6101-W1-D15

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Fazaia Degree College, M.R.F, Kamra, Attock *

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6101

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Nursing

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Nov 24, 2024

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docx

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Uploaded by maryamberlas

Family Nurse Practitioners (FNPs) are Advanced Practice Registered Nurses (APRNs) licenses who have scope with patients of all ages and mainly focuses on health prevention and promotion. They provide primary care services and treat all range of diseases in all patient groups. As per state laws, APRNs have liberty to work autonomously and they typically work on care teams with the physicians, Registered Nurses and other nurses on the healthcare team (Schlunegger et al., 2023). They have the skills and expertise to treat common illnesses independently and may refer patients to specialists when necessary. They would perform wellness exams, manage treatment plans, prescribe and administer medications and vaccines, would order screening tests and analyse results, and may initiate lifestyle changes in patients to improve their health. The APRNs are active members of the healthcare team and would consult doctors and other healthcare professionals. APRNs in family practitioner role are also responsible for patient education for prevention of illnesses and promoting health in communities (Schlunegger et al., 2023). In particular, the Family Nurse Practitioner (FNP) are APRNs who can offer a comprehensive and patientcentred care protocol in primary care practice. They are responsible for conducting physical exams, diagnosis, prescribing medications, and patient education related to health and wellness. FNPs also focus on holistic healthcare delivery and thus emphasizes on patient-centred care delivery and employ preventive strategies. FNPs will not only provide medication management but will also reduce triggers in the environment that could exacerbate the disease process. The FNPs collaborate with other healthcare providers and follow a team-based approach to healthcare so that complex clinical cases that are outside their scope of practice can also be attended and resolved (Schlunegger et al., 2023). Chronic Obstructive Pulmonary Disease (COPD) is a treatable disease and it is characterized by structural changes in lungs that causes airflow obstruction and cause tissue destruction. This cellular inflammation is caused by narrowing of airways and decrease in lung recoil because of prolonged exposure to toxic inhalants particularly from cigarette smoking. COPD symptoms are cough, dyspnea, sputum production etc. Apart from cigarette inhalation, COPD may also occur due to second-hand smoke, environmental and occupational exposures. The prevalence of COPD increases after the age of 40 and it is the third most prevalent cause of morbidity and mortality worldwide. In 2015, the prevalence of COPD was 174 million and caused 3.2 million deaths due to COPD worldwide (Hurst et al., 2021). The acute exacerbation of COPD is the worsening of symptoms and requires additional therapy. COPD flares with upper respiratory tract infections and chronic bronchitis due to bacterial infections. The GOLD guidelines for COPD indicates that exacerbations can be self-limiting and requires change in regular medications. It increases the need for steroid or antibiotics and severity of exacerbation also requires hospital admission in patients (Dobler et al., 2020). Our intended study will also assess the treatment interventions that could limit severity of COPD exacerbation and may limit the hospital admission rates. The PICO question for our study is as follows. Population: Adult patients (age 40 and above) with a history of COPD exacerbation. Intervention: High-flow nasal cannula (HFNC) oxygen therapy. Comparison: Conventional oxygen therapy (e.g., nasal cannula) Outcome: Reduction in hospitalization rates and improvement in respiratory function during COPD exacerbation.

The PICO question will help in investigating the effectiveness of HFNC oxygen therapy in improving respiratory function compared to conventional oxygen therapy in elderly COPD patients during exacerbations. References: Dobler, C. C., Morrow, A. S., Beuschel, B., Farah, M. H., Majzoub, A. M., Wilson, M. E., ... & Wang, Z. (2020). Pharmacologic therapies in patients with exacerbation of chronic obstructive pulmonary disease: a systematic review with meta-analysis. Annals of Internal Medicine, 172(6), 413-422. Hurst, J. R., Siddiqui, M. K., Singh, B., Varghese, P., Holmgren, U., & de Nigris, E. (2021). A systematic literature review of the humanistic burden of COPD. International Journal of Chronic Obstructive Pulmonary Disease, 1303-1314.

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