You are on page 1of 4

Vitamin D Doesn't Help Chronic Obstructive Pulmonary Disease Academic Journal Main Category: COPD Article Date: 18 Jan

2012 - 9:00 PDT

Chronic Obstructive Pulmonary Disease (COPD) is characterized by diseases such as Bronchitis and Emphysema, where breathing becomes more difficult as the airways are inflamed, blocked with mucus and ultimately permanently damaged. The problem is usually caused by cigarette smoking, although exposure to industrial chemicals, pollutants or smoke inhalation may also be involved. It was thought that vitamin D might be effective in helping to ease the condition, because most patients with COPD havevitamin D deficiency, but new research published in Annals of Internal Medicinesuggests otherwise. The study was carried out by scientists at The University Hospitals Leuven, Leuven, Belgium and funded by Applied Biomedical Research Program, Agency for Innovation by Science and Technology. Wim Janssens, MD, PhD, of University Hospitals Leuven, Belgium, and colleagues gave test subjects monthly doses of 100,000 IU or more than 3,200 IU per day, where the standard recommended dose is only 600 IU daily to 800 IU daily for lactating women and the elderly. However no marked change or improvement was seen in the patients' symptoms. In total, 182 patients were part of the trial and all had moderate to severe COPD and recent history of exacerbations. The primary outcome was time to first exacerbation. Secondary outcomes were exacerbation rate, time to first hospitalization, time to second exacerbation, quality of life, and death. Patients' vitamin D level was measured by blood test throughout the trial, and patients were given either 100,000UI of vitamin D per month for a year, or a placebo. The researchers then recorded whether patients had exacerbations of COPD during the study. Although patients receiving the supplements of vitamin D showed increased levels in their blood, the number of exacerbations over the course of the year was no different to those on the placebo. Researchers did note that a small group of patients that started the trial with extremely low vitamin D levels may have showed some improvement, but results were inconclusive. They recommended a further research to investigate whether patients with very low vitamin D levels may benefit from supplements, but so far it appears in general that most patients won't benefit greatly, if at all, and certainly Vitamin D supplements are not an effective way to prevent exacerbation of COPD. Dr. Wim Janssens, from the respiratory division at University Hospital Gasthuisberg in

Leuven, the lead investigator said :

"There are studies showing that patients with vitamin D deficiency are more susceptible to different inflammatory, infectious and autoimmune diseases, and most likely COPD ... [however] ... Vitamin D restoration to normal levels in COPD patients does not reduce the number of exacerbations, does not reduce the infections andinflammation." REFERENCE: http://www.medicalnewstoday.com/articles/240466.php

11. A 40n year old male patient is complaining of chronic progressive and mental deterioration is admitted to the unit. The nurse recognizes that these characteristics indicate a disease that results in degeneration of the basal ganglia and cerebral cortex. The disease is called: a. multiple sclerosis b. myasthenia gravis c. Huntingtons disease d. Guillain-Barre syndrome 12. Dianne Hizon is a 27 year old woman who has been admitted to the ER due to severe vomiting. Her ABG values are pH= 7.50, PaCO2= 85, HCO3= 31, and SaO2= 93%. The nurse interpretation of this ABG analysis is: a. respiratory acidosis b. respiratory alkalosis c. metabolic acidosis d. metabolic alkalosis 13. Mr. Perkson has a parkinsons disease and he finds the resting tremor he is experiencing in his right hand very frustrating. The nurse advises him to: a. take a warm bath b. hold an object c. practice deep breathing d. take diazepam as needed 14. A shuffling gait is typically associated with the patient who has: a. Parkinsons disease b. Multiple sclerosis c. Raynauds disease d. Myasthenia gravis 15. The priority in preparing the room for a client with a C7 spinal cord injury is having: a. the halo brace device b. a catheterization tray

c. a ventilator on stand by d. the spinal kinetic bed 16. A 47 year old man with liver failure who has developed ascites. The nurse understands that ascites is due to: a. dehydration b. protein deficiency c. bleeding disorders d. vitamin deficiency 17. A client with rheumatoid arthritis may reveal which of the following assessment data: a. Heberdens nodes b. Morning stiffness no longer than 30 minutes c. Asymmetric joint swelling d. Swan neck deformities 18. Elsa Santos is a 18 year old student admitted to the ward with a diagnosis of epilepsy. She tells the nurse that she is experiencing a generalized tingling sensation and is smelling roses. The nurse understands that Esla is probably experiencing: a. an acute alcohol withdrawal b. an acute CVA c. an aura d. an olfactory hallucination 19. Mr. Lucas, a 63 year old, went to the clinic complaining of hoarseness of voice and a cough. His wife states that his voice has changed in the last few months. The nurse interprets that Mr. Lucass symptoms are consistent with which of the following disorders: a. chronic sinusitis b. laryngeal cancer c. gastroesophageal reflux disease d. coronary artery disease 20. Sarah complains of a nursing sensation, cramping pain in the top part of her abdomen that becomes worse in the afternoon and sometimes awakes her at night. She reports that when she eats, it helps the pain go away but that pain is now becoming more intense. Which of the following is the best condition for the nurse to draw: a. these symptoms are consistent with an ulcer b. The client probably has indigestion c. A snack before going to bed should be advised d. The client probably developing cholelithiasis

11. c. Huntingtons disease Huntingtons disease is a hereditary disease in which degeneration of the basal ganglia and cerebral cortex causes chronic progressive chorea (muscle twitching) and mental deterioration, ending in dementia. Huntingtons disease usually strikes people ages 25 to 55.

12. d. metabolic alkalosis Ms. Hizons pH is above 7.45, which makes it alkalatic, and her bicarbonate is high which is also makes it basic. Thus, the diagnosis is metabolic alkalosis. 13. b. hold an object The resting or non-intentional tremor may be controlled with purposeful movement such as holding an object. A warm bath, deep breathing and diazepam will promote relaxation but are not specific interventions for tremor. 14. a. Parkinsons disease A shuffling gait from the musculoskeletal rigidity of the patient with Parkinsons disease is common. Patients experiencing a stroke usually exhibit loss of voluntary control over motor movements associated with generalized weakness; a shuffling gait is usually not observed in stroke patient. 15. c. a ventilator on stand by Although a ventilator is not required for injury below C3, the innervation of intercostal muscles is affected. Hemorrhage and cord swelling extends the level of injury making it likely that this client will need a ventilator. 16. b. protein deficiency Protein deficiency allows fluid to leak out of the vascular system and third space into the tissues and spaces in the body such as the peritoneal space. Bleeding tendencies, dehydration and vitamin deficiency can occur but dont cause ascites. 17. d. Swan neck deformities Swan neck deformities of the hand are classic deformities associated with rheumatoid arthritis secondary to the presence of fibrous connective tissue within the joint space. Clients with RA do experience morning stiffness, but it can last from 30 minutes up to several hours. RA is characterized by symmetrical joint movement, and heberdens nodes are characteristic of osteoarthritis. 18. c. an aura An aura frequently precedes an epileptic seizure and may manifest as vague physic discomfort or specific aromas. Patients experiencing auras arent having a CVA, substance withdrawal or hallucination. 19. b. laryngeal cancer These symptoms, along with dysphagia, foul-smelling breath, and pain when drinking hot or acidic, are common signs of laryngeal cancer. 20. a. these symptoms are consistent with an ulcer The description of pain is consistent with ulcer pain. The pain is epigastric and is worse when the stomach is empty and is relived by food.

REFERENCE: www.nurseslabs/boardexam-questions/1234529.com

You might also like