Hi, need to submit a 2000 words paper on the topic Assesment and Techniques in Sssessment for Patient with Long Term Medical Condition.

Hi, need to submit a 2000 words paper on the topic Assesment and Techniques in Sssessment for Patient with Long Term Medical Condition. The net result of these dysfunctions gives rise to the typical clinical picture of a wasted person, with peripheral edema and an increased respiratory effort evident by the hyper-inflated chest and pursed lip breathing along with the use of accessory muscles. COPD is one of the most common respiratory diseases and as it is a chronic progressive condition developing over the span of years, it often passes unrecognized and the patients present at the stage when complications of chronic disease have already developed. COPD is a source of considerable morbidity and mortality around the globe. The prevalence of COPD in UK is 1%, with about 60, 000 people having been diagnosed as cases of COPD. The ratio is thought to be even more as the statistics only take into account definite diagnosis from the people presenting at later stages. Approximately 30, 000 people die due to COPD each year in UK, making it the sixth leading cause of death in that region. COPD is growing concern worldwide. It is estimated that by 2020, COPD will the third leading cause of death worldwide (Bellamy 2011, Boon and Davidson 2006). The major risk factor towards the development and progression of COPD is cigarette smoking. There is a strong correlation between COPD and the number of pack years (where 1 pack year refers to 20 cigarettes smoked per day per year). COPD often develops after 10 pack years of cigarette smoking. In sharp contrast, not all people who smoke develop COPD. COPD develops in only about 20% of smokers (Bellamy & Booker 2011). This leads to the concept that other environmental or genetic factors play important role as well. Alpha 1 antitrypsin deficiency is evident in patients with emphysema. Other factors that put a person at an increased risk for acquiring COPD are biomass fuel fires, exposure in coal mine workers, pollution, infections and low socio economic status. Apart from these, perinatal events (low birth weight babies) and childhood infections also play a role in the development of COPD later in life (Hanania et al 2011) The pathology in COPD is multisystem. In the pulmonary system, chronic inflammation involving the large and the small airways is attributed to inflammatory cell infiltration and an increase in size and number of mucus secreting goblet cells. This leads to production of large amounts of sputum leading to chronic bronchitis. It is defined by the ‘presence of productive cough on most days for 3 months, for 2 consecutive years’, in the absence of any alternative explanation (Philip jevan). Emphysema is due to the deficiency of alpha 1 antitrypsin, which results in unhindered action of proteases causing destruction of the alveolar walls. The alveoli collapse during expiration due to the lack of support and this leads to gas trapping, giving rise to air spaces. Emphysema can be panacinar, centriacinar or periacinar, depending on the location of enlarged air spaces in relation with the airway tree (Hall & Guyton 2011, Ganong 2005). Also in COPD, the lungs and airways lose elasticity. Fibrosis combined with premature airway closure results in airway constraint. This leads to chest hyperinflation and reduced chest wall compliance.