Tag: COPD

Discuss the use of evidence-based solutions to manage patient problems. How would this approach be implemented within the doctor’s office?

Health care

As a nurse, Identify the nursing care delivery system (team nursing model) used in the doctor’s office. Identify the patient population usually served. (Diabetic patients, patients with high blood pressure, and COPD)

Identify high-volume or high-risk types of cases in the doctor’s office (cases of poor diabetes management, covid-19, uncontrolled high blood pressure)

Determine the usual care problems at the doctor’s office.

Identify the standards of care applied in relation to the patient population.
List the desired goals and/or outcomes (to provide education related to the illness, get baseline vital signs, review past medical history, provide referrals for medications, and schedule follow-up doctor appointments) to address the usual problems.

Describe the doctor’s office’s approach to quality improvement. How is this approach Implemented?

Identify the style of leadership (democratic, transformational, servant) demonstrated at the doctor’s office and its relationship to the implementation of change.

Discuss the use of evidence-based solutions to manage patient problems. How would this approach be implemented within the doctor’s office?

make sure to use scholarly, peer-reviewed articles to support the topic. Make sure materials are published within 5 years and include the DOI link.

 Describe the patient’s presentation and your initial assessment of the patient based on the history and physical you completed in i-Human. What are your top three concerns for this patient and why (based on objective and subjective data)?

PCP as a final diagnosis

Describe the patient’s presentation and your initial assessment of the patient based on the history and physical you completed in i-Human. What are your top three concerns for this patient and why (based on objective and subjective data)?

Patient is CHarlie Harris who presented with fevers in the last 3-weeks, progressive dyspnea at rest and on exertion, and a 5-pound unintentional weight loss. Physical exam revealed a fever of 101 F/38.3C, hypoxemia with a pulse ox of 82%, and cervical and axillary adenopathy.

Based on your initial assessment, describe the top five differentials you selected, and discuss which tests you ordered to either rule in or rule out those conditions. Address if the tests you ordered are both time/cost effective, or if a better approach could have been used.

Asthma, COPD, HIV, lung neoplasm, bacterial pneumonia

Present the patient’s final diagnosis, and discuss the pathophysiology behind the condition.

HIV/AIDS with Pneumocystis jirovecci pneumonia

Describe how you plan to treat this patient based on current clinical guidelines.

Support your analysis with at least five reliable references from the text, clinical guidelines, and research. At least two of the five references must come from peer-reviewed research that is less than five years old.

Why is a patient with COPD at greater risk of a respiratory tract infection?Describe the pathophysiology of Atsuto’s breathlessness – include in your answer why an infective exacerbation of COPD would cause breathlessness.

Airway and breathing

Discuss in detail the pathophysiology of an infective exacerbation of COPD. How is this related this to Atsuto’s current condition as described above?

What evidence exists to show that his condition is well managed or not well managed? Explain your rationale. Support your discussion with evidence from literature

Question 2
Why is a patient with COPD at greater risk of a respiratory tract infection?

Describe the pathophysiology of Atsuto’s breathlessness – include in your answer why an infective exacerbation of COPD would cause breathlessness.

You should refer to pathophysiology, epidemiology (the Australian and global context) and justify your discussion with evidence from relevant literature.

Question 3
Describe your priority nursing interventions for Atsuto in detail and give and explanation for why each intervention is a priority.

Identify 3 priority nursing assessments you will undertake for this patient and describe why these are important

How will you plan this care? Include priorities of care and argue why these are important alongside long and short term goals

Identify 3 priority nursing referrals that you will make for this patient

Analyse how you will evaluate the effectiveness of the interventions and include what you would expect to see and why.

Describe what you found most interesting or concerning in the study you selected.Critically appraise literature for level and quality of evidence to support practice change. (POs 1, 3, 5, 6, 7) Appraise global healthcare practice problems and DNP practice relevant to advanced nursing practice. (POs 1, 3, 9)

Critically appraise literature for level and quality of evidence to support practice change. (POs 1, 3, 5, 6, 7) Appraise global healthcare practice problems and DNP practice relevant to advanced nursing practice. (POs 1, 3, 9)

Conduct a search of the library to find one quantitative research article related to one of the National Practice Problems. You will use the quantitative article you have selected for your paper. The DNP-prepared nurse uses the most recent (within 5 years) evidence available.

Present the written reference and the permalink to the article you chose.

Attach your completed Johns Hopkins Appraisal Tool to your response.

Describe what you found most interesting or concerning in the study you selected.

When discussing, for the Week 3 Assignment, the Johns Hopkins Appraisal Tool,refer to the Level of Evidence and Quality Grading as:

Level of Evidence is identified as (I, II, or III)

Quality Grade is identified as A, B, or C for quantitative or A/B or C for qualitative.

These eight National Practice Problems include: COPD, mental illness, addiction, heart disease, diabetes, cancer, obesity, and safety. You will successfully demonstrate your library search skills to identify evidence.

Discuss the specific effects of aspirating vomitus on Sammy, including the probable effects on his bronchi and lungs. Why might one lung be affected more than the other?Discuss the pathophysiologic changes causing the signs and symptoms and any tests required to clarify the effects on Sammy.

Pathophys Wk 3

The initial post must include responses to all the questions in this discussion.

Mr. J, age 42, is a construction worker in Las Vegas who lives with his daughter and grandson, Sammy. He recently noticed that a mole on his face seemed to be getting larger and darker.

At first, he did not worry because he was in the sun a lot and assumed the change may have been caused by sunburn. After a month, not only was the mole larger and darker, but it appeared to be “bumpy.” His doctor diagnosed a malignant melanoma skin cancer following biopsy of the nevus. Mr. J reports pain in his right shin that does not go away when he puts his feet up or sleeps.

Discussion Questions

Relate Mr. J’s skin changes to the warning signs for malignant melanoma.

Discuss the normal progression of this malignancy. What is the significance of the bone pain that Mr. J is experiencing?

Discuss the treatment available for this patient and the prognosis for recovery.

Discussion Questions

Mr. J is babysitting his grandson Sammy, age 3 years, who ate his dinner and then said his tummy hurt. Mr. J suggested he lie down in the adjacent room while his parents finished dinner. A few minutes later, Mr. J heard Sammy vomiting.

He rushed in to lift Sammy up. When vomiting ceased, he noticed Sammy continued to cough and seemed to be choking. He was struggling to breathe, and a wheezing sound was obvious. It appeared that he had aspirated some vomitus. Mr. J drove him to a nearby hospital for examination.

Discuss the specific effects of aspirating vomitus on Sammy, including the probable effects on his bronchi and lungs. Why might one lung be affected more than the other?

Discuss the pathophysiologic changes causing the signs and symptoms and any tests required to clarify the effects on Sammy.

Suggest some reasons for Sammy’s difficulty breathing and wheezing.

Discuss the potential complications of aspiration of vomitus.

Weekly Outcomes Weekly Objectives

Articulate alterations in structure and function of the respiratory and integumentary systems. (CO 1)

Trace the impact that alterations in the respiratory and integumentary systems have on the body. (CO 2)

Summarize the impact of alterations in the respiratory and integumentary systems on homeostasis. (CO 3)

Understand normal respiratory and integumentary system disorders.

Compare and contrast common respiratory and integumentary disorders: causes, clinical manifestations, diagnostic tests, and treatments.

Apply understanding of alterations in respiratory and integumentary systems across the lifespan to formulate care priorities.

Examine responses to aging and its impact on pathophysiologic changes in the respiratory and integumentary systems.

Describe how heredity and genetics influence pathophysiological alterations in the cardiovascular and integumentary systems.

Examine factors leading to cancers of the respiratory and integumentary systems.

Main Topics and Concepts Sub-Concepts with Exemplar

Alterations in the respiratory system: Oxygenation

Pathological processes in structures and functions

Cancers of the respiratory system

Pathophysiologic respiratory system response to aging

Genetic influences on respiratory system pathology

Alterations in the integumentary system (skin disorders)

Pathological processes of the integumentary system

Cancers of the integumentary system

Genetic influences on the integumentary system

Oxygenation: Upper (Infectious Rhinitis) respiratory condition; Lower respiratory conditions (Pneumonias); atelectasis; pneumothorax

Genetics: Cystic fibrosis and congenital heart defects/anomalies

Acid-Base Imbalance: Arterial blood gases

Acute versus Chronic conditions: Infant Respiratory Distress Syndrome (IRDS), Adult Respiratory Distress Syndrome (ARDS), and Asthma (single episode), Chronic Obstructive Pulmonary Disease (COPD)

Cellular adaptation: Lung cancer

Immunity: Inflammatory skin disorders

Infection: wounds; abscess; viral and fungal rashes

Inflammation: skin infection; skin irritation

Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

Case Study: Mrs. J.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD).

Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances.

She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

Is very anxious and asks whether she is going to die.

Denies pain but says she feels like she cannot get enough air.

Says her heart feels like it is “running away.”

Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

Height 175 cm; Weight 95.5kg.

Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.

Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.

Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.

Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

IV furosemide (Lasix)

Enalapril (Vasotec)

Metoprolol (Lopressor)

IV morphine sulphate (Morphine)

Inhaled short-acting bronchodilator (ProAir HFA)

Inhaled corticosteroid (Flovent HFA)

Oxygen delivered at 2L/ NC

1. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

2. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.

3. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed.

Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.

4. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

5. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.