Nursing Assignment: Understanding Emphysema and Related Conditions

This nursing assignment provides a detailed overview of several key conditions including emphysema, angina, myocardial infarction (MI), and congestive cardiac failure (CCF). It explains the pathophysiology of emphysema, focusing on reduced pulmonary elastic recoil and alveolar wall destruction, and discusses vital sign changes associated with the condition. The report also covers the pathophysiology of angina and MI, highlighting the importance of blood flow to the heart muscle. Furthermore, it explores the connection between MI and CCF, as well as the relationship between swollen ankles/legs and CCF. The assignment includes nursing care plans for a patient (Mr. Brown) experiencing chest pain, activity intolerance, and risk of decreased cardiac output, detailing goals, actions, and outcome evaluations. It also touches on the roles of allied health workers in patient care, particularly physiotherapists, occupational therapists, and podiatrists. Additionally, the report addresses transient ischemic attacks (TIA), stroke, pulmonary embolism (PE), and asthma, providing definitions, pathophysiology, and relevant nursing interventions. Key terms such as dyspnea, tachycardia, hemoptysis, and diaphoresis are defined, and a matching exercise on medical terms is included to reinforce understanding. The report concludes with references to support the information presented.

Running head: NURSING ASSIGNMENT
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Nursing Assignment
Name
Institution

NURSING ASSIGNMENT 2
NURSING ASSIGNMENT
PART A:
Q1: Pathophysiology of emphysema: It can be described on the basis of reduced pulmonary
elastic recoil. Pathophysiology of emphysema is, therefore, well-defined as the unique permanent
broadening of distal airspace to the bronchioles terminal, leading to the destruction of the walls
of alveolar and minus palpable fibrosis (Goldklang & Stockley, 2016). Clinically, the word
emphysema is mostly applied interchangeably with the disease of the chronic obstructive
pulmonary (COPD).
Q2: Vital signs in emphysema: Vital symptoms changes are often linked to hypoxemia which
forces the body to try compensating by stimulating perfusion/ cardiac output. As a result, blood
pressure and heart rate are typically increased. An obstruction disorder makes the patients exhale
with a lot of difficulties and prevent air from entering distal regions.
Q3: Pathophysiology of angina: Angina is the actual pain in the chest. It can be triggered by
various reasons, conditions, and diseases. The pathophysiology of angina begins with the
inability of the muscle of heart to receive enough blood flow. This causes crushing pain in the
chest, difficulty in breathing and suffocation.
Q4: Pathophysiology of a Myocardial Infarction: It indicates irreversible damage of myocardial
due to prolonged hypoxia and ischemia. It mostly happens, when blood flow stops or decreases
in some sections of the heart, leading to injury to the muscle of the heart (a blood clot). One type
of MI is the primary coronary event. For example, dissection or plaque. The right side of the
heart might have been affected.

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Q5: AMI caused CCF: MI occurs due to loss or reduction of blood flow through the coronary
artery. It enables the loss of more blood. This may then cause injury and damages to the lining of
the artery thereby causing CCF.
Q6: Relationship between swollen ankles; legs and CCF: Swelling in ankles and legs occur due
to the accumulation of fluids in leg tissues or inflammation. It may happen because of the
damage of coronary artery which interferes with the function of the heart in maintaining balance
body fluid.
Q7: Benign Prostate Hypermegaly (BPH): It is also known as benign prostatic. It describes
histologic diagnosis accompanied by a proliferation of cellular prostate elements.
Q8: Pulmonary Oedema: It is a condition that occurs due to excess lungs fluid. The fluid then
accumulates in the numerous air sacs inside the lung, hence interfering with the breathing
process. PO’s signs include:
• A feeling of drowning or suffocating
• Gasping or wheezing for breath
• Chest pain when caused by disease of the heart
Q9: Nursing care plans for Mr. Brown:
Plan1:
Patient problem/issue: Chest pain
Goal: To relieve chest pain
Courses of action: #1: Monitoring and documenting features of pain, noticing verbal reports,
non-verbal cues, and BP/ HR alterations. #2: Administering supplemental oxygen via nasal
cannula/face mask.

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Outcome Evaluation: The plan shall have worked if the patient records a reduction in tensions,
increased relaxed manner and increased movements with ease. Also, the plan’s effectiveness
will be validated when the patients demonstrate use of techniques for relaxation (Amakali,
2015).
Plan 2:
Patient problem/issue: Activity intolerance
Goal: To stabilize heart rhythm
Courses of action: #1: Documenting HR and rhythm and alterations in BP prior to, during and
following activity and correlating it with chest pain reports or breathe shortness. #2: Instructing
the patient to evade increasing pressure at abdomen (straining during defecation)
Outcome evaluation: The plan will be effective if desired goals such as the patient demonstrating
the progressive/measurable surge in activity tolerance with HR and BP with his normal limits
and skin is warm, dry and pink.
Plan 3:
Patient problem/issue: risk of decreased cardiac output
Goal: To reduce the workload of cardiac
Courses of action: #1: Auscultating BP and comparing both arms as well as obtaining lying,
standing, and sitting pressure. #2: Maintaining IV or hep-lock access.
Outcome evaluation: The plan will be effective if the patient records decreased angina or
dyspnea episodes. Also, it will be effective if hemodynamic stability is maintained like BP
within normal range.
Q10: Allied Health workers: They have a critical, indispensable and distinct role in providing
maximum care and satisfaction for the patients.

NURSING ASSIGNMENT 5
Q11: Allied Health Workers: They include physiotherapists, occupational therapists, and
podiatrists. Podiatrists offer diagnosis, preventive care, and treatment of different problems of
the ankles, the feet, and lower legs. Physiotherapist assists patients with physical disabilities.
PART B:
1: TIA and a stroke: Stroke occurs when the artery is blocked due to a blood clot. Both TIA and
ischemic stroke starts in the same manner. However, the main difference is that in TIA,
obstruction is temporary and the flow of blood returns on its own.
Pathophysiology: It is the functional changes associated with a particular disease.
2. FAST: It denotes Facial drooping, Arm Weakness, Speech difficulties and Time for calling
emergency services. This acronym is utilized as a mnemonic to assist in the detection and
enhancement of stroke responsiveness to the needs of a victim. FAST provides an easier method
of identifying and remembering the most common signs of a stroke.
3. Concerned:
HR of 104 is higher than the normal one which is between 60 to 100 beats a minute and hence
should be lowered.
4. Signs and symptoms of a PE:
• Unexpected shortness of breath
• Problem breathing
• Chest pain
• Coughing
• An arrhythmia/irregular heartbeat
• Deep vein thrombosis
5: Definitions of Terms

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Dyspnea: It is the labored or difficult breathing or shortness of breath.
Tachycardia: It is an abnormally rapid heart rate. It describes increased heart rate.
Hemoptysis is the act of coughing of blood content which originates from respiratory tract
located below the level of the larynx.
Diaphoresis: It is excessive sweating.
6. Pathophysiology of asthma: It involves bronchial hyperresponsiveness, airway inflammation,
and intermitted airflow obstruction.
7. Positioning Jack: I will help him sit in upright position
8. Jack’s HR and RR: Both Jack’s HR and RR will increase. RR increases because when air
enters Jack’s lungs, with each breadth is decreased, Jack will have to take additional breaths in
shorter time to avail his body with the required oxygen to function effectively. HR increases
because asthma causes a decreased amount of oxygen in blood stream. Therefore, the heart
cardiac output must be higher to combat the comprised lung volume, capacities and rate of flow.
9. Allied Health workers: Physiotherapists: Helpful after stroke to restore strengths following
weaknesses or paralysis and helping the patient to move. Occupational therapists: Helpful in
facilitating and improving motor control alongside hand function in the affected upper limb.
Q10: Matching
TERM DEFINATION
1 Tachycardia Rapid, irregular heart rate
2 Pneumonia Inflammation of the lungs due to an infection
3Atherosclerosis Narrowing of blood vessels due to development of plaques
4Pneumothorax An abnormal collection of air or gas in the pleural space
5 Pleurisy Inflammation of pleura

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References
Amakali, K. (2015). Clinical care for the patient with heart failure: a nursing care
perspective. Cardiovascular Pharmacology: Open Access.
https://www.omicsonline.org/open-access/clinical-care-for-the-patient-with-heart-failure-
a-nursing-careperspective-2329-6607-1000142.pdf
Goldklang, M., & Stockley, R. (2016). Pathophysiology of Emphysema and
Implications. Chronic Obstructive Pulmonary Diseases, 3(1), 454.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559126/