All your Writing needs covered


Calculate the price
your order:

275 words
Approximate price
$ 0.00

EHR509 CLINICAL ASSESSMENT & EXERCISE PRESCRIPTION Question: Discuss About The Persistent Systemic Inflammation Associated?   Answer: Introducation The seventy three year old retired Susan Bennett has been diagnosed with COPD. COPD or chronic obstructive pulmonary disease is the disease of the lung that is characterized by the economics obstruction of the airflow to the lung. The normal breathing mechanism is greatly influenced by it and the patient who is suffering from the COPD often experiences shortness of breath which is increased gradually (Nordén et al., 2015). The client is complaining her GP of her breathlessness even while carrying out her regular life activities. Her GP interrogated her and came to know that she is also suffering from poor appetite and could not eat. She has a history of smoking which she quitted a year back. The pathophysiology of COPD is initiated with the airways and the air sac damage followed by the cough and the difficulty in the breathing (Agustí et al., 2012). An additional interrogation is carried out by the attending GP of Susan Bennett. She complained of wheezing, frequent coughing which is sometimes accompanied by sputum and tightness in the chest. She also complained that her coughing is getting severe and it is making her difficult to eat. Her attending GP also observed that Susan has begun to lose weight significantly and Susan also complained of her loss of appetite (Lainscak et al., 2016).  Her attending GP also examined that Susan is suffering from high blood pressure and that may lead to the condition known as pulmonary hypertension. COPD patients are often prescribed with exercises. Aerobic exercise is of much help to the patients suffering from COPD as it helps to improve the tolerance of exercise (Mohammed et al., 2017). They help to overcome the problem of breathlessness. Stretching of the arms and legs in order to lengthen the arms slowly is an effective measure to improve the motion and flexibility. Strengthening of the muscles by contracting the muscles repeatedly is helpful as it strengthens the respiratory muscle.   Fatigue In Leg Is The Outcome Of The Six Minute Walk In A Patient Suffering From COPD. Oxygen Desaturation Is Also Observed In COPD Patients. Susan Bennett if suggested to have a walk every day, it is likely that she will continue to suffer from breathlessness and fatigue in leg. This would be tiresome for her and even after resting for some time after taking the walk; dyspnea or difficulty in breathing or labored breathing can be observed (Esser et al., 2015). The practice of exercise by a patient suffering from COPD has many goals. The first goal is the improvement of the circulatory system of the body and enables the body to use the oxygen (Troosters et al., 2016). The heart and the cardiovascular muscle are strengthened by regular exercising and the endurance power of the body is increased. The aim of practicing the exercise is to lower the blood pressure which tends to rise significantly in patients suffering from COPD. The benefit of exercising regularly by the COPD patient is that it helps to perform regular life activities without getting tired or suffering from breathlessness (Brusasco, 2012). The COPD patients thus if perform regular exercise can benefit them by improving the physical condition of the patient and making him fit enough so that he can carry out all the regular life activities. Physical exercise is one of the most important interventions suggested to the patients suffering from COPD. Physical exercise is suggested after carrying out a thorough check up of the patient’s physiological condition and his capability of performing exercise. Patients suffering from COPD are more often suggested to carry out aerobic exercise. Aerobic exercise helps to improve the circulations, thus enabling the body to efficiently use oxygen. The resting heart rate condition is improved and decreases the blood pressure thus helping the individual to breathe properly (Divo et al., 2012). Initial Consultation A COPD- specific management program is carried out which provides lesson on exercise and educates the people and helps them in restoring a better quality of life. The main aim of the AEP service provision is to increase the capacity to work independently, educating the COPD patients about the symptoms and outcome of the COPD and give them the training to promote the long term self-management (Dransfield et al., 2013). The AEP reduces the risk factors of dyspnea and mortality which is associated with the COPD. Susan Bennett had a habit of smoking regularly and there were also a history of lung cancer in her family. She was also suffering from right ventricular ejection fraction and that requires an echocardiogram. Susan Bennett also had a healthcare history of depression and GORD or gastro-oesophageal reflux disease.   Risk Assessment Pre-exercise screening is important in assessing the physical condition of the COPD patients and their risk factors. Exercise may risk Susan Bennett because she is having a cardiovascular problem and is echocardiogram is suggested for her. Physical activity may pose risk to her as these may results in the condition of low build–up fatty plaques (Durup et al., 2012). The risk of cardiovascular diseases is greatly increased by vigorous physical activity. Susan Bennett is suffering from cardiovascular disease and is suggested echocardiogram. Any physical exercise may pose risk to Susan Bennett (Esser et al., 2015). Approach To Exercise Assessment One of the major causes of morbidity and mortality are chronic obstructive pulmonary disorder or COPD. The patient is suggested to carry out a regular physical activity as a part of the treatment. The exercise assessment is mainly done by the pulmonary rehabilitation which includes the supervision of the exercise training, psychological support o the COPD patients, a self-management education and a counseling process. The patients are meant to attend this session that would help to assess the exercise outcomes that they are undergoing. The assessments also includes the study and understanding of the patient’s medical history, the examination of the current breathing condition of the patient and identification of other limitations that may interfere with the rehabilitation process. The nutritional assessment of the patient is also carried out which becomes a part of the rehabilitation process. Client Goals Susan Bennett was prescribed to do vigorous exercise after a pre-exercise screening was conducted. The goal of prescribing the physical activity is the improvement of the circulation and the COPD symptoms. The goal of the physical activity is to strengthen the cardiovascular system and help Susan Bennett to increase her power to endure. It also aims to lower the blood pressure that tends to increase in the patients suffering from COPD. Another most important goal of the physical exercise is that it helps to improve the oxygen utilization by the body (Galbán et al., 2012). Stretching exercise would help Susan Bennett to increase her flexibility as it involves the heart and lungs and thus in turn help to improve the endurance. Susan Bennett would get help if she performs aerobic exercise as it would help her to increase the endurance level of the heart and the muscle (Gloeckl, Marinov & Pitta, 2013). Thus, one of the goals of the exercise intervention is met. The aerobic exercise would also help the body to use the oxygen efficiently which gradually increase the breathing capacity of Susan Bennett. Susan Bennett is also suffering from cardiovascular disorder and is also suggested to take rest and is not encouraged to perform her physical activity in a continuous process. A continuous physical activity would pose a threat to Susan Bennett’s life. Susan Bennett is also suggested to have a walk regularly which is also a part of the aerobic exercise and proves to be one of the most effective measures for the treatment of the patients suffering from COPD (Kerwin et al., 2012). Strengthening exercise involves the tightening of the muscle and Susan Bennett is suggested to do this. Strengthening exercise would increase the capability of the breathing muscle and helps in the greater uptake of water and helps to breathe effortlessly. Susan Bennett would be benefitted if she carries out this physical activity as a part of her treatment. The goals of the physical exercise can be achieved by performing these exercises and would help to control and minimize her COPD symptoms (Lainscak et al., 2012).   Exercise Interventions Susan Bennett has been diagnosed with COPD. She has complained of breathlessness and that she is becoming tired even when she is carrying out her daily life activities. She is also suffering from poor appetite and coughing. After a thorough physical examination, an electrocardiogram has been suggested for Susan Bennett. Susan Bennett also has a medical history of depression and GORD (Magnussen et al., 2014). She has been suggested for some physical activity which would help her to overcome her COPD symptoms. Patients suffering from COPD are suggested to carry out physical exercises. Susan would gradually be able to improve her physical condition. Exercise training can greatly increase the quality of life in relation to health of the patient and enhance the exercise tolerance by the patient suffering from COPD. Susan Bennett has a history of depression and pulmonary rehabilitation would be of much help to her. Pulmonary rehabilitation is a treatment procedure of the COPD patient that includes the psychological counseling and exercising training for the COPD patients (Menezes et al., 2014). It is one of the most important parts of the treatment of the COPD patient and becomes a significant management programs that is carried out to control the chronic obstructive pulmonary disorder. Susan must consult with her physician before she starts her physical exercise in order to undergo a thorough a check up of her physiological condition. Her physician must consult with her to set the goals to enhance her body fitness and enables her to breathe effortlessly. They should discuss if there is any risk factors of her doing the physical exercise. It is the duty of the physician to inform Susan Bennett that she should adjust the amount of physical exercise she should carry out according to her physiological condition (Mohammed et al., 2017). Stretching exercises is one of the best options available for the COPD patients; it helps in lengthening the muscles of the patients and increases their flexibility as well, these aerobic exercises are known to increase the endurance and functionality of the heart and lungs and are known to be extremely beneficial for the COPD patients. Aerobic exercises increase the capability of oxygen saturation of your body allowing you to use more of the oxygen consumed and improves the breathing as well. Walking and using stationary bikes are other alternatives applicable for COPD patients to try as well (Nordén et al., 2015). Pursed lip breathing is another highly effective breathing exercise for the COPD patients, this exercise is advised by respiratory disease experts to utilize while doing other exercises as well, to improve breathing and increase the functionality of the lungs as well. However, pursed lip breathing can be exercised in any condition, at any time of the day and the patient can do it as many times in a day as preferred (Soler-Cataluna et al., 2012). In order to do this exercise the patient will need to follow three simple steps, relaxing the neck and shoulder muscles, followed by breathing in for 2 seconds through nose, and then breathing out via pursed lips for 4 seconds.   Diaphragmatic breathing is an exercise that can be performed by the COPD patients as well. It has to be understood that diaphragm is the most vital respiratory muscle, which is the most affected after an episode of chronic obstructive pulmonary disorders. Exercising diaphragmatic breathing can revive the potentiality and functionality of the diaphragm slowly but steadily, however this particular exercise is a little more complicated than rest of breathing exercises and the patient must pay attention to the details in order to get the most benefit out of it (Suissa et al., 2013). The patient will need to lie down bending her knee placing one hand below the rib cage and breathe very deeply through the nose and hold the breath for three seconds allowing the rib cage expand and then very slowly exhale through the slightly puckered lips; it will stretch the diaphragm and revive its functionality that has been lost due to COPD. There are some exercise-induced risk factors identified among the patients who are suffering from COPD and Susan Bennett can also be the victim of this. These risk factors include exercise-induced hypoxemia, sympathetic overactivity and progressive respiratory acidosis.  The exercise-induced hypoxemia reduces the quality of life in the COPD patients. They also results in diminishing the level of the exercise tolerance, reducing the function of the skeletal muscle. These conditions would significantly increase the risk of death to the COPD patients (Troosters et al., 2016). Cardiovascular functions are often affected by the sympathetic over- activity in the patients who are suffering from the chronic obstructive pulmonary disorder. Susan Bennett was suggested to undergo electrocardiogram and maybe she is also suffering from cardiovascular disorder. Over exercising may also become a threat to Susan’s life. Exercise induced sympathetic over- activity may also results in the significant cardiovascular diseases like stroke, heart failure and many others and may even lead to death. Hence she will have to undergo exercise activities that will not exacerbate her cardiovascular risk factors or will not cause any potential harm to her cardiovascular conditions (Weiss et al., 2013). Progressive respiratory acidosis is also another type of exercise-induced risk factors that may result in the patients who is undergoing chronic obstructive pulmonary disease. It is a condition where a disturbance occurs in the balance of the acid and base as a result of the alveolar hypoventilation. This also proves to be fatal to the COPD patients and is often life threatening. These drug-induced risk factors in the COPD patients can be treated by pulmonary rehabilitation (Wells et al., 2012). Susan Bennett’s physician therefore must be careful enough in prescribing her the type of physical exercise she would carry out by assessing thoroughly the physiological condition. She must also remember that Susan has a history of intense smoking and that she also suffered from depression and GORD. There are a few exercises that Susan must avoid at all costs unless completely recovered from her respiratory disorder, such as heavy lifting, push- ups, isometric exercises, running, steep walking, shoveling, etc. Susan’s physical exercise is monitored by the Follick’s diary, Physical activity scale for the elderly and many others. These methods fall under the physical activity monitoring which is carried out on the COPD patients to monitor the physical activity that they are capable to do. Self-motivated exercise program may also be suggested for Susan. These monitoring techniques are affordable and effective to monitor the physical activities that Susan will carry out as a part of treatment for COPD (Boerrigter et al., 2012).   References   Agustí, A., Edwards, L. D., Rennard, S. I., MacNee, W., Tal-Singer, R., Miller, Nursing., … & Crim, C. (2012). Persistent systemic inflammation is associated with poor clinical outcomes in COPD: a novel phenotype. PloS one, 7(5), e37483. Boerrigter, B. G., Bogaard, H. J., Trip, P., Groepenhoff, H., Rietema, H., Holverda, S., … & Vonk-Noordegraaf, A. (2012). Ventilatory and cardiocirculatory exercise profiles in COPD: the role of pulmonary hypertension. CHEST Journal, 142(5), 1166-1174. Brusasco, V. (2012). Spirometric definition of COPD: exercise in futility or factual debate?. Divo, M., Cote, C., de Torres, J. P., Casanova, C., Marin, J. M., Pinto-Plata, V., … & Celli, B. (2012). Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine, 186(2), 155-161. Dransfield, M. T., Bourbeau, J., Jones, P. W., Hanania, N. A., Mahler, D. A., Vestbo, J., … & Lettis, S. (2013). Once-daily inhaled fluticasone furoate and vilanterol versus vilanterol only for prevention of exacerbations of COPD: two replicate double-blind, parallel-group, randomised controlled trials. The Lancet Respiratory Medicine, 1(3), 210-223. Durup, D. J. H. C. J. S. P. H. A. L. B., Jørgensen, H. L., Christensen, J., Schwarz, P., Heegaard, A. M., & Lind, B. (2012). A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice: the CopD study. The Journal of Clinical Endocrinology & Metabolism, 97(8), 2644-2652. Esser, R. W., Stoeckel, M. C., Kirsten, A., Watz, H., Lehmann, K., Taube, K., … & Von Leupoldt, A. (2015). Neural correlates of dyspnea in COPD. Galbán, C.J., Han, M.K., Boes, J.L., Chughtai, K.A., Meyer, C.R., Johnson, T.D., Galbán, S., Rehemtulla, A., Kazerooni, E.A., Martinez, F.J. and Ross, B.D., 2012. Computed tomography-based biomarker provides unique signature for diagnosis of COPD phenotypes and disease progression. Nature medicine, 18(11), pp.1711-1715. Gloeckl, R., Marinov, B., & Pitta, F. (2013). Practical recommendations for exercise training in patients with COPD. Kerwin, E., Hébert, J., Gallagher, N., Martin, C., Overend, T., Alagappan, V. K., … & Banerji, D. (2012). Efficacy and safety of NVA237 versus placebo and tiotropium in patients with COPD: the GLOW2 study. European Respiratory Journal, 40(5), 1106-1114. Lainscak, M., Schols, A., Farkas, J., Sulz, I., Themessl-Huber, M., Laviano, A., … & Schindler, K. (2016). Weight loss, food intake and mortality in hospitalized patients with chronic obstructive pulmonary disease (COPD): the NutritionDay survey analysis. Magnussen, H., Disse, B., Rodriguez-Roisin, R., Kirsten, A., Watz, H., Tetzlaff, K., … & Chanez, P. (2014). Withdrawal of inhaled glucocorticoids and exacerbations of COPD. New England Journal of Medicine, 371(14), 1285-1294. Menezes, A. M. B., de Oca, M. M., Pérez-Padilla, R., Nadeau, G., Wehrmeister, F. C., Lopez-Varela, M. V., … & Tálamo, C. (2014). Increased risk of exacerbation and hospitalization in subjects with an overlap phenotype: COPD-asthma. CHEST Journal, 145(2), 297-304. Mohammed, J., Derom, E., Van Oosterwijck, J., Da Silva, H., & Calders, P. (2017). Evidence for aerobic exercise training on the autonomic function in patients with chronic obstructive pulmonary disease (COPD): a systematic review. psychology. Nordén, J., Grönberg, A., Bosaeus, I., Forslund, H. B., Hulthén, L., Rothenberg, E., … & Slinde, F. (2015). Nutrition impact symptoms and body composition in patients with COPD. European journal of clinical nutrition, 69(2), 256. Soler-Cataluna, J. J., Cosío, B., Izquierdo, J. L., López-Campos, J. L., Marín, J. M., Agüero, R., … & González, M. C. (2012). Consensus document on the overlap phenotype COPD–asthma in COPD. Archivos de Bronconeumología (English Edition), 48(9), 331-337. Suissa, S., Patenaude, V., Lapi, F., & Ernst, P. (2013). Inhaled corticosteroids in COPD and the risk of serious pneumonia. Thorax, 68(11), 1029-1036. Troosters, T., Lavoie, K., Leidy, N., Maltais, F., Sedeno, M., Janssens, W., … & Bourbeau, J. (2016). Effects of bronchodilator therapy and exercise training, added to a self-management behaviour-modification programme, on physical activity in COPD. In Abstract presented at the ERS International Congress (pp. 3-7). Weiss, D. J., Casaburi, R., Flannery, R., LeRoux-Williams, M., & Tashkin, D. P. (2013). A placebo-controlled, randomized trial of mesenchymal stem cells in COPD. CHEST Journal, 143(6), 1590-1598. Wells, J. M., Washko, G. R., Han, M. K., Abbas, N., Nath, H., Mamary, A. J., … & Beaty, T. H. (2012). Pulmonary arterial management and acute exacerbations of COPD. New England Journal of Medicine, 367(10), 913-921.

Basic features

  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support

On-demand options

  • Writer's samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading

Paper format

  • 275 words per page
  • 12pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, CHicago/Turabian, Havard)

Guaranteed originality

We guarantee 0% plagiarism! Our orders are custom made from scratch. Our team is dedicated to providing you academic papers with zero traces of plagiarism.

Affordable prices

We know how hard it is to pay the bills while being in college, which is why our rates are extremely affordable and within your budget. You will not find any other company that provides the same quality of work for such affordable prices.

Best experts

Our writer are the crème de la crème of the essay writing industry. They are highly qualified in their field of expertise and have extensive experience when it comes to research papers, term essays or any other academic assignment that you may be given!

Calculate the price of your order

You will get a personal manager and a discount.
We'll send you the first draft for approval by at
Total price:

Expert paper writers are just a few clicks away

Place an order in 3 easy steps. Takes less than 5 mins.

error: Content is protected !!
Open chat
Need Homework Help? Let's Chat
Need Help With Your Assignment? Lets Talk