Pulmonary Function Testing

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PULMONARY FUNCTION TESTING

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Chronic Obstructive Pulmonary Disease (COPD) is a preventable andtreatable disease, characterized by a persistent limitation ofairflow. The condition consequently results in chronic inflammatoryinfections in the lungs and the airways as a result of their responseto gases and small particles. The most common symptoms of COPDinclude a chronic cough, dyspnea, and chronic sputum production. TheCOPD guidelines state that its diagnosis should be conducted in anyperson who shows signs such as a chronic cough, dyspnea, or sputumproduction. More so, all patients at the risk of exposure to factorsas indoor air pollution, tobacco smoke occupational chemicals, anddust should be diagnosed (Gruffydd-Jones &amp Loveridge, 2011). Thispaper addresses the diagnosis, management strategies and theprevention of Chronic Obstructive Pulmonary Disease.

According to Pauwelset al. (2012), the clinical diagnosis of COPD requires the use of thespirometry an instrument that is used to monitor and confirm thepresence of airflow limitation. Therefore, for the purpose ofimplementation in a clinical setting, all the nurses who take care ofthe COPD patients need to have access to the instrument. However, insome situations, the diagnosis of COPD may be difficult. In suchcases where the signs and symptoms resemble those of other chronicdiseases, then there arises the need to conduct a differentialdiagnosis. The most common differential diagnosis has been chronicasthma.

According to theGlobal Initiative for Chronic Obstructive Lung Disease, once apatient has been diagnosed, active management depends on theassessment of the individual’s current symptoms and the possibilityof future attacks. Bronchodilators are the most commonly usedmanagement strategies of COPD. They aim at reducing or preventing thesymptoms and thus long-acting bronchodilators are more preferred asopposed to the short-acting bronchodilators. Inhaled corticosteroidsimprove the quality of life, reduce the frequency and severity ofexacerbations, and improve lung function. However, withdrawal fromcorticosteroids may lead to increased exacerbations. Other managementstrategies include methylxanthines, vaccines, and antibiotics.Prevention of COPD can be achieved through reduction of exposures tothe risk substances and avoiding smoking (Vestbo et al. (2013).

James, a 58-year-oldplumber, was diagnosed with COPD 6years ago. According to hisclinician, James contracted the disease approximately 11 years agofrom his grandchildren. His current symptoms include green sputum,fatigue, and occasional breathlessness. Immediately after diagnosis,he was put under short-acting bronchodilators, which reduced thesymptoms. Nevertheless, recently, symptoms like breathlessness beganinterfering with his work. He now experiences severe exacerbations,which take him averagely two weeks before he can recover fully and goback to work. The severity of his condition was because his conditionwas only formally noticed after six years of infection. For histreatment, James has been put on the long-acting agonists to reduceand prevent future exacerbations. Additionally, close follow-up isbeing done on James to reduce his exacerbations and ensure that heattends all the set appointments.

In both the casestudy and the guidelines as per Global Initiative for ChronicObstructive Lung Disease, the diagnosis is based on the individual’ssymptoms. Based on the severity of the exacerbations, therefore, thepatients can either be put on short-acting or long-acting agonists.For James’s case, after the initial detection of the disease, hewas placed on the short-acting medications, which were changed to thelong-acting agonists when his condition worsened. Additionally, hewas advised to stop smoking and avoid other risks to prevent symptomsor reduce their severity (Davis et al., 2015).

References

Gruffydd-Jones, K., &amp Loveridge, C. (2011). The 2010 NICE COPDGuidelines: how do they compare with the GOLD guidelines? Primarycare respiratory journal, 20(2).

Pauwels et al. (2012). Global strategy for the diagnosis,management, and prevention of chronic obstructive pulmonary disease.American journal of respiratory and critical care medicine.

Vestbo et al. (2013). Global strategy for the diagnosis,management, and prevention of chronic obstructive pulmonary disease:GOLD executive summary. American journal of respiratory andcritical care medicine, 187(4), 347-365.

Davis et al. (2015). Continuing to Confront COPDInternational Physician Survey: physician knowledge and applicationof COPD management guidelines in 12 countries. Int J ChronObstruct Pulmon Dis, 10, 39-55.