Value: 100 points
Due: To facilitate scholarly discourse, create your initial post by Day 3, and reply to at least two of your classmates, on two separate days, by Day 7.
Gradebook Category: Discussions
It is understood that thoughtful responses to your topic question(s) will take some time and thought. Please organize your thoughts before creating your initial post.
Based on your assigned team, create an initial post by answering all questions in your team’s case study, making sure to address all components of all questions.
By Day 3, post your initial response to your assigned part of the case study as a reply to the appropriate discussion thread. Please be sure to number the questions addressed and include all components of each question in your response. Each initial response must have a reference, including at least two scholarly references other than your textbook or course materials. Your post should comprehensively address the questions posed.
Mr. CY, age 71, has had significant emphysema for six years. He has reduced his cigarette smoking since mild congestive heart failure was diagnosed (right-sided heart failure; refer to Chapter 12). He has been admitted to the hospital with a suspected closed pneumothorax and respiratory failure.
- Describe the pathophysiologic changes in the lungs with emphysema and explain how these affect oxygen and carbon dioxide levels in the blood.
- Explain how emphysema can lead to heart failure. What signs and symptoms would you expect to develop in Mr. CY? Classify each as a subjective or objective finding.
- Explain how a pneumothorax has probably occurred in the presence of emphysema.
- Explain how a pneumothorax can cause respiratory failure. Describe the pathophysiologic effects on lung function and gas exchange in your answer. Include the criteria for respiratory failure.
- Explain why caution must be exercised in administering oxygen to Mr. CY.
- The impaired respiration Mr. CY experiences as a result of his emphysema causes immobility. Immobility can lead to other respiratory complications. Identify two of these conditions and describe preventative measures for each.
- Describe several respiratory therapy interventions that might help Mr. CY return his body to a more homeostatic state.
- Emphysema, as experienced by this patient, is an obstructive pulmonary disease, which is different than restrictive pulmonary diseases. Compare and contrast the pathophysiology, manifestations, and interventions to help return to homeostasis for obstructive and restrictive respiratory disorders.
Baby M is a four-month-old who presented to the emergency department with wheezing and difficulty breathing. Her mother reports she has had a fever at home and has been getting worse over the last several hours. She exhibits tachypnea and chest retractions, and you can here both audible and auscultated wheezes. After consulting with the team, it is determined that Baby M most likely has bronchiolitis.
- What is the most common etiology of bronchiolitis? What patient population is most at risk for this condition?
- What symptoms from the scenario support the diagnosis of bronchiolitis? Explain the pathophysiologic process causingese symptoms, and identify each as subjective or objective.
- What is meant by “chest retractions”? Think about the pathophysiology of what is occurring in her lungs, then describe the location of the following retraction types: intercostal, suprasternal, supraclavicular, substernal, and sub cos.
- Baby M’s mother asks you to give her some antibiotics to help her get better. What is your best response to her? How will you explain how you can help Baby M get better?
Baby M is admitted to the hospital for management. As her provider, you understand she is disposed to developing pneumonia secondary to the process occurring in her lungs.
- What signs and symptoms would you expect to change and/or develop if Baby M were to develop pneumonia? What will you instruct her parents and caregivers to be on the lookout for?
- Identify the three major classifications of pneumonia. Which one do you think Baby M is most at risk for?
- Compare and contrast these three different types of pneumonia, including causative organisms, pathophysiology, distribution in the lungs, onset, and significant signs and symptoms.
- If Baby M does develop pneumonia, how would this change the interventions needed to help return her body to a homeostatic state?
CJ is a 22-year-old with a history of asthma since childhood. He was tested for allergies and demonstrated marked responses to a number of animals, pollens, and molds. CJ also has a history of asthma related to exposure to very cold weather.
- Describe the pathophysiology of an acute asthma attack in CJ following exposure to cats.
- Describe the early signs and symptoms of an acute asthma attack, and relate each of these to the pathophysiologic changes taking place in the lungs. Identify each as a subjective or objective finding.
- If you were updating a medical and drug history for CJ, list several significant questions you should ask.
- Is asthma considered an obstructive or restrictive respiratory condition? Explain your answer.
- Explain how a beta2-adrenergic agent is helpful in treating asthma and how it is usually administered.
- In addition to beta2-adrenergic agents, identify one other pharmacologic and one other non-pharmacologic intervention that can be used to help manage acute asthma attacks and correct the pathophysiology that is occurring. Explain how each helps return the body to a homeostatic state.
- What is the term for a prolonged asthma attack? Explain the pathophysiology that occurs and how this can lead to respiratory distress and failure. Identify three signs or symptoms of impending respiratory distress.
- Identify two preventative measures that CJ can take to help manage his disease and keep his body in a homeostatic state. Explain how this will impact the disease process.
Review all your peers’ posts, as they will help you prepare for the quiz this week. Select posts from two peers that addressed a case study from a different team than you. For example, students from Team A reply to one post from Team B and one post from Team C. Each reply must use at least one scholarly reference other than your textbook.
Thinking about your population specific NP track and anticipated practice area:
- Identify and explain two “pearls of wisdom” or “key concepts/ideas” you learned from reading your peers’ responses.
- Describe a patient you might encounter in your future practice where you could apply the information learned in your peer’s post.
Please refer to the Grading Rubric for details on how this activity will be graded.
Posting to the Discussion Forum
- Select the appropriate Thread.
- Select Reply.
- Create your post.
- Select Post to Forum.