For patients diagnosed with chronic obstructive pulmonary disease with a history of smoking cigarettes (P) can the use of nicotine replacement therapy (I) compared to only using nicotine replacement therapy (C) increase the patient's ability to permanently stop smoking (T) and slow down the progression of the effects of the disease?( O)
Introduction to my patient
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.
Picot development
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my first obstacle to drafting my PICOT question was to first learn the principles of how to construct a research question that was both searchable and answerable that highlighted an area of care my patient needed addressing in this case he required help to stop smoking due to COPD.
i used the Murdoch library and found an article on how to style my question using the criteria of population, intervention, comparison, observation and time (Riva, J. J., Malik, K. M. P., Burnie, S. J., Endicott, A. R., & Busse, J. W. 2012)started to question why patients who had repository issues like the ones that are accompanied with COPD would continue to smoke and risk further implantations to their health and dramatically decrease their ability to breathe. This question helped to form the background concept of my picot question of what is the most effective way to help people to quit smoking permanently.
I felt the best way to answer this issue was to gain a better understanding of both COPD and why patients found it hard to break the habit of smoking and what methods had been most successful in helping smokers to become
smoke-free. Trying to gain a better understanding of the correlation between COPD and Smoking I needed to find articles and studies that had been peer reviewed and well researched to give credibility and weight to my findings, therefore, I used well-known databases such as CINAL and Pub Med and the Johanna Briggs institute for more information, however, I found my search terms were too broad and needed to be narrowed down. It was during my readings of the articles I found two methods were commonly used to approach helping patients quit smoking these practices were nicotine replacement therapy (NRT) and behavioural modification therapies that focused on the patients emotional and physical state by adding these parameters to my search criteria fields I was able to uncover a vast amount of articles. it was in these articles I was able to add the comparison portion to my question. Can behavioral therapies and the use of Nicotine Replacement therapy compared to patients using Nicotine replacement therapy alone increase the ability of patients with COPD the patient's ability to permanently stop smoking (T) and slow down the progression of the effects of the disease?( O)
Mrs. Jones has a history of COPD. She was already taking albuterol for her illness and it was ineffective when she took it that day. Mrs. Jones had been a smoker but had quit several years ago. According to Chojnowski (2003), smoking is a major causative factor in the development of COPD. Mrs. Jones's primary provider stated that she had a mixed type of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was established to address the growing problem of COPD. The GOLD standards identify three conditions that contribute to the structural changes found in COPD: Chronic bronchiolitis, emphysema, and chronic bronchitis. A mixed diagnosis means that the patient has a combination of these conditions (D., Chojnowski, 2003). Mrs. Jones chronically displayed the characteristic symptoms of COPD. "The characteristic symptoms are cough, sputum production, dyspnea on exertion, and decreased exercise tolerance." (D., Chojnowski, 2003, p. 27).
Growing up with a best friend who has been smoking since middle school, I have seen many of the negative effects it has on a person. Football was a passion and way of life for Andy; however, smoking caused him to struggle with breathing while running up and down the field. He would cut down on his daily amount of cigarettes before and during the season, but cutting down was little help for him. Not only was his breathing affected by smoking, but he also had yellow teeth, smoker’s cough, and would get “the shakes” when in need of a smoke.
1. What is the difference between a. and a. Which K, S, and A pertain to the care you provided to the patient you have chosen? Why do you need to be a member? K- Describe the limits and boundaries of therapeutic patient-centered care. S- Assess levels of physical and emotional comfort.
To effectively manage COPD it is essential for patients to monitor themselves by writing a list of dates and times when experiencing symptoms and reactions to treatments. (Lung Chicago Managing COPD, 2016). Understanding a patient’s personal disease characteristics will help in determining treatment to prevent exacerbations. To maintain stable condition of the disease, COPD patients need to understand and reduce risk factors. Counseling programs such as smoking cessations need to be available for COPD patients as part of their treatment. Pharmacotherapy for the disease is also used to reduce its symptoms and difficulties on
Introduction : Mrs Dorothy Beecham has been admitted to hospital with community –acquired pneumonia and query DVT. She is currently on waiting list of total knee replacement. Her past medical history including cardiovascular disease, COPD, osteoporosis, varicose vein and recurrent DVT in the past two years. A blood test has been done and result is available. DVT on her right calf is also confirmed by Doppler ultrasound. This article is going to explain the future risk of how recurrent DVT going to impact on her health by use literature and relevant pathophysiology knowledge. At the same time, a patient education plan will be established for supporting care needs. This care plan including the symptoms of recurrent DVT and when to seek for medical advice after Dorothy after her discharge from hospital.
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.
Someone diagnosed with COPD must understand that the damage done to the lungs by this disease is not reversible. The prognosis is one of stopping further damage to the lungs. To minimize this damage the person is treated for symptoms of the disease and not healing of it. The symptoms of COPD usually show up after the lungs have been significantly damaged and due to this late formation of symptoms and their inability to ...
Evidence-based practice (EBP) and research are quintessential guides that professional nurses use in the quest to deliver the best care and achieve optimal outcomes. The aim of EBP is to aid practitioners to structure care of patients with the best and most current evidence. The first step and basis of EBP is to determine there is a gap in the knowledge base to be able to ask an answerable question by forming a focused clinical question. The most useful tools to assist in forming a focused clinical question is the PICO model. This tool can be used to construct searchable questions as the initial step in using research data to guide decision-making. The tool lists search terms to look at the connection around an issue and intercessions to address the issue. Pico is a critical mnemonic that is used to form the vital parts of a well-built, clinical question.
The prevalence of COPD is heavily associated with elderly persons that are predisposed to various risk factors (Viegi et al., 2001). The prevalence of these risk factors is often a major aspect in the diagnosis of the disease, the most detrimental of these being cig...
Vijayan, V. K. (2013). Chronic obstructive pulmonary disease. Indian Journal Of Medical Research, 137(2), 251-269.
Smoking is the leading cause of preventable death in the United States and worldwide (Centers for Disease Control, 2013, World Health Organization, 2008). Tobacco cessation counseling is a vital component of any public health strategy seeking to decrease mortality, disease and costs associated with smoking. To that end, the Healthy People 2020 Tobacco Use Objectives cover three main areas: reducing tobacco use, instituting health system changes, and creating social and environmental changes (U.S. Department of Health and Human Services, 2013). Objective TU-10 falls under the category of health system changes as it seeks to open doors for patients to make quit attempts and to pursue tobacco cessation methods by increasing tobacco cessation counseling by physicians and other health care providers.
This area will facilitate my personal, professional, and course learning objectives. The office cares for a diverse patient population without prejudice. The key nurse practitioner was a former Marine, who has practiced for ten years. I look forward to learning under his guidance and increasing my clinical knowledge base. Learning to develop health partnerships with patients who have various needs, differing backgrounds, diverse culture, and assorted socioeconomic status levels is exciting. Also, I hope to integrate evidence-based practices in daily assessments, diagnosis, and planning. With ongoing practice, I strive to enhance my verbal and written communication with both the patient and care team. Contributing to societal health is important to me. I would love to begin a project on smoking cessation. Smoking contributes to an immense global health issue. According to the Centers for Disease Control and Prevention smoking is the leading cause of preventable death. (2016). As a result, A project that focuses on smoking cessation would contribute to both my personal learning goals and societal
Chronic obstructive pulmonary disease is a lung disease that includes chronic bronchitis, emphysema, asthma and bronchiectasis. COPD is a known to increase breathlessness, frequent coughing, wheezing, and tightness in the chest. Many patients are unaware of their symptoms and spend years not knowing that they are COPD patients. In the begging COPD may cause no symptoms or only mild symptoms, but as the years pass and the disease gets worse symptoms are usually more severe. One common test to test for COPD is the spirometry test. COPD is so common it affects almost 30 million people in the U.S. COPD can be developed from inhaling pollutants, which includes smoking and second-hand smoke. Fumes, chemicals, and dust are also some reasons people develop COPD. Genetics is also one of the big reasons many patients develop COPD. COPD mostly affects people at the age of 40 and older who are mostly smokers. There is no cure for COPD, only treatments to relieve symptoms and to keep the disease from getting worse. One example of a COPD patient, is Mrs. S who is a 65 years old man with COPD, but Mr. S has never been treated for COPD. Meaning
Diclemente, C., Fairhurst, S., Prochaska, J., Rossi, J., Velasques, M., Velices, W. (1991). The process of smoking cessation: An analysis
The smoker also helps 500-1000 non smokers die each year from lung cancer and cardiovascular disease . Moreover, the person to the children developing asthma and allergies.