including bargaining, anger, and depression, before acceptance finally sets in and the person is able to get on with life as much as possible. Chronic illnesses can include things like diabetes, kidney disease, heart disease, COPD, and other health problems (CDC, 2010). Many of these diseases are preventable, but they are not curable…… [Read More]
The success was remarkable, according to the researchers: Even muscles that had already lost half of its mass, recovered visible. (Leppanen et al. p5549-65) At the same time, the mice survived for several weeks longer than their untreated counterparts and also developed a healthy appetite again. (Mantovani, p296) The new study is therefore interesting in two respects: First, it demonstrates that the muscle loss at least in animal models in fact, affects the chances of survival, and secondly, it shows a way, may be how to prevent this degradation, and even reversed. (Bruera et al. p857)
Muscle atrophy is a medical term that refers to the decrease in the size of skeletal muscle, losing muscle strength because of the strength of muscle is related to its mass. (Burnfoot, p323-34)
All changes in cell morphological character may affect isolated cells or groups of them, therefore the modification of a…… [Read More]
A Solution Refinement for Individual Smoking Cessation
Cigarette-smoking, tobacco addiction and nicotine dependency are widespread and permeating public health concerns. Indeed, the combination of the high rate of addiction to tobacco products and the clear empirical relationship between these products and a number of critical negative and even fatal health outcomes qualifies this is a substantial problem requiring a direct solution. According to the National Cancer Institute (NCI), "smoking is a leading cause of cancer and death from cancer. It causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix, as well as acute myeloid leukemia. Smoking also causes heart disease, stroke, aortic aneurysm (a balloon-like bulge in an artery in the chest), chronic obstructive pulmonary disease (COPD) (chronic bronchitis and emphysema), asthma, hip fractures, and cataracts." (NCI, p.1)
This constitutes a very compelling motive for pursuing resolution of the problem…… [Read More]
Elevating heads of beds for patients on mechanical ventilation
Along with the recommendations for removal of plaque, there is also a guideline made by CDC that for proper treatment to "elevate at an angle of 30 to 45 degrees the head of the bed of a patient at high risk for aspiration." The benefits elevation of the head of the bed is on the theory that then gravity will reduce the possibilities of regurgitation that exists in an overly distended stomach. The recommendation by CDC also clearly states that the patients should not be lying flat unless there is some clinical need for that. At the same time, some medical authorities feel that this is likely to make the patients uncomfortable, though the recommendation is from CDC. This makes them reduce the angle of laying the patients bed at a lower angle than the angle specified by CDC.…… [Read More]
At any rate, the identity of the subjects may not be significant. hat will be needed are basic demographic information (such as age, level of family income etc.), and the direct answers to the survey questions.
A second ethical consideration is the use of other research paper or reports as references. But this can be easily solved by citing all the references that I will be using though a credible citation style. This then shows that the research abides with the copyright law of those published journals, articles and/or reports.
Summary of the reviewed literature will serve as one major factor for the conclusion. This will provide amble information regarding the subject matter. From the said literature review, statistics and other vital information regarding parent smokers and children smokers will be revealed. This information is not limited from one country or area alone, because for sure, the epidemiology and…… [Read More]
Causes of Chronic Bronchitis in Workers
This review shows the literature and research available in the issue of respiratory diseases and the various occupations. The review shows that there is a pressing need to evaluate and conduct research in the known areas like coal, cement, and pesticides, but alarmingly agriculture and other industries have also to be included.
It is not only the factories that are hazardous. There are arguments to show that even farming can cause allergies. osenman (2012) in viewing "respiratory hazards that farmers and family members" argues that the grains that can be "contaminated with fungi, bacteria or microbial toxins; pesticides; solvents; gasoline and diesel fuels; and irritant gases such as oxides of nitrogen and ammonia." This may lead to occupational asthma and the allergens in such cases could be grain dust, cow dander, cow urine, egg yolk proteins, alternaria, aspergillus, cladosporium, meal worm, poultry mites, fungi,…… [Read More]
ENEFITS, ARRIERS, CHALLENGES
ackground and Origin
Progressive mobility refers to a series of planned and sequential movements aimed at bringing the patient back to his or her baseline (Vollman, 2010). It consists of positioning and mobility techniques. A meta-analysis of 39 randomized trials was conducted to examine the effect of bed rest on 15 different medical conditions and procedures. Four short-term medical conditions were identified for critically ill patients. ut the major and long-term complication was the reduced quality of life after discharge on account of lost physical functions during their stay at the ICU. Another study conducted among survivors of acute respiratory conditions found that they lost 18% of their body weight and suffered much functional limitations from muscle wasting and fatigue. The more than 5 million who get confined at the ICU must come to terms with both the short- and long-term complications of immobility or prolonged…… [Read More]
Patient eduation an be desribed as a proess by whih majorly health professionals and other related stakeholders impart information to patients together with their aregivers so that there an be improvement of health status and also alter health behavior of patients. Those who may be involved in health eduation may inlude physiians, pharmaists, registered nurses, psyhologists, speial interest groups, and pharmaeutial ompanies. Health eduation an also be used as a tool by managed are plans in general preventative eduation and health promotion. Some of the important elements that are supposed to be onsidered when dealing with patient eduation are skill building and responsibility. It is neessary for patients to know why, when and how they are required to make their lifestyle hange. This proess of patient eduation is apable of reduing healthare osts.
Looking at studies pertaining ost ontainment, it shows that patient eduation results to…… [Read More]
Hospital quality and mortality rates
People often have relatively little choice in selecting what particular hospital they must have a procedure performed at or where to go to the E. But "the assumption that the nearest hospital is as good a choice as any other is a risky one" according to the American Hospital Quality Outcomes 2014: Healthgrades eport to the Nation (Healthgrades, 2014: 3). Uneven quality of care is a serious problem for healthcare institutions. In a study of Atlanta hospitals, a stroke patient's risk of dying is 17 times higher if they go to one hospital vs. another with a lower rate. In a study of hospitals overall, patients have a significantly higher risk of dying if they go to a one-star rated hospital vs. A five-star hospital. For a heart attack there was a 48.1% lower risk (11.0% vs. 5.7%) going to a higher-quality hospital;…… [Read More]
Nursing Education Assessment Project
Coursework early in a nursing education program covers a broad range of topics and extensive amount of details must be committed to memory. Assessments that are directly tied to coursework are primarily formative assessments, which demonstrate the ongoing learning over the period of the course. Formative assessments generally take the form of quizzes and clinical demonstrations of a particular knowledge set recently covered in during a class or classes. ummative assessments are generally used at the end of a course to assess the overall learning that has taken place during the course; summative assessments include final exams or tests, practicum demonstrations, and capstone projects.
The focus of this assessment project is a formative criterion-referenced test of general, fundamental nursing education knowledge. The items used in the test are included in Appendix A -- Nursing Education -- Fundamental Concepts. Twelve individuals were approached to take the exam…… [Read More]
The author of this report has been asked to assess the medical condition and prognosis for John Smith. John is a sixty-eight years old and has a pretty good array of medical problems. He has had psoriasis for more than a generation and the ointments he has been using to treat it have become ineffective. Beyond that, the psoriasis is spreading to parts of his body that have not been trouble areas before. His son Patrick asserts that he believes that the psoriasis is to the point that it is contagious. While John is facing some challenges, there are things that can be done and this includes properly education both John and Patrick.
Straight off the top, the assertion by Patrick that the psoriasis is "contagious" is patently and absolutely false. Psoriasis is never contagious and there is not a chance that anyone around John will "catch" it.…… [Read More]
Vectura Group PLC is a product development business based in the UK, focusing on the advance of pharmaceutical therapies for the treatment of airways illnesses or airways-related illnesses. The market for such pharmaceutical therapies (inhaled therapies) is growing as it encompasses both COPD (chronic obstructive pulmonary disease) and asthma and is projected to be worth globally, $44 billion. With eight products marketed through partners via increasing international royalty streams as well as a portfolio of drugs currently in clinical development, Vectura has positioned themselves to gain a large market share ($25 billion) in the near future. In addition to clinical development, the company has also licensed some of their drugs to major pharmaceutical companies like Sandoz, UCB, Baxter, Novartis, Ablynx, Janssen Biotech, GlaxoSmithKline, and Tianjin KingYork Group Company.
The company's turnover (m) is 58.0 with a market cap (m) of 718.43. Founded in 1999 and headquartered in Chippenham, UK, it…… [Read More]
Interstitial lung disease is a blanket term for a big group of disorders categorized by progressive scarring of both the lung tissue supporting and between the air sacs. This tissue is called the interstitium. The interstitium consists of the region between the alveolar space and the capillaries. The scarring causes inflammation and damage in the lung tissue followed by lung stiffness, meaning the air sacs cannot expand as much as before. Lung stiffness makes it harder to breathe. People affected by the condition are not able to get enough oxygen from the lungs into their bloodstream.
Although some potential causes have been researched, there may be no underlying cause for development of interstitial lung disease. If there is no known cause, it is called idiopathic interstitial lung disease. IPF or idiopathic pulmonary fibrosis remains the most common type of this illness. Of the causes most widely recognized, cigarette smoking is…… [Read More]
There are two important things to remember when it comes to the health issues of older adults. First, older and senior adults account for the lion's share of healthcare problems and costs as compared to the younger groups. This makes sense as the body is aging and/or shutting down not to mention that the bad habits (if any) of a person in their younger years truly start to take hold and render their effects once a person reaches their 50's, if not before. Second, there are common sense and evidence-based ways to handle these issues and help improve healthcare outcomes. Rather than try to "reinvent the wheel" and/or go with unproven methods in general, it is generally better to go with what is known to be effective based on past research and initiatives. While the older groups of Americans will always have more health problems than the younger…… [Read More]
Care of Vulnerable Populations
COMMUNITY ASSESSMENT, ANALYSIS, and NURSING INTERVENTION
• Week 1: Windshield Survey and Key Informant Interviews. Complete the First Section of the course template and submit. (Keep this section attached to Weeks 2 and 3 assignments.)
• Week 2: Statistical Analysis of Community Health Problem. Complete the Second Section of the course template and submit. (Keep this section attached to Weeks 1 and 3 assignments.)
• Week 3: Community Health Nursing Intervention. Complete the Third Section of the course template and submit. By now, you should have Sections 1-3 as one whole document.
• Each section of the course template is submitted on a WEEKLY basis, depending on which week you are working on. DO NOT wait to submit all three sections at the end of the third week.
• Please note that students are not to make any changes to the content of the course template,…… [Read More]
The US Health Care system: beliefs, Values and health
The health care system is a wide area that spans over the medical aspect, the financial aspect, the ethical field, the management aspect, the political angle and the individual aspect of it where the personal beliefs, values and the health of an individual is looked into. This indicates that healthcare is wide in scope and each aspect is important in the well being of individual American.
In the study of this week, the most important and outstanding issue that came up is the fact that in a health care facility, people therein, both the patients, medics and the support staff go through a lot of challenges. These challenges are not restricted only to medical conditions but extend to the personal issues that affect the social life at the family level, at work, career wise, in the school and the community at…… [Read More]
As to the availability of safe and clean water supplies, and safe waste disposal facilities, Native Peoples are again on the short end of the stick. About twelve percent of Native People do not have adequate supplies of fresh drinking water and dependable waste facilities while only one percent of the general American population do not have those needed facilities (Indian Health Services).
The U.S. Commission on Civil rights reports that the rates Native Americans are dying resulting from diabetes, alcoholism, suicide, unintentional injuries and other health conditions is "shocking" (www.USCCR.gov). Going back to the arrival of the Europeans on the North American Continent, many diseases were brought to the Native Peoples which were "far more lethal than any weapon in the European arsenal" so anyone even preliminarily examining the health care history of Native Peoples can clearly see that this dilemma has been a plague for Indians (www.USCCR.gov). The…… [Read More]
But a program must be established to ensure that Jose is eventually able to re-enter society and become somewhat functional. Social isolation is one of the most debilitating symptoms of schizoaffective disorders. Meeting with a nutritionist to get his diabetes under control with proper food intake is an important first step, and a nutritionist can work with a substance abuse counselor to treat Jose's addiction to sweets and drugs in tandem. These counselors will also be able to establish a sense of intimacy with Jose to decrease his social isolation.
Although Jose will still need physical care, if his diabetes can be brought under control along with his drug dependence, the impact of his physical issues will be mitigated and also he will be less likely to socially withdraw from supportive group activities. Continuing to meet with a nutritionist and substance abuse counselor on a regular basis after his release…… [Read More]
A way to better distribute the information that is being taught in the classrooms is also through the community so that the changes are also effecting the parents to the students, as a change on their part as well would be helpful in the battle against obesity. It would be useful to initially target pamphlets, an informational booth or table at grocery stores, where the foundation of the problem lies. It would be effective if information is given before families go grocery shopping so they are more conscious of the items that they are purchasing. Furthermore, information should also be initially presented on TVs, in newspapers and magazines and other mediums that would likely be used in the more low-key and sedentary setting in order to galvanize individuals to get outside. Once outside, in order to sustain the physical activity, it would be nice to have water and juice at…… [Read More]
Stereotactic Breast Biopsy
Breast cancer is a very common disease, and is the most common type of cancer in women, although it is not unheard of for a man to have breast cancer. About one women in eight (12% of all women) will develop breast cancer at some time in her life. Approximately 50,000 women die from breast cancer every year. Early detection is an important factor in the successful treatment of breast cancer. Utilizing monthly self breast exams, periodic professional exams, and mammography breast cancer can usually be detected early. With early detection, breast cancer can be treated more effectively and patient outcomes improve. Mammograms are an essential part of this screening process. Although there is some controversy, the generally accepted recommendations for mammogram include a screening mammogram at age 35, annual mammograms every one or two years from age 40-50, and an annual mammogram after age 50. The…… [Read More]