Case Pre Ppt
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Transcript of Case Pre Ppt
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8/6/2019 Case Pre Ppt
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Patients Name: G.B.R
Age: 69 years old
Sex: MaleCivil Status: Married
Attending Physician: Dr. Valdez, Dr.
Arada, Dra. Toledo
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Chronic Obstructive Pulmonary
Disease possibly bladder
obstruction, s/p suprapubiccystostomy
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Chief Complaint/s:
Difficulty of Breathing
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NURSING HISTORY
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Anxiety
Relation of stress to anxiety
Sister Callista Roys Adaptation Model
Care of the client in the Obstetric ward
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oliguria
Decreased renal blood flow primary kidney disease
damage from other diseases urine overflowobstruction
Decreased GFR
Reduced clearance
Modifiable Risk Factor:
Cigarette smoking
Intake of Salty Foods Hypertension
Diabetes status
Non-Modifiable Risk Factor:
Age
Gender- women
Metabolic
acidosis,
hyponatremia
Urea, nitrogen and creatinine rise
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Electrolyte
imbalanceKidney lose their ability to concentrate urine
Functioning nephrons decline in number
GFR decreases further
Loss of kidney function
Renal Failure
Chronic Kidney Disease
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Muscle ContractionBronchial smooth
muscle cell hyperactivity
bronchospasm
Obstruction of airflow
Mucosal EdemaHypertrophy of
bronchial mucusglands
Mucus SecretionGoblet cell
hyperplasia
Narrowing of bronchiallumen
Squamous cellmetaplasia
Accumulationof secretions
yproductive cough with
thick and mucupurulent
sputum
yDecreased tactile fremitus
yNasal flaring and
use of accessory
muscle
y
Dyspnea
Ventolin nebule
Predisposing Factors
yOld age
ySocioeconomic status
Precipitating Factors
yExposure to chemical
irritants such cigarettesmoke
Mucosal Inflammation
CHRONIC OBSTRUCTIVE PUMLMONARY DISEASE
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Air trappingimpaired gas exchangeDecrease ventilation
Hypoxemia Hypercapnia
Mechanical Ventilator
COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to
breathe. "Progressive" means the disease gets worse over time.
COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing,shortness of breath, chest tightness, and other symptoms.
Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to
smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may
contribute to COPD.
To understand COPD, it helps to understand how the lungs work. The air that you breathe goes
down your windpipe into tubes in your lungs called bronchial tubes or airways.
Within the lungs, your bronchial tubes branch into thousands of smaller, thinner tubes called
bronchioles. These tubes end in bunches of tiny round air sacs called alveoli. Small blood vessels called
capillaries run through the walls of the air sacs. When air reaches the air sacs, the oxygen in the air passesthrough the air sac walls into the blood in the capillaries. At the same time, carbon dioxide (a waste gas) moves
from the capillaries into the air sacs. This process is called gas exchange.
The airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air
like a small balloon. When you breathe out, the air sacs deflate and the air goes out.
In COPD, less air flows in and out of the airways because of one or more of the following:
The airways and air sacs lose their elastic quality.
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed.
The airways make more mucus than usual, which tends to clog them.
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Amlodipine
Calcium Gluconate
Hydrocortisone Itraconazole
Meropenem
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Medication
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MupirocinOmeprazole
Paracetamol
Piperacillin Tazobactam
VancomycinTranexamic Acid
Simvastatin
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Medication
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Nursing Priorities
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Problem No. Problem Date Identified
1 Thick bloody
secretions at ET tube
May 10, 2011
2 Bed sores at buttocks
area
May 10, 2011
3 Risk for Aspiration May 10, 2011
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NCP
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Ineffective airway clearance r/t thicktracheobronchial secretions 2 COPD
Impaired Skin Integrity related todecreased blood and nutrients to tissues
secondary to bedsore on the buttocks
area.
Risk for Aspiration related to excessive or
thick secretions secondary to COPD15
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DISCHARGE PLAN
> Compliance
Medication
> Diet
> Exercise
> Activity/ Lifestyle Changes
> Follow up/ Check up
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It is not how muchyou do but how
much love you put inthe doing.
- Mother Theresa
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