SHadow health 12.2.docx - Nursing Hero (2024)

SHADOW HEALTH FOCUSED EXAM 1 Assignment 12.2: Shadow Health Focused Exam: COPD and Anti-Asthmatics Concept Lab Dora Aguilar Maryville University

SHADOW HEALTH FOCUSED EXAM 2 Synopsis We encountered and treated 55-year-old Debbie O'Connor during this week's Shadow Health assignment. Debbie, who has COPD Group B—chronic bronchitis—came into the clinic complaining of breathing difficulties and a recent bronchospasm. She has noticed a significant decline in her health over the past few years, which she attributes in large part to her 37-year smoking history. Formoterol inhaler 12 mcg once every twelve hours is the prescription she currently takes at home. She doesn't use any vitamins or other over-the-counter drugs at the moment. According to the CDC (2023), 16 million Americans have been diagnosed with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Your capacity to work and even perform basic everyday duties may be limited by COPD. Mrs. O'Connor had to move in with her daughter Ava, who helps take care of her when she is not working. Nevertheless, the hardship of moving in with herdaughter and losing her spouse to lung cancer kept her in a downward spiral of smoking to cope. Not to mention, she also lost both her parents to smoking. It has been difficult for Mrs. O'Connor to walk up a few stairs, go shopping, or even pick up her prescriptions. The slightest amount of activity causes her to feel short of breath resulting in a coughing fit. She reports that her last coughing fit was three days ago. Her main complaint was acute bronchospasm, and she stated that she was taking her medication as prescribed (Elsevier, 2024). Since smoking is one of the primary causes of COPD it will be imperative to provide Mrs. O'Connor with the necessary tools and resources to help her quit smoking. Her vital signs in the office were stable given her health status. Her heart rate was 90, her respiration rate was 20, her blood pressure was 129/79, and her oxygen saturation was 92% (Elsevier, 2024). 92% can be regarded as normal for someone with COPD. Temperature was normal and she was negative for a respiratory infection.

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SHADOW HEALTH FOCUSED EXAM 3 What did I learn? For this week's Shadow Health assignment, the anti-asthmatic concept lab was a very helpful addition. Reviewing the mechanisms of action of bronchodilators, muscarinic agonists, corticosteroids, anticholinergics, and B2 adrenergic agonists, was incredibly helpful (Elsevier, 2024). Understanding the mechanisms of action of these drugs was made easier by remembering how the neurotransmitters work in the parasympathetic and sympathetic nervous systems earlier in this course. It was imperative to remember the action of neurotransmitters in our body to better help me understand how these medications work in the lungs. It was helpful to keep in mind that while bronchodilators dilate the airways, they do not address inflammation in cases of severe asthma attacks or COPD. Prescription of anti-inflammatory drugs such as fluticasone or prednisone in addition to other anti-asthmatic treatments is therefore essential (Elsevier, 2024). I effectively communicated with Mrs. O'Conner throughout my visit by utilizing my empathy and communication abilities. Upon completion of her evaluation, I determined the suitable pharmacological treatment based on Mrs. O'Connor's COPD symptoms, complaints, and circ*mstances. The fact that it took me three tries to figure out Mrs. O'Connor's COPD medicine was a little disappointing. It appeared that my issue with this specific medication was that I still need to have greater confidence when prescribing prescription combinations. For her COPD, I ultimately decided on a umeclidinium/ vilanterol inhaler. For patients with stage C COPD, a LABA / LAMA combination is a great option to prescribe (Elsevier, 2024). On my initial try at managing her COPD symptoms, I chose albuterol, and while it was a goodchoice, it was not the right one. I made the right decision when I chose the albuterol/ipratropium inhaler on my second try. As for the medication to help treat her smoking cessation, I selected bupropion on my first attempt. Given that it's more affordable, more effective, and better tolerated, this was a wise