Copd case study presentation. Case Study: 60 2022-10-11
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"There Will Come Soft Rains" is a short story by science fiction author Ray Bradbury, first published in 1950. It tells the tale of a futuristic, automated house that continues to function long after its human occupants have been destroyed in a nuclear war. The story is notable for its use of personification, as the house and its various systems are described as if they were sentient beings.
One of the most famous quotes from the story is the opening line: "The morning of August 4, 2026, was clear and sunny, with the fresh warmth of a full-summer day." This sets the stage for the events that unfold, as the house goes about its daily routine, unaware that its inhabitants are no longer alive.
Another memorable quote from the story is: "The house stood alone in a city of rubble and ashes. This was the one house left standing." This passage highlights the devastation that has occurred as a result of the nuclear war, and the contrast between the house's pristine condition and the ruined city around it.
A third quote that is particularly notable is: "The trees were green. The grass was green. The streets were quiet." This passage serves to further contrast the house's normal functioning with the chaos and destruction that have taken place outside its walls. The trees and grass continue to grow, while the streets are silent, suggesting that there is no longer any human activity in the area.
In conclusion, "There Will Come Soft Rains" is a thought-provoking short story that uses personification and vivid imagery to explore themes of technology, survival, and the dangers of nuclear war. Its memorable quotes serve to enhance the story's themes and add to its overall impact on the reader.
Case Study: 60
Investigations: Pulmonary function tests: FEV1: 0. One of the primary things that he needs is education that his COPD is treatable. He and his wife have always had a great relationship, and he has respect for her, but yet, he wants to take care of himself as well as possible. It typically impacts the elderly at the age of greater than 60 years old, and approximately 90% of cases occur during the winter months. The environment should be kept clean by the public and organizations to provide safe breathing. Thank you for your participation in the discussion of the Jim B. Introduction Chronic obstructive pulmonary disease COPD is a common disease that affects up to 15% of adults.
His symptoms were dry hacking cough, discomfort in his chest, weakness and he looks very thin by his picture. It was mentioned that his PCP was a 'rural doctor' which I did not feel was necessary. While less likely, a history of hypothyroidism should raise suspicion of myxedema coma in a patient with any cognitive changes. She had similar symptoms approximately 1 year ago with an acute, chronic obstructive pulmonary disease COPD exacerbation requiring hospitalization. Great case, thanks for sharing!! Non-invasive positive pressure ventilation NPPV is a mode of mechanical ventilation given by facemask that aids oxygen delivery and decreases work of breathing. Yuranga Weerakkody and Dr. That would contribute to his poor mental state.
COPD Patient Case Study: Clinical Simulation Exam Scenario
Although it must take precautionary steps in administering medications such as Mr. Information to be considered in this report contains the main aspects related in the development of the ailment includes smoking, genetic factor and environmental pollutant. Physical examination: A woman of average build and height with no signs of distress lying on the bed. We created this study guide to help. No sensation losses Initial Evaluation Initial evaluation to elucidate the source of dyspnea was performed and included CBC to establish if an infectious or anemic source was present, CMP to review electrolyte balance and review renal function, and arterial blood gas to determine the PO2 for hypoxia and any major acid-base derangement, creatinine kinase and troponin I to evaluate the presence of myocardial infarct or rhabdomyolysis, brain natriuretic peptide, ECG, and chest x-ray. The psychosocial benefits of PR will likely motivate him--just being with others that are facing the same issues and making progress may inspire him. Patient is to follow-up with his primary care physician.
This sort of medicine, however, must be used commonly to be helpful as it does not work immediately and should not be used likewise to relieve a sudden COPD attack. Chest X-ray Findings: Bibasilar airspace disease that may represent alveolar edema. Singh as he is diabetic and may boost his amount of blood glucose. Same with the blood pressure. Myxedema coma is an illness that occurs primarily in females at a rate of 4:1 compared to men. CBC Largely unremarkable and non-contributory to establish a diagnosis. It is the next logical step in therapy for the patient not responding to standard treatment.
The blood gas should be evaluated for the degree of hypoxia, acidosis, and CO2 retention. BiPAP is the preferred mode of NPPV in COPD. What adjustments would you make to the BiPAP settings? Remember COPD is a chronic illness with ups and downs. Visible use of accessory muscles. Travel, weather, time away from home can be tiring. There are many rural physicians that keep quite up to date and also know their patients far better than city doctors. At home, the patient used a nebulizer every 4 hour during the night.
An inhaler, used once or twice a day with a rescue inhaler in his pocket might give him back a sense of freedom and independence. The factors which suggest a poorer prognosis include increased age, persistent hypothermia, bradycardia, low score GlasgowComa Scale, or multi-organ impairment indicated by high APACHE Acute Physiologyand Chronic Health Evaluation II score. Repeated monitoring of TSH and T4 should be performed every 1 to 2 days to evaluate the effect and to titrate the dose of medication. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. No mention of his financial status from beginning to end.
B-2 agonists Like asthma, the use of beta-2 agonist is first line therapy to get immediate improvement. He needs to learn how to manage his shortness of breath so it is less intimidating. Thyroid hormone is necessary throughout the body and acts as a regulatoryhormone that affects many organ systems. Doe has COPD, you can initiate low-flow oxygen to treat hypoxemia while avoiding knocking out the hypoxic drive. The pericardial fluid is collected primarily posteriorly, laterally but not apically. As for this actual case, "Jim" entered into pulmonary rehab a number of years ago. Maybe a psychiatrists should be considered, that is assuming anti-depressants might be in order.
. The drug goes straight to the lungs, making it simpler to breathe by minimizing airway swelling swelling and irritation. Additionally, hypothyroidism leads to decreased glucose uptake and utilization in neurological tissue, thus worsening cognitive function. The higher heart rate would contribute to his shortness of breath; something to lower his blood pressure and slow down his heart rate would help him feel better. COPD is a chronic, mid-life disease that is progressive.
There is no role for long acting beta-agonists such as salmeterol and formoterol in treatment of the acute exacerbation. Look for pursed lip breathing and cyanosis. Until coexistent adrenal insufficiency is ruled out using a random serum cortisol measurement, 50 to 100 mg every 8 hours of hydrocortisone should be administered. Eventually, these values became normal once her TSH level was close to 50. Assuming that Jim would be a "non-compliant" patient and have poor inhaler technique, his primary doc prescribed daily prednisone. Based on history and physical assessment my impression is COPD with probable Asthma Overlap Syndrome. What is your next treatment recommendation? Like an asthma patient, a COPD patient may state to the ED physician the current episode is exactly like a prior episode that improved with standard treatment of oxygen, bronchodilators, steroids, and antibiotics.
It is not uncommon for people in his profession small business to not have his own insurance with SS contributions. In most observed cases, an excessive and long-term cigarette has been cited as the primary cause of lung damage leading to COPD Fodor and Tóth, 2009. The patient is admitted to the medical floor for further management. Al-Farra has no conflicts of interest to disclose. Corticosteroids have been shown to reduce treatment failure, hospital stay, and the need for additional medical therapy.