Pulmonary Rehabilitation Paper

Pulmonary Rehabilitation Paper
Pulmonary rehabilitation has been clearly demonstrated to reduce dyspnea, increase exercise
capacity, and improve quality of life in individuals with chronic obstructive pulmonary disease.
There has been an increased evidence of the effcicay of pulmonary rehabilitation for COPD and
other related respiratory diseases such as interstitial lung disease, bronchiectasis, cystic fibrosis,
asthma, pulmonary hypertension, lung cancer, lung volume reduction surgery, and lung
transplantation (Spruit et al., 2013).
Among the benefits of pulmonary rehabilitation are: reductions in subsequent hospital admissions,
reduction o the extend of functional decline, reduction dyspnea, increase in exercise performance
and improvement of the psychological levels.
The intervention should be individualized to the unique ... Show more content on Helpwriting.net ...
This should be individualised and objective/subjective measures of benefit in place before patients
graduate, and reassessment at 4 weeks and graduation to independent gym training is a feasible
possibility (Bolton, Singh and Walker, 2013).
Resistance training in combination with aerobic training leads to greater improvements in peripheral
muscle strength than aerobic training alone(Bolton, Singh and Walker, 2013). To ensure strength and
endurance benefits in patients with COPD, a combination of progressive muscle resistance and
aerobic training should be delivered during a pulmonary rehabilitation programme (Bolton, Singh
and Walker, 2013).
Interval training and continuous training are equally effective modes of training in patients with
COPD. Interval and continuous training can be applied safely and effectively within the context of
pulmonary rehabilitation to patients with COPD. The choice of interval or continuous training will
be down to the patient and/or therapist preference (Bolton, Singh and Walker,
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Pulmonary Symbolism Essay
Pulmonary embolism, synonymous with deep vein thrombosis; are important and is a growing
public health problem. Both contribute to the 300,000–600,000 individuals affected by this each
year in the US alone. This condition does not discriminate against age, gender, or race and occurs
across all boards causing morbidity and mortality. When misdiagnosed, unrecognized, or untreated,
PE can cause death quickly; within just an hour. It's fatal in up to 26% of cases (Andrews, 2010).
However, prompt treatment greatly reduces the risk of death. Taking the necessary preventative
measures to prevent blood clots is the key to protecting one's self of these conditions.
Pulmonary embolism (PE) is a condition in which one or more arteries in the lungs become ... Show
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The following being evaluated includes: increased perfusion; patients understanding of condition,
therapy regimen, and medication side effects; patient reporting of pain being relieved or is
controlled; followed and continues to follow the prescribed pharmacologic regimen. However not
all cases all the same and there will be times when the treatment is not effective for the patient. In
cases as such documentation of changes and ineffectiveness must be communicated to the healthcare
team, so that time is not lost and treatment is not delayed furthermore. With that said teaching and
education does not end when the patient outcome is a positive and near being discharged. There are
still many points the nursing team must teach and they include the following: the nurse should
instruct the patient about preventing recurrences and report the signs and symptoms associated with
PE; the nurse should educate again about the importance of the prescribed management plan; remind
the patient about keeping up with follow–up appointments for coagulation tests and appointments
with their primary care provider (Mistovich et al.,

Pulmonary Fibrosis Research Enhancement Act ( Pfrea )
Abstract
Pulmonary Fibrosis is a serious disease that claims and terrorizes thousands of lives and families.
Due to severity of the disease two Senators have decided to introduce an Act that is dedicated to this
horrifying disease (the Pulmonary Fibrosis Research Enhancement Act (PFREA)). After the onset of
symptoms of pulmonary fibrosis, a person has about 5 years of lifespan, that's taking in
consideration treatment that will be given to the patient. About 30 present of patient that receive
treatment for pulmonary fibrosis with oral glucocorticoids will see improvement in their lung
function. There are many studies that are being to find a cure for the disease or find a way to present
it, unfortunately the studies are still on going ... Show more content on Helpwriting.net ...
get PF. According to (Food & Drug Law Weekly, 2010) the Pulmonary Fibrosis Research
Enhancement Act (PFREA) that has been introduced by Senators Patty Murray (D–WA) and Mike
Crapo (R–ID) in the U.S. Senate working together with The Coalition for Pulmonary Fibrosis
(CPF). The PFREA is designed to help the registry for Pulmonary Fibrosis for patients with PF. The
PFREA also calls on the National Institutes of Health (NIH) to expand and intensify PF research
efforts (Food & Drug Law Weekly, 2010). The PFREA was first introduced in 2009 by
Congressman Brian Baird (D–WA) and Congressman Mike Castle (R–DE) to the House. The reason
why the two Congressman introduced this Act was because they both had family members that were
affected by PF. PFREA was also the first congressional legislation to increase federal funding for
PF, a fatal disease that affects more the 128,000 Americans (Food & Drug Law Weekly, 2010).
Unfortunately, PF claims 40,000 lives each year which is the same number as breast cancer. PF also
kills two–thirds of the patients are diagnosed with the onset symptoms usually expire within five
years of the diagnosis. The National PF Education and Awareness Plan was created because the
PFREA ordered it, this also collaborated with the National Institutes of Health and the Centers of
Disease Control. The purpose for these three organization collaboration is to focus of improving
public awareness of PF and accelerate

Causes And Treatment Of Pulmonary Edema
Abstract
Pulmonary edema can be divided into two categories, cardiogenic and non–cardiogenic. Both of
these can be life threatening if not treated on time. One of the main characteristics of this disease is
the increased fluid in the interstitial spaces and alveoli in the lungs. Cardiogenic pulmonary edema
as the name implies, is cause by heart failure. The most common type of heart failure seen with
cardiogenic pulmonary edema is left ventricular failure also known as congestive heart failure
(CHF). On the other hand, non–cardiogenic pulmonary edema can be caused by many factors
including high altitudes, drugs, inhaled toxins, etc. When a patient has pulmonary edema, some
common signs and symptoms include excessive shortness of breath, ... Show more content on
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Pulmonary edema is characterized as a restrictive pulmonary disorder. People with pulmonary
edema cannot fully fill their lungs with air due to stiffness of the lungs.
Definition
Pulmonary edema happens as a result from excessive movement of fluid from the vascular system to
the extravascular system and air spaces of the lungs.1,3–5,7,11 It is generally divided into two main
pathogenetic types which are hydrostatic (commonly cardiogenic) and permeability edema, also
termed "normal pressure" noncardiogenic.1–3,5,7–8,11Cardiogenic pulmonary edema is caused by
increased pressures in the heart. This condition occurs when the left ventricle is not able get out
enough of the blood it receives from the lungs (congestive heart failure).1,3,5–7 However,
Noncardiogenic, as the name implies, is not caused by the heart. In this condition, fluid may leak
from the capillaries in your lungs' air sacs because the capillaries become more penetrable or leaky,
even without the increased pressure that is built from your heart.1,3–5,7–8,11
Etiology Heart failure can be caused by many different types of problems in the heart.1–3,5,7–8,11
We all know that the heart itself is responsible for the movement of fluids in the body. And that if
the heart fails to function properly, the whole body can be affected in many ways. Heart failure may
affect the right side or the left side of the heart.1–3,7–8,11 Hydrostatic pulmonary edema is known
as cardiogenic pulmonary

Chronic Obstructive Pulmonary Disease
Bobby Muniz
12/5/15
A block
Introduction Chronic Obstructive Pulmonary Disease is a disease that effects the respiratory system.
It is a progressive disease, which means the get gets worse as time passes ("What Is COPD?").
Although their are different types of COPD, the common similarity in the disease is increasing
breathlessness. The main symptoms are increasing of breathlessness, frequent coughing, wheezing
and tightness in the chest. One major issue is that when people age they assume that these COPD
symptoms are symptoms of aging. People think their bodies are just waring out. This makes it hard
to diagnose people with the disease, because they are unaware of the symptoms. COPD is a common
... Show more content on Helpwriting.net ...
This proteins help prevent the disease. Without out the protein the disease is common. Their are two
major types of COPD, emphysema and chronic bronchitis. In emphysema the walls between the air
sacs are destroyed. In turn the sacs loose their shape. Their become fewer larger air sac instead of of
numerous smaller one. This causes problems with the body getting enough oxygen ("COPD").
Without oxygen the body has to use anaerobic respiration, this is only a short term solution. Our
bodies can do this but it produces lactic acid. Our bodies normally use aerobic respiration with
requires oxygen. Chronic Bronchitis is when the airways are irritated and inflamed. The linings of
the airways also become thick, along with an excess mucus formation. This causes breathlessness
("COPD"). Living with this disease can be an endless struggle. It is the leading cause of disability. It
is also the third leading cause of death in america. It is not transmittable but still is a huge problem
in society. It that isn 't enough COPD gets worse over time so this can lead to depression. In sever
cases COPD can limit basic actives. These ca be as simple as cooking a meal or cleaning a house
("COPD").
Symptoms
In mild cases a person might not show symptoms of COPD. Symptoms do increase as the disease
progresses. The main symptom that show in most people include respiratory related problems.
Shortness of breath is common because of all the mucus in the lungs. Wheezing can be caused

A Nurse's Perspective on the Alert for Pulmonary Arterial...
On The Alert for Pulmonary Arterial Hypertension
On The Alert for Pulmonary Arterial Hypertension
Summarized by: Joanne Marie Tarrobal–Baynosa
Arellano University – INP
Summarized by: Joanne Marie Tarrobal–Baynosa
Arellano University – INP
By Vincent M. Vacca, Jr., RN, CCRN, MSN
Nursing Journal, December 2009 Issue
By Vincent M. Vacca, Jr., RN, CCRN, MSN
Nursing Journal, December 2009 Issue
Nurse Vincent M. Vacca, Jr. aptly described in this issue of the Nursing Journal the significance of
early detection and health management of people who are or are maybe suffering from Pulmonary
Arterial Hypertension. He described PAH as a condition wherein a patient is having a mean
pulmonary arterial (PA) pressure of greater than 25 mm ... Show more content on Helpwriting.net ...
A lung or heart transplant is then recommended for patients whose condition doesn't improve or
worsens. The survival rate according to nurse Vacca for patients receiving lung transplant is 74%
after 1 year and 45% after 5 years of receiving the new lung. However, he said the wait time for
donor lung can take up to 3 years but sadly patients with PAH can not wait that long. Therefore
nurse Vacca emphasized the importance of educating families and patients with PAH the proper
management of this condition in order for patients to live longer and have a better quality of life.
Some of the examples he mentioned in the proper management of this condition includes proper
administration of medication including knowing its side effects, appropriate planning of activities
and rest, reducing fluid retention by following a low sodium diet, daily weight monitoring and being
alert in recognizing peripheral edema, the use of supplemental oxygen if needed, and knowing when
to contact a health care provider upon onset of symptoms. Most importantly, encourage patients to
discuss end of life issues with their family and/or social services and support

Glycopyrronium–
Introduction
The critical appraisal of a research article is a method of examining its validity, value and relevance
to study. This assignment will focus on critically appraising a research article which evaluated the
safety and efficacy of a drug (Glycopyrronium) used for chronic obstructive pulmonary disease,
against a second drug (Tiotropium) used in the treatment of the same condition.
Chronic obstructive pulmonary disease (COPD) is the name used for diseases related to the lungs,
which cause breathing difficulties due to the narrowing of airways in the lung. Patients suffering
from COPD experience symptoms of breathlessness when enduring physical activity, a persistent
cough with ... Show more content on Helpwriting.net ...
I used keywords 'glycopyrronium' and 'COPD'. Going through the results, I came across an article
titled;
"A blinded evaluation of the efficacy and safety of glycopyrronium, a once–daily long–acting
muscarinic antagonist, versus tiotropium, in patients with COPD: the GLOW5 study"
I chose to critically appraise this article as it evaluated the efficacy and safety of Glycopyrronium
against Tiotropium, another mainly used drug in the treatment of COPD.
A randomized controlled trial approach was used in this study. Over a period of 12 weeks, the
blinded double dummy method was used where neither the participants nor the people giving the
intervention know what it is. Due to both drugs having specific inhalation devices, each had a
placebo, hence masking the identity of the drug. The advantages of the randomized controlled trial
approach are that it allows for a thorough evaluation of the variables, there is potential for the
eradication of bias results and this type of trial can be used to give a meta–analysis. However, this
type of trial can be expensive, time consuming and can be ethically challenging or stopped if
extensive adverse effects are seen.
The baseline characteristics used in this trial for the participants were men and women aged ≥40
with moderate to severe COPD (stage II or stage III), who were current or ex–smokers that had or
have been smoking for 10 years or more. 980 participants were

Pulmonary Hypertension Research Paper
Pulmonary Hypertension Pulmonary Hypertension is high blood pressure that occurs in the arteries
in the lungs.
Classifications of Pulmonary Hypertension
There used to be two types of Pulmonary Hypertension. Primary Pulmonary Hypertension is when
there is no other disease or illness accompanying it. Secondary Pulmonary Hypertension is when
there is a pre–existing disease that triggers the Pulmonary Hypertension.
Etiology
"Why the blood vessels in the lungs thicken in Pulmonary Hypertension has a complex answer–
numerous factors can be involved."(medicalnewstoday.com) The most common causes of
Pulmonary Hypertension are left heart failure, parenchymal lung disease with hypoxia,
miscellaneous conditions such as sleep apnea, connective tissue ... Show more content on
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The first thing to look for when trying to determine if a person has pulmonary hypertension is a
family history of the disease and all of the details of their symptoms. A physical exam looks for
swollen ankles or legs, bluish color to the skin or lips, and looks for signs of pulmonary
hypertension in a person's heart and lungs. There are quite a number of tests that are done to confirm
a diagnosis of pulmonary hypertension. A blood test will check oxygen levels, liver and kidney
function, and certain blood tests can assess the strain on the heart. Chest x–rays can reveal an
enlarged right ventricle or pulmonary arteries. An electrocardiogram will check the electrical
impulses of the heart. An echocardiogram estimates the pressures in the right heart and will tell how
well the heart is functioning. Pulmonary function tests how much air your lungs can hold and how
much air moves in and out of them. The test also tests a person's lungs ability to exchange oxygen. A
patient will likely be asked to perform a six minute walk test which identifies the patient's exercise
tolerance level. Nuclear scans will test for blood clots in the lungs. Once these tests have been done
and they point to a diagnosis of pulmonary hypertension a right heart catheterization will likely be
performed. "Right–heart catheterization is one of the most accurate and

Pulmonary Arterial Hypertension ( Ph )
Pulmonary Arterial Hypertension (PAH) belong to group 1 in the classification of Pulmonary
Hypertension (PH). It is a chronic progressive disease caused by narrowing of the minor pulmonary
arteries due to vascular proliferation and remodeling.
Figure 1: Changes occur in blood vessels in PAH.
The estimated prevalence for PAH is 15–50 cases per million although it is a rare disease. The
female to male ratio is 1.7:1 with higher prevalence between 30–40 years old. To date there are 52
cases per million population of Scotland diagnosed with PAH. (1)
The current treatments available for PAH are prostaglandin (PG), calcium channel blocker (CCB),
Endothelin Receptor Antagonist (ERA), and Phosphodiesterase–5–inhibitors (PDE–5–I). The need
for new drug therapy is due to the drawbacks of the current treatment as shown in the tables below.
(3) This has led to the development of Opsumit (Macitentan), a new drug therapy for PAH.
Table 1: Drawbacks of using Calcium Channel Blocker (CCB) in PAH
Calcium Channel Blocker (Nifedipine, Diltiazem) The proportion of patient benefited from this drug
is too little.(2)
Table 2: Drawbacks of using Prostaglandins (PGs) in PAH
Epoprostenol I.V Iloprost nebulized Treprostinil S.C
– Inconvenience administration through IV route which requires hospitalization
– Unpresentable body image
– Administration of the drug might be associated with high risk of infection (need to be given
through continuous I.V infusion due to short half–life)

Pulmonary Circulation Loops
There are two primary circulation loops in the human body known as pulmonary circulation loops
and systemic circulation loops. o Pulmonary circulation loops: is responsible for transporting
oxygenate–poor blood from right atrium, to the right ventricle and then to the lung. The blood then
picks oxygen in the lung and then returns to the left atrium. o Systemic circulation loops: then
systemic circulation loops transport the oxygenate–rich blood from the left atrium to then left
ventricle. From there, the heart pumps the oxygenated blood to the rest of the body. The systemic
circulation loops also get rid of waste from body tissue and return deoxygenated blood back to the
right atrium.
Superior vena cava (Upper body)
Interior vena cava (lower and middle body) ... Show more content on Helpwriting.net ...
The right atrium contracts, the tricuspid valve opens, blood is then pumped into the right ventricle.
The tricuspid valve closes itself when the right ventricle is full to stop blood from flowing back into
the right atrium. (Dao, 2017)
The right ventricle contracts, which opens the pulmonary valve. Once the pulmonary valve is
opened, blood is pumped into the pulmonary artery which goes into the lungs. The blood then picks
oxygen in the lung which turns the deoxygenated blood into oxygenated. The pulmonary valve
closes itself to hinder blood from flowing back into the pulmonary artery. (Dao, 2017).
The oxygen–rich (oxygenated) blood return from the lung to the heart through the pulmonary vein
and into the left atrium. The mitral valve them opens and blood is pumped into the left ventricle.
(this happens at the same time as the right atrium pumps blood into the right ventricle). (Dao, 2017)
The mitral valve closes itself when the left ventricle is filled with blood. The aorta valve opens
which contracts the left

Pulmonary Disease Annotated Bibliography
Annotated Bibliography
Chronic obstructive pulmonary disease (COPD): Coping with COPD. Created: August 12, 2015;
PubMed Health. Retrieved April 27, 2018 from:
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0079011/. Accordingly, to this information of
COPD: Coping with COPD from PubMed Health, this article provides the early stages, progression,
coping and emergency plan and this disease affects family and friends. It is written answering the
question, what to expect from COPD and how to manage this lung disease? A team of health care
professionals, scientists and editors, and experts (Chronic obstructive pulmonary disease (COPD),
2015), provides education of how this disease may affect daily lives, how to live with this disease
and what causes ... Show more content on Helpwriting.net ...
In Chronic obstructive pulmonary disease: It takes your breath away, Dr. Simon states that COPD is
the fourth leading cause of deaths in America and some people are unaware they are ill with the
crippling breathing disease. He briefly describes what COPD is and its symptoms to be aware of.
What are the effects of COPD and treatment of medications used to keep this lung disease under
control. How exercise may affect your breathing with this disease. The CREDO reference is located
within the American Public University System Library and describes and explains how to live with
COPD that will educate me of this lung disease that I have.
References
Chronic obstructive pulmonary disease (COPD): Coping with COPD. Created: August 12, 2015;
PubMed Health. Retrieved April 27, 2018 from:
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0079011/. Protecting your lungs: Tips to keep
your lungs healthy. n.d. American Lung Association.
Retrieved April 27, 2018. http://www.lung.org/lung–health–and–diseases/protecting–your–lungs/.
Simon, H., MD. (2014). Chronic obstructive pulmonary disease: It takes your breath away. In
Harvard. Ed, Publications, Harvard Medical School Commentaries on Health. Retrieved
April 24, 2018, from CREDO:

Chronic Obstructive Pulmonary Disease ( Copd )
COPD Case Study Chronic obstructive pulmonary disease (COPD) is an interchangeable phrase
used to describe respiratory diseases characterized by airway obstruction. COPD is now a well–
known and serious chronic disease, killing many and affecting a mass number of people per year.
COPD is a result in restricted (obstructed) airflow in the lungs. Obstructive diseases include
bronchitis, in which inflammation causes chronic bronchial secretions and narrowing of the bronchi
and emphysema a permanent destructive enlargement of the airspaces within the lung. 1) What
clinical findings are likely in R.S. as a consequence of his COPD? There are a number of clinical
findings that can be consequences due to R.S. COPD. R.S. has developed chronic bronchitis also
coined as typed B COPD or the blue bloater. A productive cough or an acute chest illness is
common. The cough mostly is worse in the mornings and creates a small amount of colorless
sputum. Wheezing may occur in some patients, predominantly during exertion and exacerbations
(Mosenifar, 2014). Alterations in the airway involve chronic inflammation and swelling of the
bronchial mucosa causing scarring with increased fibrosis of the mucous membrane. There is
hypertrophy of the bronchial glands and goblets cell with an increase in bronchial wall thickness,
which leads to an obstruction of airflow. Goblet cells and mucosal glands that experience
hypertrophy cause a product of increased mucus that then combines with purulent exudate

Massive Pulmonary Embolism: A Case Study
Several studies have demonstrated use of tPA in massive or sub–massive pulmonary embolism to
accelerate lysis of thrombi in patients presenting with sustained right ventricular dysfunction or
circulatory collapse. Even though systemic tPA is the mainstay therapy, catheter directed techniques
can also be employed in patients in severely critical condition or who have significant bleeding risk.
A 41–year–old male arrived at Augusta University Medical Emergency room after a motorcycle
collision with ejection. Upon arrival, patient was hemodynamically unstable and after resuscitation
was taken to operating room as level one exploratory laparotomy. In the OR, the patient was found
to have a large retroperitoneal hematoma due to right renal vein injury – ligation and right
nephrectomy were performed. Patient continued to have a tenuous course throughout the next day,
requiring nephrology consults, selective embolization of several second and third order hypogastric
arteries bilaterally. Patient returned to shock ... Show more content on Helpwriting.net ...
Most common presenting signs are dyspnea at rest, pleuritic pain, cough and orthopnea. Upon initial
presentation of PE hemodynamic status should be assessed based and patients should be strafed into
low risk, moderate or high risk. Majority of patients with PE are hemodynamically stable. Roughly
8% of the patient's present with hemodynamic instability and circulatory collapse. These patient
have either systolic blood pressure 15 minutes, hypotension requiring vasopressors or clear evidence
of shock. However, there are a few patients who are hemodynamically stable but have significant
ventricular dysfunction and borderline SBP due to extensive clot burden – these patients are
characterized as intermediate risk or

What Is Pulmonary Vascular Disease?
Pulmonary vascular disease is used to identify any disorder that may affect blood flow through the
vessels between the heart and lungs. Blood flow begins at the right side of the heart and makes its
way to the lungs in the process of oxygenation. Deoxygenated blood from the tissue travels to the
right side of the heart through the veins and is eventually pumped towards the lungs through
pulmonary arteries. The lungs oxygenate the blood and send it towards the left side of the heart
through the pulmonary vein in order to pump it throughout the body. Any disruption of this process
would be labeled a Pulmonary Vascular Disease. There are several kinds of PVD, the two main
types are Pulmonary Embolism and Pulmonary Hypertension. Pulmonary Embolism

Chronic Obstructive Pulmonary Disease, also known as COPD, is defined as a progressive, chronic
lung disease that makes it difficult to breathe by limiting airflow and it is characterized by chronic
inflammation of the airway and shortness of breath and wheezing. BOOK/FAM PRAC
"Progressive" means that the disease gets worse over time. "COPD is one of the important diseases
that lead to restrictions, disability, and an increase in mortality rates among elder population"
[4,5].TURK STUDY QUOTE The primary cause of death among COPD individuals is
cardiovascular disease. PLOS More people (37%) die due to coronary heart disease or heart failure
than those (34%) who die from COPD alone. #2 PLOS
Approximately 12 million people in the United States have been diagnosed with COPD. BOOK.
There may be more individuals affected and not be aware of it. According to the World Health
Organization and the National Heart and Lung Institute, COPD was the fourth leading cause of
death in the United States in 2012. FAM PRAC Its prevalence increases with age. And generally
occurs between the ages of 35 and 70 years old [27]. TURK Based on the literature review from the
TURK STUDY, "COPD is more prevalent among males and its prevalence increases with age. Men
are more likely to have the disease, but the death rate for men and women is about the same. BOOK
This gender difference is explained by the facts that smoking is more prevalent among males and
males are exposed to toxic substances more

Venous Thromboembolism And Pulmonary Embolism
Venous Thromboembolism
Venous thromboembolism (VTE), including both deep venous thrombosis (DVT) and pulmonary
embolism (PE), is reognised as the leading cause of preventable in–hospital mortality. DVT is the
formation of blood clots in a deep vein– usually the large veins in the leg or pelvis. The most serious
complication of a DVT is that the clot could dislodge and travel to the lungs, becoming a life–
threatening blood clot in the lungs, pulmonary embolism. When a blood clot breaks loose and
travels in the blood, this is called a venous thromboembolism. An inflammatory reaction is usually
present mainly in the superficial veins and, for this reason this pathology is often called
thrombophlebitis. It is a disorder that can occur in all races and ethnicities, all age groups, and both
genders. Despite a marked increase in federal and national efforts to raise awareness and
acknowledge the need for VTE prevention, VTE continues to remain as an important and growing
public health problem. Unfortunately, VTE recurs frequently and is commonly overlooked, affects
both hospitalized and non–hospitalized patients, and results in long–term complications including
chronic thromboembolic pulmonary hypertension (CTPH) and the post–thrombotic syndrome
(PTS).
Venous thrombi, composed predominately of red blood cells but also platelets and leukocytes bound
together by fibrin, form in sites of vessel damage and areas of stagnant blood flow such as the valve
pockets of the deep veins of

A Silent Killer : Pulmonary Embolism A Silent Killer
Pulmonary Embolism a Silent killer
Pulmonary Embolism is a life–threatening condition that has most serious manifestation of venous
thromboembolism that is leading cause of sudden death. "With massive pulmonary embolism (PE)
being the first or second leading cause of unexpected death in adults, protection against PE is critical
in appropriately selected patients" (Georgiou, Katz, Ganson, Eng, & Hon, 2015). How does this
effect the nursing? If Pulmonary embolism is suspected, nurses goal is to halt PE that is forming a
clot and from embolizing. Nurses must be extra diligent in preventing Pulmonary embolism, be able
to recognize it early, provide prompt help and start appropriate treatment because if it is
unrecognized or untreated it can cause death very quickly. Knowing how to intervene when PE is
suspected can make a difference in life a threatening emergency. "Massive PE, defined as causing
50% or more occlusion of the pulmonary capillary bed, can result in obstructive shock with systemic
hypoperfusion (low cardiac output and acute pulmonary hypertension with right ventricular failure).
ANA''.
Pathophysiology of PE
A Pulmonary Embolism is usually caused by a blood clot (thrombus) that migrates from its original
site to occlude a distal vessel. Normally, human body lyses the thrombi that was formed within the
circulatory system, but if the clot not fibrinolyzed, it may break off and can travel with a
deoxygenated blood to the heart and goes in the lungs by obstructing the

Case Study On Acute Pulmonary Oedema Secondary
Case study The case study relates to Mr Brown, who diagnosed with acute pulmonary oedema
secondary to acute renal failure, due to excessive use of opioids. The assignment will address Mr
Brown's initial presentation and assessment, relevant past history, medications as well as the current
assessment finding that had him admitted to intensive care unit. Briefly discussing the patients'
pathology results scans and as well as drug treatments to correct electrolyte imbalances.
Furthermore discuss the effects of age related physiological effects on respiratory, cardiovascular
and renal system and lastly the pathophysiology and treatment on opioid toxicity, acute renal failure
and acute pulmonary oedema. Mr Brown is a 76 year old male, which presented to the emergency
department via ambulance with thoracic back pain, which commenced two days prior to the
presentation. The triage assessment stated the patient is alert, orientated, distressed, chest clear and
equal, neurovascular intact with equal strength in all extremities and good strong regular pulses. The
nil injury stated patient said he 'just woke up with it'. The patient's observation displayed a
temperature of 36.9°C, blood pressure of 169/105, pulse rate of 99 beats per minute, respiratory rate
of 20 breaths per minute, Glasgow coma score of 15, and a blood glucose level of 5.4. Mr Brown's
has a past medical history of atrial fibrillation, asthma, emphysema, hypertension, chronic back
pain, lumbar fusion (L1), total

Pulmonary Valve Research Paper
The pulmonary valve is one of the semi lunar valve next to aortic valve, lying between the right
ventricle and the Pulmonary artery which takes deoxygenated blood from the body and pumps it
into the heart. Generally tricuspid, the pulmonary valve is considered simpler in anatomical sense. A
semi lunar valve separates a ventricle from a blood vessel which the ventricle leads into in its flow
path of blood. The absence of chordae tendinae is prominent in the semilunar valves. The pulmonary
leaflets are names based on the anatomic orientation to the aortic valve faces that lie adjacent to the
pulmonary trunk. The commissures of the right and left leaflets are supported by the
supraventricular crest of the right ventricle which separates the pulmonary valve from the tricuspid
valve. The left cusp is in the anterior region of the interventricular septum while the anterior cusp is
located on the delicate wall of the pulmonary conus. Meanwhile the right cusp is on the ... Show
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If there were no valves, blood would flow in all directions inside the heart not pumping the blood to
the body. If the functioning of these valves are effected they would cause increased load on the heart
reducing the distribution rate of the blood inside the body, leading to eventual heart failure. Hence
the timing and structural integrity of these valves is essential for a healthy living. These heart valves
are sometimes diseased and their functioning is effected which is one of the major cause of
congestive heart failure. The atrioventricular valves present between the atria and ventricles, they
control the direction of the flow of blood preventing it from backflow into the atria while the
ventricle contract. Whilst the semilunar valves prevent the backflow of the blood into the ventricles
during systole, the aortic valve and the pulmonary valve prevent the over loading of the

Pulmonary Embolism Paper
Pulmonary Embolism Outcomes and Pathophysiology Pulmonary embolism, what is it and how are
the outcomes for this disease process and why is this disease so very important to treat as soon as
possible? Well according to Medline Plus pulmonary embolism are essentially blot clots that get into
the arteries of the lungs and cause a blockage which can lead to many serious problems if not treated
correctly. The type of clot that is usually attributed to this disease is one that comes from deep vein
thrombosis which often comes from one of the lower legs. Pulmonary Embolism: Medline Plus
(2016, March 15). The lungs are a very important part of the body as important in the process
cellular respiration, which with the lungs take the carbon dioxide ... Show more content on
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Now it is easier to treat the disease with the newer medications that are available and better
procedures that can be performed with lower risks. The outcome for this disease today is a higher
rate of survival and lower risk of complications. With a study that was conducted from 2001 to 2007
they determined that 70% of participants in the study were free of any recurring problems after the
first year at the end of the study. After two years the rate dropped to 60% and then four years after
the end of the study it was concluded to be less than 50 percent were free of any problems. Klok, F.
A., & Zondag, W. (2010). This outcome can be attributed to many factors such as diet and exercise
which are necessary to help prevent blood clots. After the treatments and therapies for the
pulmonary embolism a certain percent of those treated my redevelop a pulmonary embolism for
unknown reasons that are still being studied in clinical trials being conducted to this day. The
general prognosis for pulmonary embolisms is good with the rate of recurrence being less than 5
percent if a person is on anticoagulant

COPD which is Chronic Obstructive Pulmonary Disease is known as a condition that progressively
makes it harder to breathe because the airflow into and out of the lungs is reduced. This usually
occurs because the airways and air sacs lose their elastic quality, the walls between the air sacs are
destroyed, the walls of the airways become swollen, or if the airways are clogged because they made
more mucus than usual. Three main conditions of this disease are emphysema, chronic obstructive
bronchitis, and asthma. Most patients who suffer from COPD also suffer from emphysema and
chronic bronchitis as to why they are commonly just defined as COPD. The patients who experience
one or more of these conditions usually find it even more difficult to ... Show more content on
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There is no cure for this condition, but certain treatments may help a patient to feel better, remain
more active and also keep their condition from progressing so fast. First, the doctor will tell you if
you are a smoker the best thing to do is to quit. And, depending on the severity of your COPD your
doctor may advise you to see a pulminologist, who is a doctor who treats patients with lung
problems. Then, different medications may be prescribed such as bronchodilators, short–acting or
long–acting again depending on the severity of the disease. Both are used to relax the muscles
around your airways to help make breathing easier; however, short–acting is said to only last four to
six hours, whereas, long–acting is said to last twelve hours or more. Most bronchodilators are used
through metered–dose inhalers. Also, inhaled steroids may be prescribed to reduce the airways from
swelling. Doctors will usually prescribe the steroid for a trial period of six weeks to three months.
Other treatments to help this disease from progressing may be pulmonary rehabilitation, oxygen
therapy, and vaccines to prevent the patient from the pneumonia or the flu. Rarely, a patient may be
advised to have surgery such as a bullectomy, which is a removal of one or more very large bullae of
the lungs, a lung volume reduction surgery, which is used to removed damaged tissue from the
lungs, or a lung transplant may also benefit patients who suffer

Pulmonary Fibrosis : A Type Of Disease
Idiopathic Pulmonary Fibrosis
Jasmine A. Bowers
Keiser University
Associates of Science Radiologic Technology
RTE 1814 A–B
August 7, 2015
ABSTRACT
Idiopathic Pulmonary Fibrosis is a type of disease that can happen differently in each person. The
medical definition of Idiopathic Pulmonary Fibrosis is a disease marked by scarring in the lungs
which can be very chronic. However, statistics state that this disease affects just about 128,000
people in the United States. Also, there are 48,000 new cases diagnosed and 40,000 that die each
year because of Idiopathic Pulmonary Fibrosis (Facts About Idiopathic Pulmonary Fibrosis, 2015).
Sometimes the disease can happen quickly or slowly in each person or it can stay the ... Show more
content on Helpwriting.net ...
Every person that has Idiopathic Pulmonary Fibrosis has different symptoms such as a dry cough,
weakness, shortness of breath, aching muscles and joints, weight loss, and finger and toes began to
get wider. This patient had caregiver which was his son, and he helped me understand the conditions
that the patient was in. Well, I introduced myself to the caregiver and he gave me subjective data
about the patient while I was taking objective data about the patient at the same time. I began
explaining the procedure that I was going to preform of the patient, then asked the caregiver if he
had any questions about the procedure. In that time, I found out the patient 's' medical history, the
history of the disease, and the best treatment possible for the patient.
Patients' Medical History
The patient 's birthday is April 5, 1926. The caregiver that was with the patient explained to me that
he was having shortness of breaths, dry coughs, weakness in his muscles and joints as he would try
and help him move in and out of the bed and wheelchair. So, I realized how breathing actually

works and it has to deal with the lungs and moving oxygen throughout the body. The caregiver of
the patient has explained the past medical conditions such as Cardiomegaly, Hepatomegaly, and
Altered Mental State. He had a couple of surgeries: Pacemaker placed in his chest, and Coronary
Artery Bypass Graft (CABG). The caregiver

The Cause And Causes Of Pulmonary Hypertension
Introduction
Pulmonary hypertension is high blood pressure within the arteries in your lungs (pulmonary
arteries). It is different from having high blood pressure elsewhere in your body, such as blood
pressure that is measured with a blood pressure cuff. Pulmonary hypertension makes it harder for
blood to flow through the lungs. As a result, the heart must work harder to pump blood through the
lungs, and it may be harder for you to breathe. Over time, this can weaken the heart muscle.
Pulmonary hypertension is a serious condition and it can be fatal.
What are the causes?
This condition is caused by many different medical conditions. Pulmonary hypertension can be
categorized by cause into five groups:
Group 1. Pulmonary hypertension that is caused by abnormal growth of small blood vessels in the
lungs (pulmonary arterial hypertension). The abnormal blood vessel growth may have no known
cause, or it may be:
Passed along from a parent (hereditary).
Caused by another disease, such as a connective tissue disease (including lupus or scleroderma) or
HIV.
Caused by certain drugs or toxins.
Group 2. Pulmonary hypertension that is caused by weakness of the main chamber of the heart (left
ventricle) or heart valve disease.
Group 3. Pulmonary hypertension that is caused by lung disease or low oxygen levels. Causes in this
group include:
Emphysema or chronic obstructive pulmonary disease (COPD).
Untreated sleep apnea.
Pulmonary fibrosis.
Group 4. Pulmonary hypertension that is caused by

Pathology and Treatment of Pulmonary Arterial Hypertension
The pulmonary vasculature contains arteries and arterioles, which branch in the lungs to create a
dense capillary bed to provide blood flow. The pulmonary capillary bed is a high–volume, low–
pressure, low–resistance system that delivers blood to and from the lungs via the arterial and venous
circulation systems. The right ventricle of the heart is responsible for pumping blood to the
pulmonary artery and to the lungs so it can be oxygenated while the left ventricle pumps oxygenated
blood to the tissues. Typically, hypertension refers to high blood pressure in the systemic circulation,
however, an increase in blood pressure may also occur in pulmonary circulation. The pulmonary
artery supplying blood to the lungs can become narrowed, ... Show more content on Helpwriting.net
...
Increased levels of pro–inflammatory cytokines and chemokines result in an infiltration of
inflammatory cells forming plexiform lesions consisting of T cells, B cells and macrophages (Savaj
et al., 2012). Scleroderma, or systemic sclerosis, is a connective tissue disease characterized by a
thickening of the skin. Accumulation of collagen by fibroblasts, platelet adhesion and a type II
hypersensitivity reaction lead to endothelial damage. Endothelial damage and decreased
vasodilatation result in increased arterial pressure leading to PAH (Mclaughlin, 2009). Patients
generally have a poor prognosis unless detected early, as a cure for slceroderma does not exist.
Patients with advanced liver disease can also develop PAH. Portopulmonary hypertension (PPH) is a
combination of high blood pressure in the portal and pulmonary systems. Unless transplantation can
occur, prognosis for these patients is less than ideal. In order to be considered for transplantation,
patients must have a mean arterial pressure less than or equal to 35 mm Hg.
Long term cocaine and methamphetamine abuse have been linked to developing PAH (McLaughin
et al., 2009). Cocaine can cause overexcitement of the sympathetic nervous system triggering an
erratic, potentially severe condition called vasospasm, which involves a rapid

Pulmonary Valve Syndrome Research Paper
Pulmonary Valve Stenosis, Pediatric
Pulmonary valve stenosis is a heart problem some children are born with (congenital heart defect).
This defect is a stiffening or narrowing (stenosis) of a one–way valve in the heart. It is the valve that
allows blood to flow from the pumping chamber on the right side of the heart (right ventricle) into
the blood vessel that carries blood to the lungs. If not enough blood is flowing through the valve, not
enough oxygen will get into your child's blood. The child's heart will also be forced to work harder.
Pulmonary valve stenosis develops during the first 8 weeks as a child is growing inside the womb. It
sometimes develops with other types of heart abnormalities. Pulmonary valve stenosis can range
from ... Show more content on Helpwriting.net ...
This is the most common treatment. In this procedure, a catheter is placed in the heart. The catheter
is placed through the valve. Then a tiny balloon on the end of the catheter is blown up to open the
valve.
○ Heart surgery to open, repair, or replace the valve.
HOME CARE INSTRUCTIONS
Follow all instructions from your child's health care provider.
Give your child over–the–counter and prescription medicines only as told by his/her health care
provider.
Do not give your child aspirin unless instructed to do so by your child's health care provider or
cardiologist.
Ask the health care provider whether your child has any activity restrictions. Depending on the
severity of the the condition, some children can participate in the usual activities.
Your child does not have to follow a special diet.
Make sure your child's immunizations are current.
Let all health care providers know that your child has pulmonary valve stenosis before any medical
procedure.
Ask your health care provider if your child should take antibiotic medicine before having any
medical or dental procedure.
Keep all follow–up visits as told by your health care provider. This is

Anatomy Of The Pulmonary, Coronaries And Veins
Anatomy Of The pulmonary, Coronaries and aorta arteries
Gross anatomy
The heart and great vessels are roughly in the middle of the thorax, being surrounded laterally and
posteriorly by the lungs and anteriorly by the sternum and the central part of the thoracic cage. The
heart acts a twofold, self–modifying suction and pressure pump, the parts of which work in union to
push blood to all parts of the body. The right half of the heart (right heart) gets ineffectively
oxygenated (venous) blood from the body via the SVC and IVC and pumps it through the
pulmonary trunk to the lungs for oxygenation. The left half of the heart (left heart) gets well–
oxygenated (arterial) blood from the lungs via the pulmonary veins and pushes it into the aorta for
circulation to the body (Fig.1) (Moore and Dalley, 2006).
Fig.1. The heart and great vessels (Quoted from Shah, 2005)
I– Anatomy of pulmonary arteries:
The lungs get blood by means of two sets of arteries: pulmonary arteries and bronchial arteries.
Deoxygenated blood goes through the pulmonary trunk which separates into a left pulmonary artery
that enters the left lung and a right pulmonary artery that enters the right lung. Return of the
oxygenated blood to the heart happens by method of the four pulmonary veins which deplete into
the left atrium (Tortora and Nielsen, 2012). The fundamental divisions of the trunk are the right and
left pulmonary arteries. The right pulmonary artery goes in front of the

Pulmonary Case Study : Chronic Obstructive Pulmonary...
Pulmonary Case Study Analysis and Care Plan Chronic obstructive pulmonary disease (COPD) is
most prevalent in the older adult and smokers. It is the third leading cause of death in the United
States and affects 329 million people worldwide. The disease also carries a burden on the economy
with an estimated cost of $29.5 billion annually for treating exacerbations (Hattab, Alhassan,
Balaan, Lega, & Singh, 2016). It is defined as the limitation of airflow within the airway and lungs
secondary to a chronic inflammatory response from exposure to noxious stimuli. Repeated exposure
to chemicals like cigarette smoke lead to the destruction of the lung parenchyma and alveoli
decreasing the lungs ability to appropriately exchange gases (Baraldo, Turato & Saetta, 2012). The
disease is both preventable and treatable with appropriate evidence–based practice and patient
education as presented. Normal Pulmonary Function The primary function of the lungs is to move
air into and out of the respiratory system and to perform gas exchange of oxygen into the blood and
release carbon dioxide through expirations. The air movement begins with the bronchial tree with
inspired air being moved into the lungs then into the pulmonary capillaries and finally into the
alveoli where gas exchange takes place (Baraldo, Turato & Saetta, 2012). Within the bronchial tree,
pollutants or foreign noxious stimulants are often identified here. Cilia work to remove them by
triggering the cough reflex and with

Obstructive Pulmonary Disease
Chronic Obstructive pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is not one single disease but an umbrella term used
to describe chronic lung diseases that cause limitations in the air flow.
According to the latest World Health Organization (WHO) estimates (2004), currently 64 million
people have COPD and 3 million died of COPD, WHO predicts that COPD will become the third
leading cause of death worldwide by 2030.
Common causes of COPD:
Inhaling pollutants: Smoking, fumes, chemicals or dust.
Genetics can also play a role in development of COPD.
Symptoms may include:
Treatment of COPD:
When the patient is diagnosed with chronic obstructive pulmonary disease (COPD), which includes
chronic bronchitis and emphysema,

Chronic Obstructive Pulmonary Disease also known as COPD, is one of the third leading cause of
death in the United States (National Heart Lung and Blood Institute [NHLBI], 2013a). According to
the Centers for Disease Control and Prevention (CDC) (2015) approximately 15 million Americans
are affected by COPD, with a morbidity rate of 6.8 million. Data from the CDC from 2011 states
that 6.3% of the U.S population suffer from this disease; Florida has the COPD prevalence rate of
7.1% with the highest percentage going to Kentucky with a rate 9.3% as summarized by the COPD
foundation (2015). CDC calculated the cost of having COPD as $32.1 billion in 2010 and they
expect it to rise to $49 billion by 2020, all for a disease that could be prevented. Additionally CDC
has stated the mortality rate has decreased in men in the United States from 57.0 per 100,000 to 47.6
per 100,000 from 1999 to 2010. However, regarding the rate for women, there has not been much
change during the same time period. The rate shifted from 35.3 per 100,000 to 36.4 per 100,000
(CDC, 2014). COPD is one of the many preventable diseases that health care providers deal with.
Nurses needs to familiarize themselves with this disease process and how it affects the body,
preventative methods, and treatment plans, so that they can be well informed when it comes to
patient education. Education is a big part of nursing and considering COPD is the third leading
cause of death, nurses will be in frequent contact with

Factors That Patients With Idiopathic Pulmonary Fibrosis
Author/Title/Year in APA Reference Citation Problem Purpose Sample/
Population Data Collection
Method Major Findings/Conclusions
Collard, H. R., Ward, A. J., Lanes, S., Hayflinger, D. C., Rosenberg, D. M., & Hunsche E., Burden
of illness in idiopathic pulmonary fibrosis, (2012). Idiopathic pulmonary fibrosis (IPF) is a highly
morbid disease of aging in which the incidence has been reported to be climbing, with no widely
accepted therapy in the U.S other than a lung transplant. Harold et al., 2012). The purpose of this
study was to describe the burdens that patients with idiopathic pulmonary fibrosis (IPF) encounter,
such as comorbidites, healthcare utilization, and associated costs (Harold et al., 2012). The sample
for this study ... Show more content on Helpwriting.net ...
This PROMIS scale measures associations between HRQOL and symptoms that patients with IPF
experience (Yount et.al, 2016). The sample from this study was 220 individuals who presented with
IPF and were ages fifty and older who had not already received a lung transplant (Yount et.al, 2016).
The data for this study was collected by individuals, reported being told by a doctor that they have
idiopathic pulmonary fibrosis (IPF), who completed an online questionnaire, and seven to ten days
later were retested for reliability. When reliability was determined, these individuals where then
given a survey of demographic and helath related questions, the Modified Medical Research Council
Dyspnea Scale, the PROMIS 29 profile, and the PROMIS dyspnea severity short form (Yount et.al,
2016). The results from this study concluded that compared to the general population, patients with
IPF had PROMIS scale scores that were significantly lower. The deficits that these patients face
need motioring in clinical practice and also need consideration when investigating new therapies
Yount et.al, 2016).
Martinez, F. J., Andrade, J. A., Anstrom, K. J., King Jr, T. E., Raghu, G., & King, T. J., Randomized
trial of acetylcysteine in idiopathic pulmonary fibrosis (2014). Idiopathic pulmonary fibrosis is a
progressive lung disease of unknown cause that to date has no pharmacologic

CHRONIC OBSTRUCTIVE PULMONARY DISEASE Have you ever known a person who
smokes and has a hard time doing every day activities, due to difficulty of breath, or constantly
coughing. He or she may have Chronic Obstructive Pulmonary Disease, or COPD. COPD is a
progressive and treatable lung disease that causes shortness of breath due to obstruction of air way
(COPD, 2013). Progressive means that is gradually gets worse over time. It is a combination of
chronic bronchitis and emphysema (Causes,2014). Chronic bronchitis is inflammation of the
bronchioles, which causes mucus build up (Davis,2016). Emphysema is when the air sacs get
enlarged (Smoking, 2016). Since the disease does not have a cure yet it is important to know
pathology (path of disease), epidemiology (who is effected in a population), ethology (who is
effected genetically), manifestation (symptoms), treatment, and outcome.
First step preventing COPD is to know how it affects the body and the path taken; this is called the
pathology. In normal, healthy breathing a person breathes in air that is moves through the bronchial
tubes to the bronchioles. At the end of the bronchioles there are air sacs called alveoli. The alveoli
are elastic air sacs that control the gas exchange of oxygen and carbon dioxide to the body
(Smoking, 2016). The alveoli consist of elastic tissue so when a person breaths in the the alveoli can
expand and when the carbon dioxide is released it can deflate and return to it's normal size.

A ninety–two year old Caucasian male was brought to the emergency room by his son. Patient was
admitted to the hospital with a chief complaint of difficulty breathing; diagnosis includes congestive
heart failure exacerbation (CHF) with pneumonia (PNA). He has a full code status. Past medical
history includes congestive heart failure, COPD, peptic ulcer, chronic kidney disease stage 3,
anemia, and hypernatremia. Patient is a widower who lives with son and consumes no alcohol or
illicit drugs, he has is an ex–smoker with a 70 pack year history. Patient is a retired mechanic with
no family medical history on file; it is suspected that father had heart issues. He has no known
allergies although is contraindicated to take aspirin due to GI bleeding.
Upon physical examination the patient looked well–nourished and in relatively good spirits. He
exclaimed his "chest is heavy and hurts." His vitals showed a respiratory rate of 24 breaths per
minute, his tachypnea is possibly due to his exacerbation of congestive heart failure and/or
pneumonia. Heart rate of 75 beats per minute is within normal limits of 60–100 beats per minute.
Blood pressure of 130/86 suggesting prehypertension and/or a result of discomfort from CHF and/or
pneumonia. Temperature of 96.8 °F showing the patient is afebrile. SpO₂ was 92% on room air
which is within normal limits of an individual who has COPD. Physical inspection showed his skin
was warm and dry. Pedal edema was detected possibly due to

Surfactant Replacement Therapy And The Affects On Rds And...
Surfactant Replacement Therapy and the Affects on RDS and Other Pulmonary Disorders Jacquelyn
M. Wood Grossmont Community College 2015 INTRODUCTION As a newborn makes their
entrance to this world from intrauterine life all should go smoothly. The newborn is delivered and is
stimulated to breathe and then is followed by inspirations, followed by a cry showing a successful
arrival to this world, but not all deliveries go as planned. There are diseases of the respiratory
system. The most common disease is Respiratory Distress Syndrome (RDS). The Primary cause of
RDS is the underdevelopment of the premature lungs states Perretta, 2015. RDS is caused by a
deficiency and immaturity of alveolar surfactant with the anatomical immaturity of the premature
infants lungs. The incidence of RDS increases with decreasing gestational age says J. Haitsma,
2010. The biggest factor is surfactant deficiency caused by decreased surface area in the lungs for
proper gas exchange and thick alveolar–capillary membranes. "Surfactant replacement therapy for
preterm infants with RDS has shown to be a major breakthrough in neonatal medicine," says J.
Wirbelauer and Speer, 2009. It has become routine for the prevention and treatment for infants
suffering from respiratory distress syndrome. Surfactant replacement therapy is a life–saving
treatment for all neonates showing signs of RDS characterized by surfactant deficiency. By
replenishing the lungs with an exogenous surfactant shows

Currently the 4th leading cause of mortality worldwide, COPD or Chronic Obstructive Pulmonary
Disease is reported to account for more than three million deaths per year 1 and is estimated to rank
fifth in disease burden in 20202. The Global Initiative for Obstructive Lung Disease (GOLD)
guidelines updated their definition of COPD in 2006 as "a preventable and treatable disease with
some significant extra–pulmonary effects that may contribute to the severity in individual patients.
Its pulmonary component is characterised by airflow limitation that is not fully reversible. The
airflow limitation is usually progressive and associated with an abnormal inflammatory response of
the lungs to noxious particles or gases"3.
COPD is characterized by a spectrum of diseases namely: chronic bronchitis, obstructive
bronchiolitis, emphysema, pulmonary vascular disease, cor pulmonale or the abnormal enlargement
of the right side of the heart as a consequence of the malfunctioning of the lungs or pulmonary blood
vessels, muscle weakness, and cachexia or the eventual wasting of the body due to chronic illness4.
Our research mainly focusses on the emphysema phenotype of the Chronic Obstructive Pulmonary
Disease.
Among many other risk factors, cigarette smoke exposure plays a major role in COPD,
progressively affecting 15% of smokers2. Apart from being a complex concoction of 4700 chemical
compounds, cigarette smoke extract can also increase endogenous reactive oxygen species (ROS) in

The Treatment Of Pulmonary Hypertension
Treatments in Pulmonary Hypertension
Brooke Throckmorton
Kettering College
Abstract This paper discusses some of the different medications used in the treatment of pulmonary
hypertension. There are six different articles being used for each the medications, and other basic
information pertaining to pulmonary hypertension. The articles discuss studies performed on the
drugs to demonstrate their effectiveness on pulmonary hypertension. The articles exhibit important
information about how the therapeutic effects of the drugs have different levels of success in varying
patients. A few of the most common medications used in the treatment of pulmonary hypertension
being discussed in this review are: Vasodilators, High–Dose ... Show more content on
Helpwriting.net ...
Therefore, the pressure of the blood in the vessels is higher, causing pulmonary hypertension. If
blood cannot filter through the lungs properly, it does not get completely oxygenated. Poorly
oxygenated blood can cause many other issues to the body, so it is important to properly treat
pulmonary hypertension. Many different medications are used in treatment of pulmonary
hypertension including: Vasodilators, Endothelin Receptor Antagonists, Sildenafil, Tadalafil,
Prostacyclins, Calcium Channel Blockers, Anticoagulants, Diuretics, and Oxygen. Due to the fact
that the underlying cause of pulmonary hypertension is unknown, there are many studies on the
disease and the drugs used to treat it (Voelkel, Bogaard, Gomez–Arroyo, 2015). This review will
discuss the different types of medications used to treat pulmonary hypertension. Some of the
medications are found to be more effective than others based on the results of many studies that
have been performed on animals and humans. The goal of this review is to successfully compare and
contrast these different drugs based off of the studies performed on them.
Method
For this review, the Kettering College library online database was used to find peer reviewed articles
as references. Beginning on February 22, 2015, the search "treatment of pulmonary hypertension"
was used to narrow the results for the study. To shorten the results further, the year limit was set
from 2005

Chronic Obstructive Pulmonary Disease ( Copd )
Nursing Teaching Paper
Synopsis
All over the world, chronic obstructive pulmonary disease (COPD) is a very significant and
prevalent cause of morbidity and mortality, and it is increasing with time (Hurd, 2000; Pauwels,
2000; Petty, 2000). Due to the factor of COPD being an underdiagnosed and undertreated disease,
the epidemiology (Pauwels, Rabe, 2004) is about 60 to 85 % with mild or moderate COPD
remaining undiagnosed (Miravitlles et al., 2009; Hvidsten et al., 2010).
The risk factors of COPD include genetic factors as well as environmental causes. The chief risk
factor for COPD is smoking; which also includes people exposed to enormous amounts of
secondhand smoke. However, there are certainly other causes that can increase the risk of a person
developing the disease such as dust and chemicals. Long term exposure to their fumes, vapors or
particles can also cause the swelling of lungs (Eisner et al., 2010).
My patients demographic was an older, Caucasian women, who had a 10th grade education. She had
a rough up bringing which led to her turning to substances abuse to help with the difficulties. She
started smoking cigarettes as well as marijuana at the age of 15. Ever since she found out the she has
COPD, she has quit smoking and being corporative with learning how to cope with it.
The main characterizing feature of Chronic obstructive pulmonary disease is that there is limitation
of airflow because the smoke of cigarette directly damages the epithelial cells of the

What Is Pulmonary Valve?
Tricuspid Valve
The tricuspid is found in the right side of the heart. It rests between the atrium and the ventricle. The
function of this valve is to make sure that blood flows in the correct direction, forward, from the
atrium to the ventricle. This is important to make sure that blood doesn't move backwards through
the heart. When blood flows backwards through the heart it is referred to as regression or tricuspid
regurgitation.
Pulmonary Valve
The pulmonary valve is found to the right side of the heart. It is located between the pulmonary
artery and the right ventricle. The pulmonary valve functions by moving blood from the heart to the
arteries. Blood can only flow one way through this valve. Heart rate affects how frequently this
happens.

Types And Classifications Of Pulmonary Hypertension
Abstract Pulmonary hypertension is a disease that without treatment becomes progressively worse
until a patient dies. It is characteristically a disease of young adults, but may occur all across the
lifespan making this disease even more devastating.1 Pulmonary hypertension is characterized by
elevated intrapulmonary pressures which cause dynamic changes to the cardiovascular system of the
affected individual. The adequate functioning of the cardiovascular system is vital to the survival of
the patient so while treatment is rarely curative, with the exception of organ transplant which will be
discussed later, the main goal of medical therapy is to optimize cardiovascular functioning and stop
disease progression allowing people living with this disease the best possible quality of life and
level of functioning. There are several types and classifications of pulmonary hypertension with
multiple pathogenesis. Different treatment modalities have been proven effective to treat this disease
process; the mainstay of treatment relies heavily on pharmacologic therapies. Pharmacologic
treatments include drugs in the following pharmacological classes: calcium channel blockers,
prostacyclins including synthetic prostacyclins and prostacyclin analogues, endothelin receptor
antagonists, and phosphodiesterase inhibitors. While pharmacologic therapies are the mainstay of
treatment, heart and, or lung transplant maybe available for a specific subtype of PH, primary PH.
Organ transplant is

The Clinical Picture of Acute Pulmonary Embolism
Introduction The clinical picture of acute pulmonary embolism (PE) is not similar from various
aspect of its pathophysiological course presenting from minimal symptoms to variety of severity of
disease like severe hypoxia, hypotension, right heart failure and death1. Massive pulmonary
embolism is defined as obstruction of blood flow to a lobe or multiple segments of the lung, or for
unstable hemodynamics, i.e. failure to maintain blood pressure without supportive measures." This
case highlights about aggressiveness of treatment and role of thrombolytic therapy for a severely
hemodynamic unstable patient2. Case report In February 2013, a forty–eight years old male with no
prior co–morbidities transferred from Quetta to Aga Khan University Hospital, Karachi after
sustaining multiple lacerations and left tibia bone closed fracture in a bomb blast. After initial
management in the hospital, he underwent an orthopedic procedure (application of illiazarov over
left tibia) under general anaesthesia. The surgery went uneventful, and he then shifted to ward. From
next day morning, he suddenly developed dyspnea and became hypotensive and tachycardiac
(respiratory rate about 40/min, pulse 140 beats per min and blood pressures were around 60/30). He
was barely maintaining oxygen saturation 90% on 10 liters of O2 via facemask. Initially, he was
given 2 liters of fluid bolus but hemodynamics did not respond. A few minutes later, he went into
pulseless electrical activity and

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