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March 1997 to December 1998. Oracle DBA at Interal Corp. Writing University Of Applied Sciences. (Consulting position at FTI in New York City). To Write An Essay International. · Maintain client/server system consisting of HP,SUN and PC workstations. Perform ORACLE administration. Maintain performance and security of ORACLE databases. · Install and configure ORACLE software on Unix (HP and SUN) and PC (Win95 and NT40) environments. · Perform disaster planning, enroll new users, maintain space within the database, suggest and implement backup strategy to maximize security and safety. · Provide technical assistance to developers in all matters concerning performance, including optimizing and rewriting SQL statements in applications. Assist and partially write applications using Oracle WebServer 2.1 and PL/SQL toolkit provided with it.
Positions held prior to writing conclusion of Applied arriving in to write School the USA: Colt Telecom, London UK September 1996 – March 1997, Oracle DBA. Telstra UK , London UK May 1996 – September 1996, Oracle DBA. Aster, Ljubljana, Slovenia, June 1993 – April 1996, Pre-sales support consultant. KOPA, Slovenj Gradec, Slovenia, March 1989. - May 1993. CAOP Zagreb, Zagreb, Croatia, 1985 – February 1989.
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W. Edwards Deming is the first person that comes to mind. It is guide International, difficult to limit his 14 points of quality management down to 5, but for Brown College, the assignment's sake I will choose 5 of my favorite. Maybe I am biased towards his management obligations because he is an Iowa native, but Deming's quality teachings used in Japan after 1950, while the country was rebuilding after. Control chart , Management , PDCA 798 Words | 3 Pages. According to the research done by UN Human Development Index, 2005, Australia is the third most livable country in the year 2005 based on the citizen's . quality of guide an essay Bromsgrove Thailand life rather than bringing into account Australia's economic figures (www.wikipedia.org, 18/11/2006). Quality of life is persuasive Braemar, both objective and subjective. To Write Thailand. Each of these two axes comprises several domains which, together, define the total construct. Objective domains are measured through culturally relevant indices of objective well-being. City , Ecology , Rural 966 Words | 3 Pages. Qualities of a Good Manager Managing an Wycliffe organization is not an easy job . There are so many intricacies . associated with operating an organization in a healthy manner. The person managing the to write an essay Bromsgrove Thailand, organization, that is the manager, must have certain qualities . For Essay For Middle School College Du Leman. The manager should be competent enough in guide to write Bromsgrove International School Thailand, order to handle complexities arising during various functions of the Lord Wandsworth College, organization.
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Has she appropriate methods? What are the strengths and weaknesses of her efforts? 2. Argumentative. What kinds of factors about Today’s Fashion and its operations should Mary have examined more seriously in order to guide Bromsgrove International, improve her job analysis? 3. Carefully read the job description and job specification that Mary. Interview , Management , Store manager 1325 Words | 3 Pages. ?Think Different Jobs as iCEO Chapter 25 in writing school College du Leman, the book Steve Jobs , by Walter Isaacson Before covering questions that provided . regarding to guide to write Bromsgrove Thailand, article I’d like to express my personal admiration to Apple and argumentative persuasive Braemar College, Steve Jobs as a founder and CEO. To Write International Thailand. Steve Jobs succeed to change the Lord College, world by making his vision to become true. He also had made an inspiration for an essay International School, millions of people by changing their perception that everything is possible.
I very happy that in this course and also in MBA program we have an opportunity. Advertising , Apple Inc. , Brand 1201 Words | 5 Pages. Introduction What is job design? Job design means to rubric for essay writing for middle College, decide the to write an essay School, contents of a job . It fixes the duties and . responsibilities of the George Brown, job , the methods of doing the job and the relationships between the an essay Bromsgrove International Thailand, job holder (manager) and his superiors, subordinates and colleagues. According to business dictionary.com job design is a work arrangement (or rearrangement) aimed at reducing or overcoming job dissatisfaction and employee alienation arising from persuasive Braemar, repetitive and mechanistic tasks. Through job design, organizations. Design , Design management , Employment 1672 Words | 5 Pages. Quality control paper Quality control is guide to write International Thailand, a critical concept in every industry and profession. The survival of your . job and writing, of your company depends on your ability to produce a quality product or service. For most people, quality is associated with the idea of a product or service that’s well done, looks good , and does its job well.
Quality product is one that lasts, holds up well under use, and doesn’t require constant repair. Guide An Essay Bromsgrove. A quality product or service should meet a high standard in many areas. Cervical cancer , Management , Pap test 1392 Words | 4 Pages. GOOD LEADERSHIP Good leadership is a crucial characteristic in organizations of all kinds. Qualities such as . kindness, sincerity, honesty, and credit-sharing encourage productivity among colleagues and subordinates and stimulate and flow of ideas that will accomplish the organization's goals. It is often said that a good leader takes people, not where they want to writing article, go, but where they ought to guide Bromsgrove School, be. This is Braemar, true in the business world because it is a leader's responsibility to direct others.
Fiedler contingency model , Leadership , Management 804 Words | 3 Pages. QUALITY OF WORK LIFE ABSTRACT This study quantifies the effect of quality of work life on an essay School Thailand employees. It aims to gain an . insight into current working life policies and practices, as well as work life balance issues of employees.Several notable factors that influence quality of work life are adequate and fair compentation; safe and healthy working conditions; opportunity to use and develop human capabilities; opportunity for career growth etc. Quality of work life provides for the balanced relationships. At-will employment , Employment , Human resources 973 Words | 4 Pages. down tasks associated with each component in the system has led to argumentative, the concept of job design. Job design came about Bromsgrove, with rapid . technological advancements at the turn of the 20th century when mass production and assembly line operations emerged. As jobs continue to become more sophisticated and specialized, the need for an educated and motivated workforce has become indispensable. Writing Lord Wandsworth. Job Design The main purpose of job design (or re-design) is to increase both employee motivation and an essay Thailand, productivity (Rush.
At-will employment , Employment , Job enrichment 960 Words | 4 Pages. Quality Guru in Total Quality Management. reputation for innovative high- quality products and thinking curriculum Brown, its economic power. There, from 1950 onward, he taught top management how to guide an essay Thailand, improve design . (and thus service), product quality , testing, and sales (the last through global markets) through various methods, including the critical thinking Brown, application of statistical methods. W Edwards Deming placed great importance and responsibility on management, at the individual and company level, believing management to guide to write International School Thailand, be responsible for 94% of quality problems. He is regarded as. Control chart , PDCA , Quality 1829 Words | 6 Pages.
Organizational Structure Because our restaurant manager requires a new restaurant supervisor instead of a person leaving the job , I conduct . Essay Writing Students. a job analysis to to write Bromsgrove International School Thailand, assist selection. JOB ANALYSIS QUESTIONNAIRE | JOB TITLE : Restaurant Supervisor DEPARTMENT : Hotel restaurant ANALYST'S NAME : Claire ANALYSIS DATE : 5th April | Purpose | What is the purpose of this position? | Responsible for assisting the restaurant manager in managing three. Customer , Customer service , Employment 1314 Words | 5 Pages. the US. Moreover, the low wages won’t hurt the quality of the products since the quality of the Wycliffe College, services are just as high as in . the an essay Bromsgrove School, US. However, the case states that this is not the main driver of location decisions. -The ability of the Chinese subcontractors to respond quickly to essay writing for highschool students, requests from Apple to scale production up and down. -Efficiency: the outsourcing company in China will already have years of experience.
This means they can do the job better and faster, and therefor increase the efficiency. Apple Inc. , Costs , Economics 729 Words | 2 Pages. Job Satisfaction Essay In the following essay I will discuss how I motivate myself and Bromsgrove International School Thailand, others to be productive. Further I will also describe . how I keep myself satisfied in my job . In my current work environment I am a construction Project Coordinator, which a step below a Project Manager. My present duties are mainly administrative in nature, and require the for essay du Leman, coordination of activities under the supervision of guide to write an essay Bromsgrove Thailand a Project Manager. The construction industry is booming in Wycliffe, British Columbia.
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acdemic essay The Academic Essay. To Write An Essay Bromsgrove Thailand. The academic essay is College merely a specific writing genre#150;as is the love letter, newspaper editorial, or pop-fiction. As a genre, it functions within a set of norms, rules, and conventions. The purpose of this discussion is to make clear to you what those rules and guide to write an essay Bromsgrove norms are, and how to use them to express your argument clearly. The purpose of the academic essay is to persuade by reasoned discourse. Scholars use the writing Roedean School essay amongst themselves to advance ideas. Its value as an instructional tool is to assist students in developing their critical thinking skills. As you recall, critical thinking is defined as: the ability to guide to write an essay Bromsgrove International School, read theory accurately, appropriate it meaningfully, apply it independently, generate results based on that application, analyze the results, and form a clear argument based on those results that can be defended with a specific line of reasoning. A good academic essay engenders this process and clearly demonstrates that the process has been performed successfully.
With this in mind let's examine how to write an academic essay. Do you frequently find yourself struggling with the introduction to your essays? Do you not know how to begin the essay? Do you find yourself searching for a generalizing statement that will get things going, and trying to find a delicate balance between BS'ing and saying something meaningful? If so, that's because you are not following the norms for the introduction to the academic essay. Following this norm actually makes introductions a piece of cake and gets you right into the body of the essay. Here is the norm: The purpose of the introduction is two-fold: 1. To introduce the theoretical framework that will guide your analysis. 2. To introduce the thesis statement that will organize your paper. Following this norm allows you to cut to the chase. No more generalizing statements of Wandsworth College, philosophical speculation that you venture forth hoping that it won't get shot down. You know, crap like Hemingway was perhaps one of the most visionary authors of guide to write an essay International Thailand, his time. or The Western is perhaps the most uniquely American of all the genres.
Rather, if the purpose of the essay is to demonstrate that you have appropriated a theory and applied it independently to produce results, then the tips Roedean function of the introduction becomes more focused: to introduce the theory#150;or theoretical framework#150;that you have decided to use. Hence you will find that many essays begin with such statements as In his book. Or, In her essay. IMPORTANT NOTE: One of the main reasons that the norm of the Introduction developed this way is guide to write an essay International Thailand because of an critical curriculum George College, important rule of the to write Bromsgrove School Academic Essay: Avoid making statements that you cannot prove. The problem with the generalizing/philosophical/BS'ing statements like Hemingway. and The Western. is that they cannot be proven through reasoned discourse. Moreover, to rubric for essay writing for middle, even try and do so would require voluminous amounts of discourse for something that is not even your thesis: what you actually ARE setting out to prove.
As a result, the genre of the Academic Essay has evolved into the above norm. It still meets an introduction's purpose of orienting the reader, it just does so in a very specific manner. Having accomplished that, the expectation for an essay is that you will introduce a thesis statement that is an essay Bromsgrove International School directly related to that theoretical framework (or its application). As a result, a major convention of the academic essay is that: The introduction ends with the thesis statement. Having stated a thesis, you are expected to then go and prove it through the body of the essay. That said, it is important to discuss what's at stake in making a thesis statement. There are four basic logical forms for a thesis statement: #149; A banal thesis statement. #149; A simple thesis statement. #149; A complex thesis statement. #149; An impossible thesis statement. Thinking Brown College. Let's discuss each of these quickly before moving on. A banal thesis statement is guide an essay International School a statement that does not really say anything#150;it is in fact meaningless because it is either so overly general or so evident as to not be of significance.
Here's an writing article Lord Wandsworth College, example from literature. A frequent argument students will make is This author used symbolism to make his point. The statement, however, is meaningless precisely because it is not of significance: every author writing literature uses symbolism of one kind or another, either using language metaphorically or metonymically. Thus, to attempt to single out or make a distinction of a piece for using symbolism is to guide International School, not say anything that even needs proving to begin with. Persuasive. A simple thesis statement is not quite what it may sound like. A simple thesis statement means that only one main point or argument is going to be proved. The term simple argument can thus be misleading because the argument itself can and frequently is very theoretically sophisticated. What makes them simple is that in terms of their logical structure, they only take on one line of proof, and hence, their organization of proof will be simple. One has to Bromsgrove School Thailand, be careful, however, because sometimes one main argument may require SEVERAL supporting arguments. The example here would be the argument that Star Wars belongs within the critical thinking curriculum Western Genre. An Essay Bromsgrove International Thailand. Here the writer has only one thing to prove, but in essay, order to do so will have to establish the Bromsgrove International elements that comprise the critical thinking curriculum George Western Genre and demonstrate how the film embodies them--not a small task.
Simple thesis statements are eminently preferable in guide an essay International Thailand, terms of writing an essay for a course. It allows you to focus on your points and your proofs rather than getting lost in an essay conclusion Hanze of Applied, the organization of your arguments. A complex thesis statement means that the thesis has more than one point to prove. In this respect, the essay will have to organize more than one line of reasoning in guide Bromsgrove International School, so far that more than one thing has to be proven. Persuasive Essay College. Complex theses are not necessarily more theoretically sophisticated than simple thesis statements, they are only more difficult to to write an essay Bromsgrove, organize clearly. In this respect, they are not worth what they entail and should be avoided.
An example of a complex thesis statement would be something like: Faulkner's novels critique the ideologies of critical George Brown, patriarchy and racism. Guide To Write Bromsgrove International. This would be an appropriate analysis for the work of Faulkner, but I'm not sure it would be worth it. To begin with, it is not clear what the writer has to gain in terms of proving BOTH of these aspects of the work rather than just the one. Instead, with this complex thesis, there are going to thinking, be long sections of the essay where half of what needs to be proved will be left suspended while the other half gets discussed. In addition, the thesis picks the work of Faulkner which necessitates discussing every book, rather than just one. Thus it is that an important convention of the academic essay is that: A complex thesis statement can usually be restructured into a more theoretically sophisticated (if not interesting) simple thesis statement. Making an Argument. As stated earlier, the academic essay is an exercise in reasoned persuasion. In this respect, the guide to write International thesis statement is an writing Lord Wandsworth, important organizational structure insofar as it establishes how the rest of the essay will be organized.
Classical logic maintains that there are 3 basic kinds of persuasive statements: statements of fact, statements of value (or evaluation), and statements of policy (or action, which argue what we should do). To Write An Essay Bromsgrove International Thailand. Unless otherwise specified, the first of these, the statement of fact, is the form that the thesis statement for essay Wycliffe College an academic essay should take#150;the obvious exception being when you write evaluative criticism (which you will NEVER do in my course). Statements of guide School, fact can themselves be grouped into two basic forms: arguments of school, classification, and arguments of operation or function. It is guide to write an essay Bromsgrove School possible to make other distinctions, like for example, arguments of relationship (how to things relate to each other) but these distinctions can be readily subsumed into writing conclusion University of Applied Sciences these two basic groups. Arguments of classification are when you establish some sort of criteria, and then argue that something meets or fails to meet that criteria. The earlier example that Star Wars belongs within the Western Genre is an example of an argument of classification. Having established what comprises the Western Genre, the writer will then go on to prove how Star Wars embodies, contains, or possesses those elements. The writer will, in other words, prove that Star Wars meets that criteria. Arguments of operation or function argues in terms of what something does, or how it functions. Guide An Essay Bromsgrove School Thailand. The earlier argument that Faulkner's work critiques the ideology of patriarchy is an example of argumentative essay, function. This statement argues that Faulkner's work DOES something: it criticizes the ideology of patriarchy.
Note that unlike the argument of classification, the writer of this essay SEEMS to have to do more to prove their thesis. They will not only have to define what the ideology of guide Thailand, patriarchy is#150;and thus establish criteria#150;they will also have to demonstrate that Faulkner's work DOES something with that criteria. The question of HOW leads to a discussion of the body of the essay. The Body of the Essay. From a conceptual standpoint, the function of the body of the essay tips Roedean essay is to prove the thesis statement laid out in the introduction. Easy enough. This section discusses how the writer accomplishes that proof.
In the discussion of types of argument, I made the point that the writer will have to establish criteria that can be used to prove their argument. The body of the essay is the location where the writer accomplishes that. An introduction is precisely that: It INTRODUCES the theoretical framework and the thesis statement. Bromsgrove International Thailand. It does not DESCRIBE or DISCUSS these two things. Writing Article Wandsworth. This is a fairly common mistake that beginning essay writers make. They fear that they have not said enough in the intro and as a result, go on to discuss aspects of their theory or elaborate on guide to write an essay Bromsgrove International School a thesis. The problem with doing so is essay Braemar that it screws up your organization. An Essay International Thailand. What comes next is no longer clear to the reader. If you keep it clear to yourself that the purpose of the introduction to your essay is to for essay writing du Leman, only INTRODUCE your theoretical framework, and your thesis statement, then the School function of the body of your essay will also become evident to the reader.
They will expect you to establish criteria so that you can prove your thesis. As a result, another important norm of the academic essay is: A primary function of the body of the essay is to establish the essay writing tips for highschool students Roedean School criteria by which the guide to write Bromsgrove School thesis statement will be proven. Thus it is writing conclusion of Applied that having argued that Star Wars is a Western, the body of the paper is going to have to guide an essay Bromsgrove School Thailand, first establish the elements that comprise the Western#150;it will have to establish the criteria by which the thesis can be proven. To argue that Faulkner's work criticizes thee ideology of argumentative essay Braemar College, patriarchy is going to require that the writer establish what the ideology of patriarchy is. Establishing the criteria by which the thesis statement will be proven leads to the next logical step: demonstrating how the object under investigation meets those criteria. Guide To Write An Essay Bromsgrove Thailand. Clearly it is not enough for the Faulkner essayist to just define what the ideology of patriarchy is. Their thesis is that Faulkner's work criticizes that ideology. Argumentative College. As a result, they will have to point to specific things within the text and argue that they relate to guide an essay International Thailand, those criteria IN A SPECIFIC WAY#150;in this case through a process of criticism.
This process of writing tips for highschool, relating the object of investigation back to the established criteria is another fundamental component of the to write Bromsgrove International School Thailand body of the essay. Without it, the proof is not complete. As silly as that sounds, I kid you not that the persuasive essay most frequent mistake of beginning essay writers is a failure to relate their analysis back to the criteria they have established. Thus it is that another important norm for the academic essay is: Relate the guide to write an essay International School analysis back to the terms and concepts of the established criteria. The Star Wars example brings up another fundamental logical task to this process.
From the beginning you have probably thought the Star Wars thesis to not be very feasible. The film is not set in the West, and it occurs in tips for highschool, the future. The question becomes, however, whether these are ESSENTIAL criteria to the Western, and if not, what is? In terms of proving that thesis statement, the writer is going to have to clearly establish what the elements of the Western Genre are, and then relate aspects of the film back to guide to write Bromsgrove School, ALL of those criteria. Herein lies the essential importance of completeness to that process.
If the Star Wars writer establishes the criteria but can only point to the gun-fighting that occurs in the film, then their essay will fail to persuade. Their essay will fail to persuade precisely because it inadequately addresses the scope of the criteria. Thus it is that another important norm for this process is: Fully address the established criteria. It is very important to writing an essay University of Applied, note that fully addressing the scope of the criteria does NOT mean that the object under discussion has to fully meet ALL the criteria. Guide To Write An Essay School Thailand. To stick with the Star Wars example, the rubric writing for middle school College du Leman writer can not IGNORE the to write an essay International Thailand issue of setting and essay writing even remotely hope to persuade the audience. In some way, the writer is going to have to guide International School, address the argumentative persuasive essay Braemar College fact that both time and place are out of the bounds of the Western. This is the point precisely. The author will have to ADDRESS that point#150;those criteria#150;not necessarily MEET those criteria. In this respect, the writer is going to have make a supporting argument about how these criteria relate to each other in terms of comprising the genre (or in a logical sense the whole).
The important point is that all criteria are addressed adequately. Guide School Thailand. Failure to address any of the established criteria creates a gap in logic. Subsequently, the reasoning process (and its ability to persuade) fails. Fully relating the object of the thesis to the established criteria fulfills the logical requirements necessary to persuade reasonably and allows the writer to draw conclusions. Before that process is discussed, however, it is necessary to examine an important component of this relating back process. The Role of Description. Article Wandsworth College. Relating the object of investigation or the object of the thesis back to the established criteria is necessarily going to involve description. Guide To Write. Description is frequently an unclear and thorny issue for writers of the argumentative essay Braemar academic essay#150;especially in terms of International Thailand, scope (how much is enough?).
The purpose of description, however, clarifies the issue of scope. The purpose of description to is to make clear, or establish WHAT in the object of investigation (the film, the scene, the shot) relates to the criteria being used. It therefore becomes important for the writer to argumentative, use description in guide to write Bromsgrove, such a manner as to Braemar, establish the basis of the relationship between the object and the criteria. Furthermore, the writer should LIMIT description to accomplishing only this task. Guide To Write Bromsgrove. Added description is not only superfluous, but distracts from trying to prove your argument.
As a result, another important norm for the body of the academic essay is: Subordinate description to the purpose of analysis. Writing An Essay Hanze University Of Applied Sciences. As stated above the process of fully relating the object of the thesis to guide to write an essay Thailand, the established criteria has the effect of fulfilling the for essay writing for middle school logical requirements. It is THAT task which ultimately persuades, not the conclusion itself. It is for this reason that, in guide, some respects, the conclusion does not seem to have a FUNDAMENTAL role in the process of reasoned persuasion. That in itself probably accounts for how many dopey tips exist for what to do with a conclusion, like: repeat the thesis statement (like people have forgotten it despite the fact that you've been working to prove it the essay Braemar entire time) or some other such thing. What to do with a conclusion if the work of proof is already done? The most effective thing to do with a conclusion is to guide an essay International School, first signal that the work is coming to close, and then close off the discussion itself by rubric for middle school College, stating something definitive about the work.
Like the introduction, then, the conclusion has a dual role: to guide to write Bromsgrove International School Thailand, signal the transition to closure, and to close the discussion with a definitive statement. The work of the conclusion should reference the thesis, without necessarily repeating the for essay writing for middle school du Leman thesis (or the steps by which it was proven) It should then say something definitive that signals closure by pointing to the implications of what you've discussed, by amplifying what you've discussed, or by contextualizing what you've discussed. In each case, you are striving to close discussion by being definitive, and you are taking caution not to violate rule #1 of the academic essay: avoid statements that you cannot prove. To stay with the guide Bromsgrove International School running examples, the conclusion to the Faulkner paper could look something like this: . it therefore serves as an example of how literary texts structure their criticisms of dominant ideologies. Argumentative Persuasive Essay. (pointing to the implications of proving your argument). Thus, far from to write Bromsgrove Thailand, being a portrait of its time Faulkner's work demonstrates that literary works actively engage ideologies. (amplifying your argument) Rather than a story centered exclusively on war, Hemingway's novel instead participates in the reinforcement of dominant ideologies with American culture. Argumentative Persuasive Essay Braemar College. (Contextualizing the argument) Note that the guide similarity here is how definitive these statements are. They draw upon writing article Wandsworth the work that has been done, but say something different and final that is logically based upon what has been discussed.
There are, of Bromsgrove School Thailand, course, variations on the genre of the academic essay--some rather large difference exist, for example, between the social sciences and the humanites. This discussion is based on the humanties approach. Other variations can result from the idiosyncracies of specific instructors. To the critical George Brown degree that what is written here sounds heavy handed and inflexible, I caution instead that such tone is trying to guide to write International School, reflect the article Lord Wandsworth manner in which your own analysis and writing will need to Bromsgrove School, sound precise and essay rigorous#150;the standards by which the academic essay is evaluated. The precision and rigor with which these norms and conventions are applied should function only to demand that your own analysis and reason engender these standards. They are thus meant to elevate your thinking, not control it.
The principles by which the academic essay structures itself is designed to be a discipline that frees your thinking, not subjugate it. Within its conventions is unlimited creative potential whose only demand, ultimately, is that you say something meaningful that others can be persuaded of via your logic. What I have attempted to do here is make the norms and conventions of the genre explicit so that you can refine your skills working within it. School. Mastering this genre has the benefit of developing your skill to analyze situations using explicit criteria, and be able to make decisions based on article Lord College that analysis. More than a few people have found that possession of such a skill is invaluable in life and professional endeavors.
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Chronic Obstructive Pulmonary Disorder (COPD) Case Study. Chronic obstructive pulmonary disease (COPD) is a disease state characterized by to write an essay Bromsgrove International School airflow limitation that is not fully reversible. This newest definition COPD , provided by the Global Initiative for Chrnonic Obstructive Lung Disease (GOLD), is a broad description that better explains this disorder and its signs and symptoms (GOLD, World Health Organization [WHO] National Heart, Lung and Blood Institute [NHLBI], 2004). For Essay For Middle College. Although previous definitions have include emphysema and chronic bronchitis under the umbrella classification of COPD , this was often confusing because most patient with COPD present with over lapping signs and symptoms of these two distinct disease processes. COPD may include diseases that cause airflow obstruction (e.g., Emphysema, chronic bronchitis) or any combination of these disorders. Other diseases as cystic fibrosis, bronchiectasis, and an essay School asthma that were previously classified as types of chronic obstructive lung disease are now classified as chronic pulmonary disorders. However, asthma is now considered as a separate disorder and is classified as an writing Wandsworth College abnormal airway condition characterized primarily by reversible inflammation. COPD can co-exist with asthma.
Both of these diseases have the same major symptoms; however, symptoms are generally more variable in asthma than in COPD . Currently, COPD is the to write an essay Bromsgrove International fourth leading cause of mortality and the 12 th leading cause of disability. However, by the year 2020 it is estimated that COPD will be the essay College third leading cause of guide International death and the firth leading cause of tips Roedean School disability (Sin, McAlister, Man. Et al., 2003). International. People with COPD commonly become symptomatic during the middle adult years, and the incidence of the disease increases with age. The respiratory system consists of all the organs involved in breathing. These include the nose, pharynx, larynx, trachea, bronchi and lungs.
The respiratory system does two very important things: it brings oxygen into our bodies, which we need for our cells to live and Lord Wandsworth College function properly; and an essay Bromsgrove International Thailand it helps us get rid of carbon dioxide, which is a waste product of cellular function. The nose, pharynx, larynx, trachea and bronchi all work like a system of pipes through which the air is writing an essay conclusion University of Applied Sciences funneled down into our lungs. There, in very small air sacs called alveoli, oxygen is brought into the bloodstream and carbon dioxide is pushed from the blood out into International School Thailand the air. When something goes wrong with part of the respiratory system, such as an infection like pneumonia, chronic obstructive pulmonary diseases, it makes it harder for us to get the oxygen we need and to get rid of the an essay University of Applied waste product carbon dioxide. Common respiratory symptoms include breathlessness, cough, and chest pain. When you breathe in, air enters your body through your nose or mouth.
From there, it travels down your throat through the guide to write Bromsgrove Thailand larynx (or voicebox) and into the trachea (or windpipe) before entering your lungs. All these structures act to funnel fresh air down from the outside world into your body. The upper airway is important because it must always stay open for you to writing for middle school College du Leman, be able to breathe. It also helps to moisten and School Thailand warm the air before it reaches your lungs. The lungs are paired, cone-shaped organs which take up most of the space in our chests, along with the heart. Their role is to take oxygen into the body, which we need for our cells to live and school College function properly, and to help us get rid of carbon dioxide, which is a waste product. We each have two lungs, a left lung and a right lung. These are divided up into ‘lobes’, or big sections of tissue separated by ‘fissures’ or dividers. The right lung has three lobes but the left lung has only two, because the to write School Thailand heart takes up some of the space in writing tips Roedean the left side of our chest. Guide To Write Bromsgrove School Thailand. The lungs can also be divided up into even smaller portions, called ‘bronchopulmonary segments’.
These are pyramidal-shaped areas which are also separated from writing College, each other by membranes. There are about 10 of them in each lung. Each segment receives its own blood supply and an essay Bromsgrove International air supply. COPD VERSUS HEALTHY LUNG. Air enters your lungs through a system of pipes called the bronchi.
These pipes start from the bottom of the rubric for essay writing school trachea as the left and International right bronchi and branch many times throughout the lungs, until they eventually form little thin-walled air sacs or bubbles, known as the writing an essay Hanze of Applied Sciences alveoli. Guide. The alveoli are where the Wycliffe important work of gas exchange takes place between the air and your blood. Bromsgrove School Thailand. Covering each alveolus is a whole network of little blood vessel called capillaries, which are very small branches of the pulmonary arteries. It is important that the air in the alveoli and the blood in the capillaries are very close together, so that oxygen and carbon dioxide can move (or diffuse) between them. Students Roedean School. So, when you breathe in, air comes down the trachea and through the bronchi into the alveoli. This fresh air has lots of oxygen in it, and guide International some of this oxygen will travel across the walls of the alveoli into your bloodstream. Traveling in the opposite direction is carbon dioxide, which crosses from the blood in the capillaries into the air in the alveoli and is then breathed out. In this way, you bring in to your body the oxygen that you need to live, and get rid of the waste product carbon dioxide. The lungs are very vascular organs, meaning they receive a very large blood supply. This is because the pulmonary arteries, which supply the lungs, come directly from the right side of your heart.
They carry blood which is low in oxygen and for middle school high in carbon dioxide into your lungs so that the carbon dioxide can be blown off, and to write Bromsgrove Thailand more oxygen can be absorbed into the bloodstream. The newly oxygen-rich blood then travels back through the paired pulmonary veins into the left side of your heart. An Essay Hanze University Sciences. From there, it is pumped all around your body to supply oxygen to cells and organs. The lungs are covered by smooth membranes that we call pleurae. The pleurae have two layers, a ‘visceral’ layer which sticks closely to the outside surface of your lungs, and guide to write an essay Bromsgrove Thailand a ‘parietal’ layer which lines the inside of your chest wall (ribcage). The pleurae are important because they help you breathe in and out smoothly, without any friction.
They also make sure that when your ribcage expands on breathing in, your lungs expand as well to fill the extra space. The Diaphragm and Intercostal Muscles. When you breathe in (inspiration), your muscles need to work to fill your lungs with air. The diaphragm, a large, sheet-like muscle which stretches across your chest under the ribcage, does much of this work. At rest, it is shaped like a dome curving up into writing an essay Hanze University Sciences your chest. When you breathe in, the diaphragm contracts and flattens out, expanding the space in your chest and drawing air into your lungs. Other muscles, including the muscles between your ribs (the intercostal muscles) also help by moving your ribcage in to write an essay International School and out.
Breathing out essay Wycliffe College (expiration) does not normally require your muscles to work. This is because your lungs are very elastic, and guide Bromsgrove International when your muscles relax at the end of inspiration your lungs simply recoil back into their resting position, pushing the air out as they go. The Respiratory System and Ageing. The normal process of ageing is associated with a number of changes in both the structure and function of the respiratory system. These include: Enlargement of the alveoli.
The air spaces get bigger and lose their elasticity, meaning that there is essay argumentative Wycliffe less area for guide an essay, gases to for essay school, be exchanged across. This change is sometimes referred to Bromsgrove School, as ‘senile emphysema’. The compliance (or springiness) of the chest wall decreases, so that it takes more effort to breathe in and out. Essay Argumentative College. The strength of the respiratory muscles (the diaphragm and intercostal muscles) decreases. This change is closely connected to the general health of the person. All of these changes mean that an older person might have more difficulty coping with increased stress on their respiratory system, such as with an infection like pneumonia, than a younger person would. Risk factors for COPD include environmental exposures and host factors. The most important risk factor for COPD is cigarette smoking. An Essay Bromsgrove. Other risk factors are pipe, cigar, and argumentative persuasive Braemar other types of tobacco smoking.
In addition, passive smoking contributes to respiratory symptoms and COPD. Smoking depresses the activity of to write an essay Bromsgrove Thailand scavenger cells and affects the respiratory tract’s ciliary cleansing mechanism, which keeps breathing passages free of inhaled irritants, bacteria, and other foreign matter. When smoking damages this cleansing mechanism, airflow is argumentative Braemar College obstructed and air becomes trapped behind the an essay Bromsgrove School Thailand obstruction. The alveoli greatly distend, diminished lung capacity. Essay Writing Tips For Highschool. Smoking also irritates the goblet cells and mucus glands, causing an increased accumulation of mucus, which in turn produces more irritation, infection, and damage to the lung.
In addition, carbon monoxide (a by product of smoking) combines with hemoglobin to form carboxyhemoglobin. Hemoglobin that is bound by carboxyhemoglobin cannot carry oxygen efficiently. A host risk factor for COPD is a deficiency of an essay International alpha antitrypsin, an enzyme inhibitor that protects the lung parenchyma from injury. This deficiency predisposes young people to rapid development of lobular emphysema, even if they do not smoke. Genetically susceptible people are sensitive to environmental factors (eg. Tips For Highschool Roedean. Smoking, air pollution, infectious agents, allergens) and eventually developed chronic obstructive symptoms. Guide. Carriers of rubric for essay for middle du Leman this genetic defect must be identified so that they can modify environmental risk factors to delay or prevent overt symptoms of disease. In COPD , the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. The inflammatory response occurs throughout the airways, parenchyma, and guide an essay Bromsgrove International pulmonary vasculature.
Because of the chronic inflammation and the body’s attempts to repair it, narrowing occurs in writing for middle College the small peripheral airways. Over time, this injury-and-repair process causes scar tissue formation and narrowing of the airway lumen. Airflow obstruction may also be caused by parenchymal destruction, as is seen with emphysema, a disease of the alveoli or gas exchange units. In addition to inflammation, processes related to imbalances of an essay School proteinases and antiproteinases in the lung may be responsible for airflow limitation. When activated by chronic inflammation, proteiness and other substances may be released, damaging the rubric for essay writing for middle du Leman parenchyma of the lung. The parenchymal changes may occur as a consequence of inflammation or environmental or genetic factors (eg. Alpha1-antitrypsin deficiency). Early in the course of COPD , the inflammatory response causes pulmonary vasculature changes that are characterized by thickening of the vessel wall. These changes may result from exposure to cigarette smoke, use of tobacco products, and the release of guide to write an essay Thailand inflammatory medicators. Lung damage and inflammation in the large airways results in chronic bronchitis. Chronic bronchitis is defined in clinical terms as a cough with sputum production on writing for middle College du Leman most days for 3 months of a year, for 2 consecutive years.
In the to write Bromsgrove School Thailand airways of the an essay Hanze of Applied Sciences lung, the hallmark of chronic bronchitris is an increased number (hyperplasia) and increased size (hypertrophy) of the guide Bromsgrove International School Thailand goblet cells and mucous glands of the airway. As a result, there is more mucus than usual in the airways, contributing to argumentative persuasive essay Braemar College, narrowing of the airways and causing a cough with sputum. Bromsgrove School. Microscopically there is writing for middle College infiltration of the airway walls with inflammatory cells. Inflammation is followed by scarring and to write an essay International School Thailand remodeling that thickens the walls and also results in narrowing of the airways. Wandsworth College. As chronic bronchitis progresses, there is squamous metaplasia (an abnormal change in the tissue lining the inside of the to write Bromsgrove International School Thailand airway) and fibrosis (further thickening and scarring of the Brown airway wall). The consequence of these changes is a limitation of airflow. Patients with advanced COPD that have primarily chronic bronchitis rather than emphysema were commonly referred to guide to write an essay Bromsgrove School, as “blue bloaters” because of the bluish color of the argumentative Braemar skin and lips (cyanosis) seen in them.
The hypoxia and fluid retention leads to them being called “Blue Bloaters.” One of the most common symptoms of COPD is shortness of breath (dyspnea). To Write Bromsgrove Thailand. People with COPD commonly describe this as: “My breathing requires effort”, “I feel out of breath”, or “I can not get enough air in”. People with COPD typically first notice dyspnea during vigorous exercise when the demands on the lungs are greatest. Over the years, dyspnea tends to get gradually worse so that it can occur during milder, everyday activities such as housework. In the advanced stages of essay writing tips for highschool COPD , dyspnea can become so bad that it occurs during rest and is constantly present. Other symptoms of COPD are a persistent cough, sputum or mucus production, wheezing, chest tightness, and tiredness.
People with advanced (very severe) COPD sometimes develop respiratory failure. When this happens, cyanosis, a bluish discoloration of the lips caused by a lack of oxygen in guide to write Bromsgrove International School the blood, can occur. An excess of carbon dioxide in the blood can cause headaches, drowsiness or twitching (asterixis). A complication of advanced COPD is cor pulmonale, a strain on the heart due to the extra work required by an essay University of Applied the heart to pump blood through the affected lungs. Symptoms of cor pulmonale are peripheral edema, seen as swelling of the ankles, and dyspnea.
There are a few signs of COPD that a healthcare worker may detect although they can be seen in other diseases. To Write Bromsgrove. Some people have COPD and essay argumentative Wycliffe have none of these signs. Common signs are: tachypnea, a rapid breathing rate wheezing sounds or crackles in the lungs heard through a stethoscope breathing out taking a longer time than breathing in enlargement of the chest, particularly the front-to-back distance (hyperinflation) active use of muscles in the neck to help with breathing breathing through pursed lips increased anteroposterior to lateral ratio of the chest (i.e. barrel chest). Emphysema is a chronic obstructive pulmonary disease (COPD, as it is School Thailand otherwise known, formerly termed a chronic obstructive lung disease). It is often caused by exposure to toxic chemicals, including long-term exposure to tobacco smoke. Emphysema is conclusion characterized by loss of elasticity (increased pulmonary compliance) of the lung tissue caused by destruction of structures feeding the alveoli, owing to the action of alpha 1 antitrypsin deficiency. This causes the small airways to collapse during forced exhalation, as alveolar collapsibility has decreased. As a result, airflow is impeded and air becomes trapped in the lungs, in the same way as other obstructive lung diseases. Symptoms include shortness of guide to write Bromsgrove International School Thailand breath on exertion, and an expanded chest. Writing Tips Roedean. However, the constriction of air passages isn’t always immediately deadly, and treatment is available. Signs of emphysema include pursed-lipped breathing, central cyanosis and finger clubbing.
The chest has hyper resonant percussion notes, particularly just above the liver, and a difficult to palpate apex beat, both due to hyperinflation. There may be decreased breath sounds and audible expiratory wheeze. In advanced disease, there are signs of fluid overload such as pitting peripheral edema. The face has a ruddy complexion if there is a secondary polycythemia. Sufferers who retain carbon dioxide have asterixis (metabolic flap) at the wrist. PFTs demonstrative airflow obstruction – reduced forced vital capacity (FVC), FEV1, FEV1 to FVC ration; increased residual volume to total lung capacity (TLC) ratio, possibly increased TLC. ABG levels- decreased PaO2, pH, and increased CO2. Chest X-ray – in late stages, hyperinflation, flattened diaphragm, increased rettrosternal space, decreased vascular markings, possible bullae. Alpa1-antitrypsin assay useful in guide an essay International identifying genetically determined deficiency in emphysema. The goals of writing an essay conclusion of Applied Sciences COPD treatment are 1) to an essay Bromsgrove, prevent further deterioration in lung function, 2) to alleviate symptoms, 3) to for essay school College, improve performance of daily activities and quality of life.
The treatment strategies include 1) quitting cigarette smoking, 2) taking medications to dilate airways (bronchodilators) and decrease airway inflammation, 3) vaccinating against flu influenza and an essay International Thailand pneumonia and 4) regular oxygen supplementation and essay writing tips 5) pulmonary rehabilitation. Quitting cigarette smoking. The most important treatment for COPD is quitting cigarette smoking. Patients who continue to International School, smoke have a more rapid deterioration in lung function when compared to rubric for middle College du Leman, others who quit. Aging itself can cause a very slow decline in lung function. In susceptible individuals, cigarette smoking can result in a much more dramatic loss of lung function. It is important to note that when one stops smoking the decline in lung function eventually reverts to that of a non-smoker.
Nicotine in cigarettes is addictive, and, therefore, cessation of smoking can cause symptoms of nicotine withdrawal including anxiety, irritability, anger, depression, fatigue, difficulty concentrating or sleeping, and intense craving for cigarettes. Patients likely to develop withdrawal symptoms typically smoke more than 20 cigarettes a day, need to smoke shortly after waking up in the morning, and have difficulty refraining from smoking in non-smoking areas. However, some 25% of smokers can stop smoking without developing these symptoms. An Essay Bromsgrove Thailand. Even in those smokers who develop symptoms of withdrawal, the writing an essay Hanze University of Applied symptoms will decrease after several weeks of abstinence. Treating airway obstruction in COPD with bronchodilators is similar but not identical to treating bronchospasm in asthma. Bronchodilators are medications that relax the muscles surrounding the small airways thereby opening the airways. Bronchodilators can be inhaled, taken orally or administered intravenously. Inhaled bronchodilators are popular because they go directly to the airways where they work. To Write Bromsgrove International. As compared with bronchodilators given orally, less medication reaches the rest of the body, and, therefore, there are fewer side effects. Metered dose inhalers (MDIs) are used to deliver bronchodilators.
An MDI is an essay conclusion Hanze University of Applied Sciences a pressurized canister containing a medication that is released when the canister is compressed. A standard amount of medication is released with each compression of the guide Bromsgrove International School MDI. To maximize the delivery of the medications to the airways, the patient has to learn to essay argumentative, coordinate inhalation with each compression. Incorrect use of the MDI can lead to guide Bromsgrove, deposition of much of the medication on the tongue and the back of the throat instead of on the airways. To decrease the deposition of medications on students Roedean the throat and increase the amount reaching the to write Thailand airways, spacers can be helpful. Spacers are tube-like chambers attached to the outlet of the MDI canister. Critical Thinking Curriculum Brown. Spacer devices can hold the released medications long enough for patients to inhale them slowly and guide to write Bromsgrove International School deeply into the lungs.
Proper use of spacer devices can greatly increase the proportion of medication reaching the airways. Pulmonary rehabilitation has become a cornerstone in argumentative Wycliffe College the management of moderate to guide to write Thailand, severe COPD. Pulmonary rehabilitation is a program of education regarding lung function and dysfunction, proper breathing techniques (diaphragmatic breathing, pursed lip breathing), and proper use of respiratory equipment and medications. An essential ingredient in for middle College this program is the use of increasing physical exercise to overcome the reduced physical capacity that usually has developed over time. Guide To Write Bromsgrove International. In addition, occupational and physical therapy are used to for middle school College du Leman, teach optimal and efficient body mechanics. Lung volume reduction surgery (LVRS) has received much fanfare in the lay press. LVRS is a surgical procedure used to to write Bromsgrove International, treat some patients with COPD.
The premise behind this surgery is argumentative essay that the to write an essay Bromsgrove Thailand over-inflated, poorly-functioning upper parts of the lung compress and impair function of the better-functioning lung elsewhere. Thus, if the over-inflated portions of argumentative College lung are removed surgically, the compressed lung may expand and function better. In addition, the guide Bromsgrove School Thailand diaphragm and the chest cavity achieve more optimal positioning following the essay writing for highschool School surgery, and this improves breathing further. The best criteria for choosing patients for LVRS are still uncertain. A national study was completed in 2003. Patients primarily with emphysema at the top of their lungs, whose exercise tolerance was low even after pulmonary rehabilitation, seemed to do the best with this procedure. On average, lung function and to write an essay International exercise capacity among surviving surgical patients improved significantly following LVRS, but after two years returned to about the same levels as before the procedure. Patients with forced expiratory volume in FEVI of less than 20% of predicted and either diffuse disease on the CAT scan or lower than 20% diffusing capacity or elevated carbon dioxide levels had higher mortality.
The role of LVRS is at present is very limited. Beta-agonists Beta-2 agonists have the bronchodilating effects of adrenaline without many of its unwanted side effects. Beta-2 agonists can be administered by MDI inhalers or orally. They are called “agonists” because they activate the essay argumentative Wycliffe beta-2 receptor on guide to write an essay International Thailand the muscles surrounding the essay Braemar College airways. Activation of to write beta-2 receptors relaxes the argumentative muscles surrounding the airways and opens the airways. Dilating airways helps to relieve the symptoms of dyspnea (shortness of guide to write an essay International School breath). Beta-2 agonists have been shown to relieve dyspnea in many COPD patients, even among those without demonstrable reversibility in airway obstruction. The action of beta-2 agonists starts within minutes after inhalation and lasts for essay argumentative College, about 4 hours. Because of their quick onset of an essay School action, beta-2 agonists are especially helpful for patients who are acutely short of Wycliffe breath. Because of their short duration of to write an essay International Thailand action, these medications should be used for symptoms as they develop rather than as maintenance. Evidence suggests that when these drugs are used routinely, their effectiveness is diminished.
These are referred to as rescue inhalers. Examples of rubric writing for middle beta-2 agonists include albuterol (Ventolin, Proventil), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire), and isoetharine (Bronkosol). Levalbuterol (Xopenex) is a recently approved Beta-2 agonist. In contrast, Beta-2 agonists with a slower onset of action but a longer period of activity, such as salmeterol xinafoate (Serevent) and formoterol fumarate (Foradil) may be used routinely as maintenance medications. These drugs last twelve hours and should be taken twice daily and guide to write School Thailand no more.
Along with some of these inhalers to thinking curriculum College, be mentioned, these are often referred to as maintenance inhalers. An Essay International. Side effects of beta-2 agonists include anxiety, tremor, palpitations or fast heart rate, and low blood potassium. Anti-cholinergic Agents Acetylcholine is a chemical released by nerves that attaches to receptors on the muscles surrounding the airway causing the muscles to contract and the airways to narrow. Anti-cholinergic drugs such as ipratropium bromide (Atrovent) dilate airways by blocking the receptors for acetylcholine on writing College the muscles of the airways and preventing them from narrowing. Ipratropium bromide (Atrovent) usually is administered via a MDI. In patients with COPD, ipratropium has been shown to alleviate dyspnea, improve exercise tolerance and improve FEV1. Ipratropium has a slower onset of an essay Bromsgrove School action but longer duration of argumentative College action than the shorter-acting beta-2 agonists. Guide To Write Bromsgrove School Thailand. Ipratropium usually is well tolerated with minimal side effects even when used in higher doses. Tiotropium (SPIRIVA) is article Lord College a long acting and more powerful version of Ipratropium and has been shown to be more effective. To Write An Essay International Thailand. In comparing ipratropium with beta-2 agonists in the treatment of patients with COPD, studies suggest that ipratropium may be more effective in dilating airways and improving symptoms with fewer side effects.
Ipratropium is especially suitable for use by elderly patients who may have difficulty with fast heart rate and tremor from the beta-2 agonists. Essay Roedean School. In patients who respond poorly to either beta-2 agonists or ipratropium alone, a combination of the two drugs sometimes results in a better response than to either drug alone without additional side effects. Methylxanthines Theophylline (Theo-Dur, Theolair, Slo-Bid, Uniphyl, Theo-24) and aminophylline are examples of guide to write an essay methylxanthines. Methylxanthines are administered orally or intravenously. Essay Argumentative Wycliffe College. Long acting theophylline preparations can be given orally once or twice a day. Theophylline, like a beta agonist, relaxes the muscles surrounding the airways but also prevents mast cells around the airways from releasing bronchoconstricting chemicals such as histamine. Theophylline also can act as a mild diuretic and increase urination. Theophylline also may increase the force of contraction of the an essay Bromsgrove Thailand heart and lower pressure in the pulmonary arteries. Thus, theophylline can help patients with COPD who have heart failure and pulmonary hypertension. Patients who have difficulty using inhaled bronchodilators but no difficulty taking oral medications find theophylline particularly useful.
The disadvantage of methylxanthines is their side effects. Dosage and University of Applied blood levels of theophylline or aminophylline have to be closely monitored. Excessively high levels in the blood can lead to nausea, vomiting, heart rhythm problems, and even seizures. In patients with heart failure or cirrhosis, dosages of methylxanthines are lowered to avoid high blood levels. An Essay International School. Interactions with other medications, such as cimetidine (Tagamet), calcium channel blockers (Procardia), quinolones (Cipro), and allopurinol (Zyloprim) also can alter blood levels of methylxanthines. Corticosteroids When airway inflammation (which causes swelling) contributes to airflow obstruction, anti-inflammatory medications (more specifically, corticosteroids) may be beneficial. Examples of corticosteroids include Prednisone and Prednisolone. Twenty to thirty percent of patients with COPD show improvement in lung function when given corticosteroids by mouth. An Essay Conclusion Sciences. Unfortunately, high doses of oral corticosteroids over prolonged periods can have serious side effects, including osteoporosis, bone fractures, diabetes mellitus, high blood pressure, thinning of the skin and easy bruising, insomnia, emotional changes, and weight gain. Therefore, many doctors use oral corticosteroids as the an essay Bromsgrove Thailand treatment of last resort. When oral corticosteroids are used, they are prescribed at writing an essay conclusion of Applied Sciences the lowest possible doses for the shortest period of guide to write Bromsgrove time to minimize side effects.
When it is necessary to use long term oral steroids, medications are often prescribed to help reduce the development of the above side effects. Curriculum George College. Corticosteroids also can be inhaled. Inhaled corticosteroids have many fewer side effects than long term oral corticosteroids. Examples of guide to write Bromsgrove inhaled corticosteroids include beclomethasone dipropionate (Beclovent, Beconase, Vancenase, and Vanceril), triamcinolone acetonide (Azmacort), fluticasone (Flovent), budesonide (Pulmicort), mometasone furoate (Asmanex) and flunisolide (Aerobid). Writing An Essay Conclusion Hanze University. Inhaled corticosteroids have been useful in to write School Thailand treating patients with asthma, but in patients with COPD, it is not clear whether inhaled corticosteroid have the rubric for essay for middle College same benefit as oral corticosteroids. Nevertheless, doctors are less concerned about using inhaled corticosteroids because of their safety. The side effects of inhaled corticosteroids include hoarseness, loss of voice, and oral yeast infections. A spacing device placed between the mouth and the MDI can improve medication delivery and to write an essay Bromsgrove International School reduce the argumentative persuasive essay Braemar side effects on the mouth and throat. Rinsing out the mouth after use of a steroid inhaler also can decrease these side effects. Treatment of Alpha-1 antitrypsin deficiency Emphysema can develop at a very young age in some patients with severe alpha-1 antitrypsin deficiency (AAT). An Essay International School. Replacement of the missing or inactive AAT by injection can help prevent progression of the associated emphysema.
This therapy is of no benefit in other types of COPD. Respiratory failure Pneumonia, overwhelming respiratory infection Right-sided heart failure, dysrhythmias Depression Skeletal muscle dysfunction. Monitor for adverse effects of bronchodilators – tremulousness, tachycardia, cardiac arrhythmias, central nervous system stimulation, hypertension. Monitor condition after administration of aerosol bronchodilators to assess for improved aeration, reduced adventitious sounds, reduced dyspnea. Monitor serum theophylline level, as ordered, to Lord College, ensure therapeutic level and prevent toxicity. Monitor oxygen saturation at rest and an essay Bromsgrove International School with activity. Eliminate all pulmonary irritants, particularly cigarette smoke. Smoking cessation usually reduces pulmonary irritation, sputum production, and cough. Keep the patient’s room as dust-free as possible. Use postural drainage positions to help clear secretions responsible for airway obstructions. Teach controlled coughing.
Encourage high level of fluid intake ( 8 to 10 glasses; 2 to 2.5 liters daily) within level of argumentative Wycliffe College cardiac reserve. Give inhalations of nebulized saline to guide Bromsgrove International School, humidify bronchial tree and liquefy sputum. Lord Wandsworth College. Add moisture (humidifier, vaporizer) to indoor air. Guide To Write International School. Avoid dairy products if these increases sputum production. Encourage the essay for highschool students patient to assume comfortable position to decrease dyspnea. Instruct and supervise patient’s breathing retraining exercises. Use pursed lip breathing at intervals and during periods of dyspnea to control rate and depth of respiration and improve respiratory muscle coordination. Discuss and guide to write Bromsgrove School Thailand demonstrate relaxation exercises to reduce stress, tension, and anxiety. Maintain the patient’s nutritional status. Reemphasize the importance of graded exercise and physical conditioning programs.
Encourage use of portable oxygen system for ambulation for patients with hypoxemia and an essay University Sciences marked disability. Train the patient in energy conservation technique. An Essay Bromsgrove International School Thailand. Assess the essay Wycliffe College patient for reactive-behaviors such as anger, depression and acceptance. Education and guide to write Thailand health maintenance. Review with the patient the objectives of treatment and nursing management. Advise the patient to avoid respiratory irritants. Suggest that high efficiency particulate air filter may have some benefit. Warn patient to essay, stay out of extremely hot or cold weather and to an essay Bromsgrove International School, avoid aggravating bronchial obstruction and sputum obstruction. Warn patient to essay Braemar, avoid persons with respiratory infections, and to avoid crowds and areas with poor ventilation.
Teach the patient how to to write Bromsgrove Thailand, recognize and report evidence of respiratory infection promptly such as chest pain, changes in character of sputum (amount, color and consistency), increasing difficulty in raising sputum, increasing coughing and wheezing, increasing of shortness of breath. Medical and Surgical Nursing by Brunner and Suddarth’s. Medical Surgical Nursing by Josie Quiambao Udan. Manuals of Nursing Practice by critical thinking curriculum Lippincott. Mosby’s Medical Surgical Nursing. Daisy Jane Antipuesto RN MN.
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
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