Perhaps, if a situation happened where a patient came in with a chronic cough, there are some questions that I would ask him/her. This is a collection of subjective, and objective data that I will be collecting from the patient to pass on to the Physician to help them make an assessment. “SOAP charting is very common.” (Correa, Dahl, Lindh, Morris, & Tamparo, 2018). There are a quite a few forms of charting, but this is the most common. First, I will discuss some of the questions I would ask my patient. Furthermore, I will give reasons of why I would be asking these questions.
First, I would ask how long the cough has been going on. Verifying from the patient that it has in fact, been going on for three weeks. Because I’m a sufferer
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What does the cough sound like? Is it a wheezing sound, or dry cough? Finding out what the cough sounds like and feels like can give the Physician more information about what the next test could be. Wheezing is typically asthma, while other noises mean other things. Is it a wet or dry cough? This is also a great question to ask when trying to get the patient to describe the cough. Mucus can be very descriptive as to what’s going on. Wet or dry, “it’s caused by mucus dripping down your throat (due to either allergies or a cold), which tickles nerve endings, triggering coughing, Dr. Parsons says.” (Levine, 2015). In addition, this could also be a sign of allergies. Either way, getting this information gives the Physician really good information about what the cough is …show more content…
Again, being an asthma sufferer myself I know that my cough gets worse at night. Laying down is especially difficult. “Other telltale symptoms: The cough gets worse at night or while exercising chest tightness; shortness of breath; fatigue.” (Levine, 2015).
Fourth, I would ask the patient what they are taking for the cough. Finding out what kind of over the counter medications the patient is taking is important. This will give the Physician a better idea of what might be working for them. Perhaps, the medications themselves could be irritating the cough, so this is all good information.
Finally, I would ask the patient about past family history. Conceivably, there could be a history of smoking. Smoking can cause a long series of illnesses. Maybe a parent died from lung cancer, had asthma, or even emphysema. Regardless, it’s important to gather all family history from the patient because all of these factors help the Physician determine their
The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
The Andrews family consists of an African American father and mother that are in their early 50s and two teenage children. This paper will focus on primary heart health for Mrs. Andrews. Mrs. Andrews has a significant risk for developing heart disease, MI, and stroke. Mrs. Andrews non-modifiable risk factors include being an African American female in her 50s. Her modifiable risk factors include stress, hypertension, being overweight, and not seeing a primary care practitioner for two years. She quit smoking three years ago which is a modifiable risk factor that she has changed prior to this visit, the goal is not to sustain the change long term. According to the American Cancer Society the risk of developing coronary heart disease (CAD) is significantly reduced after quitting for year ("when smokers quit," 2014).
My PICOT question was developed after reading the case study about a patient named Vincent Brody who had for the last 50 years of his life consumed 40 cigarettes a day and despite his diagnosis of Chronic obstructive pulmonary disease (COPD) and a recent episode of exacerbation of his condition that required him to be admitted to hospital he was continuing to smoke.
...r illness causes them (). Service users expect respect and sensitivitiy as well as competent treatment and practical support. Nurses must be willing to engage with patients with effective therapeutic communication as well as demonstrating the 6 C’s (). It is evident that nutritional and fluid intake is important for COPD sufferers. It is a long term condition, so enabling people with the condition to self manage and to be educated about the importance of their health choices (By implementing a nursing model or theory and following the cycle of ASPIRE, it would seem impossible for the primary carer to not treat Mr B holistically. Every aspect of his life is affected by his COPD and by evaluating and backing up the care plan with evidence based practice, being in partnership with Mr B every step of the way, he would be able to get the help he needs.
Cough-induced asthma is one of the most difficult asthmas to diagnose. The doctor has to eliminate other possibilities, such as chronic bronchitis, post nasal drip due to hay fever, or sinus disease. In this case the coughing can occur alone, without other asthma-type symptoms being present. The coughing can happen at any time of day or night. If it happens at night it can disrupt sleep.
...spiratory infections. The patient must always be under continuous scrutiny since they can undergo aspiration or lack the ability to change from the passageway to their lungs versus their stomach and their spit travels to the lungs which, in turn, causes bronchopneumonia. The patient also does not have the facility to cough and so must undertake a treatment to shake up their body to eliminate the mucus from the lining of their lungs.
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
Martin, J. (2008). Who’s looking at your medical records? COPDConnection.com Retrieved November 12, 2011, from http://www.healthcentral.com/copd/c/19257/30481/comments
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
Introduction: This paper will discuss a case study of Liam, a three-month-old boy who is transferred from the General Practitioner (GP) to a paediatric ward with bronchiolitis. Initially, Liam’s chief health issues will be identified, followed by a nursing assessment and diagnosis of the child’s needs. Focus will be made on the management of two major health problems: respiratory distress and dehydration, and summary and evaluation of the interventions with evidence of learning. Lastly, a conclusion of the author’s self-evaluation will be presented. Identification of specific key issues: Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days.
Physicians typically diagnose asthma by looking for the classic symptoms: episodic problems with breathing that include wheezing, coughing, and shortness of breath. When symptoms alone fail to establish a diagnosis of asthma, doctors may use spirometry, a test that measures airflow. By comparing a patient’s normal airflow, airflow during an attack, and airflow after the application of asthma medication, doctors determine whether the medicine improves the patient’s breathing problems. If asthma medication helps, doctors usually diagnose the condition as asthma.
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
On my first day of week three clinical at 0830, client W and I were on our way to the dinning room and client B asked me to put his jacket on, so I told client W that I would meet him in the dinning room. After I helped Client B, I was on my way to the dinning room and nurse A told me that client W was experiencing difficulty breathing and we needed to give him his 0900 inhalers earlier. He was having audible wheezing and rapid respiratory rate. Therefore, we had to give client W his inhalers, SalbutaMOL Sulfate, which is a bronchodilator to allow the alveoli in the lung to open so th...