INTRODUCTION BB, 86, presented to EMCH with pneumonia and a history of COPD and heart failure.

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,

EH is a 68-year-old male who comes into the clinic complaining of a fever with a temperature of 103 °F. He has had a cough for the last three days that is producing some thick green brown mucous. The MD feels he most likely has bacterial pneumonia. He also has a history of having rheumatoid arthritis, and being immune compromised as he is on an immunosuppressant methotrexate. He has noted that over the last year he has lost weight unintentionally and feels he is underweight.

D.Z., a 65-year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD; emphysema). He has a past medical history of hypertension, which has been well controlled by Enalapril (Vasotec) for the past 6 years. He has had pneumonia yearly for the past 3 years, and has been a 2-pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 F, SaO2 88%. His admitting diagnosis is an acute

D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and

Accordingly, to this information of COPD: Coping with COPD from PubMed Health, this article provides the early stages, progression, coping and emergency plan and this disease affects family and friends. It is written answering the question, what to expect from COPD and how to manage this lung disease? A team of health care professionals, scientists and editors, and experts (Chronic obstructive pulmonary disease (COPD), 2015), provides education of how this disease may affect daily lives, how to live with this disease and what causes

The team will navigate patients through the program, resources and pulmonary rehabilitation. The registered nurse will meet with the patient prior to discharge to evaluate and refer them to the appropriate services along with the social worker, which may find alternative way to pay for patients medication and other support services that may be offered. The nurse practitioner and the respiratory therapist will see the patient within 48 of hours upon admission into program. The nurse practitioner and respiratory therapist will evaluate the needs at home and enroll the patient in pulmonary rehabilitation, which will be part of the care offered to all patients. Resources for the patient will consist of a 24-hour hotline for patients who may need to seek medical advice prior to going to the emergency room. Patient will be supplied with emergency medications for home use if symptoms begin to appear. A nurse practitioner will be available to advice the patient in intervention with the emergency medications is indicated and advice if treatment may need to be continued in the emergency room. With the protocols in place for medications, the patient will be seen within 12 hours if use of the emergency medications were taken in the home. The nurse practitioner will update the electronic medical chart of the patient to document

Many patients have comorbid conditions (eg, cardiovascular disease, diabetes mellitus) that may interfere with COPD management and increase health care resource utilization

History of Present Illness: Ms. Babula is a very pleasant 76-year-old woman who was previously seen in this office by Elvira Aguila, MD for moderate COPD by pulmonary function testing in 2010. She is currently on monotherapy with Atrovent p.r.n. and she has not used her bronchodilators for quite some time. She does have some stable dyspnea on exertion, which does not limit any of her activities. She does take care of an 18-month-old child as well. She denies any cough, though she does feel that she has some chest congestion in the morning. She denies any chest pain or wheezing.

Plan: The primary goal for the nurse is to ensure Caroline is discharged able to administer and monitor her medications as well as recognise the indication, desired effect and potential side effects and adverse reactions for each drug. The nurse must apply health literacy principles, consider verbal and non-verbal communication techniques as well as apply adult learning principles to achieve this goal.

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).

Exacerbation of COPD is usually caused by infection due to a virus and/or bacteria, environmental pollutants or other factors. Patients usually present to the ED after symptoms are no longer tolerable or symptoms are worsening due to the factors stated above. During the presentation in the ED, trained professionals assess the patient. COPD assessment is usually to determine how severe the patient is, how is the airflow in the patient, and how this current manifestation will determine if the patient will be admitted in the

Chronic Obstructive Pulmonary Disease, also known as COPD, is the third leading cause of death in the United States. COPD includes extensive lungs diseases such as emphysema, non-reversible asthma, specific forms of bronchiectasis, and chronic bronchitis. This disease restricts the flow of air in and out of the lungs. Ways in which these limitations may occur include the loss of elasticity in the air sacs and throughout the airways, the destruction of the walls between air sacs, the inflammation or thickening of airway walls, or the overproduction of mucus in airways which can lead to blockage. Throughout this paper I am going to explain the main causes, symptoms, diagnosis, and ways to reduce COPD.

S. It is the fourth leading cause of chronic morbidity and mortality in the United States and is projected to rank fifth in 2020 as a worldwide burden of disease according to a study published by the World Bank/World Health Organization (Pauwels, 2012). Yet; COPD fails to receive adequate attention from the health care community and government officials (Pauwels, 2012). In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientist encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (Pauwels, 2012). GOLD’s intention is to bring awareness to individuals who treat COPD and the individuals who suffer and die every year due to the complications from the disease. GOLD used a consensus report for this study and updates the version to reflect on vital changes, stages and signs of COPD. The goals for GOLD are to improve management; and prevention of COPD through effort of people involved in all areas of healthcare and the policies of health care, including worldwide involvement. One strategy to help achieve the objectives of GOLD is to provide health care to workers, health care authorities, and the general public with state-of-the-art information about COPD and specific recommendations on the most appropriate management and prevention strategies (Pauwels,

According to the conditions presented in the case study, it is important to treat the patient for the infection and also to help the patient quit smoking. As far as easing the exacerbations is concerned, antibiotic treatment is the best option. The long-term treatment can include the use of 250mg azithromycin on a daily basis for up to twelve months (Verduri et al., 2015). This treatment option is known to ease most of the bacterial infections and reduce the breathing problems as well as the obstruction faced by the patient due to the infection. Since the patient already uses the β2-agonist for the management of COPD, the infection induced complications can be managed

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity