screened for anxiety, depression, and PTSD. A college student is brought to the emergency department by a roommate who is concerned about symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and blood pressure and pupillary dilation, along with hyperactive bowel sounds.
Ceftriaxone and azithromycin. Usual treatment for gonorrhea/Chlamydia includes ceftriaxone 250 mg IM in conjunction with 1 g azithromycin by mouth. A 25-year-old female presents with lower abdominal pain.
Nurses have a central role in the care and management of people with chronic obstructive pulmonary disease. Inhaled bronchodilators are the mainstay of drug therapy. Support for smoking cessation can be important in slowing the progression of the disease.
Citation: Gundry S (2019) COPD 2: management and nursing care.
Key points. Nurses have a central role in the care and management of people with chronic obstructive pulmonary disease.
Long-acting beta-2 agonists (LABAs), such as formoterol and salmeterol, and long-acting muscarinic antagonists (LAMAs), such as tiotropium, umeclidinium and aclidinium, provide ongoing maintenance therapy to help control COPD symptoms. They are frequently used in combination.
NICE (2018b) recommends first-line oral antibiotic treatment with amoxicillin, doxycycline or clarithromycin; options for intravenous antibiotics include amoxicillin, co-amoxiclav, clarithromycin, co-trimoxazole and piperacillin with tazobactam.
Many nursing roles are ideally placed to support patients to live well with COPD. As discussed in part one, COPD has no cure and, although medication can help to mitigate some of the symptoms, it cannot alter the inevitable course of the disease – exacerbations can feature, particularly as COPD becomes more severe.