5.2.1: FRAME 1- Recognize Cues
- Page ID
- 90245
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CORRECT Answer
Question Type: Multiple Response Select All That Apply
Scoring: +/-
NCSBN Item Type and Scoring: https://www.ncsbn.org/public-files/p...main_stage.pdf
After reviewing the client’s information, select findings that negatively contribute to Stanley’s COPD symptoms?
\(\bigotimes \) Asthma
\(\bigotimes \) Tobacco abuse
\(\bigcirc \) Hypertension
\(\bigotimes \) Poor adherence to medication regime
\(\bigcirc \) History of ruptured aortic aneurysm
\(\bigotimes \) Anxiety increased feelings of restlessness and perceived symptoms
RATIONALE
Cigarette smoking is the leading cause of COPD. According to the American Lung Association (2023), approximately 75 percent of all COPD cases occur in people with a history of smoking. When a cigarette burns, it creates more than 7,000 chemicals and many are harmful. The chemicals in cigarette smoke weaken your lungs’ defense against infections, causes constriction of the bronchial tubes, inflammation of the bronchioles and destroy the alveoli-all which are contributing factors for COPD. Asthma and COPD are both chronic inflammatory lung diseases associated with significant morbidity and mortality. In both conditions, inflammation is associated with structural alterations at large and small airway levels. Both asthma and COPD are characterized by various degrees of airflow limitation, inflammation, and tissue remodeling (Kim & Rhee, 2010). This type of pathology is known as asthma-COPD overlap syndrome (Hikichi et al., 2018). Breathing patterns in COPD clients result in shallow respirations. When this occurs, the brain can sometimes perceive there to be a stressful situation, even when there is not one. This can cause a stress response in the body, often referred to as anxiety. COPD clients should be encouraged to engage in psychotherapy, attend support groups, connect with spiritual communities, and talk with their healthcare providers to assist with the complex emotions that arise with the diagnosis of COPD (American Lung Association, 2023).
FOCUSED GUIDE
This case study focuses on an individual with COPD and addresses four of the five SDOH domains, Health Care Access and Quality, Neighborhood and Built Environment, Social and Community Context, and Economic Stability. The first of the domains is Health Care Access and Quality. Stanley was recently hospitalized for a COPD exacerbation recording his sixth hospital admission in six months. Access to quality health care includes assessing if the client has health care insurance. According to Healthy People 2030, about 1 in 10 people in the United States do not have health insurance. Related objectives the Health Care Access and Quality domain to reduce the proportion of emergency department visits with longer wait time than recommended and to increase the proportion of adults who get recommended evidence-based preventive health care. Prevention of exacerbations is a therapeutic goal for clients with COPD. Stanley’s scenario could factor into the population data objectives, reducing emergency department visits and receiving evidence-based preventive healthcare.