EuthanasiaMedical / Generic definitionBioethical definition.Describe pain and suffering within context of faithPhysician Assisted Suicide / Death ( PAS / PAD)DefinitionIs it ethical?Should we have the right to end our lives? Why yes or why not?Better alternatives to PAS; compare and contrast each:HospicePalliative care / Terminal sedationCase studies. Brief summary of:Hemlock SocietyJacob KevorkianBritanny MaynardRead and summarize ERD paragraphs #: 59, 60, 61: 59. The free and informed judgment made by a competent adult patient concerning the use or withdrawal of life-sustaining procedures should always be respected and normally complied with, unless it is contrary to Catholic moral teaching. 60. Euthanasia is an action or omission that of itself or by intention causes death in order to alleviate suffering. Catholic health care institutions may never condone or participate in euthanasia or assisted suicide in any way. Dying patients who request euthanasia should receive loving care, psychological and spiritual support, and appropriate remedies for pain and other symptoms so that they can live with dignity until the time of natural death. 61. Patients should be kept as free of pain as possible so that they may die comfortably and Ethical and Religious Directives for Catholic Health Care Services, Sixth Edition with dignity, and in the place where they wish to die. Since a person has the right to prepare for his or her death while fully conscious, he or she should not be deprived of consciousness without a compelling reason. Medicines capable of alleviating or suppressing pain may be given to a dying person, even if this therapy may indirectly shorten the person’s life so long as the intent is not to hasten death. Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.

Discussion responses these are the responses of other students. We need to read this present our opinion on it 150-200 words and add reference. i need 1-2 by Friday, 3-4 by Saturday and 5-6 by Sundayhttps://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/home1 - Chronic Obstructive Pulmonary Disease (COPD) is another name for chronic, progressive, nonreversible, respiratory disease. COPD includes emphysema and chronic bronchitis, as well as nonreversible asthma. Symptoms include chronic cough, wheezing, or shortness of breath. COPD is diagnosed and managed with spirometry, which is a test where a patient blows into a machine called a spirometer. To have COPD, the ratio of forced expiratory volume and forced vital capacity must be 80% or less. The 2017 Global Initiative for Obstructive Lung Disease (GOLD) recommendations suggest that nonpharmacological therapies, such as pulmonary rehabilitation (pulmonary rehab), relaxation, diet, and exercise, should be employed before medications. Medications for COPD include long-acting inhaled medications, such as beta-agonists (LABAs) or muscarinic agonists (LAMAs), used alone or together; inhaled corticosteroids (ICS), such as fluticasone or budesonide; and short-acting inhaled medications (SABA), such as albuterol. Patients with COPD often have multiple comorbidities, such as cardiovascular disease (CVD), diabetes, anxiety, and depression. In addition to administering medications, nurses should educate patients on pursed-lip breathing. Pursed lip breathing allows patients to feel more in control of their COPD through controlled breathing. It increases alveolar airways, helps to remove carbon dioxide, and reduces anxiety. (Johnson, A. R. 2018).Patients must be educated to avoid risks and engage in health promotion activities. Health promotion activities include: following recommended nutritional and exercise guidelines, losing weight, avoiding tobacco smoke, getting recommended immunizations, and taking all prescribed medications. Patients with COPD have increased nutritional requirements because of the additional work of breathing (COPD Foundation, 2016). If dietary requirements are not met, the musculature of the chest wall could deteriorate. If COPD patients are underweight, patients can be educated to add the following sources of additional calories: butter, margarine, mayonnaise, peanut butter, nuts, and high-fat ice cream (COPD Foundation, 2016). Meeting nutritional requirements is one-way nurses can help to reduce hospital readmissions for COPD patients. Patients with COPD and asthma should be encouraged to exercise, as it increases cardiac function, muscle mass and bone density, and overall mobility. In COPD patients particularly, exercise increases the ability to perform ADLs, such as combing hair or reaching above the head. Respiratory patients should get clearance from their pulmonologist before starting any exercise program. To promote health, nurses should encourage patients to get all the recommended immunizations. Nurses should encourage patients to be forthcoming with their ability to afford medications, as there are many resources available to reduce or eliminate their cost. ( Johnson, A. R. 2018). ReferencesJohnson, A. R. (2018). Cardiorespiratory Complexities. Retrieved October 21, 2020, from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/2 - Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion.A myocardial infarct or MI is a blockage in one or more of the heart's coronary arteries, and this blockage prevents blood flow to the heart, causing a heart attack (Johnson, 2018). This blockage develops over time due to a build of plaque, causing narrowing or atherosclerosis, which is caused by morbidities and comorbidities like hypertension, diabetes mellitus, and hyperlipidemia (Johnson, 2018). This plaque can completely occlude the vessel or break off pieces that form a clot. The occlusion or clots can block blood flow to the rest of the heart, causing a heart attack or MI. Education to our patients is vital to their understanding of disease prevention. According to Johnson (2018), the following are risk factors that can be changed or modified behaviors:1st and 2nt hand cigarette smokeDiabetes mellitusHigh cholesterolObesity; unhealthy eating habitsLack of physical activityEducating patients' to make changes to these listed risk factors can prevent a fatal Heart attack or MI. Steps to modify or aid in the prevention and health promotion of these risk factors are as follow:Avoid or stop smoking. Smoking can raise blood pressure, causes vasoconstriction, slow healing, and cause respiratory issues. Follow the recommended nutritional guidelines. It is important to eat vegetables, fruits, and whole grains while limiting foods with high fats, high sugar, and high sodium. Loose weight, follow the recommended exercise guidelines, as exercise has great benefits, including strengthening the heart and improving circulation, maintain a healthy weight, lower cholesterol and blood pressure, which all lower the risk for a heart attack. Take all prescribed medications. See your primary care physician for annual check-ups.Sleep - healthy sleeping patterns maintain or help lower blood pressure. Stress is linked to high blood pressure and high heart rates. The long-term effects of stress on an individual can result in a heart attack.Reference: Johnson, A. (2018). Pathophysiology: Clinical applications for client health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/; labs: Cholesterol 3 - Pneumonia is an infection of the lungs caused by bacteria, fungi, and viruses. This typically starts with the colonization of the offending organism in the nasopharyngeal area but can also occur when infectious droplets are directly inhaled and as a secondary infection because of sepsis or bacteremia. Pneumonia can be hospital-acquired pneumonia and community-acquired pneumonia. The typical signs and symptoms of pneumonia are fever, productive cough, sharp pleuritic chest pain, anorexia, tachypnea. These symptoms are common for any type of pneumonia regardless of the organism. Diagnosis is done by chest x-ray, sometimes requires a CT scan of the chest. Patients become symptomatic from the body's response to invading organisms and from the destruction of cells from viral organisms and/or through the release of toxins from bacterial cell walls. As white blood cells and other chemicals from the immune system arrive at the site of the invading organism and they fill the alveoli in the lungs. This impairs oxygenation and produces the symptoms typical of pneumonia, cough, hypoxia, fever, chills, tachypnea, fatigue, and malaise (Brashers, 2008; Chesnutt & Prendergast, 2011; Ranganathan & Sonnappa, 2009).Pneumonia can be prevented by following a healthy lifestyle by having a healthy diet and regular exercise, stop smoking, follow hand hygiene, and getting both pneumonia & flu vaccine. Vaccination is recommended for adults above 65 years & people with a weakened immune system, chronic heart, lung diseases, liver disease, diabetes, alcoholism.Health promotion strategies are adequate sleep & rest, drinking plenty of water, monitoring of signs & symptoms, avoiding crowded areas, air pollution, etc.ReferenceCherese Severson, DNP, APRN, FNP‐BC, (Facility Medical Director & FNP), 1 Collette Renstrom, DNP, APRN, FNP‐C, (Clinical Nursing Faculty), 2 and Meg Fitzhugh, DNP, APRN, FNP‐C, (Adjunct Clinical Faculty) (September 2013) Health promotion, risk stratification, and treatment options to decrease hospitalization rates for community‐acquired pneumonia in adults retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7166367/Daniel M Musher, MD (September 2020) Patient Education: Pneumonia Prevention in Adults retrieved from https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basicsJohnson, A. (2018). Cardiorespiratory complexities. In Pathophysiology: Clinical Applications for Client Health. Grand Canyon University (Ed.). https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/4 - The most useful resource for non-acute care for cardiorespiratory issues is cardiac rehabilitation because it helps in the recovery after the acute phase and is vital in the secondary prevention of cardiac disease (Shields et al., 2018). Patients who have chronic conditions face a higher risk of readmissions because of their previous and current medical history. Consequently, to decrease such readmissions, nurses should increase patient independence by providing effective patient education to equip patients of non-acute conditions with self-care skills. Moreover, other resources for such patients include community centers, educational programs provided by hospitals, and websites like the American Heart Association, where they can obtain the primary health education.The initial diagnosis with non-acute cardiorespiratory issues comes as a shock to many patients because of its change. The patients often face the struggle to learn new medications, diet, and activity level; thus, lowering their independence and confidence level. The implementation of education and cardiac rehabilitation can increase patient confidence over their disease and return to regular physical activities (Shields et al., 2018). Community resources such as peer support groups can also positively impact patients who feel alone in their diagnosis. The American Heart Association is a great resource that provides free information on dieting, healthy lifestyles, and smoking cessation (Heart Failure Society of America (HFSA), n.d). Disadvantaged patients are also highly at risk for readmission. To combat this, patients can be referred to the Heart Failure Society of America, which helps patients who might need assistance in cost savings.ReferencesHeart Failure Society of America (HFSA) (n.d.) Patient Resources. Retrieved from https://www.hfsa.org/patient/patient-resources/.Shields, G. E., Wells, A., Doherty, P., Heagerty, A., Buck, D., & Davies, L. M. (2018). Cost-effectiveness of cardiac rehabilitation: a systematic review. Heart, 104(17), 1403-1410.5 - The cardiorespiratory patient will have a variety of needs after being discharged from an acute care facility. This includes cardiac rehabilitation, pulmonary rehabilitation, or just the need for different types of durable medical equipment like walkers, canes, or wheelchairs for balance or mobility, oxygen concentrators or supplies, portable oxygen, etc. They also need to have prescription medication assistance to avoid running out of medications. Such patients should have arrangements for transportation for Specialist appointments, and primary care appointments so that they can get continuous observation on their disease condition. Patients should modify their living conditions like move to the ground floor if the respiratory status is compromised or move to a family, group home, or skilled nursing facility if unable to live independently. Cardiac Rehab help patients learn to self-manage conditions with the help of a team. Pulmonary Rehab helps them rehabilitate their lungs and learn to exercise and manage the condition in a controlled environment. Change of duties and modification of workload also helpful for those who have a job. ( Johnson, A. R. 2018).Patient independence is often jeopardized by a cardiorespiratory illness. Patients may have to change where they live if there are access problems, such as narrow stairs hallways; they need a great deal of help with their activities of daily living (ADLs); or if their employment is lost. Nurses should help patients stay as independent as possible while advocating for patient safety. When learning to live with a cardiorespiratory diagnosis, patients will need an abundance of psychosocial support. Psychosocial support can come in the form of formal counseling or talk therapy, one-on-one, or in a group. Many patients do not have insurance to cover medications or psychotherapy. If that is the case, patients and caregivers can join support groups through local chapters of the American Heart Association or COPD Foundation or through their religious/spiritual affiliations. Patients may even join a free online group for their condition, which can help people who live in remote areas or with mobility issues to connect with peers. Sharing feelings with others who are going through similar experiences can help to improve a patient mood and self-esteem. The patient with the new cardiorespiratory illness will have a plethora of needs, most of which they had never considered prior to the occurrence of their illness. Nurses are uniquely qualified to educate patients on available resources. All these will help to reduce readmissions and to live the patient independently. (Johnson, A. R. 2018).ReferencesJohnson, A. R. (2018). Cardiorespiratory Complexities. Retrieved, from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/6 - Because the cardiac and respiratory system are so closely related, when one system is affected by a disease process the other system is also affected. When a disease process of the heart and lungs education is very important. One resource once the acute phase is over is cardiopulmonary rehabilitation. If a patient receives cardiopulmonary rehab within 30 days after ICU discharge there is a lower mortality rate and a lower readmission rate ( Lai et al.,2019). Cardiac rehab can increase medication compliance, improve the knowledge of a person’s risk factors, and can decrease depression, anxiety and improve the quality of life for the patient (Molan et al., 2019). One study showed how 30 minutes of education increased the knowledge base of the patients who recently had a cardiovascular event. By educating the patients, it empowers them to have more access and knowledge relating to their condition (Molan et al., 2019). There are several areas to cardiac rehab, and they can include safe exercise, which helps with flexibility, stability, and prevention of falls. Education regarding medications allowing the patient to understand what their medications are for and this can help with medication compliance. Another aspect of cardiac rehab includes education regarding smoking cessation as well as resources for medical equipment (Johnson, 2018). When a patient has the information to understand their disease process and resources that can be utilized this increases a patients independence and when compliant with exercise, diet, medication, doctor visits, and smoking cessation can prevent or decrease future admissions to the hospital (Johnson, 2018)Johnson, A. (2018) Cardiorespiratory Complexities.Pathophysiology Clinical Applications for Client Health. https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/1Lai, C.-C., Chou, W., Cheng, A.-C., Chao, C.-M., Cheng, K.-C., Ho, C.-H., & Chen, C.-M. (2019). The effect of early cardiopulmonary rehabilitation on the outcomes of intensive care unit survivors. Medicine, 98(11), e14877. https://doi-org.lopes.idm.oclc.org/10.1097/MD.0000000000014877Molan, N., Emmanuel, S., Langley, T., & Holloway, C. J. (2019). Evaluating the Effectiveness of an Online Cardiac Rehabilitation Resource (www.svhhearthealth.com.au) in Improving Knowledge and Confidence for Patients With Newly Diagnosed Cardiac Conditions: A Pre-Experimental Pilot Study. Heart, Lung and Circulation, 28(5), 761–770. https://doi-org.lopes.idm.oclc.org/10.1016/j.hlc.2...