Chronic Obstructive Pulmonary Disease
Smoking is the most common cause of the disorder, followed by the presence of fumes in the air as a result of poor ventilation and open fire used for cooking. The particles inhaled by the patient cause an inflammatory response and, by extension, narrowing of the airways. Eventually, chronic bronchitis develops as a reaction to the inflammation, occasionally accompanied by emphysema – the destruction of the alveoli and collapse of small airways (Mayo Clinic, n.d.).
A physical examination would be necessary to gain important information on patient health. Next, a review of family history and an analysis of residential and working conditions need to be performed to determine the presence of additional factors, such as exposure to secondary tobacco smoke, ventilation of the household, and fumes in the workplace. Pulmonary function tests should be administered to measure the performance of the patient’s lungs and the amount of oxygen remaining in the exhaled air. A chest x-ray needs to be made to validate the diagnosis by determining the presence of emphysema. Alternatively, a CT scan should be administered to confirm emphysema and rule out conditions with similar symptoms.
A specific assessment of the arterial blood gas will be necessary once the diagnosis is confirmed, as the amount of carbon dioxide and oxygen in the patient’s blood would determine the need for oxygen treatment (WebMD, n.d.a).
Care plan would include regular monitoring of the respiratory status, reaction to oxygen therapy (if prescribed), the elevation of the bed’s head during sleeping, installation of a room humidifier, a consistent increase in daily fluid intake, training on coughing techniques, administering inhalation medications with post-administration mouth care, ensuring the presence of rest periods following the intake of medications, and incorporation of nursing follow-up.
The co-management of the patient with a hematologic problem would be conducted through cross-checking of the medications that might affect the results of the arterial gas test results as well as the subsequent coordination of hematologic treatments for conflicts with the oxygen therapy.
Peptic Ulcer Disease
Helicobacter pylori are the most common cause of the disorder. The bacteria disrupt the ability of the mucosal surface to resist the acidic environment, leading to pain and inflammation of the ulcer. Several secondary factors contribute to the disorder occurrence through the promotion of acid secretion, such as alcohol consumption and cigarette smoking, although their influence is relatively minor (Vakil, 2016).
After a physical exam and inquiry into family history, two tests should be performed. First, a test for the presence of H. pylori must be administered. Breath test provides higher accuracy of the results than blood or stool counterparts. Nevertheless, it can produce a false-negative result when administered to the patients undergoing antacid medications, so such an issue should be discussed with the hospital staff before administering it. Second, in the case when a patient has difficulty eating or experiences signs of internal bleeding, an endoscopy procedure is to be conducted. The test allows for biopsy of the tissue for lab tests.
Additional specific assessment related to the disorder includes fecal occult blood test if the presence of blood in the stool is suspected and the complete blood count to establish whether bleeding ulcer causes anemia (Vakil, 2016).
A care plan would include pain relief through the promotion of healthy eating habits, avoidance of coagulants, and education on relaxation techniques. Next, family participation and information on treatment should be ensured to reduce anxiety. Finally, consulting the patient on essentials of self-management (e.g. regular food intake, symptom detection, aggravating factors) must be done in-home care.
The essential co-management for the patient with a chronic neurological disorder would necessitate closer cooperation with the family to ensure reliable self-management, monitoring of the symptoms and complications, and anxiety avoidance.
Urinary Tract Infection (UTI)
A common cause of the UTI is E. coli, a bacterium that proliferates in the urinary tract. After getting to the urethra, the bacteria infect the bladder and, if not timely identified and treated, expand to the kidneys. The inflammation of the infected areas usually causes pain, burning feeling, and fever (WebMD, n.d.b).
Urine is noticeably affected by the infection. Thus an analysis of the urine sample is the most common and easy to perform test available for the disorder. Lab analysis could detect bacteria in the sample or identify abnormalities in the amount of red and white blood cells. Next, urine culture could be necessary for the clinician to determine the bacteria responsible for the infection.
In the case where the infection is recurring, a specific assessment in the form of a CT or an MRI scan of the bladder might be necessary to establish whether abnormalities in the urinary tract cause increased susceptibility to the disorder.
A care plan would include the detection and elimination of potential infection sources such as indwelling catheters. Next, the promotion of regular bathroom visits and encouragement of emptying the bladder would be necessary. The medication intake should be overseen. Simultaneously, the greater urinary output must be facilitated through the increased fluid intake. Finally, the patient should be educated on the proper techniques of perineal cleansing (front to back wiping) to decrease the risk of recurring infections.
The most important area of co-management for a patient with a chronic cardiac problem is the increased risk of mortality. While UTI is not a life-threatening disorder, it can in some cases severely undermine the health of an individual, so coordination of actions and cross-exchange of information with a cardiologist would be required.
Mayo Clinic. (n.d.). Symptoms and causes.
Vakil, N. (2016). Peptic ulcer disease.
WebMD. (n.d.a). COPD (chronic obstructive pulmonary disease) – exams and tests.
WebMD. (n.d.b). Your guide to urinary tract infections (UTIs).