RESUMO
Chronic obstructive pulmonary disease (COPD) is an umbrella term used to describe respiratory diseases characterised by airway obstruction. COPD is now an established and significant chronic disease, killing over 30 000 people in the UK every year. According to the World Health Organization, COPD will become the third biggest killer in the world by 2020. The financial and human cost of the disease is huge. To appreciate the pathophysiology of obstructive pulmonary diseases, it is first necessary to understand a number of important lung concepts. This article discusses the pathophysiology of COPD, highlighting the main mechanisms involved, provides an outline of the associated signs, symptoms and treatment of COPD and explore how health care professionals in the community/residential care settings can help manage and improve the quality of life for patients with COPD.
Assuntos
Papel do Profissional de Enfermagem , Doença Pulmonar Obstrutiva Crônica/enfermagem , Enfermagem em Saúde Comunitária , Humanos , Medicina Estatal , Reino UnidoRESUMO
In the UK, chronic respiratory diseases cause 13% of adult disability. The major chronic respiratory disease is chronic obstructive pulmonary disease (COPD), a condition involving chronic airway inflammation that causes airflow obstruction and destruction of lung tissue. This leads to a progressive loss of respiratory membrane, which accounts for the clinical manifestation of COPD, which is difficulty maintaining sufficient gas exchange to meet metabolic demands. The primary cause is smoking, with the vast majority of COPD patients having a past or present history of smoking. However exposure to industrial pollutants is also a contributing factor, as is a rare genetic predisposition to developing COPD.
Assuntos
Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Assistência Terminal , Adulto , Biomarcadores , Humanos , Pessoa de Meia-Idade , Prognóstico , Doença Pulmonar Obstrutiva Crônica/enfermagemRESUMO
In the UK, chronic respiratory diseases cause 13% of adult disability. The major chronic respiratory disease is chronic obstructive pulmonary disease (COPD), a condition involving chronic airway inflammation that causes airflow obstruction and destruction of lung tissue. This leads to a progressive loss of respiratory membrane, which accounts for the clinical manifestation of COPD, which is difficulty maintaining sufficient gas exchange to meet metabolic demands. The primary cause is smoking, with the vast majority of COPD patients having a past or present history of smoking. However, exposure to industrial pollutants is also a contributing factor, as is a rare genetic predisposition to developing COPD.
Assuntos
Dispneia/epidemiologia , Doença Pulmonar Obstrutiva Crônica/mortalidade , Magreza/epidemiologia , Índice de Massa Corporal , Doenças Cardiovasculares , Comorbidade , Depressão/epidemiologia , Progressão da Doença , Volume Expiratório Forçado , Humanos , Hipertensão Pulmonar/epidemiologia , Obesidade/epidemiologia , Prognóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Fibrose Pulmonar/epidemiologia , Reino Unido , Capacidade Vital , Teste de CaminhadaRESUMO
Sepsis has gained increasing publicity in recent years, and there is now a strong focus of clinical education and training following the Surviving Sepsis Campaign. The assessment and management of a septic patients is far from simple and requires a systematic approach in both identifying and managing the condition. This second part explores sepsis care bundles and the research that underpins each of the interventions. These discussions will enable nurses to understand why each component of the sepsis care bundle is important and thus enable them to rapidly prioritise care, as early effective interventions have been shown to optimise patient outcomes.
Assuntos
Hiperglicemia/enfermagem , Hipotensão/enfermagem , Hipóxia/enfermagem , Avaliação em Enfermagem , Pacotes de Assistência ao Paciente , Sepse/enfermagem , Corticosteroides/uso terapêutico , Antibacterianos/uso terapêutico , Gerenciamento Clínico , Hidratação/métodos , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Oxigenoterapia/métodos , Respiração Artificial , Vasoconstritores/uso terapêuticoRESUMO
Sepsis has gained increasing publicity in recent years, and is now a strong focus of clinical education and training following the launch of the 'Surviving Sepsis' campaign. The assessment and management of a septic patient are far from simple and requires a systematic approach in both identifying and managing the condition. This two-part series explores the assessment and management of a septic patient, with this article emphasising the need to identify the signs and symptoms of sepsis at the early stages if positive patient outcomes are to be realised. The ABCDE approach to patient assessment is explored in the context of sepsis, as this approach can ensure the nurse will identify sepsis as opposed to the basic method of only performing vital observations.
Assuntos
Protocolos Clínicos , Papel do Profissional de Enfermagem , Avaliação em Enfermagem , Sepse/enfermagem , Gerenciamento Clínico , Diagnóstico Precoce , Humanos , Sepse/diagnóstico , Sepse/terapia , Choque Séptico/diagnóstico , Choque Séptico/enfermagem , Choque Séptico/terapia , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/enfermagem , Síndrome de Resposta Inflamatória Sistêmica/terapia , Vasoconstritores/uso terapêutico , Sinais VitaisRESUMO
In the hospital environment, patients can deteriorate rapidly and for many different reasons. Maintaining a patient's breathing is the main priority in any emergency situation, although achieving airway control can be difficult. All health professionals need to be able to undertake airway management safely. The key is a thorough assessment to ensure first of all whether the airway is patent (open and clear) or not. This article will discuss airway management, both acute and chronic, as well as associated nursing care.
Assuntos
Manuseio das Vias Aéreas/métodos , Manuseio das Vias Aéreas/normas , Competência Clínica/normas , Serviços Médicos de Emergência/métodos , Intubação Intratraqueal/métodos , Intubação Intratraqueal/normas , Guias de Prática Clínica como Assunto , Manuseio das Vias Aéreas/enfermagem , Humanos , Intubação Intratraqueal/enfermagem , Medicina Estatal/normas , Reino UnidoRESUMO
Needlestick injuries are a serious concern for nurses and other healthcare workers. One of the main clinical risks from needlestick injury is the possible infection by blood-borne diseases, such as hepatitis and HIV. A number of different measures have been introduced to minimise the risk and impact of needlestick injuries, including the use of fixed-needle safety syringes. However, some healthcare workers refuse to use such devices, for reasons that include the perceived need to change syringe needles between drawing up a medicine and its administration to a patient. This paper will explore the literature relating to needlestick injuries and the reasons commonly given for not using fixed-needle safety syringes.
Assuntos
Agulhas/normas , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Recursos Humanos de Enfermagem/normas , Doenças Profissionais/prevenção & controle , Equipamentos de Proteção , Seringas/normas , HumanosRESUMO
Maintaining a patient's airway and facilitating breathing are the main priorities during any emergency situation in which breathing is compromised. The key to safe management of an airway is thorough assessment, primarily to ensure the airway is patent. In an emergency situation, a bag-valve-mask may be the most effective way to assist ventilation. If ventilation is required for prolonged periods in an emergency situation, then endotracheal intubation should be performed. This involves the placement of a cuffed, endotracheal tube in the trachea, through which ventilation is maintained. Each tracheal intubation event should be anticipated as a potentially difficult intubation. Longer term ventilatory support may be achieved by the use of mechanical ventilators, which are designed to assist the movement of gases (air) into and out of a patient's lungs, while minimising the work and effort of breathing. This article provides nurses with an overview of the techniques and equipment that is most often used within emergency and intensive care units to maintain the patency of a patient's airway and provide ventilatory support.