Copd case study presentation. Chronic Obstructive Pulmonary Disease Case Study 2022-10-27
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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.
Respiratory For worsening metabolic acidosis and airway protection, the patient was emergently intubated. In the setting of her hypothyroidism history, this may be myxedema coma or due to the involvement of another organ system. Treatment doses for 20 minutes in an hour includes 4-10 puffs with spacer. Integrated Care in Chronic Obstructive Pulmonary Disease and Rehabilitation. Trace mitral valve regurgitation is present. Avoid excessive O2 supplementation as this may cause unnecessary intubations.
COPD Patient Case Study: Clinical Simulation Exam Scenario
What was the role of his PCP? Initial Therapy for COPD Exacerbation Medication Dose Route Prednisone Solumedrol 40-60 mg 125mg Oral Intravenous Albuterol 2. No clubbing, cyanosis or lower extremity edema is noted. I agree anything critical should be addressed asap, but the others can wait. He was cheerful with a fun sense of humor, and always a great support to our staff and his fellow classmates. Severely ill COPD patients with increased work of breathing who do not require immediate intubation and are not responding to nebulizer treatments may respond to non-invasive ventilatory support NPPV. Creatinine kinase was elevated along with serial elevated troponin I studies. Physicians should only claim credit commensurate with the extent of their participation in the activity.
I also do not understand the prednisone 10mg q day with an FEV1 of 38% unless he is having another exacerbation. There is no absolute guideline for a specific level of built -up carbon dioxide and it is not uncommon for severely affected patients to be awake and relatively stable with a PC02 over 60mmHg. 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. Deconditioning with muscle weakness 6. No mention of the location of PR or location of various consultants. Long acting beta-2 agonist agents have only been shown to be effective in maintenance therapy. It is an antimuscarinic that has a comparable overall affinity to muscarinic receptors from M1 to M5.
She uses BiPAP ventilatory support at night when sleeping and has requested to use this in the emergency department due to shortness of breath and wanting to sleep. However, COPD may be as a result of genetics since as earlier mentioned, about 20-30% smoker has chance to develop the problem. The patient's white blood cell count was normal. His heart rate runs on high side, normal but on the high end. Echocardiogram The left ventricular systolic function is normal.
Corticosteroids: They are effective in severe and very severe disease and in conditions where beta2 agonists have a limited role. A CT head without contrast was normal. Astute ED clinicians will ask their patient and themselves: Why today? I did a quick check and that can cause depression and shortness of breath. Gastroenterologist if acid reflux symptoms do not abate. Observe if finger clubbing is present.
Therefore, deficiency of this hormone is characterized by systemic decreased metabolism and decreased glucose utilization along with increased production and storage of osmotically active mucopolysaccharide protein complexes into peripheral tissues resulting in diffuse edema and swelling of tissue. Initial impression and work up required: The patient seems to suffer from COPD. In the absence of identified hypothyroidism, myxedema coma is a diagnosis of exclusion when all other sources of coma have been ruled out. A chest x-ray, EKG, and troponin are obtained with no acute changes. Prognosis: Myxedema coma is a medical emergency. Far and away, smoking tobacco is the leading cause of COPD.
Mildly affected patient may only note mild dyspnea on exertion. Defining Disease Modification in Chronic Obstructive Pulmonary Disease. BiPAP is the preferred mode of NPPV in COPD. Hi Clipper, the ibuprofen is Jim's way of controlling his constant shoulder pain and lack of shoulder mobility. A typical dose is 0.
Now, after further What home therapy would you recommend? Remember COPD is a chronic illness with ups and downs. Until these results return, broad-spectrum antibiotics are indicated and may be discontinued once the infection is ruled out completely. One of the most difficult aspects of being a Respiratory Therapy Student is trying to apply what you learn in the classroom to real-life clinical scenarios. Another blood gas was collected and the results show a PaCO2 of 65 mmHg and a PaO2 of 59 mmHg. Frozen shoulder PR Team, Physician Plan: 1.
Family history: Father had emphysema, died at age 69, mother died of breast cancer at 62. In part, the pulmonary findings of diffuse edema and bilateral pleural effusions can be explained by cardiac dysfunction. There is a broad spectrum of disease from patients with mild symptoms and occasional flares to the patient who is oxygen dependent and frequently hospitalized. He is no longer able to ride a bike with his grandchildren. Exposure: Chest is exposed showing retractions and paradoxical breathing. Investigations: Pulmonary function tests: FEV1: 0. It is a part of a medication classification known as corticosteroid.
He does not complain of weight loss or loss of appetite. She reports difficulty breathing at rest, forgetfulness, mild fatigue, feeling chilled, requiring blankets, increased urinary frequency, incontinence, and swelling in her bilateral lower extremities that are new-onset and worsening. Some patients retain carbon dioxide and high flow oxygen may cause respiratory depression with the rapid rise in serum PO2 depressing the central ventilatory drive. Stop smoking, and follow up visits. Nicotine replacement therapy may be indicated as well. Handbook of pulmonary diseases: Etiology, diagnosis and treatment.