Nursing diagnoses, outcomes and interventions to elderly patients with diabetes: Among the implications arising from the aging population, there is the increasing prevalence and chronic diseases circulatory, pulmonary, osteoarticular, neuropsychiatric disorders and diabetes mellitusconstituting a major public health problem due to its high impact on morbidity, mortality, reduction quality of life and health care costs 2.
Dyspnea, is defined by the American Thoracic Society as a subjective experience of breathing discomfort. This experience comes from interactions among various physiological, psychological, and environmental factors.
Dsypnea is a symptom and it should not be confused with the increased work of breathing, which is a physical sign. In order to be reported as a symptom, a sensation should be perceived as unpleasant and felt as abnormal.
Dyspnea is one of the most common complaints faced by a hospitalist. What is the differential diagnosis for this problem? Generally speaking, causes of dyspnea can be divided into: Pulmonary such as bronchospasm, pneumonia, pneumothorax, airway obstruction, pleural effusion, interstitial lung disease Cardiovascular congestive heart failure, myocardial infarction, cardiac tamponade, pulmonary embolism, arrhythmias Miscellaneous anemia, deconditioning, drugs, pregnancy, diabetic ketoacidosis, neurological, fractures, psychiatric causes, and obesity.
Discussions of all of the these etiologies are beyond the scope of this chapter. Here, we will focus on the pathologies which hospitalists come across every day.
These include pneumonia, bronchospasm chronic obstructive pulmonary disease COPDasthmacongestive heart failure, and pulmonary embolism PE. The diagnostic approach is discussed in detail below. History information important in the diagnosis of this problem.
In addition to obtaining general history, physicians should focus on associated cough, sputum production, hemoptysis, chest pain, wheezing, orthopnea, palpitations, abnormal weight loss, and generalized, ie. Patients should also be asked about acuity, severity, and frequency of their dyspneic episodes.
When evaluating a patient with shortness of breath, it is always important to consider life-threatening conditions and to stay vigilant that a heart attack, a pulmonary embolism, acutely decompensated heart failure, acute severe hypoxemia of various reasons, could happen at any time, in a hospitalized patient.
During the initial interview, all patients should be asked about their smoking history, also including the underlying second hand exposure which is usually associated with a previous similar episode. Asthma and COPD are the most common obstructive lung diseases.
Patients suffering from these conditions usually mention wheezing or chest tightness as a presenting complaint. For example, a patient with an acute bronchoconstrictive episode, may describe a sense of chest tightness, even when their lung function is preserved.
Patients with COPD have strong smoking history. Any diseases of the chest wall, such as those which cause stiffness, such as kyphoscoliosis, or weakens the respiratory muscles, such as Guillain-Barre or myasthenia gravis, could also cause dyspnea. Pleural effusions, whether as a stand alone diagnosis, or associated with other conditions, could also cause an increase in the work of breathing.
Diseases of the lung parenchyma, such as pneumonia could also cause dyspnea. Diseases of the heart or pericardium could present with dyspnea. Diastolic dysfunction, described as a stiff left ventricle, is also associated with severe dyspnea, even with minimal physical activity, especially if it associated with other valvulopathies, such as mitral regurgitation.
The patient was in his usual state of health until 3 months before presentation, when he noted the onset of bilateral lower extremity edema and dyspnea. Since then, his symptoms have progressed to include fatigue, orthopnea, paroxysmal nocturnal dyspnea, and, for the last month, a . PHYSICAL DIAGNOSIS FINAL EXAM STUDY GUIDE. Download a copy of this study guide. Chapter 2: Head and Neck; Chapter 3: Respiratory EXERTIONAL DYSPNEA: Dyspnea on exertion is a common symptom of mild or severe Congestive Heart Failure. Anasarca: Severe generalized edema and ascites, as seen in severe CHF, liver . Consumer Behaviour For Branded Clothing Essay Study On Diabetic With Exertional Dyspnea And Anasarca Essay, Ethics In The Modern Business World: A Case Study On Leisure Net Essay, Ethics In The Modern Business World: A Case Study On Leisure Net Essay African Psychology Essay, Toyota Industry Founder Is Sakichi Toyoda Essay.
Constrictive pericarditis can present with an increased of the pulmonary and intracardiac pressures, followed by dyspnea.
Cardiac tamponade has a similar mechanism.
Venous thromboembolism, such as PE pulmonary embolism causes dyspnea.Diabetic Case Study - Download as Word Doc .doc), PDF File .pdf), Text File .txt) or read online. Scribd is the world's largest social reading and publishing site. Explore. Severe anasarca, estimated at about 70 kg of volume expansion, resulted from hypoalbuminemia with diabetic nephropathy and sodium retention with beriberi heart disease.
Notes Acknowledgments. Pathophysiology Final Exam. STUDY. PLAY. Pathology. study of the basic disease process. Disease. when structures deviate from the norm to the point that internal homeostatis is destryoed. Pathogensis. exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, fatigue and weakness, confusion, dizziness (brain not getting .
Diabetic With Exertional Dyspnea and Anasarca: Case Study A fifty year old gentleman a known diabetic and hypertensive for eight years presented with exertional dyspnea of one month duration. Published: Thu, 04 Jan Consumer Behaviour For Branded Clothing Essay Study On Diabetic With Exertional Dyspnea And Anasarca Essay, Ethics In The Modern Business World: A Case Study On Leisure Net Essay, Ethics In The Modern Business World: A Case Study On Leisure Net Essay African Psychology Essay, Toyota Industry Founder Is Sakichi Toyoda Essay.
Diabetic With Exertional Dyspnea and Anasarca: Case Study A fifty year old gentleman, a known diabetic and hypertensive presented with exertional dyspnea and fluid overload. He was detected to have renal failure and.