COPD is characterized by airflow obstruction caused by chronic bronchitis or emphysema. Chronic bronchitis is defined by cough and sputum production for at least 3 months a year for two years. Emphysema results from destruction of alveolar walls, impairing gas exchange. Smoking is the leading cause of COPD. Symptoms include cough, sputum production, and dyspnea. Treatment involves smoking cessation, bronchodilators, corticosteroids, pulmonary rehabilitation, oxygen therapy, and lung transplantation in severe cases. Nursing management focuses on airway clearance, breathing exercises, smoking cessation education, and self-management education.
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma. This disease is characterized by increasing breathlessness
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma. This disease is characterized by increasing breathlessness
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic
Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.
CHRONIC RENAL FAILURE (CRF) or CHRONIC KIDNEY DISEASE (CKD)
Chronic or irreversible renal failure is a progressive reduction of functioning of renal tissue such that the remaining kidney mass can no longer maintain the body’s internal environment.
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic
Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.
CHRONIC RENAL FAILURE (CRF) or CHRONIC KIDNEY DISEASE (CKD)
Chronic or irreversible renal failure is a progressive reduction of functioning of renal tissue such that the remaining kidney mass can no longer maintain the body’s internal environment.
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation that is slowly progressive. It is also known as Chronic obstructive lung disease. “(COLD)”
It refers to Chronic Bronchitis and emphysema, a pair of two commonly coexisting disease of the lungs in which the airways become narrowed.
Reading material on COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE) for Nursing students and teachers. It tells pathophysiology, clinical manifestations, diagnostic evaluations, medical and nursing management of COPD.
Chronic obstructive pulmonary disease, commonly referred to as COPD, is a group of progressive lung diseases. The most common are emphysema and chronic bronchitis. Many people with COPD have both of these conditions.
Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow. Bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to build up.
The top cause of COPD is tobacco smoking. Long-term exposure to chemical irritants can also lead to COPD. It’s a disease that usually takes a long time to develop.
Diagnosis usually involves imaging tests, blood tests, and lung function tests.
There’s no cure for COPD, but treatment can help ease symptoms, lower the chance of complications, and generally improve quality of life. Medications, supplemental oxygen therapy, and surgery are some forms of treatment.
Untreated, COPD can lead to a faster progression of disease, heart problems, and worsening respiratory infections.
It’s estimated that about 30 million people in the United States have COPD. As many as half are unaware that they have it.
Presented by Mr B.Kalyankumar Msc(N) Dept Of MSN
Chronic obstructive pulmonary disorders COPD is a [preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual clients.
It is characterized by airflow limitation that is not completely reversible.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
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2. COPD
COPD is a disease state characterized by the
presence of airflow obstruction caused by
chronic Bronchitis or emphysema. The
airflow obstruction is generally progressive,
may be accompanied by airway hyperactivity,
and may be partially reversible.
3. Chronic Bronchitis
Chronic bronchitis, a disease of the airways,
is defined as the presence of cough and
sputum production for at least 3 months
in each of two Consecutive years. In much
case, smoke or other environment
pollutants irritates the airways, resulting
in hyper secretion of mucus and
inflammation.
4.
5. Emphysema
In emphysema, impaired gas exchanges
results from destruction of the walls of
over distended alveoli “emphysema in a
pathological form that describes an
abnormal distention of the air spaces
beyond the terminal bronchioles, with
destruction of the walls of the alveoli.
6. Pan Lobular (Panacinar)
There is destruction of the respiratory
bronchiole, alveolar duct, and alveoli. All
air space within the lobule are essentially
enlarged, but there is little inflammatory
disease. The patient shows hyper inflated
(hyper expended) chest (barrel chest on
physical examination), dyspnea and
weight loss.
7.
8. Centrilobular
In this from, pathologic changes takes place
mainly in the center of the secondary
lobule. In which the respiratory
bronchioles enlarge, the walls are
destroyed and the bronchioles became
inflamed.
9. Causes
1)Cigarette Smoking
when cigarettes are smoked, Approximately 4000
chemicals and gases are inhaled into the lungs.
2) Infection
3) Occupational exposure
4) Air pollution
5) Heredity
6) Aging
10.
11. Clinical Manifestation
COPD is characterized by three primary symptoms
1. Cough
2. Sputum production
3. Dyspnea on exertion
4. Weight loss
5. Hypoxemia during exercise
6. Cyanosis
16. STAGES
STAGE CHARACTERISITICS
O Normal Spirometry,
Chronic symptoms of
cough, sputum production
I (Mild COPD) FEV1/ FVC <70%
May or may not have
chronic symptoms of
cough, sputum production.
17. Cont..
II (Moderate COPD) FEV1/ FVC <70%
May or may not have
chronic symptoms of cough
and sputum production.
III (Severe COPD) FEV1/FVC <70%
FEV1 30% predicted plus
respiratory failure or clinical
signs of right heart failure.
[FEV1 = volume of air that the patient can forcibly exhale
in 1 second to forced vital capacity (FVC).
18. Diagnostic Finding
1. Extensive history collection
Exposure to risk factors
Past medical history
Family history of COPD
Pattern of symptoms development
History of previous hospitalizations
Current medical treatments
Potential for reducing risk factors
19. Cont..
Physical examination
Spirometry: - to evaluate airflow obstruction.
ABG analysis
Chest X-Ray
Bronchodilator reversibility Test
Alpha1, antitrypsin deficiency screening
Pulmonary function Test
ECG
Echo – cardiogram
25. Dietary Management
Liquid, blenderized diet may be given
Foods that require a great deal of chewing should be
avoided
Avoid exercise before and after eating
Avoid gas-forming foods
High protein and calorie diet given
Avoid high CHO diet
Avoid sodium if this is heart failure.
29. Pulmonary Rehabilitation
Inpatient
ADVANTAGES
1. 24 hour nursing
care
2. Sicker patients
3. No transportation
problems
4. Family
participation
5. Best for ventilator,
tracheostomy
patients
DISADVANTAGES
1. Cost and insurance
difficulties
2. Not suitable for less
severe patients
3. Family transportation
problems
31. Pulmonary Rehabilitation
HOME - BASED
ADVANTAGES
1. Convenience to patient
2. Transportation no issue
3. Exercise in familiar
environment may lead
to better adherence
long term
DISADVANTAGES
1. Cost/insurance issues
2. Lack of group support
3. Lack of full spectrum of
multidisciplinary
personnel
33. Pulmonary Rehabilitation
Benefits in COPD
1. Improves exercise capacity
2. Improves perceived breathlessness
3. Improves quality of life
4. Reduces hospitalizations
5. Reduces anxiety and depression
6. Benefits extend beyond training period
7. Improves survival
34. Nursing Management
The nurses play a key role to manage the client
condition.
Assess the general and respiratory condition of the
patient.
Collect the important health information
Assess the functional health patterns
Physical examination.
35. Nursing Diagnosis
1. Impaired gas exchange and airway clearance
due to chronic inhalation of toxin.
INTERVENTION
Evaluates current smoking status, educate
regarding smoking cessation
Provide comfortable position
Administer and teach appropriate use of
bronchodilators
Administer O2 to increase O2 saturation.
36. Cont..
1. Impaired gas exchange related to ventilation –
perfusion inadequately.
INTERVENTION
Administer bronco dilators
Evaluate effectiveness of nebulizer
Instruct and encourage patient in diaphragmatic
breathing and effective coughing.
Administered O2
Instruct the patient to avoid smoking
Provide comfortable portion.
37. Cont..
3.Ineffective airway clearances related to bronco
constriction, increased mucus production.
INTERVENTION
Adequately hydrate the patient
Teach and encourage the use of diaphragmatic
breathing and coughing techniques.
Assist in nebulizer.
Avoid the smoking
Administer antibiotic
38. Cont..
4.Ineffective breathing pattern related to
shortness of breath, mucus and airway
irritants.
INTERVENTION
Facilitate deep breathing by elevating head
Provide semi fowler position
Encourage alternating activity with rest period
39. Cont…
5. Imbalance nutrition: less than body
requirement related to poor appetite.
INTERVENTION
Monitor calorie intake, weight.
Provide menu suggestion for high protein &
calorie foods
Give high protein and calorie diet.
Provide liquid and frequent diet.
Plan periods of rest after food intake.
40. Cont..
6.Self care deficits related to fateful secondary to
increased work of breathing.
INTERVENTION
Teach patient to coordinate diaphragmatic
breathing with activity.
Encourage patient to begin to bathe self, walk
Teach about postural drainage.
41. Cont..
7.Activity intolerance due to fatigue, hypoxemia.
INTERVENTION
Support the patient in establishing a regular
regimen of exercise.
Provide adequate ventilation
42. Cont..
8. Sleep pattern disturbance related to anxiety,
dyspnea, and hypoxemia.
INTERVENTION
Assess the sleeping habit, identify cause and
reduce them
Encourage exercise & activity during day time
Avoid day time sleeping
Instruct patient in maintaining an environment
conductive to rest.
Teach avoidance of alcoholic beverages, caffeine
products before bedtime.
43. Cont..
10.Deficient knowledge about self-management to
be performed at home.
INTERVENTION
Teach the patient about self-care.
Give strong message to stop smoking
Advise the patient to take regular treatment
Teach about exercise.
45. SHOCK
Definition
It is defined as a condition in which systemic blood
pressure is inadequate to deliver oxygen and
nutrient to support vital organs and cellular
function.
46. Septic Shock
It is most common type of circulatory shock and caused
by wide spread infection. Nosocomial infections in
critically ill patient frequently originate in blood
stream, lungs.
Septic shock = Presence of sepsis with hypotension
despite fluid resuscitation + Presence of tissue
perfusion abnormalities
47. Causes
The common causative micro- organisms of septic
shock are :-
Gram-negative and gram-positive bacteria
Endotoxin stimulates inflammatory response
48. Patho Physiology
When microorganism invades the body tissue
↓
Patients exhibits the immune response
↓
Activation of Bio- chemical mediator associated
with an inflammatory response
↓
Increased capillary permeability
↓
49. It lead to fluid seeping from the capillary,
vasodilatation
↓
It interrupts ability of the body to provide
adequate perfusion, oxygen, nutrient to the
tissue and cells
↓
Shock occurs
50. Clinical manifestation
Two phases :-
1.“Warm” shock - early phase
1. Hyperdynamic response,
2. Vasodilation
2.“Cold” shock - late phase
1. Hypodynamic response
2. Decompensated State
52. Late--- Hypodynamic State
Decompensation
1. Vasoconstriction
2. Skin is pale & cool
3. Significant tachycardia
4. Decreased BP
5. Chang Metabolic & respiratory acidosis
with hypoxemia
6. LOC
55. Medical Management
1. Eliminating the causes of infection
2. Antibiotic-coated IV central line may be placed
3. Fluid replacement
4. Pharmacologic therapy
-Antibiotic drugs
5. Nutritional therapy
6. External feeding is preferred to the parenteral route
56. Collaborative treatment
1. Prevention !!!
2. Find and kill the source of the infection
3. Fluid Resuscitation
4. Vasoconstrictors
5. Inotropic drugs
6. Maximize O2 delivery Support
7. Nutritional Support
8. Comfort & Emotional support
57. Nursing Management
1. Maintain the personal hygiene of patient
2. Administered prescribed IV fluid and medication
3. Maintain intake and out of the patient
4. Elevated temperature may not be treated unless it
reaches dangerous level (more that 400C or 1040F)
60. References
BOOK :-
Lewis’s medical –surgical nursing , assessment and
management of clinical problems. Second edition.
Page no . 610-625. 1164,630,635,1722-1723.
Brunner and suddarth’s textbook of medical –surgical
nursing twelfth edition page no. 602-619.
NET :-
COPD, www.mpedia.com
Septic shock, www.Myoclinic.Org
Copd medlineplus.Gov/copd
Septic shock, wikipedia.Org/wiki/