Principles of spiritual care … Other risk factors include reoccurring respiratory tract infections in childhood, tuberculosis, asthma, aging, gender, and genetics. Over time, this injury-and-repair process causes scar tissue formation and narrowing of the airway lumen. Recommend a “diet high in calories and protein, moderate in carbohydrate, and moderate to high in fat” (Lewis, Bucher, Heitkemper, & Harding, 2017). The patient’s FEV₁ was 40% of expected value. The patient has recently lost weight, so nutritional therapy is important. A chest x-ray would be a reasonable … Oxygen therapy is also recognized as a primary treatment. COPD/Pneumonia SKINNY Reasoning Case Study Presentation. It is used to decrease inflammation for management of acute exacerbation of COPD. COPD case presentation Prepared by: Sara Abudahab, Ala’a Alhayek and Amani Almani Supervised by: Dr. Abla Albsoul Jordan UniversityFaculty of pharmacy 2. VAT Registration No: 842417633. Patient is dyspneic with diminished lung sounds in the bases and diffuse rhonchi and some faint, expiratory wheezing. All work is written to order. Solu-medrol’s anti-inflammatory process works by suppressing the migration of fibroblasts and leukocytes, decreasing capillary permeability and lysosomal stabilization. (Lewis, Bucher, Heitkemper, & Harding, 2017), COPD is a progressive disease and clinical manifestations develop slowly. Breath in slowly and deeply, hold breath and remove mouthpiece, then resume normal breathing. Her blood pressure is borderline hypotensive at 100/54. Case Questions for Medical Nutrition Therapy: A Case Study Approach 4th ed. (Lewis, Bucher, Heitkemper, & Harding, 2017) (Skidmore-Roth, 2017) Emergency Department: The patient was prescribed Solu-medrol, 50 mg IV, every 6 hours. Respiratory status & paradoxical bronchospasm, Adult PO/IV 40-80 mg/day in 1-2 divided doses, Depression, flushing, sweating, headache, mood changes, circulatory collapse, thrombophlebitis, embolism, tachycardia, hyperglycemia, adrenal suppression/insufficiency, blurred vision, diarrhea, nausea, GI hemorrhage, peptic ulcer, pancreatitis, thrombocytopenia, poor would healing, osteoporosis, poor growth in children, candidiasis, dysphonia, Do not use with grapefruit juice, long-term po glucocorticoids must be given increased doses during times of increased physiologic stress, do not discontinue abruptly, increase intake of potassium, calcium & protein, carry emergency ID, take PO with food, avoid OTC products. This LAMA is used for long-term treatment and once-daily maintenance of bronchospasm associated with COPD. (Lewis, Bucher, Heitkemper, & Harding, 2017) DuoNeb and Solu-medrol, the medications ordered in the emergency room, were ordered to decrease inflammation and dilate the bronchioles, therefore increase the amount of available oxygen for the patient. • In the US, direct costs of COPD … Practice Nurse, 30(4), 59-68. The patient will also have a decreased FEV₁ and FEV₁/FVC. View Notes - Unfolding Case Study Pneumonia-COPD Case Study (with answers)(3)(1)(1)(1)(1) (1).docx from NURSING 13 at Riverside City College. These interventions and additional interventions are discussed during nursing and medical treatments for the disease process. (Lewis, Bucher, Heitkemper, & Harding, 2017) Chronic inflammation causes structural deviations in the lungs which leads to airflow limitation and obstruction. This case study explains the symptoms, causes, pathophysiology, diagnosis and management of chronic … Estimated to be the third leading cause of death by 2020. COPD case presentation 1. When cor pulmonale occurs secondary to another disease process the treatment revolves around treating the primary disease. (Skidmore-Roth, 2017)  By combining these bronchodilators, DuoNeb “improves their effect and decreases the risk of adverse effects” (Lewis, Bucher, Heitkemper, & Harding, 2017). (Lewis, Bucher, Heitkemper, & Harding, 2017). a. Her oxygen saturation is low with a SaOâ‚‚ of 88%. Start studying COPD case study answers. Rock active learning as an educator or if you are a student, use this written case study with fully developed answer … The patient should be monitored for signs and symptoms of cor pulmonale such as dyspnea upon exertion, cough, tachypnea, fatigue and an increased S2 sound. Use only Solu-Medrol IV, never use methylPREDNISolone acetate suspension IV. Oxygen therapy is also used to correct hypoxemia. ... Clinical Case Study on COPD. This preview shows page 1 - 2 out of 3 pages. She has been in the. Position the patient to minimize respiratory efforts: elevate the head of the bed, have patient sit in high fowlers and provide an overbed table for the patient to lean on, in order to promote chest expansion and effective breathing and save energy. If this patient was producing sputum it would need to be collected and cultured and antibiotics would be prescribed, if appropriate. Administer medications (Solu-medrol and DuoNeb) to promote airway patency and gas exchange. All of these signs and symptoms are manifestations of the patient’s inadequate oxygenation due to an exacerbation of her COPD. Lewis, S., Bucher, L., Heitkemper, M., & Harding, M. (2017). The patient’s pH is low at 7.25 which indicates acidosis. Drug-drug interactions. Laboratory Values and Diagnostic Testing: Lab values for this patient are located in table 1 in the appendix. Adult inhale content of 1 cap/day (18 mcg) using HandiHaler inhalation device or 2 INH (spray) 2.5 mcg each daily. Company Registration No: 4964706. The results indicated “the nurses described the intervention as a useful, structured and individualized tool to guide COPD patients in living with the consequences of COPD” (Weldam, Lammers, Zwakman, & Schuurmans, 2017). His … Assess the patient’s ability and technique when using MDIs and DPIs via patient demonstration in order to confirm proper use of medications and alter or simplify medication regime if necessary. Are B.T.’s vital signs (VS) acceptable? Outline Patient presentation COPD assessment according to GOLD 2017 Pharmaceutical care plan Smoking cessation Newly approved drugs for COPD … If the patient is having trouble expectorating, teach and promote airway clearance techniques such as huff coughing to loosen secretions and promote expectoration. COPD– non-pharmacological approaches, exacerbations, oxygen therapy and care delivery. (Lewis, Bucher, Heitkemper, & Harding, 2017). Evidence-based recommendations for the disease are similar to the actual treatment plan which was garnered from textbook information as well as student education. He is alert and oriented, but … 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. View professional sample essays here. Renal compensation of respiratory acidosis manifests in increased levels of HCO₃⁻ and increased levels of H⁺ in urine. As the disease process progresses, functional residual capacity is increased and air trapping causes chest hyperextension and the patient may become barrel chested and the diaphragm may flatten. His current antihypertensive regimen includes hydrochlorothiazide … This intervention is applied after a sputum culture to identify the cause of infection. The patient is scheduled for follow up radiography in 24 hours. The patient also uses supplemental oxygen via nasal cannula to increase her PaOâ‚‚ and oxygen saturation levels. Early signs include chronic cough, usually with sputum production and dyspnea, especially upon exertion. The patient uses Serevent Diskus DPI (50 mcg/inhalation), 1 puff twice a day. This will reveal if the cause of the exacerbation is an infection and whether it is bacterial or viral. The result of the culture will also determine if antibiotics are necessary and what type of antibiotic is appropriate for treatment. If this complication were to occur, it is most frequently treated by inserting a chest tube with drainage. Registered Data Controller No: Z1821391. Not for treatment of acute exacerbations. 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). COPD Case Study - Winter 211 From BCP 323-3797 Chandler Bing is a 52 year old male admitted for management of influenza B. Pt is a current smoker with a 4Opkyr history. Title: Case 27 – COPD with Respiratory Failure. This will include: diagnosis, assessment and care planning of the patient, treatment of the disease, prevention of … Low levels of ATT can be detected by a blood test. Auscultate breath sounds, noting areas of decreased or absent breath sounds and adventitious sounds to obtain ongoing data on patient’s response to therapy. Chronic obstructive pulmonary diseases (COPD) Adult Case Study Explain the role of smoking in the pathogenesis of COPD. Digital Edition: Diagnosis and management of COPD: a case study 04 May, 2020. “The main function of ATT, an α₁ -protease inhibitor, is to protect normal lung tissue from attack by proteases during inflammation related to cigarette smoking and infections. The patient’s lab values also reflect her disease process and are discussed under the laboratory values section. St. Louis: Elsevier. It has the same method of action as Tiotropium, inhibiting acetylcholine at receptor sites on bronchial smooth muscle, resulting in decreased cGMP and bronchodilation. Chronic obstructive pulmonary disease (COPD) is a group of common chronic … The patient should also use spirometry to measure their FEV₁/FVC ratio to monitor the effects of the medications. Chronic obstructive pulmonary disease (COPD) is a progressive disease state characterized by airflow limitation that is not fully reversible. Methylprednisolone (Solu-medrol) is a corticosteroid (glucocorticoid), an anti-inflammatory. Study for free with our range of nursing lectures! Respiratory acidosis is caused by a build-up of COâ‚‚, resulting in increased carbonic acid in the blood. Search. Free resources to assist you with your nursing studies! *You can also browse our support articles here >. CASE STUDY 2 COPD Case Study Case Mr. H.B is a 68-year-old African American widower. Monitor the effectiveness of this therapy via ABGs and pulse oximetry to evaluate the patient response to therapy. She had similar symptoms approximately 1 year ago with an acute, chronic obstructive pulmonary disease (COPD) exacerbation requiring hospitalization. In COPD, the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. A bit more about Jim: Medical history: COPD… The increased carbonic acid dissociates, resulting in increased H⁺ which is the cause of the patient’s decreased pH. 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. We're here to answer any questions you have about our services. Share your impressions in our latest COPD case study. Nursing Essay Bullae and blebs can form, further decreasing gas exchange and putting the patient at risk of spontaneous pneumothorax. (Lewis, Bucher, Heitkemper, & Harding, 2017), Once the exacerbation has subsided, nursing interventions would focus on patient teaching. Suggest the patient rest at least 30 minutes before eating and break up meals into five or six small meals a day to conserve energy. 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. 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