Case Study On Chronic Respiratory Health

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II. Health Problems for Further Assessment and Follow-up
Chronic Respiratory Disease Based on Mr. Jim’s history of cigarette smoking, the chronic respiratory disease that he could be suffering from is chronic obstructive pulmonary disease (COPD). COPD is primarily caused by cigarette smoking and is typified by partially reversible, progressive airway obstruction, systemic manifestations, lung inflation, and increased severity and frequency of exacerbations (O’Donnell et al. 2007, p. 5). Jim’s lung function should be assessed. The role of the RN in further assessment of Mr. Jim’s respiratory health is to conduct thorough history and physical examination as this can enable prediction of air flow obstruction. Findings on physical examination
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Jim has been experiencing chest pain on exertion. Chest pain refers to ache, pressure, stabbing or burning sensation in the chest. Chest pain is a common symptom and one of the commonest reasons for emergency department visits. Chest pain can be a sign of ischemic heart disease (Nilsson 2008, p. 7). Chest pain assessment can help in the diagnosis of acute coronary syndromes and the identification of patients at immediate risk of adverse clinical events (Czarnecki et al. 2013, p. 1386). When conducting clinical assessment of Jim’s chest pain, the nurse should inquire about the onset, location, duration, radiation, and characteristics of the pain. The nurse should also inquire about the aggravating and relieving factors. Chest pain that occurs on exertion and relieved by rest signifies stable angina pectoris (Czarnecki et al. 2013, p. 1390). Ischemic chest pain presents as squeezing, burning, pressure, or a sense of heaviness over the chest (Nilsson 2008, p. 7). Assessing Jim’s chest pain will enable the nurse to collect vital information that can help ascertain the cause of his chest pain, which can then guide management strategies. Even after discharge from the hospital, a patient with chest pain is still at risk of adverse clinical outcomes. Therefore, Mr. Jim would require close monitoring and follow-up for early detections and management of any potential adverse events. Lack of follow-up of patients treated for chest pain has been associated with increased risk of …show more content…
Jim has a long history of hypertension and is on antihypertensive medication. Hypertension is the leading risk of mortality globally (Khatib et al. 2014, p. 1). Hypertension is defined as systolic blood pressure ≥140 mmHg and diastolic blood pressure of ≥90 mmHg (Hareri et al. 2014, p. 760). Appropriate management of hypertension requires its identification, initiation of appropriate treatment using medication or lifestyle changes, and follow-up to monitor compliance with treatment strategies and determine whether the blood pressure is well-controlled (Khatib et al. 2014, p. 1). The nurse should conduct assessment to determine Jim’s level of knowledge regarding hypertension, including the risk factors, management strategies, medications, and prognosis. The nurse should assess whether Jim takes the antihypertensive medication as prescribed, as this would provide information regarding his level of adherence to the medication. Low adherence to antihypertensive medication has been cited as a major factor that contributes to impaired efficiency and effectiveness of pharmacological management of hypertension (Khatib et al. 2014, p. 1). Poor adherence can also predispose Jim to heart disease and stroke (Hareri et al. 2014, p. 761). The nurse should address any knowledge deficits by providing appropriate information about hypertension to Jim so that he can understand his conditions and its management approaches. The nurse should advice Jim on the importance of smoking

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