The main pathogenic risk factor for emphysema is inhaled tobacco smoke (Snider, 1985) and the patient in this case study has been a heavy smoker for the past 40 years. Over time the pulmonary capillary bed and alveolar septa is destroyed by cigarette smoke, resulting in the loss of elastic lung tissue recoil, the trapping of air in the peripheral lungs, and hyperinflation (MacNee, 2005)
Recent advancements in point-of-care testing have generated several rapid diagnostic tests that can provide some information is as little as 1 to 3 hours, but these tests are not universally available, nor comprehensive. The main diagnostic indicators of a pulmonary infection are fever and leukocytosis (Mouton et al
The experience of dyspnea can be so frightening in older adults with severe COPD that depression and anxiety are common. A definitive diagnosis of COPD is based on the presence of an airway obstruction, which can occur in a number of chronic airway diseases and conditions, including asthma, chronic bronchitis, and emphysema (Nakawah, Hawkins, & Barbandi, 2013)
A defining feature of COPD and asthma is a reduction in forced expiratory volume in the first second (FEV1) below normal limits (GICOPD, 2013, p. 7); however, total lung capacity (TLC) and carbon monoxide diffusing capacity (DLCO/VA) will be normal or above normal in asthma, whereas patients with COPD will have an elevated TLC and reduced DLCO/VA (Pelligrino et al
The patient considered here has hyperinflated lungs and is a heavy smoker (Wender et al., 2013), but is not hypoxemic based on pulse oximetry (Pretto, Roebuck, Beckert, & Hamilton, 2014)
S. population over the age of 65, respectively (Schiller, Lucas, & Peregoy, 2012, p
The patient has expressed concerns that she might have heart disease or cancer, which may be a sign of generalized anxiety disorder; however, the fever and leukocytosis supports a diagnosis of acute exacerbation of chronic bronchitis due to a lower airway infection. The patient should be immediately admitted and empirically administered an antibiotic cocktail containing a macrolide and ? lactam to combat the suspected airway infection (Drancourt, Gaydos, Summersgill, & Raoult, 2013) and neutrophilic inflammation (Simpson, Phipps, & Gibson, 2009)
Inhaled corticosteroids have also been shown to be less effective in treating neutrophilic asthma and/or COPD (Nakawah, Hawkins, & Barbandi, 2013). For these and other reasons, the success of any long-term treatment plan will depend on the results of comprehensive lung function testing and a lung biopsy to determine the nature of the inflammatory process (Thomsen et al
Care Plan: Integrated Disease Management Despite the patient's past resistance to diagnostic testing the symptoms were severe enough to cause her to seek medical help, which implies that the patient is probably very sick and anxious about her health. The worsening of a non-productive cough, morning sore throat, fever, and mild anorexia over the past two days should be cause for concern; however, psychogenic dyspnea and COPD exacerbations can occur secondary to generalized anxiety disorder and depression, respectively (Wahls, 2012)
COPD patients are typically heavy smokers presenting with hyperinflated lungs, hypoxemia, and diffusion impairment (Akgun, Crothers, & Pisani, 2012). The patient considered here has hyperinflated lungs and is a heavy smoker (Wender et al
In light of the patient's obesity and sedentary lifestyle a metabolic panel should be run to check for metabolic syndrome. Sedentariness and metabolic syndrome has been associated with systemic inflammation, which could be contributing to pulmonary inflammation (Yawn, 2012)
The research arose from study of Nancy Roper in 1970 in which she "sought to identify the core of nursing activities across any field of nursing practice, which could then be supported by knowledge, skills and attitudes required to working the individual specialist's fields." (Holland, Jenkins, and Solomon, 2003) Roper, Logan and Tierney published the 'Elements of Nursing' in 1980, which identified the "individual aspects of the model as a whole and how nursing could use it as a framework for the care of patients in a wide variety of situations
" Staff that are involved in the patient process of discharge are capable of understanding and interpreting both patients and carer needs and from the perspectives of each of the two as well as within the "constraints of local post-discharge service organization and availability." (Grimmer, et al
Economic factors were soon replaced by the need to provide the best treatment and medial technology. (Stanley, 1997) Insurances like Medicare and Medicaid were covering the entire costs of the treatment
This is a major obstacle in the country's economic performance especially after the bankruptcies that have occurred in the past. (Wright, 2012) The hospital is not funded from any source except the government, and the officials cannot stand to go through more laws
In order to achieve this, the plan establishes an innovative Medicare-like program for non-elderly residents without any health insurance coverage. Furthermore, the plan will increase the affordability of health insurance coverage by creating the National Health Insurance Exchange (NHIE), a governmental marketing organization which will directly sell health insurance plans to people without public or employer coverage (Laszewski, 2008)
Pros of the Health Plan: President Obama's proposed health care reform plan has several advantages to millions of common Americans including: Elimination of Discrimination: As compared to current health care system, Obama's health care plan will eliminate the discrimination of health insurance companies. Since the proposed health care plan is a national plan instead of a private health insurance plan, the pre-existing conditions phrases in health insurance contracts will be eliminated (Edenloft, 2010)
Under Obama's health care plan, health insurers are banned from imposing different premium charges that are dependent on the customer's health. Moreover, the proposed health care reform plan will also bar rewarding people who follow a healthy lifestyle (Tully, 2010)
Obama's health care plan adopts a national health insurance plan rather than the current private health insurance plan. This national health insurance plan will be managed and controlled by the federal government and would be helpful in the reduction of the national deficit (Longley, 2009)
The quality of health care being delivered is expected to improve under the plan because of the competition among health insurance companies as they strive to offer improved products and services. Cons of the Health Plan: While the proposed health care plan will lower the costs of health insurance and provide health coverage to many Americans as compared to now, the plan has several disadvantages including: Slower Economic Growth: As revealed by President Obama in efforts to combine both the current House and Senate bills, the new health care reform plan will cost approximately $950 billion (Jackson, 2010)