NCD

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Mr. Chan

CA Lung

treat excessive musus

Augmentin

treat pneumonia

Aspirin

low dosage (80mg Daily)

lower the incidence rate of cancer (about 1/4)

Diagnostic method

Other tests

AFP

mean certain types of cancer

PSA

test for prostate cancer

Sputum x C/ST

T&S

prepare the right blood

Clotting Profile

check abnormal blood clot

Ca lung may produce mucin

risk of blood clot

LRFT

indicate the stage of Ca lung

check the amount of WBC,platelet

Blood x C/ST (>38.5^C)

NPA x PCA

Specific test

Cytology

CEA

tumor maker

Non-specific Symptoms

poor appetite

Local & Regional Symptoms

Pleura

right pleural effusion

Lung

Bronchus

pneumonia symptoms

Airborne precaution

recurrent fever

hemoptysis

Respiration

shallow

Limited expansion

Sign

SpO^2:88%

tumor cell

alveolar cells collapsed

lower the rate of gas exchange

Temp 38^C

Pulse: 58bmp & irregular

Respiratory centre affected

Heart's electrical system affected

BP: 90/60mmHg (

tumor: easy to bleed

lower cardiac output

affect other organ

chronic smoker

Stages

4

3

2

Lobar atelectasis (lung cannot expand) OR Pneumonia

1

Local affected

Carcinogens

Damage cells &DNA

Mutation

Celluar changed & abnormal cell growth

Malignant cell developed (Tumor)

Spead

Angrognes

Hematogmous

Lymphatic system

Other Organ

Invasion

Heart Failure

Oxygen therapy

Oxygen 0-6L/min via nasal cannula, keep SpO2 >=95%

Metoprolol

Low blood pressure

Fluid retention

Affects the heart and circulation

Treat or prevent heart attack

Treat hypertension

Amlodipine

Less common

A heart attack on rare occasions

Most common

Edema of the lower extremities

Prevent heart pain (angina) resulting from reduced flow of blood to the heart

Increases the flow of blood to the heart

Lisinopril

Anxiety

Treat high blood pressure

Indapamide

Side effects

Nervousness

Hypotension

Hypokalemia

Muscle weakness

Treat hypertension

Vital sign

Blood pressure: 90/60 mmHg

Low blood pressure

Sp02: 88% on room air

Respiration: 24 bpm(shallow)

Cough

Brings up frothy phlegm that may be blood tinged

Because of congestion and fuild in the lung

Low oxygen level in the blood

Shortness of breath

Occurs when lying down and can interrupt sleep

Tranexamic Acide

edema in the lower body

weakness

Dizziness

Fatigue

anxiety

Risk factors

Medical history

Atrial fibrillation

Coronary artery disease

Hypertension

Result from impaired cardiac functioning and excessive workload demands

Acute or chronic heart failure

Unable to provide sufficient pump action to maintain blood flow to meet the needs of body and lungs

One side fails first

Right heart failure

Left heart failure

COPD

Treatment

NPO

Oxygen 0 – 6 L/min via nasal cannula, keep SpO2 >= 95%

treat low blood oxygen level

Respiratory rate is fast

body compensation due to low oxygen supply

SpO2: 88% on room air

show low oxygen level in blood

chest pain

due to air trapping

low blood oxygen level

bad gas exchange

weight loss

use accessory muscles to breathe

consume more energy

poor appetite

breathing assist with month

shortness of breath

dyspnea

Respiration: 24 bpm (shallow)

Risk Factor

Smoking

a chronic smoker for more than 40 years

obstructive lung disease

air trapping

airflow limitation

airway irritants cause neutrophils

inflammatory cells to accumulate in the airways

trigger an inflammatory response

airways constrict and narrow and swollen

excess mucus production

Tranexamic Acide (tranexamine)

Treat Bleeding

Paracetamol (Panadol)

Treat Fever

Tuberculosis

Sputum test

Chest X- ray

Right pleural effusion

Vital Sign

Body Temperature: 38^C

Weight loss

No appetite

Droplet containing tubercle bacilli inhales and reach to lung

Bacilli multiply in alveoli

Macrophages ingest and surround the bacilli. The cells then forms granuloma and keeps the bacilli inside and under control

When the immune system cannot make bacilli under control, bacilli start to multiply and form tuberculosis

Main topic

Pneumonia

Medical management

Therapeutic management

Pleurocentesis

Treat pleural effusion

Medication therapy

Intravenous fluid (IVF)

Reduce fluid loss

Paracetamol (Panadol)

Treat fever and relieve pain

Bromhexine (Bisolvon)

Treat respiratory disorder with excessive mucus

Tranexamic Acide (Tranexamine)

Treat bleeding

Augmentin (amoxicillin and clavulanate)

Treat bacterial infection e.g. pneumonia

Diagnostic and laboratory findings

Laboratory findings

RFT

Evaluate dehydration

CBC

Monitor increase in WBC

C/ST

Check sputum

Chest x-ray

Right pleural effusion

Diagnostic findings

Hemoptysis

Body weight decreased from 70kg to 60kg

Vital signs

Body temperature

38^C

SpO2

88% on room air

Respiration rate

24 breaths per minute

Sign and symptoms

Poor appetite

Chest pain

cough

Pleural effusion

Fever

Low SpO2

Shallow respiration

Dyspnea

Risk factor

Chronic smoker

Pathophysiology

Bacteria pass through the upper airway to lower airway

Trigger inflammatory response in alveoli

Increases mucus production

Leaking of the capillaries cause mucus with blood

Mucus decreases the gas exchange within the lung

Fluid fills up in the alveoli

The debris results from white blood cells fight the infection fills up the alveoli