Question

What are the treatments for 89 yr old man with AF,Prostate cancer,COPD/Emphysema, Vit D deficiency’s. What other tests can be done and Nursing care

Answer 1

1, Atrial fibrilation(AF):-
It is a abnormal fast irregular heart beat..in AF heart rate will be fast more than 140 to 180bpm and irregular.
Treatment:
?Rate control treatment: some medication can slow the heart rate down.beta-blocker(atenolol and propranolol)calcium-channel blocker(diltiazem and verapamil and digoxin) it will work in heart by passing electrical impulses..
?Rhythm control treatment: Cardioversion it means redirecting the abnormal heart beat back to normal regular rhythm..it can be done by electric shock..one more medicine for thythm control is amiodarone.this cardioversion can be done with certain condition..Anew technique for this AF is catheter ablation..A long ,thin catheter passed into chamber of heart through large blood vessel in a leg..The catheter tip can destroy the heart tissue which causing abnormal electrical impulses..
Test:
? Electro cardio gram,some times 24 hours ECG monitoring,ultrasound scan(ECHO),chest X ray,EKG,Holter moniter,24hours cardiac thythm monitor, lab tests ruleout some condition like thyroid problems..
Nursing care:
   -place the patient and connect oxygen..
?    -monitor pulse oximeter and report oxygen saturation less than 92%
    - assess the patient continuously on cardiac monitor
?    - if patient slows decreasing cardiac output shift the patient to CCU..
?    - assess the patient language level and knowledge about medication regime.
? - prescirbed antocoagulation therapy should be given and monitor continuously..
Prostate cancer:
? It is a common cancer among men..it is a slowly progressing disease.
?Treatment:
?Radiation therapy,brachy therapy,surgery..
?surgery is a removal of the tumor and some surrounding tissue an operation..it was done to prevent spreading to outside the prostate
?Radical prostatectomy: removal of entire prostate and seminal vesicle and lymph nodes..
?Robotic or laprascopic prostatectomy: A camera and instrument inserted through small key hole incision in the patient abdomen..recovery time will be short for this..this robotic instrument will remove the prostate gland and surrounding healthy tissue..
Test:
? Physical examination,prostate-specific antigen(PSA)transrectal ultrasound(TRUS) radionuclide bone scan,CT scan and MRI,Biopsies
nursing care:
? -fatigue is the most common side effect so give support to remove depression,and anxiety regarding thi treatment
? -concern about fear and expectational to support the men.
COPD:
? It is a chronic obstructive pulmonary disease.it is a group of progressive lung disease..the most common are emphysema and chronic bronchitis..
Treatment:
Medication: Bronchodilators for muscle relax around the lung and glucocorticosteroids for reduce inflammation..
?Oxygen therapy and surgery for some cases..surgery called bullectomy..in this surgeon remove large air sacs(bullae) from the lungs..
Test:
?PFT(pulmonary function test), spirometry,ABG(artrial blood gas),Chest Xray,alpha1-antitrypsin,sputum culture..
Nursing care:
?--Assess the patient exposure risk factors
?--Assess the past and present medical history
?--Assess for severioty of signs and symptoms
--Assess vital signs
?--Assess for breath sounds and knowledge about this disease
Vitamin D deficiency:
it can be preventable by getting adequate sun exposure and including vitamin D diet..
Treatment: Adequate sun exposure, intake of vitamin d diet and liver oils and egg yolk..
?medication: cholecalciferol,Delta-D,D-vi-sol, ergocalciferol,Drisdol.
Test:
25- hydroxy vitamin D blood test
?nursing care:
- Explain patient about vitamin D diet..
?--EXplain about sun exposue and symptoms of vitamin d deficiency
?--Medication and how it should be followed..