Treatment goals for an acute exacerbation of COPD are two-fold.  The first is to provide supportive care and resolve the acute exacerbation with minimal impact on the patient lung function, and the second is to prevent further exacerbations.

Read the article, “Managing hospitalized patients with a COPD exacerbation: the role of hospitalists and the multidisciplinary team”.  You may access the article at: https://doi.org/10.1080/00325481.2021.2018257  

Discuss the recommended goals/treatment strategies of COPD management in critically ill patient. 

Instructions:

Post your discussion to the Moodle Discussion Forum.  Initial post must be made by Day #3.  Word limit 500 words.  Reply to at least two other student posts with a reflection of their response.  Please make sure to provide citations and references (in APA, 7th ed. format) for your work.  

 Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition Adolescent With Diabetes Mellitus (DM) Case Studies The patient, a 16-year-old high-school football player, was brought to the emergency room in a coma. His mother said that during the past month he had lost 12 pounds and experienced excessive thirst associated with voluminous urination that often required voiding several times during the night. There was a strong family history of diabetes mellitus (DM). The results of physical examination were essentially negative except for sinus tachycardia and Kussmaul respirations. Studies Results Serum glucose test (on admission), p. 227 1100 mg/dL (normal: 60–120 mg/dL) Arterial blood gases (ABGs) test (on admission), p. 98 pH 7.23 (normal: 7.35–7.45) PCO2 30 mm Hg (normal: 35–45 mm Hg) HCO2 12 mEq/L (normal: 22–26 mEq/L) Serum osmolality test, p. 339 440 mOsm/kg (normal: 275–300 mOsm/kg) Serum glucose test, p. 227 250 mg/dL (normal: 70–115 mg/dL) 2-hour postprandial glucose test (2-hour PPG), p. 230 500 mg/dL (normal: <140 mg/dL) Glucose tolerance test (GTT), p. 234 Fasting blood glucose 150 mg/dL (normal: 70–115 mg/dL) 30 minutes 300 mg/dL (normal: <200 mg/dL) 1 hour 325 mg/dL (normal: <200 mg/dL) 2 hours 390 mg/dL (normal: <140 mg/dL) 3 hours 300 mg/dL (normal: 70–115 mg/dL) 4 hours 260 mg/dL (normal: 70–115 mg/dL) Glycosylated hemoglobin, p. 238 9% (normal: <7%) Diabetes mellitus autoantibody panel, p. 186 insulin autoantibody Positive titer >1/80 islet cell antibody Positive titer >1/120 glutamic acid decarboxylase antibody Positive titer >1/60 Microalbumin, p. 872 <20 mg/L Diagnostic Analysis The patient’s symptoms and diagnostic studies were classic for hyperglycemic ketoacidosis associated with DM. The glycosylated hemoglobin showed that he had been hyperglycemic over the last several months. The results of his arterial blood gases (ABGs) test on admission indicated metabolic acidosis with some respiratory compensation. He was treated in the Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 emergency room with IV regular insulin and IV fluids; however, before he received any insulin levels, insulin antibodies were obtained and were positive, indicating a degree of insulin resistance. His microalbumin was normal, indicating no evidence of diabetic renal disease, often a late complication of diabetes. During the first 72 hours of hospitalization, the patient was monitored with frequent serum glucose determinations. Insulin was administered according to the results of these studies. His condition was eventually stabilized on 40 units of Humulin N insulin daily. He was converted to an insulin pump and did very well with that. Comprehensive patient instruction regarding selfblood glucose monitoring, insulin administration, diet, exercise, foot care, and recognition of the signs and symptoms of hyperglycemia and hypoglycemia was given. Critical Thinking Questions 1. Why was this patient in metabolic acidosis? 2. Do you think the patient will eventually be switched to an oral hypoglycemic agent? 3. How would you anticipate this life changing diagnosis is going to affect your patient according to his age and sex? 4. The parents of your patient seem to be confused and not knowing what to do with this diagnoses. What would you recommend to them? 

Intra and Interdisciplinary Collaboration in Practice

Respond to two (2) of the following prompts:

1. Briefly describe the various agents of socialization. Which of the agents of socialization was the most important in your own upbringing and why? Provide two specific examples of values learned and how can you relate it to the agent of socialization. Lastly, will agents of socialization be different for your own children than they were for you? (USLO 2.2)
2. Explain two different theories of self-development in relationship to your own development of self. (USLO 2.1)
3. Explain why socialization matters? Then, describe the concepts anticipatory socialization, resocialization, and degradation ceremony and provide at least one example for each concept from your life. (USLO 2.1)
4. Explain ethnocentrism and cultural relativism in detail. Provide two examples of ethnocentrism in the media and explain how the subject could be addressed differently to be more in line with cultural relativism. Lastly, share a time in which you felt culture shock. Was it a positive or negative experience? (USLO 2.3)
5. Differentiate between high culture and popular culture and provide two examples of each. How do your examples of popular culture influence your culture? Do you think technology has a more positive or negative effects on culture? Give two examples of how technology has influenced your own culture. (USLO 2.3)
6. Identify a current event and utilize one of the sociological theoretical perspectives (E.g., Functionalism, Conflict theory, or Symbolic Interactionism) to explain the possible cultural influences of the event. Use concepts where ever relevant. (USLO 2.4)

This week, you will complete a literature search, find 10 research articles from peer-reviewed journals and submit an APA annotated bibliography.

Additional details for each project can be viewed in the Course Projects Module