This document discusses acute pleural effusions caused by pneumonia. It begins by explaining pleural effusions and their relationship to pneumonia. Pleural effusions occur when fluid builds up in the pleural space, usually due to conditions that increase fluid production or decrease removal. Pneumonia is a common cause of pleural effusions due to the inflammatory response. The document then discusses the pathophysiology, diagnostic studies, physical assessment, treatment including antibiotics and drainage, and nursing considerations for a patient with pleural effusions secondary to pneumonia.
The AYUSH system of medicine mostly relies on
prevention of disease. The Unani System of Medicine has much more to
offer for prevention of the disease.
Six essentials of life which form the basics of the Unani
Preventive measures are:
•Air-----Quality of air
•Food and Drinks (Ma’akool wa Mashroob)---Dietary habits,
balanced diet etc
•Physical Rest and Movement (Harkat wa Sakoon Badni)….Exercise
etc
•Mental Rest and Movement (Harkat wa Sakoon Nafsani) ….
Thinking, stress etc
•Sleep and awakeness (Naum wa Yagza)----Sleep time, good sleep
•Retention and Evacuation (Ehtibas and Estefaragh)….What is to be
retained and evacuated from the body.
The AYUSH system of medicine mostly relies on
prevention of disease. The Unani System of Medicine has much more to
offer for prevention of the disease.
Six essentials of life which form the basics of the Unani
Preventive measures are:
•Air-----Quality of air
•Food and Drinks (Ma’akool wa Mashroob)---Dietary habits,
balanced diet etc
•Physical Rest and Movement (Harkat wa Sakoon Badni)….Exercise
etc
•Mental Rest and Movement (Harkat wa Sakoon Nafsani) ….
Thinking, stress etc
•Sleep and awakeness (Naum wa Yagza)----Sleep time, good sleep
•Retention and Evacuation (Ehtibas and Estefaragh)….What is to be
retained and evacuated from the body.
Study Of Achievement in Environmental Studies, Family Environment and Learnin...paperpublications3
Abstract: Environment in developing countries like India have been threatened by problems like poverty, pollution, overpopulation, degradation and depletion of environment. As such, the environmental protection and preservation has been an urgent need of the hour. Realizing its importance, it has been enshrined in the Constitution of India, which requires both the state and the citizen to protect, preserve and improve the environment. Considering the seriousness of the problem only inclusion in Constitution will not help a lot in preserving our environment, but the issue should be initiated at the grass root level i.e. in family, school and society. In the changing scenario of our society attitude of an individual are greatly affected by family, teachers, school environment, teaching methods, learning styles and many other factors and they all have a great impact on the personality development of the child. It is well accepted fact that healthy family environment, co-operative learning and environmental education can help a lot in the development of positive desirable attitude towards environment among future citizens.
Galicia y escocia-dos_modelos_federales_v1Goyo Andión
Hemos llegado al final del ciclo sobre Federalismo. En este brillante trabajo de Begoña Lopez Portas especialista entre otras lineas de investigación de los modelos federales y la participación regional, el estudio del ambito competencial autonómico del autogobierno nacional. En concreto este resumen, que publicamos adjunto, recoge el concepto de la “devolution”, como proceso, su carácter federal y unitario, la “Scotland Act” de 1998, y cuadros comparativos de la participación en la Unión Europea, tanto de Galicia y Escocia, y su impacto sobre las competencias referido tambien a la institución europea. Con estos “mimbres” espero que todos nos hayamos acercado y podamos opinar de las similitudes y diferencias del autogobierno de Galicia, y por ende Cataluña, y el de Escocia.
Select one (1) peer-reviewed research article that you used in you.docxzenobiakeeney
Select one (1) peer-reviewed research article that you used in your research paper to share with the class.
Do not discuss en editorial or letter to editor.
After reading your selected article, post the following information:
1. Why is the research question significant to your research paper?
2. What was the purpose of the study?
3. What was the study design?
4. Who was in the study population(s)/sample(s)?
5. What was the outcome and was it consistent with the researcher(s)' original research question?
6. What recommendation(s) did the researcher offer for future studies?
7. How do you know this article was peer-reviewed?
OBSTRUCTIVE PULMONARY
DI
SEASE (COPD)
1
Chronic Obstructive Pulmonary Disease (
COPD
)
Name
Course
Tutor
Date
Chronic Obstructive Pulmonary Disease (
COPD
)
Abstract
A chronic obstructive pulmonary disease (COPD) is one of the current killers in the world. It is a preventable disease that makes it difficult for the affected individual to empty air out of the lungs otherwise referred to as airflow obstruction. The difficulties in breathing that is brought about by this condition leaves one feeling tired because they use
much
energy to
breathe
than required.
The c
hronic
obstructive pulmonary disease is a term that is used to include other types of pulmonary diseases that include chronic bronchitis, emphysema or both. Although asthma is a health condition that results in difficulties in breathing it is not included among the chronic obstructive pulmonary disease.
The effects of the disease are not instant but rather evolve at a slower rate inhibiting the breathing system of a patient.
However,
the
most important thing to note is that the disease can
be prevented
and it is relatively easier when it
is detected
in its earlier stages than in advanced stage.
In the United States, between 10 % and 20% of the chronic obstructive pulmonary disease is said to have been caused by occupational or exposure to chemical vapors,
irritants
,
and fumes which are very much contaminated. A
large
percentage of patients who are suffering from COPD are said to be
smokers
,
but a recent research indicated that 25 % of patients with COPD have never smoked in the United States. This paper provides an in-depth analysis into chronic obstructive pulmonary diseases including the historical perspective,
symptoms, and causes
of COPD,
method of spread, how it can
be contained
, and its implication on the economy,
treatment
,
and efforts being put in place to ensure that the disease is
contained
.
Keywords
COPD,
Chronic, Obstructive. Bronchodilators,
Pulmonary,
Prevalence, Mortality
.
History of the diseases
The c
hronic
obstructive pulmonary disease has been in existence for the last 200
years;
the only difference is that its prevalence back in the day was much lower mainly because of
the
lower
presence of risk factors than they are currently.
The disease
was recognized
by the.
Study Of Achievement in Environmental Studies, Family Environment and Learnin...paperpublications3
Abstract: Environment in developing countries like India have been threatened by problems like poverty, pollution, overpopulation, degradation and depletion of environment. As such, the environmental protection and preservation has been an urgent need of the hour. Realizing its importance, it has been enshrined in the Constitution of India, which requires both the state and the citizen to protect, preserve and improve the environment. Considering the seriousness of the problem only inclusion in Constitution will not help a lot in preserving our environment, but the issue should be initiated at the grass root level i.e. in family, school and society. In the changing scenario of our society attitude of an individual are greatly affected by family, teachers, school environment, teaching methods, learning styles and many other factors and they all have a great impact on the personality development of the child. It is well accepted fact that healthy family environment, co-operative learning and environmental education can help a lot in the development of positive desirable attitude towards environment among future citizens.
Galicia y escocia-dos_modelos_federales_v1Goyo Andión
Hemos llegado al final del ciclo sobre Federalismo. En este brillante trabajo de Begoña Lopez Portas especialista entre otras lineas de investigación de los modelos federales y la participación regional, el estudio del ambito competencial autonómico del autogobierno nacional. En concreto este resumen, que publicamos adjunto, recoge el concepto de la “devolution”, como proceso, su carácter federal y unitario, la “Scotland Act” de 1998, y cuadros comparativos de la participación en la Unión Europea, tanto de Galicia y Escocia, y su impacto sobre las competencias referido tambien a la institución europea. Con estos “mimbres” espero que todos nos hayamos acercado y podamos opinar de las similitudes y diferencias del autogobierno de Galicia, y por ende Cataluña, y el de Escocia.
Select one (1) peer-reviewed research article that you used in you.docxzenobiakeeney
Select one (1) peer-reviewed research article that you used in your research paper to share with the class.
Do not discuss en editorial or letter to editor.
After reading your selected article, post the following information:
1. Why is the research question significant to your research paper?
2. What was the purpose of the study?
3. What was the study design?
4. Who was in the study population(s)/sample(s)?
5. What was the outcome and was it consistent with the researcher(s)' original research question?
6. What recommendation(s) did the researcher offer for future studies?
7. How do you know this article was peer-reviewed?
OBSTRUCTIVE PULMONARY
DI
SEASE (COPD)
1
Chronic Obstructive Pulmonary Disease (
COPD
)
Name
Course
Tutor
Date
Chronic Obstructive Pulmonary Disease (
COPD
)
Abstract
A chronic obstructive pulmonary disease (COPD) is one of the current killers in the world. It is a preventable disease that makes it difficult for the affected individual to empty air out of the lungs otherwise referred to as airflow obstruction. The difficulties in breathing that is brought about by this condition leaves one feeling tired because they use
much
energy to
breathe
than required.
The c
hronic
obstructive pulmonary disease is a term that is used to include other types of pulmonary diseases that include chronic bronchitis, emphysema or both. Although asthma is a health condition that results in difficulties in breathing it is not included among the chronic obstructive pulmonary disease.
The effects of the disease are not instant but rather evolve at a slower rate inhibiting the breathing system of a patient.
However,
the
most important thing to note is that the disease can
be prevented
and it is relatively easier when it
is detected
in its earlier stages than in advanced stage.
In the United States, between 10 % and 20% of the chronic obstructive pulmonary disease is said to have been caused by occupational or exposure to chemical vapors,
irritants
,
and fumes which are very much contaminated. A
large
percentage of patients who are suffering from COPD are said to be
smokers
,
but a recent research indicated that 25 % of patients with COPD have never smoked in the United States. This paper provides an in-depth analysis into chronic obstructive pulmonary diseases including the historical perspective,
symptoms, and causes
of COPD,
method of spread, how it can
be contained
, and its implication on the economy,
treatment
,
and efforts being put in place to ensure that the disease is
contained
.
Keywords
COPD,
Chronic, Obstructive. Bronchodilators,
Pulmonary,
Prevalence, Mortality
.
History of the diseases
The c
hronic
obstructive pulmonary disease has been in existence for the last 200
years;
the only difference is that its prevalence back in the day was much lower mainly because of
the
lower
presence of risk factors than they are currently.
The disease
was recognized
by the.
1. Running Head: ACUTE PLEURAL EFFUSIONS Lofgran 1
Acute Pleural Effusions Secondary to Pneumonia
Mariah Anne Lofgran
California Baptist University
2. ACUTE PLEURAL EFFUSIONS Lofgran 2
Acute Pleural Effusions Secondary to Pneumonia
Breathing is an act necessary to sustain life for many creatures, from humans to pets,
such as dogs and cats. In order for breathing to occur, it requires the use of the whole respiratory
system, especially the lungs. Inside the lungs, there is space known as pleural space in which
small amounts of fluid help to reduce friction during breathing. Pleural effusion is “a collection
of fluid in the pleural space, which is rarely a primary disease process but one that is secondary
to another” (Smeltzer, Bare, Hinkle, & Cheever, 2010). “Pleural effusion, a complication of
community acquired pneumonia, is usually attributed to a bacterial infection” (Nascimento-
Carvalho, Oliveira, Cardoso, Araújo-Neto, Barral, Saukkoriipi, & Ruuskanen, 2013).
Pathophysiology
According to Morton and Fontaine, pleural effusions are caused by the buildup of pleural
fluid occurring because of increased production of fluid, a decrease in fluid removal, or
sometimes both (2012). There are a variety of mechanisms that cause pleural effusions, such as
“increased pressure in pulmonary capillaries including heart failure, increased capillary
permeability including pneumonia, decreased plasma osmotic pressure including cirrhosis,
increased intrapleural negative pressure including atelectasis, and impaired lymphatic drainage
of pleural space including pleural malignancy” (Morton & Fontaine, 2012). The primary
diagnosis that causes pleural effusions is pneumonia, which is an “inflammatory response to
inhaled or aspirated foreign material or uncontrolled multiplication of microorganisms invading
the lower respiratory tract” (Morton & Fontaine, 2012).
Diagnostic studies
3. ACUTE PLEURAL EFFUSIONS Lofgran 3
To diagnosis the underlying cause, pneumonia can be done using chest radiography
which also assesses pleural effusions. According to Morton and Fontaine, a lateral decubitus
radiograph gives the best image of the free pleural fluid with as little as 20mL of fluid being
visible in the image (2012). Along with the chest radiograph, “pleural fluid is analyzed by
bacterial culture, Gram stain, AFB stain, red and white blood cell counts, chemistry studies, and
pH” (Smeltzer, Bare, Hinkle, & Cheever, 2010). According to Morton and Fontaine, evaluation
of pleural fluid is needed in order to distinguish exudative from transudative pleural effusion, but
the risk of pneumothorax must be weighed against the benefit of the thoracentesis (2012).
Physical Assessment
Pleural effusion can be suspected with self-reported subjective symptoms include
shortness of breath and pleuritic chest pain along with objective symptoms like deceased breath
sounds, dullness upon percussion, tachypnea, and hypoxemia (Morton & Fontaine, 2012).
According to Morton and Fontaine, a complete respiratory and cardiovascular assessment must
be completed including monitoring for signs of hypoxemia, dyspnea, cough, sputum production,
fever, and chills which can help diagnosis the underlying cause of pneumonia (2012).
Treatment
According to Morton and Fontaine, the course of treatment is dependent upon the
underlying cause of the effusions. “Removal of the pleural effusions by thoracentesis, chest tube
placement, or surgery may be indicated depending on etiology and size of effusion” (Morton &
Fontaine, 2012). Oxygen therapy is also vital in maintaining oxygen levels at an acceptable
value over 95% saturation in order to reduce the use of accessory muscles that can cause fatigue
over time (Porat, Bhatia, & Barnett, 2002).
4. ACUTE PLEURAL EFFUSIONS Lofgran 4
Medication
Antibiotic therapy is needed to treat pneumonia; the recommendation is for the patient to
receive antibiotic therapy within the first eight hours of arriving to the hospital to improve the
patient’s outcome (Morton & Fontaine, 2012). Usual medications for this patient include
ibuprofen 600mg every four hours as needed for pain and inflammation, azithromycin to treat the
bacterial pneumonia 500mg the first day and 250mg the following days, along with an influenza
vaccination and pneumococcal conjugate (Deglin, Vallerand, & Sanoski, 2011).
Nursing Diagnosis
Nursing diagnoses for a patient experiencing pleural effusion could include monitoring
for acute pain, monitoring for changes and signs of impaired gas exchange, and anxiety.
Interventions combatting the impaired gas exchange include performing bronchial hygiene
therapy through percussion, cough and deep breathing, postural drainage, and suctioning. Also, it
is important for the patient to have the head of the bed elevated 30 to 45 degrees and have
frequent position changes at least every two hours. To intervene with the pain that the patient is
feeling, it is important to assess the pain level of the patient and administer analgesics
appropriately along with teaching and promoting relaxation and deep breathing. Lastly it is very
important to reduce the anxiety that the patient is feeling due to the hospitalization along with
having trouble breathing. It is important to listen closely to what the patient has to say and is
feeling to create a good rapport which can help to reduce some anxiety as well as taking the time
to fully explain to the patient what is happening, all procedures, and medications in order to
reduce fear and anxiety that can come from the unknown in the hospital (Ralph & Taylor, 2011).
5. ACUTE PLEURAL EFFUSIONS Lofgran 5
Pleural effusions caused by pneumonia can be diagnosed and treated with a strong focus
on the pneumonia disease process. This disease can be diagnosed using a chest radiograph and
treated using antibiotics and reducing the accumulation of fluid using thoracentesis or a chest
tube if indicated. These patients should be monitored closely for breathing changes and anxiety
from changes in life and hospitalization.
Personal Reflection
At this point in my life as a 21-year-old nursing student, to be diagnosed with pleural
effusions due to pneumonia would be painful and difficult, forcing me to rethink not only how
well I am taking care of myself, but also if I will be able to continue with nursing school.
As a full-time student, to get sick is already very difficult, but to get so sick that I must be
hospitalized and treated is even worse. Since I am so busy with school, I unfortunately waited a
long time to get seen by my doctor and get diagnosed. By that point, the pleural effusions were
very large in my lungs, and I was told I will be needing a chest tube to drain the fluid along with
extensive antibiotic treatment to combat the pneumonia that was the cause of my pleural
effusions. This is really scary, because even though I have had many patients with chest tubes
and invasive lines, getting one myself is very frightening and very painful. This is very
frustrating because not only will I get behind in school work due to the pain and fatigue from
being hospitalized along with the recovery following my chest tube, but I will also miss more
than an allotted amount of clinical and I will have to consider taking the semester off and going
back the following semester. This is very unfortunate because it will set back my graduation
another semester, which is very strenuous for me due to the fact that I pay to put myself through
6. ACUTE PLEURAL EFFUSIONS Lofgran 6
college. I will also have to rely heavily on the help of family and friends since I will have
hospital bills to pay and will be unable to work for at least a few weeks if not more.
This diagnosis is going to make me have to rely heavily on not only my family, but also
on my relationship with God. It is very hard to be accepting when such a big change comes into
your life that causes a lot of fear and anxiety. However, I know I will have to rely on God and
know that he can and will get me through this diagnosis, as well as having to leave this semester
and getting set back in school. A verse that I can look to and rely on to remind me that even in
such a dark time that God will be there for me is “I can do all things through him who gives me
strength” (Philippians 4: 13, New International Version). Through this diagnosis I will have to
overcome many obstacles and accept the ever-changing momentum of life, and as Parse states,
“Cotranscending with possibles is the powering and originating of transforming” (2014).
I will need to cotranscend through this difficult time relying heavily on my faith in Christ
and know that I can transcend from where God has me now to where he has planned for me,
doing as he says in his Word to “Trust in the Lord with all your heart and lean not on your own
understanding; in all your ways submit to him, and he will make your paths straight” (Proverbs
3: 5-6 New International Version).
7. ACUTE PLEURAL EFFUSIONS Lofgran 7
References
Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2011). Davis's drug guide for nurses.
Philadelphia: F.A. Davis.
Morton, P. G. & Fontaine, D. K., (2012) Critical Care Nursing: A Holistic Approach (10th ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.
Nascimento-Carvalho, C. M., Oliveira, J. R., Cardoso, M. A., Araújo-Neto, C., Barral, A.,
Saukkoriipi, A., & ... Ruuskanen, O. (2013). Respiratory viral infections among children
with community-acquired pneumonia and pleural effusion. Scandinavian Journal Of
Infectious Diseases, 45(6), 478-483. doi:10.3109/00365548.2012.754106
Parse, R. R. (2014). The humanbecoming paradigm: A transformational worldview.
Porat, S., Bhatia, N., & Barnett, D. W. (2002). A child with severe pneumonia, pleural effusion
and acute hypoalbuminemia. Clinical Pediatrics, 41(3), 199-200.
Ralph, S. S., & Taylor, C. M. (2011). Sparks & Taylor's nursing diagnosis reference manual.
Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K. (2010). Brunner and Suddarth’s textbook of
medical-surgical nursing (13th ed.). New York, NY: Lippincott.