- Case Study: Cough That Won’t Quit
Three weeks ago, 20-year-old Erica came down with symptoms typical of the common cold. She had a runny nose, fatigue, and a mild cough. Her symptoms had been starting to improve, but recently her cough has been getting worse. She is coughing up a lot of thick mucus, her throat is sore from frequent coughing, and her chest feels very congested. According to her grandmother, Erica has a “chest cold.” Erica is a smoker and wonders if her habit is making her cough worse. She decides that it is time to see a doctor.
Dr. Johnson examines Erica and asks about her symptoms and health history. She checks the level of oxygen in Erica’s blood by attaching a device called a pulse oximeter to Erica’s finger. Dr. Johnson concludes that Erica has bronchitis, which is an infection that commonly occurs after a person has a cold or flu. Bronchitis is sometimes referred to as a “chest cold,” so Erica’s grandmother was right! Bronchitis causes inflammation and a build-up of mucus in the bronchial tubes in the chest.
Because bronchitis is usually caused by viruses and not bacteria, Dr. Johnson tells Erica that antibiotics are not likely to help. Instead, she recommends that Erica try to thin and remove the mucus by drinking plenty of fluids and using a humidifier or spending time in a steamy shower. She also recommends that Erica get plenty of rest.
Dr. Johnson also tells Erica some things not to do — most importantly, to not smoke while she is sick, and to try to quit smoking in the long-term. She explains that smoking can make people more susceptible to bronchitis and can hinder recovery. She also advises Erica to not take over-the-counter cough suppressant medication.
As you read this chapter on the respiratory system, you will be able to better understand what bronchitis is and why Dr. Johnson made the treatment recommendations that she did. At the end of the chapter, you will learn more about acute bronchitis, which is the type that Erica has. This information may come in handy to you personally because chances are high that you will get this common infection at some point in your life — there are millions of cases of bronchitis every year!
Chapter Overview: Respiratory System
In this chapter, you will learn about the respiratory system — the system that exchanges gases such as oxygen and carbon dioxide between the body and the outside air. Specifically, you will learn about:
- The process of respiration, in which oxygen moves from the outside air into the body and carbon dioxide and other waste gases move from inside the body into the outside air.
- The organs of the respiratory system, including the lungs, bronchial tubes, and the rest of the respiratory tract.
- How the respiratory tract protects itself from pathogens and other potentially harmful substances in the air.
- How the rate of breathing is regulated to maintain homeostasis of blood gases and pH.
- How ventilation, or breathing, allows us to inhale air into the body and exhale air out of the body.
- The conscious and unconscious control of breathing.
- Nasal breathing compared to mouth breathing.
- What happens when a person is drowning.
- How gas exchange occurs between the air and blood in the alveoli of the lungs; and between the blood and cells throughout the body.
- Disorders of the respiratory system including asthma, pneumonia, chronic obstructive pulmonary disease (COPD), and lung cancer.
- The negative health effects of smoking.
As you read the chapter, think about the following questions:
- Where are the bronchial tubes and what is their function?
- What is the function of mucus and why can too much mucus be a bad thing?
- Why did Dr. Johnson check Erica’s blood oxygen level?
- Why do you think Dr. Johnson warned Erica to not take cough suppressant medications?
- How does acute bronchitis compare to chronic bronchitis and how do they both relate to smoking?
During this simulation learning experience, the participants will care for an elderly patient with chronic obstructive pulmonary disease (COPD) who requires surgery to remove the gall bladder (cholecystectomy). To prepare for this simulation summarize what you have learned from class sessions and the assigned journal articles by completing the following questions:
- Describe the underlying pathophysiology (what happens in the lungs) in patients diagnosed with chronic obstructive pulmonary disease.
Learning Insight: Please indicate your nursing insight in our activity, what did you learn from the activity.
- CASE: Newly diagnosed diabetes
This case requires the nurse to recognize the signs of hyperglycemia and convey an understanding of diabetes-related lab values. Type 1 and type 2 diabetes, complications of diabetes, and dietary guidelines are discussed. The nurse must consider the impact that culture may have on diabetes management. The nurse works with a diabetes educator to educate this newly diagnosed diabetic about blood glucose monitoring, medication administration, foot care, sick day management, and proper diet and exercise. The ethical and legal considerations of using an interpreter are addressed.
Mr. Jenaro is a 61-year-old Spanish-speaking man who presents to the emergency room with his wife Dolores. Mrs. Jenaro is also Spanish speaking, but understands some English. Mr. Jenaro complains of nausea and vomiting for two days and symptoms of confusion. His blood glucose is 796 mg/dL. Intravenous regular insulin (Novolin R) is prescribed and he is admitted for further evaluation. He will require teaching regarding his newly diagnosed diabetes.
Case Study Mr. Jenaro is newly diagnosed with diabetes. His hemoglobin A1C is 10.3%. Mr. Jenaro is slightly overweight. He is 5 feet 10 inches tall and weighs 174 pounds (79 kg). He reports no form of regular exercise. He does not follow a special diet at home. He states, “I eat whatever Dolores puts in front of me. She is a good cook.” For the past few months, Mrs. Jenaro has noticed that her husband “has been very thirsty and has been up and down to the bathroom a hundred times a day.” Neither can recall how long it has been since these changes in Mr. Jenaro began. Dolores states, “It has been quite a while now. It just seems to be getting worse and worse.”
- How will you apply a certain nursing theory or nursing model to this case scenario?
- Learning Insight: Include Nursing insight how will you apply this concept into practice?
ANSWER
Case Scenario 1
XXXX is characterized by persistent respiratory symptoms and breathing difficulties due to alveolar abnormalities. Persistent respiratory problems indicate the changes that take place in the structures of lungs, including sputum production, cough, and …..
Pathophysiology of XXXX
XXX occurs sue to combined processes of peripheral airway inflammation and the narrowing of airways. As the airways narrow, it leads to… To continue reading, click on the button below.