Care and management of chronic obstructive airways disease Essay

Care and management of chronic obstructive airways disease - Essay Example He was advised to quit smoking by the general practitioner, but the patient was unable to do so. In view of persistent cough and worsening health condition, the patient was referred to our center for further management and counseling. Other health problems in John include hypertension and hemorrhoids. He has been taking amlodipine 5 mg for hypertension. Overview of the disease Chronic obstructive pulmonary disease (COPD) is one of the devastating medical conditions that causes a great degree of suffering to humans (Mosenifar, 2011). It is a source of both economic and social burden (Sullivan et al, 2000 and Fromer and Cooper, 2008). It is defined as "a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema" (Mosenifar, 2011). There are 2 sides of coin to the disease and they are emphysema and chronic bronchitis. Chronic bronchitis refers to presence of chronic cough with no other etiology and which is productive for at least 3 months during each of the two consecutive years. Emphysema is a condition in which damage of the air spaces that are present distal to the terminal bronchioles occurs. The damage is irreversible, abnormal and associated with destruction of the air space walls with no obvious fibrosis (Fromer and Cooper, 2008). ... The most distressing symptom of COPD is breathlessness which is a progressive problem and the crux of treatment of COPD is management of breathlessness. Pathophysiology Understanding of the pathophysiology of the disease helps elaborate a good management plan. The most common cause of COPD is cigarette smoking. It develops in about 15 percent of chronic smokers (NICE, 2004). Thus, John developed COPD because of chronic smoking. Other risk factors for the development of COPD are air pollution especially due to solid cooking fuels, presence of airway hyperresponsiveness (Mosenifar, 2011). The characteristic pathophysiological changes in COPD are seen in the central airways, the peripheral airways and also the lung parenchyma. Diverse mechanisms are implicated in the pathophysiology of COPD (Thurlbeck, 1990). Primary offenders like oxidative stress due to free radicals from cigarette smoke and oxidants from phagocytes and polymorphonuclear leukocytes trigger the release of certain enzym es like leukocyte elastase in such proportions that they cannot be counteracted effectively by anti-proteases, resulting in destruction of the lung tissues (Thurlbeck, 1990) leading to necrosis or apoptosis of the lung tissue. Due to these mechanisms, certain pathological changes occur in the airways and the lung tissue like inflammation and globlet cell hyperplasia in chronic bronchitis and loss of elastic recoil in emphysema. Other changes include ciliary abnormalities, airway smooth muscle hyperplasia, bronchial wall thickening and sometimes atrophy (Mosenifar, 2011). These pathophysiological changes contribute to airway flow obstruction, airway hyperresponsiveness and mucus accumulation leading to poor ventilation and oxygenation, breathlessness, cough and infection. A

Running Water and Ground Water Essay Example | Topics and Well Written Essays - 1500 words

Running Water and Ground Water - Essay Example Rains maintain a balance through which water is maintained in the fresh water resources. Running water is the water that is present in the streams. It runs down due to the force of gravity. Groundwater is the water that seeps down from the surface and gathers under the surface in an aquifer or underground reservoir. It rains on mountains quite often, the water from the rain rushes down the mountains due to the force of gravity. At first stage, small streams are formed that combine together to make a bigger stream, streams connect together to form a river. The water in the streams and rivers is called running water. In the similar manner, due to change in temperature from winter to summer, the snow on mountains melt into water. The water rushes down the mountain due to the force of gravity. Running water has high oxygen level and most of the needs are satisfied with the help of running water. Running water is also utilized to generate energy. In olden days, the force of running water was utilized to crush wheat cornels (Hynes, 1983). Ground water is the type of water that seeps down into the surface and settles down in an aquifer or underground reservoir. This water is also the rain water but due to saturation of ground the seeps down to the aquifer. As the quantity of water above the surface decreases, the quantity of water undergrad also decreases. However, annual rains and snowfalls replenish the underground water through the saturated grounds. Wells lie directly over the aquifers. Underground aquifers are good in holding water for longer periods as compared to the above ground water resources. There is no evaporation of water from the underground aquifers. However, little water that comes to the surface due to capillary effect evaporates form the surface (Hynes, 1983). Aquifer is an underground soil or group of rock that allow the underground water to pass through them and move according