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1. Nine year old Jerry stumbled into a drug store, which is usually open late with very few attendants, gasping for breath. Blood was oozing from a small hole in his chest wall. When paramedics arrived, they said that Jerry had suffered a pneumothorax and atelectasis. Just what do both these terms mean and how do you explain his respiratory distress? How will it be treated? The respiratory system undeniably serves a very important function in the body. Anyone who has had any event where they couldn’t breathe normally, or maybe not at all, recognizes the importance and mental peace that comes with being able to breathe stress free. By looking at the physical symptoms Jerry was experiencing, paramedics determined that Jerry’s medical distress …show more content…
was the result of pneumothorax and atelectasis. Atelectasis is known more commonly by the term collapsed lung, meaning that the lung is useless for ventilation. This condition occurs when air enters the lung from either a chest wound, or its results from the rupture of a visceral pleura, which in turn results in pneumothorax. Pneumothorax occurs when there is the presence of air or gas in a pleural cavity of the lungs. The pleural cavity is a narrow, fluid filled space between the pleural membranes of the lungs and the inner chest wall. The presence of air or gas in the pleural cavity causes the affected section of the lung to shut down, halting all respiratory functions that the lung was carrying out. In the most severe cases, a collapsed lung can cause low blood oxygen levels, respiratory failure, cardiac arrest, and ultimately, death. There are a number of reasons why Jerry’s lung could have collapsed.
Collapsed lungs happen most often as the result of some sort of trauma to the chest. This trauma includes but is not limited to rib fractures, gunshot wounds, knife wounds, or a hard hit to the chest, often the result of car accidents. There are also nonviolent causes for lung collapses, such as damaged lung tissue which is a result from smoking or other unhealthy activities. Unhealthy hung tissue is weaker than healthy lung tissue so it allows the lung to collapse more easily. Underlying undiagnosed medical conditions such as pneumonia, cystic fibrosis, tuberculosis, and lung cancer could also be causes of a collapsed lung. Another possible culprit of a collapsed lung is air blebs, small air filled blisters that present themselves on the outer lining of some people’s lungs. When air blubs rupture, they have the capacity to cause atelectasis. There are a variety of ways to treat a collapsed lung, and different methods are used depending on the severity of the situation. The ultimate goal of the treatment is to restore lung function by removing external pressure on the …show more content…
lung. If the collapse affects a larger area of the lung, treatment is required that will remove the excess air from the chest cavity, by suctioning off the excess air. This is usually attained by removing the air via a chest tube or a needle and syringe. A needle is inserted into the chest near the area where the collapse occurred, and then the doctor will pull up on the syringe to draw out the excess air. The more drastic measure of treatment is surgery. Surgery is required when the underlying cause of the collapse is an air leak from the lung. Doctors will then make two small incisions in the chest, insert a camera in one incision to view the lung, and then insert a small tool through the other incision to close up the leak. If an air bleb is the culprit, the surgeon will sew the bleb closed. 3. A young woman visited her doctor for a premarital gynecological examination and requested information on contraception. She explains that her faith prevents her from using drugs or mechanical means of birth control. What are the only options for this young woman? For a young couple who does not want to get pregnant but also does not want to use drug or mechanical forms of birth control, the options of contraception are severely limited. I’m not entirely sure if condoms count as a mechanical means of birth control, but I would guess that they do, so I assume they can’t use those. That leaves sterilization techniques, such as tubal ligation or vasectomy, (cutting of the uterine tubes or ductus deferens, respectively) , but for a young religious couple I would imagine that they wouldn’t be up for sterilization, as they believe it is their calling to fill the earth. That leaves only a couple options. The couple could engage in coitus interruptus, known more commonly as the pullout method, but obviously this method is never assured to work perfectly. The final two options for this couple would be fertility awareness methods, that is, avoiding sex during the period of ovulation. This is a popular option for couples who don’t want to use contraceptives. Finally, we have the 100% guarantee birth control by means of abstinence. This is an interesting question to me because I grew up around a lot of these types of people. I grew up in a conservative Christian church, and was sent to a small conservative Christian high school where many discussions were had about sex, and mostly, abstinence. It was often argued that the purpose of sex was primarily to have children, so it was reasoned that everyone in the world should adhere to conservative Christian beliefs, that is, live a sex free life until marriage. Now obviously this isn’t very realistic, especially not to people for which religion isn’t relevant, and more importantly it was ironic, because they majority of the kids at that school were having sex anyways, they just wanted to appear holy so they’d say what their parents and teachers wanted to hear. Like I said, in my life I have met a lot of people like the hypothetical woman in the question, people who are against pill forms of birth control, are iffy about condoms, and are completely against abortion at any stage of pregnancy, and yet also somehow completely against welfare. So basically I guess what they were trying to communicate was that people shouldn’t be able to prevent themselves from having kids, even within marriage, but when they have kids that they can’t even afford to feed, it’s their own fault. This whole mindset has never made a lot of sense to me. This became a little bit of a rant, but I suppose that’s only because I have a lot of thoughts about this topic.
I am not against people wanting to wait until marriage, and I don’t care if people personally do not want to use contraceptives. What does bother me is when people begin to limit other people’s freedoms and expect other people to adhere to the same religious code that they themselves follow. What also bothers me is parents who refuse to talk to their children about sex and healthy sexual behaviours, because they have the naïve mindset that their kids will abstain from sex until marriage, just because they told them it’s the only way. Not only is this a disservice to their children, it’s also dangerous, as kids will not know what a healthy sexual relationship looks like, but will rather form their own ideas of what a healthy sexual relationship looks like from unreliable sources, such as pornography or the media. They will also not be properly educated on what constitutes sexual assault, and they won’t be aware about STI’s and how to properly protect oneself from them. The bottom line is this: talk to your kids about sex, even if you don’t want them having
it.
Fluid volume overload within the intervascular space can cause shortness of breath, fluid within the lungs, engorged neck veins, increased blood pressure and heart rate with a bounding pulse. As blood volume increases so will blood pressure and heart rate. Impaired gas exchange related to pulmonary congestion causes crackles within the lung fields. If oxygen saturation is low the nurse should supply supplemental oxygen. The nurse would raise head of the bed at least thirty degrees or higher to promote breathing and reduce cardiac pressure. Having the patient cough and breath deep can pop open alveoli to clear lung passages. Once the patient is comfortable and in safe position the nurse can call the doctor. The nurse should anticipate another dose of diuretics, such as furosemide. This treatment will decrease respiratory rate and blood pressure by reducing the amount of sodium and fluid within the body. Breath sounds will improve as crackles decrease. Maintaining appropriate fluid volume stabilizes blood pressure, cellular metabolism and proper nutrition gained or wastes lost. Supplemental oxygen if oxygen saturation is low and the nurse has already supplied the patient with oxygen. (Ignatavicius & Workman,
A pneumothorax is defined as “the presence of air or gas in the plural cavity which can impair oxygenation and/or ventilation” (Daley, 2014). The development of a pneumothorax to a tension pneumothorax can be caused from positive pressure ventilation.
Facilitating spontaneous ventilation during APRV aids in alveolar recruitment, and improves distribution of lung volume to collapsed lung units. In one year retrospective study, APRV was compeered with pressure support ventilation(PSV) in eighteen patients with ALI and ARDS. Pressure support ventilation is a patient triggered, pressure limited, and flow cycled ventilation, it allows the patient to control the rate and depth of each breath. The effectiveness of spontaneous ventilation was investigated by the use of both computed tomography scan and volumetry for a period of three days.6 This study showed superiority of APRV in providing better gas distribution, pulmonary oxygenation, and decreasing lungs atelectasis faster than PSV. The clinicians recorded the main reason for this finding was derived from alveolar recruitment without overdistention during APRV. Airway Pressure Released Ventilation allows spontaneous ventilation while providing an open lung protective strategy. 6 Dr. Varpula and colleagues also compared APRV with other forms of partial mechanical ventilation, SIMV with PS, to study the effect of spontaneous ventilation in improving gas distribution. They observed no differences in clinical outcome between APRV and SIMV in gas distribution. Authors interpreted the finding due to the long study period and the differences
The functioning of the chronic obstructive pulmonary diseases (COPD) is that it has a permanent decrease in the ability to force air out of the lungs. Consequently, it causes emphysema to become a more advanced disease with no cure. Emphysema is known for their permanent enlargement of the alveoli, which are accompanied by the destruction of the alveolar walls. The lungs lose their elasticity, so it loses its ability to recoil passively during expiration. People who have emphysema becomes exhausted fast because they need about fifteen to twenty percent of their body energy to breath which is more than what a healthy person needs. Smoking inhibits and destroys cilia in the conducting zone structures, which is the line of defense for the respiratory system.
Pritesh has a previous medical history of asthma and has experienced right-sided haemothorax as he got hit by a hockey ball during a competition. Currently, the nurse suspects that Prithesh may be developing tension pneumothorax which is a life-threatening medical emergency (Brown & Edwards, 2012). Tension pneumothorax develops when a hole in the airway structures or the chest wall allows air to enter but not leave the thoracic cavity (Rodgers, 2008). The pressure in the intrathoracic space will continue increase until the lung collapses, place tension on the heart and the opposite lung leading to respiratory and cardiac function impairment, and eventually shock may result (Professional guide to pathophysiology, 2011; Rodgers, 2008). Tension pneumothorax usually results from a penetrating injury to the chest, blunt trauma to the chest, or during use of a mechanical ventilator (Brown & Edwards, 2012; Rodgers, 2008).
Wildgruber and Rummeny (2012) define tension pneumothorax is a life-threatening condition where air enters the pleural cavity during inspiration but cannot escape during expiration. It is more common in patients with chest traumas and those with mechanical ventilations (Briggs, 2010). Increased the thoracic pressure will compress against the heart and the unaffected lung impairing cardiac functions and ventilation (Pons, & National Association of Emergency Medical Technicians, 2011). Rapid intervention is required to prevent fatal conditions include hypoxia, shock, cardiorespiratory arrest and death (Wildgruber & Rummeny, 2012; Day, 2011; Bethel, 2008).
Those who make the pledge to remain virgins until marriage are just as likely to have sex as those who don’t and are more likely to have unsafe sex when they do. The churches that facilitated these virginity ceremonies did not offer any comprehensive sex education programs to give accurate information about sex to their children before they take this pledge. Although religion in America is attempting to protect children it is in fact failing the youth of our country by not addressing the true nature of sexuality in a realistic way. The American approach to sex is to ignore that it is happening, this which ultimately results in the highest teen pregnancy, teen birth, and STD rates among the Western countries. Religious groups in America have placed significant restrictions on discussions of sexual expression, identity and health. With lacking conversations about sex that includes all teenagers in America these young people will sadly continue to pay a heavy
It has been almost thirty three years since the first federal funding was put to use in “. . . sex education programs that promote abstinence-only-until-marriage to the exclusion of all other approaches . . .” according to the article “Sex education” (2010) published by “Opposing Viewpoints in Context;” a website that specializes in covering social issues. Since then a muddy controversy has arisen over whether that is the best approach. On one hand is the traditional approach of abstinence (not having sex before marriage), and on the other is the idea that what is being done is not enough, and that there needs to be a more comprehensive approach. This entails not only warning against sex, but also teaching teens about how to have “Safe Sex” (“Sex Education,” 2010).
This assignment will examine the case of a man admitted to hospital with an exacerbation of chronic obstructive pulmonary disease (COPD). Firstly there will be a definition of COPD and COPD exacerbation. Then there will be a short discussion of how the patient’s data relates to pathophysiology of COPD exacerbation. This information is used to decide what the patient’s first two priority problems are, and two nurse interventions used to best treat those problems.
Unpleasant breathlessness that comes on suddenly or without expectation can be due to a serious underlying medical condition. Pneumonia can impact the very young and very old, asthma tends to affect young children, smokers are at greater risk of lung and heart disease and the elderly may develop heart failure. However, medical attention always needed by all these conditions as it can affect any age group and severe breathlessnes. There are short and long term causes of dyspnea. Sudden and unexpected breathlessness is most likely tend to be caused by one of the following health conditions. There is accumulating evidence that in many patients, dyspnea is multifactorial in causes, and that in most patients, there is no single, all-encompassing explanation for dyspnea.
Shoemark, A., Ozerovitch, L. and Wilson, R. 2007. Aetiology in adult patients with bronchiectasis. Epub, 101 (6), pp. 1163-70.
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...
Pneumonia in the elderly is something that needs to be taken very seriously in this day and age. According to the Center Of Disease Control, statistics say that over 800 million seniors above the age of 65 are at risk for pneumonia. They also say that 1 out of 20 adults that get pneumonia die. What is pneumonia? “Pneumonia is an infection of the lungs that can be caused by fungi, virus, bacteria, and many other germs,” says Dr. Norman Edelman, the chief medical officer for the American Lung Association. What this infection causes is inflammation of the lungs; more specifically, this is inflammation of the alveoli which results in fluid in the alveoli sacs. The alveoli is where the oxygen transfer to the blood takes place, so with the inflammation, it makes it hard for the individual to breath or do any physical activity. This paper will be covering the signs and symptoms to watch for, how to go about getting it diagnosed, treatment and what to expect, preventative measures, different types of causative agents, and if left untreated the type of complications to expect from pneumonia.
The typical morals that were set in the early times are not the same social norms we have in the 21st century. In today 's society, it is perfectly fine to lose your virginity at a young age or even as an adult, as long as you are using protection and other alternative methods such as birth control to reduce your risks of teen pregnancy. I was sixteen years old when I first got on birth control. Although I was still a virgin up until my senior year my grandmother still didn’t want to take that chance and not try to protect me from jeopardizing my future by getting pregnant before I graduated from high school because condoms are not 100% effective. Although I was raised in a Christian household and was taught that you should always value your virginity at that age the person I lost it to I thought I was “madly in love” with them. Sex is perceived to be a great thing from the time we are young from television shows, movies, magazines, and from older friends. It’s a form of satisfaction sex is all over society and it’s absolutely normal. It’s almost impossible to even engage in television shows without seeing people kissing intimately, or even having sex. I believe that sex before marriage is ok for couples in a committed relationship, who are of age and capable of making of responsible decisions. Also, I think that many people have a misunderstanding about sex. Sometimes religion can
“Forty-one percent of teens ages 18-19 said they know nothing about condoms, and seventy-five percent said they know nothing about the contraceptive pill” (Facts on American Teens). Even if schools taught just abstinence it still would not be enough. “In 2007, a study showed that abstinence only programs have no beneficial impact on the sexual behavior of young people” (Facts on American Teens). Sex education is not taken as seriously as it should be in schools, it is treated like it is not a big deal. Schools should require a sex education class that specifically teaches students about sex and goes into depth of all the possible consequences because of the high pregnancy, abortion, and virus rates.