NR 507 Week 2: Discussion Part Two

Chamberlain University NR 507 Week 2: Discussion Part Two– Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University NR 507 Week 2: Discussion Part Two assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 507 Week 2: Discussion Part Two

Whether one passes or fails an academic assignment such as the Chamberlain University NR 507 Week 2: Discussion Part Two depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 507 Week 2: Discussion Part Two

The introduction for the Chamberlain University NR 507 Week 2: Discussion Part Two is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 507 Week 2: Discussion Part Two

After the introduction, move into the main part of the NR 507 Week 2: Discussion Part Two assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 507 Week 2: Discussion Part Two

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 507 Week 2: Discussion Part Two

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NR 507 Week 2: Discussion Part Two

Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. Through and extensive work-up, she is diagnosed with bronchitis.

What is the etiology of bronchitis?
Describe in detail the pathophysiological process of bronchitis.
Identify hallmark signs identified from the physical exam and symptoms.
Describe the pathophysiology of complications of bronchitis.
What teaching related to her diagnosis would you provide?

In addition to the textbook, utilize at least one peer-reviewed, evidence based resource to develop your post.

NR 507 Week 2 Discussion Part Two

What is the etiology of bronchitis?

There are two kinds of Bronchitis: Acute Bronchitis, that is caused by “Infections or lung irritants,” and Chronic Bronchitis, that is caused by “repeatedly breathing in fumes that irritate and damage lung and airway tissues” (National Heart, Lung, and Blood Institute, 2018). This could be like smoking or inhaling second-hand smoke. The etiology of bronchitis is the same that causes upper respiratory infections. The names of the viruses that cause bronchitis are coronavirus, rhinovirus, respiratory syncytial virus, and adenovirus. Most cases of bronchitis come from a virus instead of bacteria. Current smoking is associated with a more goblet cell hyperplasia and number, and chronic bronchitis is associated with more goblet cells, independent of the presence of airflow obstruction. This provides clinical and pathologic correlation for smokers with and without COPD (Kim et al., 2015).

Describe in detail the pathophysiological process of bronchitis.

The pathophysiological process of bronchitis is very simple. The symptoms of acute bronchitis are due to acute inflammation of the bronchial wall, which causes increased mucus production along with edema of the bronchus (National Heart, Lung, and Blood Institute, 2018). This leads to the productive cough that is the hallmark of a lower respiratory tract infection. While the infection may clear in several days, repair of the bronchial wall may take several weeks. During the period of repair, patients will continue to cough. Pulmonary function studies of patients with acute bronchitis demonstrate bronchial obstruction similar to that in asthma. As the symptoms of acute bronchitis subside, pulmonary function returns to normal. Most patients will cough for less than 2 weeks with the illness. If a patient coughs longer than 1 month then the term is post bronchitis syndrome (National Heart, Lung, and Blood Institute, 2018). The bronchial walls are trying to repair after the clearance of the infection.

NR 507 Week 3: Discussion Part Two

NR 507 Week 4: Alterations in Renal and Urinary

NR 507 Week 5: Discussion Part One

NR 507 Week 6: Recorded Disease Process Presentation Peer Review

NR 507 Week 7: Reflection

NR 507 Week 8: Genomes, Genetic Alterations, and Reproductive Disorders

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Identify hallmark signs identified from the physical exam and symptoms.

The hallmark sign and symptoms are duration of cough less than 30 days, productive cough, no history of chronic respiratory illness, and fever. Production of mucus (sputum), which can be clear, white, and yellowish-gray or green in color can occur in acute bronchitis. Acute bronchitis is caused by a virus. Cough from the irritated and inflamed bronchial epithelium and increased mucus production (McCance, Huether, Brashers and Rote, 2013).

Describe the pathophysiology of complications of bronchitis.

As with most diseases, complications can arise from bronchitis. Around one person in 20 with bronchitis may develop a secondary infection in the lungs leading to pneumonia. The infection is commonly bacterial although the initial infection that caused the bronchitis may be viral. The infection affects the tiny air sacs known as alveoli in the lungs (National Heart, Lung, and Blood Institute, 2018). Although a single episode of bronchitis usually isn’t cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease, or COPD. Chronic bronchitis can lead to long term COPD with progressively diminishing lung reserves and breathing difficulties. COPD further raises the risk of occasional flare ups and increased risk of recurrent and frequent chest infections. When you breathe, air moves in your trachea through two tubes called bronchi. The bronchi branch out into smaller tubes called bronchioles. At the ends of the bronchioles are little air sacs called alveoli. And at the end of alveoli are capillaries, which are tiny blood vessels. Oxygen moves around in the lungs to the bloodstream through the capillaries. Carbon dioxide moves from the blood into the capillaries and then into the lungs and exhaled. The fibers in the walls of the lungs can become damage (Kim et al, 2015). They are not able to expand and make them less elastic when you exhale

What teaching related to her diagnosis would you provide?

I would educate Tammy about second-hand exposure to smoke. This could make her bronchitis even worse if exposed. Tammy would most likely be prescribed an inhaler that would open up her bronchioles, helping her breath better. Most people should drink at least 8 eight-ounce cups of water a day. You may need to drink more liquids when you have acute bronchitis. Liquids help keep your air passages moist and help you cough up mucus. I would encourage Tammy to get plenty of rest to help fight the infection. Tammy could use a cool mist humidifier to decrease her cough and make it easier for her to breath (National Heart, Lung, and Blood Institute, 2018).

References

Kim, V., Oros, M., Durra, H., Kelsen, S., Aksoy, M., Cornwell, WD., et al. (2015) Chronic Bronchitis and Current Smoking Are Associated with More Goblet Cells in Moderate to Severe COPD and Smokers without Airflow Obstruction. PLoS ONE 10(2). Doi: https://doi.org/10.1371/journal.pone.0116108

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby.

National Heart, Lung, and Blood Institute. (2018). Bronchitis. National Institute of Health. Retrieved from https://www.nhlbi.nih.gov/health-topics/bronchitis

Sample Answer 2 for NR 507 Week 2: Discussion Part Two

Bronchitis is a respiratory disease that can be acute or chronic in nature. For a patient to be diagnosed with chronic bronchitis they must present with a chronic productive cough that has lasted for at least 3 months for 2 consecutive years (McCance & Huether, 2014). Since Tammy’s cough did not develop until after she developed a cold, which was only 3 weeks ago, her bronchitis can be classified as acute. However, for educational purposed acute and chronic bronchitis will be covered throughout this discussion. Acute bronchitis is characterized by the inflammation of the bronchial tree, which causes excessive mucus production (Hopper, 2015). Acute bronchitis can be viral or bacterial in origin, but typically is viral (McCance & Huether, 2014). With acute viral bronchitis the cough is typically dry and can be treated with anti-inflammatory medications, hydration, and a cough suppressant (McCance & Huether, 2014). Bacterial acute bronchitis typically is characterized by a productive cough following a viral infection, such as a cold, and can be treated the same as a viral infection except with the addition of an antibiotic (McCance & Huether, 2014). Since the patient had been experiencing a productive cough and recently experienced a viral infection the patient should be educated on her antibiotic prescription. This education should include pertinent information regarding allergic reactions and potential side effects, as well as the importance of finishing all the prescribed antibiotics even if she is no longer experiencing a productive cough.

Chronic bronchitis is similar to acute bronchitis in which inflammation is the etiology of the disease (McCance & Huether, 2014). Chronic bronchitis occurs as a result of inhaled irritants that damage the airway causing an inflammatory response that creates a large influx of white blood cells into the affected areas (McCance & Huether, 2014). The inflammation leads to edema of the airways with contributes to a greater production of mucus that occludes the bronchi and cannot be cleared due to decreased ciliary action (McCance & Huether, 2014).This decreased ciliary functioning leads to a cycle of increased inflammation, infections, and decreased pulmonary functioning (McCance & Huether, 2014). Decreased pulmonary functioning in patients with chronic bronchitis includes airway obstruction, hypoxemia, hypercapnia, and hypoventilation (McCance & Huether, 2014). As the disease progresses the inflammation continues to damage both large and small bronchi, and has the potential to lead to complications such as frequent infections, pulmonary hypertension, cor pulmonale, and death (McCance & Huether, 2014). These complications signify the severity that the disease is capable of developing into. The pathophysiology behind these complications is the decrease in gas exchange occurring due to the decreased surface area of the lungs leading to a lack of oxygen within the cells leading to cyanosis (McCance & Huether, 2014). Common signs and symptoms that lead to a diagnosis of chronic bronchitis is a productive cough lasting greater than three weeks for two consecutive years, prolonged expiration, hypercapnia and hypoxemia noted during a blood gas analysis, and potential barrel chest (McCance & Huether, 2014). Chronic bronchitis requires management of symptoms and treatments to decrease the rate of pulmonary decomposition. Patient education regarding chronic bronchitis needs to focus on modifiable risk factors, breathing exercises, and medication. Modifiable risk factors that have been linked to chronic bronchitis include smoking tobacco, obesity, indoor air pollutants, and indoor mold and mildew (Pahwa et al., 2017). Patients who smoke should be given information about tobacco cessation and the important role it plays in their health. Giving patients the necessary resources to stop smoking will improve outcomes and prevent further worsening of pulmonary function. Patient will typically be prescribed bronchodilators and expectorants (McCance & Huether, 2014). Patients may also be treated with antibiotics and steroids when they present with infections (McCance & Huether, 2014). The overall goal for patients with bronchitis should include preserving pulmonary functioning as much as possible.

Hopper, P. (2015). Chapter 31: Nursing care of patients with lower respiratory tract disorders. Understanding Medical Surgical Nursing, 5^th ed. Philadelphia, Pennsylvania: F. A. Davis Company.

McCance, K. L. & Huether, S. E. (2014). Alterations of pulmonary function, Pathophysiology: The biologic basis for disease in adults and children, seventh edition (225-261). St. Louis, Missouri: Elsevier Mosby

Pahwa, P., Karunanayake, C. P., Rennie, D. C., Lawson, J. A., Ramsden, V. R., McMullin, K., & … First Nations Lung Health Project Research, T. (2017). Prevalence and associated risk factors of chronic bronchitis in First Nations people. BMC Pulmonary Medicine, 171. doi:10.1186/s12890-017-0432-4

Sample Answer 3 for NR 507 Week 2: Discussion Part Two

Very informative post and thank you for sharing. Acute bronchitis and cough is one of the most commonly seen illnesses in ambulatory care and primary care centers. It is characterized by a persistent cough, which may or may not be productive in nature, and lower respiratory tract infection without complication of chronic airway or respiratory disease. Typically upper respiratory tract symptoms and postnasal drainage precede acute bronchitis, causing inflammation of trachea and bronchus (Kinkade & Long, 2016). Acute bronchitis originates from a viral infection 90% of the time and persistent, bothersome cough, lasting more than 2 weeks, is typically the symptom that causes patients to seek treatment. Intermittent wheezing and rhonchi may be auscultated in the lungs, which should clear with cough.

Finally, while fever may be present, it is not a common or required presentation for the diagnosis of acute bronchitis (Kinkade & Long, 2016). Acute bronchitis is the most accurate fitting diagnosis for Tammy’s initial presentation. She has cold like symptoms that worsen into persistent cough. Symptoms are present for 3 weeks, which is a reasonable time frame for the presence of acute bronchitis. The complaints of scratchy throat may be a result of postnasal drainage, leading to the cough, which is also described as a contributing factor of acute bronchitis.

Chronic obstructive pulmonary disease can be classified as either chronic bronchitis, chronic inflammation of the airways with thick mucus production, or emphysema, loss of the elasticity of the alveoli. Deterioration of the alveoli results from the breakdown of elastin, causing air to become trapped. Inflammation and thick secretions noted in chronic bronchitis result from chronic exposure to irritants, decreased ciliary function, and over active goblet cells (McCance et al., 2013). Both versions of COPD lead to obstruction of the airway and increased RV, FRC. However, FVC and ERV and the amount of air exhaled in the first second of forced exhalation (FEV1) are decreased with the disease. Decline in FEV1 over the course of the disease is utilized to measure the severity of COPD and the progression of the disease process (Cerveri et al., 2012).

References

Cerveri, I., Corsico, A. G., Grosso, A., Albicini, F., Ronzoni, V., Tripon, B., Imberti, F., Galasson, T., Klersy, C., Luisetti, M., Pistolesi, M. (2012). The Rapid FEV1 decline in chronic obstructive pulmonary disease is associated with predominant emphysema: A longitudinal study. COPD: Journal of Chronic Obstructive Pulmonary Disease, 10(1), 55-61. doi:10.3109/15412555.2012.727920

Colom, A. J., Maffey, A., Garcia Bournissen, F., & Teper, A. (2014). Pulmonary function of a paediatric cohort of patients with postinfectious bronchiolitis obliterans. A long term follow-up. Thorax, 70(2), 169-174. doi:10.1136/thoraxjnl-2014-205328

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby

Perez, T., Chanez, P., Dusser, D., & Devillier, P. (2015). Prevalence and reversibility of lung hyperinflation in adult asthmatics with poorly controlled disease or significant dyspnea. Allergy, 71(1), 108-114. doi:10.1111/all.12789

Sample Answer 4 for NR 507 Week 2: Discussion Part Two

I enjoyed reading your post. I can relate to your teaching about ensuring that individuals with bronchitis wear a mask when around fumes and individuals with cold or flu symptoms. I was once diagnosed with bronchitis when I moved to West Virginia in 2009. I remember having a cold and I was very congested. Right after the cold subsided I started coughing like crazy every day all day. I coughed non-stop and would throw up from coughing too much for two months, I kept thinking it will go away. Every time I would fly I would be so embarrassed because I would cough non-stop on the plane. I took every over the counter cough suppressant and none of them worked. I finally went to the doctor and they prescribe bronchial dilator inhalers, but none of them worked. I went to the doctor the second time and she prescribed codeine which finally cleared my cough. I have learnt to wear a mask whenever I go outside due to high levels of pollen, once I moved Georgia and I sleep with a cool mist Humidifier. The doctors did not prescribe antibiotics because they told me it was a viral infection. They did some blood work and the blood work came back negative.

According to Smith (2017), a systematic review shows that there was limited evidence of clinical benefit to support the utilization of antibiotics for acute bronchitis. Some patients treated with antibiotics recovered a bit more quickly with reduced cough-related outcomes. Unfortunately surveys show that 80% of patients with acute bronchitis receive antibiotics. Antibiotic overuse contributes to emergence of drug-resistant organisms.

References

Smith, S. M., Fahey, T., Smucny, J., & Becker, L. A. (2017). Antibiotics for acute bronchitis. The Cochrane Database Of Systematic Reviews, 6, 245.doi: 10.1002/14651858.CD000245.pud4