COPD Exacerbations

Mclvor et al. state that the epidemiology of this disease will continue to change and the number of cases among women will rise (2010). In 1998, the WHO estimated that COPD was the fifth most common cause of death worldwide. (Mclvor et al., 2010) Also, the Global Burden of Disease Studies estimated that COPD would become the third most common cause of mortality by 2020 (Calverley et al., 2003). COPD presents a personal burden. Sufferers of this disease have reported significant disability and restriction as a result of COPD (Calverley et al., 2003). “Patients tend to be slow to seek medical help and are reluctant to press for more public attention to their problems” (Calverley et al., 2003). This is most likely due to the social stigma attached to being diagnosed with a disease. Under diagnosis of this disease is a major problem. In fact, Decramer, Janssens & Miravitlles state that 60-85% of patients (usually with mild to moderate disease) remain undiagnosed

How would you describe the pathophysiology of COPD and comorbid heart failure to Charlie, considering that he has no medical knowledge/background?

This is a case study on a 76 year old man.Mr Alan Chari(pseudonym used to protect the identity of a patient),was admitted over night in my department.He is a divorcee who stays with son.He is a retired teacher and his son is permanently employed by a local company as an electrician.He is independent with activities of daily livings but is occasionally limited by his ill health.He used to be a heavy smoker .After realising the burden COPD has on general New Zealand population ,affecting about15% of the adult population over the age of 45 years according to asthmanz( 2010) ,l took this case study to gain in-depth understanding.

The effectiveness of Family Support Caregiver in improving the Functional Status of Client with Pulmonary Diseases.

This assignment will explain the pathophysiology of the disease process chronic obstructive pulmonary disease (COPD). It will examine how this disease affects an individual looking at the biological, psychological and social aspects. It will accomplish this by referring to a patient who was admitted to a medical ward with an exacerbation of COPD. Furthermore with assistance of Gibbs model of reflection (as cited in Bulman & Schutz, 2004) it will demonstrate how an experience altered an attitude. In accordance with the Nursing and Midwifery Council, (NMC) Code of Professional Conduct (NMC, 2005) regarding safeguarding patient information no names or places will be divulged. Therefore throughout the assignment the patient will be referred to

Have you ever had something terrible happen to you, but you have that one friend that comforts you and helps you get through the hard times ? Throughout the story Speak Ivy has helped Melinda clear her mind, and find her voice after a traumatizing changed her life in a bad way.

The poem ‘My Country’ written and published by Dorothea Mackellar incorporates a strong representation of the Australian bush. Mackellar uses many poetic devices to portray her love for Australian bush as the land of Australia is highly representative of Australian culture. Mackellar uses a first person point of view, repetition and personification to reinforce the representation of Australia. The point of view Mackellar uses is important as it demonstrates her love for the Australian representation.

The World Health Organization (WHO) recognizes dementia as a major public health priority and a significant cause of disability.[1] With the aging of the Canadian population, dementia as a serious public health issue will continue to grow. Several research reports point to a potential link between COPD and the development of cognitive decline.[2-5] Depending on the population group and methodology, about 10 to 61% of COPD patients have cognitive impairment.[2,6] The literature indicates that cognitive impairment in COPD patients may be associated with increased adverse outcomes such as more prolonged hospitalization, difficulty with the instrumental activities of daily living (IADL),[7,8] and trouble with managing their disease and adherence to treatment.[9-11] Moreover, the cognitive impairment could affect the success of pulmonary rehabilitation[12] and smoking cessation programmes[13] in patients with COPD.

Asthma is one of the main differential diagnosis in COPD exacerbation because of the similarities in the presenting symptoms. The patient complains of a cough and shortness of breath. These are typically seen in asthma but asthma will be ruled out because the cardinal signs that include; wheezing, an intermittent sensation of chest tightness, non-productive cough and a possible trigger such as exposure to allergens (Jo & Laurie, 2014) were not noted in the patient’s H&P or in the health assessment.

Unfortunately, there is currently no cure for COPD, but there are medications that are available to help the symptoms and make it easier for the person to breathe. Bronchodilators are a type of medication that will help open the airways to get better airflow. Short acting bronchodilators are used in emergency situations for rapid relief. Some short acting bronchodilators are Albuterol, levalbuterol (Xopenex), and Ipratropium (Atrovent). They can come in an inhaler or in a liquid that can be inhaled from a nebulizer. There are some side effects to the short acting bronchodilators including dry mouth, blurred vision, tremors, tachycardia, or a cough. Long acting bronchodilators help treat the symptoms of COPD over a longer period of time, so it may take longer to see results. Patients can use long acting bronchodilators once or twice a day depended on how bad the symptoms are, which also comes in inhalers or a liquid that can be put in a nebulizer. Some examples of the medication are Tiotropium (Spiriva), Salmeterol (Serevent, Formoterol (Foradil, Perforomist), Arformoterol (Brovana), Indacaterol (Arcapta), Aclidinium (Tudorza). (Mayo Clinic Staff, 2015). Over time these medications will help if the person takes them continually. Long acting Bronchodilators are not used as emergency or rescue medication. Some of the side effects of these medications are dry mouth, dizziness, tremors, runny nose, an irritated or scratchy throat, allergic reactions, blurred vision, and

I work as a respiratory therapist and treat patients diagnosed with chronic obstructive pulmonary disease (COPD). Smoking is a leading cause associated with developing COPD. As a professional working in the healthcare field, I have been fortunate and educated about the dangers and consequences linked to cigarette smoking. I have treated and have experience with individuals who have smoked and developed COPD. Also, as an educator, I have tried to help individuals quit smoking to improve overall health. As an educator, I view smoking as an addiction to the drug nicotine and managing cravings will help individuals quit smoking.

I will analyse the prevalence of the condition and what the potential causes may be. My interests have been directed to pre hospital care and community lead treatment packages, which are potentially available to the patient, as this is the acute environment, which I will have contact with in my employment as a paramedic. The initial reading was to understand COPD as a chronic condition, what is COPD? and its prevalence in the population. The (World health organisation, 2000), states that one in four deaths in the world are caused by COPD. In 2010 (Vos T Flaxman etal, 2012), says globally there were approximately 329 million, which is 4.8% of the population who are affected by this chronic condition, In the UK (NICE, 2010), have estimated that 3 million people suffer from COPD, with more yet to be diagnosed. This information about the amount of people living with this condition was surprising, as I little knowledge of its existence. During the early 1960’s (Timothy Q. Howes, 2005), says the term COPD had been designated as a single term unifying all the chronic respiratory diseases. Since then the term COPD, has been sub divided in to three umbrella areas, Bronchitis, Emphysema and Chronic asthma, which are separate conditions, which I have been previously aware of as their individual conditions. The 58 year old patient who we visited,

All over the world, chronic obstructive pulmonary disease (COPD) is a very significant and prevalent cause of morbidity and mortality, and it is increasing with time (Hurd, 2000; Pauwels, 2000; Petty, 2000). Due to the factor of COPD being an underdiagnosed and undertreated disease, the epidemiology (Pauwels, Rabe, 2004) is about 60 to 85 % with mild or moderate COPD remaining undiagnosed (Miravitlles et al., 2009; Hvidsten et al., 2010).

Pathological changes characteristic of COPD are found in the airways , lung parenchyma and pulmonary vasculature .These include chronic inflammation, with increased numbers of CD8 lymphocytes in different parts of the lower respiratory system and structural changes which result from repeated injury . Inflammatory and structural changes increase with disease severity and smoking .(43)

We identified 52,612 records. After excluding duplicates, we screened 39,725 titles and abstracts and retrieved 3,114 articles for full text screening. We included 213 quantitative studies eligible reporting patient values and preferences on COPD related outcomes in the systematic review (See Figure 1. Flow Diagram).