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Care of specific conditions (Chronic obstructive pulmonary disease…
Care of specific conditions
hypertension
defination
Persistently raised blood pressure
risk factors
obese, high salt intake, lack of exercise, stress, diet low in vitamin D, smoking
causes
old age, obesity, family history,smoking, insulin resistance, increased activity of renin angiotensin sysyems
pathophysiology
there is hyperkinetic circulation in which the wear and tear of blood vessels is increaesd this leads to hardening of vessesls and loss of elasticity which lead to increased cardiac work and cardiac output. To maintain this increased cardiac output the heart enlarges and the myocardium outgrow its blood supply leading to ischaemia.
management
lifestyle modifacation, diuretics,beta adrenergic blocking agents, ACE inhibitors, calcium channel blockers
Diabetes mellitus
defination
This is a group of metabolic disorders characterised by elevated blood glucose levels resulting from inadequate insulin action
risk factors
genetic factors, obesity, diet, lifestyle
pathophysiology
This occurs as a result of insulin deficiency of ineffective insulin. in insulin deficiency the pancreas produce little or no insulin. whereas in ineffective insulin the pancreas produces enough or excessive insulin but the the sensitivity of target cells to insulin is decreased.Glucose and amino acid uptake to the bloodstream fails , levels of free fatty acids in the blood are elevated. Ingestion of carbohydrates worsens the situation because these are metabolised into glucose which the liver and skeletal muscles are unable to utilise. Glucose levels in the blood rise until the kidneys are unable to cope with reabsorbing the glucose in the glomerular filtrate resulting in glycosuria
sypmtoms
polyuria, polyphagia, polydispia
dietary managenent
55-65% carbohydrates, 12-20% protein, 20-30% fat, refined and complex sugars should be avoided, complex carbohydrates such as bread, cereals should be encouraged, limkt alcohol intake to one glass of wine, increase fluid intake
Chronic obstructive pulmonary disease
defination
This is a condition characterised by persistent resistance to airflow.
risk factors
Smoking, environmental irritants
causes
irritating chemicals, chronic lung infection mostly TB, allergy related conditions
clinical manifestations
difficulty in breathing, chronic cough, poor appetite, weight loss
pathophysiology
following exposure to irritating stimulus immune cells in the tracheobronchial tree, such as mast cells , basophils, and macrophages are activated once activated these cells release chemical mediators that cause constriction of the bronchial smooth muscle and increase capillary permeability in the airways producing bronchospasms. repeated exposure to the irritating stimulus produces a chronic inflammatory reaction to the lungs characterised by thickening of the mucous membrane and the production of thick tenacious secretions.
management
avoidance of environmental triggers such as pollens, house dust, and air pollution.
stress management can reduce attacks
anti-inflammatory treatment
inhaled corticosteroids
beta-two agonist such as salbutamol
Epilepsy
defination
A convulsion or fit it is often a symptom of an underlying disease.
causes
Trauma such as birth injuries,
congenital defects of the central nervous system
meningitis
brain tumours
hyperpyrexia
pathophysiology
In epilepsy, a spontaneous electrical discharge occurs from a group of neurons, referred to as a seizure focus. Seizure activity may involve the entire brain. The specific clinical manifestations associated with a seizure depend on the position of the seizure focus and the extent to which secondary recruitment occurs
clinical manifestations
altered conciousness
abnormal motor activity
abnormal sensations
abnormal behaivor
management
drug therapy
phenytoin
barbiturates
primidone
valproic acid
benzodiapines
nursing managent
ensure patency of the airway
prevent injuries
force the jaws open with a hard object
place the patient in a lateral position