NURS 6521 Week 4 Discussion: Pharmacotherapy for Respiratory Disorders

Week 4 Discussion

To the untrained ear, most coughs sound the same. However,
as you might recall from past clinical experiences, a simple cough can lead to
a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive
pulmonary disease (COPD). Although it can sometimes be challenging to diagnose
a patient based on common respiratory symptoms such as congestion, coughing,
and wheezing, it is important to be able to distinguish minor differences as
even mild symptoms might require intervention with drug treatments. When
recommending potential treatment options, advanced practice nurses must
consider how individual patient factors might impact the effects of prescribed
drugs.

To prepare:

Review Chapter 26 and Chapter 27 of the Arcangelo and
Peterson text.

Select and research one of the following respiratory
disorders: the common cold, pneumonia, or a chronic obstructive pulmonary
disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs
that would be prescribed to patients to treat symptoms associated with this
disorder.

Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact effects of

prescribed drugs, as well as any measures you might take to help reduce
negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected
including types of drugs that would be prescribed to patients to treat
associated symptoms. Then, explain how the factor you selected might impact
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different respiratory disorder than you did. If the disorder you selected is
primarily associated with the upper respiratory system, respond to colleagues
who selected disorders primarily associated with the lower respiratory system.
Provide alternative recommendations for drug treatments.

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A Sample Answer For the Assignment: NURS 6521 Week 4 Discussion: Pharmacotherapy for Respiratory Disorders

Title: NURS 6521 Week 4 Discussion: Pharmacotherapy for Respiratory Disorders

Scenario 2: Pleural Friction Rub

A 35-year-old female with a positive history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 5-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.

Question:

1. Because of the result of a pleural friction rub, what does the APRN recognize?

 

Your Answer:

Physical findings in a pleural friction rub include an adventitious breath sound on chest auscultation, which is heard as a harsh, grunting sound during systole and diastole. When examining the patient with a friction rub, the APRN will identify that SLE caused an inflammation of the pericardium resulting in pericarditis (Dein et al., 2019). When the patient was in active lupus, antigen-antibody complexes formed and mediated inflammation of the pericardium. Therefore, the APRN will recognize that the client’s symptoms are caused by pericarditis, which is characterized by fever, dyspnea, tachycardia, and faint heart sounds. Pericardial rub is a common finding on physical exam.

A Sample Answer 2 For the Assignment: NURS 6521 Week 4 Discussion: Pharmacotherapy for Respiratory Disorders

Title: NURS 6521 Week 4 Discussion: Pharmacotherapy for Respiratory Disorders

Scenario 4: Deep Venous Thrombosis (DVT)

A 81-year-old obese female patient who 48 hours post-op left total hip replacement. The patient has had severe nausea and vomiting and has been unable to go to physical therapy. Her mucus membranes are dry. The patient says the skin on her left leg is too tight. Exam reveals a swollen, tense, and red colored calf. The patient has a duplex ultrasound which reveals the presence of a deep venous thrombosis (DVT).

Question:

1. Given the history of the patient explain what contributed to the development of a deep venous thrombosis (DVT)

 

Your Answer:

The patient’s DVT was caused by venous stasis, activation of the coagulation pathway, and vein damage. The patient was at risk of developing a thrombus due to being obese. The patient likely developed Venous stasis following vein damage during the total hip replacement. Immobility of the left leg following surgery and failure to attend physical therapy caused venous stasis contributing to DVT (Chindamo & Marques, 2019). The venous stasis caused an increased viscosity resulting in the formation of microthrombi, which are not cleared by fluid movement when there is high blood viscosity. This resulted in the formation of a blood clot from the microthrombi, which interrupted blood flow in the vein.

See number 1 The three factors of Virchow’s triad include intravascular vessel wall damage, stasis of flow, and the presence of a hypercoagulable state.

A Sample Answer 3 For the Assignment: NURS 6521 Week 4 Discussion: Pharmacotherapy for Respiratory Disorders

Title: NURS 6521 Week 4 Discussion: Pharmacotherapy for Respiratory Disorders

Scenario 5:  COPD

A 66-year-old female with a 50 pack/year history of cigarette smoking had a CT scan and was diagnosed with emphysema.  He asks if this means he has chronic obstructive pulmonary disease (COPD).

Question:

1. There is a clear relationship between emphysema and COPD, explain the pathophysiology of emphysema and the relationship to COPD.

 

Your Answer:

Emphysema is characterized by two significant changes: loss of lung elasticity and hyperinflation of the lung. It occurs when protein-degrading enzymes called proteases are at higher-than-normal levels. They damage the alveoli and the small airways by breaking down elastin (Rodrigues et al., 2021). High protease levels make the alveolar sacs lose their elasticity, and the small airways collapse or narrow. Some alveoli get destroyed, and others become large and flaccid with reduced area for effective gas exchange. An increased amount of air is trapped in the lungs due to loss of elastic recoil in the alveolar walls, overstretching and enlargement of the alveoli into air-filled spaces, and collapse of small airways (Rodrigues et al., 2021). Emphysema is linked to COPD since oxygenation is affected by the loss of alveolar tissue and the increased work of breathing. Usually, inhalation begins before exhalation is completed, causing an uncoordinated breathing pattern.