NRP/511 Advanced Pathophysiology.

Posted: December 12th, 2022

NRP/511 Advanced Pathophysiology.

Jane Case Study, NRP/511 Advanced Pathophysiology

Introduction

The patient in the case study is a 66-year-old Caucasian female. She has asthma, OCPD, and a history of using oral steroid tapers. She smokes 30 cigarettes annually. Her movement is limited due to dyspnea. The spine T-score was -2.4 SD while the left hip T-score was -3.0 SD.

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Patient’s T-Score

The patient’s T-score indicates that the patient has osteoporosis. According to Vandenbroucke et al (2017), if the T-score is 2.5 or less, a person has osteoporosis. Patient education should include encouraging the patient to stop smoking and exercise because smoking cigarettes speeds bone loss while exercising reduces the risk for fracture by improving bone mass, strengthening muscles, improving balance and reducing the risk to fall. The patient will also be advised to implement measures to prevent falls. The patient will be advised to stop using steroid tapers and adhere to the prescribed medication (Vandenbroucke et al., 2017).NRP/511 Advanced Pathophysiology.

Diagnoses

• Asthma
• OCPD
• Osteoporosis

Risk Factors

The risk factors for this patient include the history of using oral steroid tapers, smoking, and limited movement. Smoking tobacco has been shown to increase the risk of respiratory diseases such as OCPD and asthma and also increases the risk of osteoporosis by speeding bone loss. The long-term use of oral steroid tapers is also a risk factor in osteoporosis. Steroids interfere with the process of bone rebuilding and can result inosteoporosis. The limited movement is also a risk factor in osteoporosis because exercises can help in maintaining bone density in postmenopausal women such as the patient in the case study (Liberman & Cheung, 2015).

The patient will be educated on various asthma allergens and how to avoid environmental factors likely to worsen asthma and COPD such as occupational dust, air pollution, volatile organic compound, flowers/pollen, household pets, among others (See et al., 2016).NRP/511 Advanced Pathophysiology.

The patient will be educated on how to manage her asthma. The patient should self-monitor herself to recognize signs of deteriorating asthma using peak flow monitoring and symptoms. The patient will also be educated about how to take the medication correctly using inhalers and understanding the difference between long-term control drugs and quick-relief medications. Long-term prevent asthma symptoms while quick-relief medications provide quick relief to asthma symptoms(NHLBI., 2012).NRP/511 Advanced Pathophysiology.

Proposed treatments

The proposed treatment to treat both asthma and COPD for this patient includesBudesonide/Formoterol-160 mcg/4.5 mcg, 2 puffs 2x/day and the dose will be dependent on thesymptom severity or control (NHLBI., 2012).

For osteoporosis, the recommended treatment is Alendronate. Alendronate lowers the risk of hip and vertebral fractures and also reduces the height loss common in vertebral fractures. The patient will take the pill once daily (Vandenbroucke et al., 2017).

Treating Patients to Avoid Negative Sequelae

This is because the negative sequalae may reduce the quality of life for the patient.

NRP/511: Advanced Pathophysiology

Wk 6 Assignment – Jane Case Study

Jane, a 66-year-old Caucasian, is 5 years postmenopausal. She smokes 30 packs of cigarettes per year, has COPD, asthma, and a history of frequent oral steroid tapers. Jane is unable to walk very often due to dyspnea. Because she is lactose intolerant, she takes 600 mg of calcium daily with vitamin D. She had her first DEXA scan and her T score at her spine was -2.4 SD and the T score at her left hip was -3.0 SD.NRP/511 Advanced Pathophysiology.

Read “Asthma Care Quick Reference: Diagnosing and Managing Asthma”.

Create an illustration, diagram, infographic, or any visual to educate Jane using terms she would comprehend that includes the following:

Explains her T scores

Identifies what diagnoses she has

Identifies what risk factors she has

What treatment do you propose for her?

What is the rationale for treating patients to avoid negative sequelae?NRP/511 Advanced Pathophysiology.