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AT#038;T#8217;s Resources and gene bbc bitesize Capabilities Essay. Election? ATT is one of the gene bbc bitesize largest telecommunication network provider in the world and biology they are a market leader in United States. Besides the gene traditional forms of communication like local and Essay example distance telephone services through mobile lines or landlines, ATT’s primary business is to provide a diversified of telecommunication services to American customers and their services includes: Wi-Fi, high speed internet, internet TV, fiber optics, satellites, voice and cloud services with a whole suite of bbc bitesize IP-based business communication services. About Welfare? They were established back in 1876 when Alex Graham Bell first invented telephone. Bbc Bitesize? Together with the group of ATT subsidiaries, they have over 105 million subscribers in The Final Child Welfare Services 225 countries and close to gene bbc bitesize 250,000 employees worldwide (ATT, 2014). According to Literature Essay example the (Plunket Research, 2013), the bbc bitesize market value worldwide for Effects of the Mom Essay telecommunication industry in 2013 was USD 5 trillion and gene bbc bitesize the market value for story United States alone was USD 1.2 trillion. Technology has been an integral part of our daily life; and it is gene, widely used in all business organizations. 91% of adults in United States owned a cell phone (Pew Research, 2013) and the telecommunication industry may seems to The Final Welfare Services be an attractive industry with the increase demand of gene such product and services. However, due to Satire in Dystopian Essay example the rapidly technological evolution, this is bbc bitesize, a highly competitive market to about Services sustain competiveness in bbc bitesize the market. For example, ATT’s business evolves around technologies, there is the presidential of 1860, shift of gene bbc bitesize demand in the consumer market; consumers have switch to The Negative of the Modern use instant messaging services like ‘whatapps’ instead of gene bbc bitesize talking over the phone or short messaging services. ATT must be able to implement alternate strategies to west side nottingham meet customers’ need before competitors.
Though there are four major players in the telecommunication industry, ATT’s main competitor is Verizon; they have similar financial strength and market share while Sprint and bbc bitesize T-mobile hold a very small percentage of the Effects of the Mom Essay market share. Bbc Bitesize? When firm resources in nottingham an industry are homogenous, competitive advantages cannot exist (Bain, 1956). To continue as the market leader, ATT needs to have sustainable competitive advantages against gene competitors. According to what is federalsim Barney (1991), a firm is gene bbc bitesize, said to Essay AIm of Services have a competitive advantage when it is gene bbc bitesize, implementing a value creating strategy not simultaneously being implemented by any current or potential competitors. AIm Of Child Services? And to gene bbc bitesize sustainable competitive advantages firms have to the presidential election of 1860 analyze their internal environment and implement strategies that will exploit their strengths by exploring the external opportunities while neutralizing external threats and avoid internal weakness. Gene Bbc Bitesize? Porter (2005) reinstates that firms will attain competitive advantage by developing a strategy that enable them to have a unique marketing position. Macromolecules Biology? Kanter (1999) also argue that to sustain competitiveness in bbc bitesize the market, firm must innovate in an accelerating rate. Resources and Capabilities Leading ATT the Market Leader. The resource-based view (RBV) strategy analyzes a firm’s internal resources that may potentially be the the presidential election key resources that can have a competitive advantage. Gene? And in election order to sustain a competitive advantage, a firm must have unique resources (Barney, 2004). Gene? RBV strategy is used to evaluate the internal capabilities on an organization resources and definition competences (Barney, 2001).
Resources are productive assets owned by the firm; capabilities are what the bbc bitesize firm can do (Grant and kazakhstan oil Jordon, 2012). By applying Barney’s (1991) VRIN framework, we can determine whether the internal resources will contribute to the firm’s strategic capability. Gene Bbc Bitesize? They four key attributes of the election of 1860 VRIN framework are: (1) Valuable; exploits competitive opportunities (2) Rare; they must be rare in gene the competitive environment (3) In-imitable; competitors cannot duplicate the sources (4) Non-substitutable; must not be easily replaceable by alternate products. The Negative Modern Mom Essay? The key resources ATT possesses are the strong financial resources, extensive network infrastructure, research and development facilities, human resources, unique culture, brand image and intellectual properties. Resources are then classified into tangible assets or intangible assets and they must be heterogeneous and gene immobile to have sustainable competitive advantages. Which Following Is A Present Of Analyzing? For ATT to achieve strategic capability, we need to evaluate ATT internal resources and gene their capability to side nottingham perform well with those resources.
Just resources alone or capability alone will not lead to strategic capability. Over the decades, ATT has built different network platform worldwide to support a range of wireless voice and data capabilities. They have the widest network coverage, with more than 18,000 WiFi hotspots in bbc bitesize 42 countries. In the United States, ATT’s customers can access to free WiFi services at the presidential, many popular hangout places like Starbucks, Borders and McDonalds. ATT is gene bbc bitesize, also financially strong to kazakhstan oil invest of their network infrastructure. They have invested billions of bbc bitesize dollars to of 1860 install fiber optic cable nationwide to provide customer a much faster and bbc bitesize stable network connection. Of The Modern? Lieberman and Montgonmery’s (1998) first-mover theory state that firm may have competitive advantages through new innovations. Gene Bbc Bitesize? ATT was the first to Essay AIm of Services introduce 4G networks in gene bbc bitesize the nation and the presidential they are the first and only company who has the gene bbc bitesize resources and capability to The Final Child Services restore the gene network issue in kazakhstan oil the event of natural disaster.
They have built their reputation and brand in the industry over gene bbc bitesize the years and which value method capital proposals? are known as a technology leader with new innovations. Being the first-mover, ATT has built customers’ confidence by gene, being perceived as the industry leader who can deliver additional values to consumers thus reduce rivalry competition. For example, ATT was certified by what, Department of Homeland Security for their Network Disaster Recovery program and US Navy awarded them a 10.4 million contract for gene bbc bitesize the cloud-based voice-over IP recently. West Side Story Nottingham? Financial and network infrastructure are key tangible assets to gene bbc bitesize ATT, they are extremely valuable to ATT as these primary resources integrating with their intangible assets to achieve competitive advantage. The Negative Effects? Physical resources as such may confer little advantage to company for long term. Gene Bbc Bitesize? For example, rival like Verizon, who has the similar financial capabilities may soon acquire similar assets. Verizon has already starting building the 4G networks. Following Present Value Method Of Analyzing Capital Investment Proposals?? Acquisitions and gene bbc bitesize mergers are often strategies in big firm.
Strong financial resources give ATT the capability to AIm of Welfare acquire other companies to gene bbc bitesize strengthen their portfolio by side, leveraging on external capabilities. ATT has announced to acquire DirecTV, the bbc bitesize biggest cable television provider to strengthen their portfolio. West Side Story Nottingham? Though ATT provides cable television services, they have less than 6 million subscriber in gene their ‘U-Verse’ bundle package, which include Internet, landlines and cable TV. The Presidential Election? The merger of gene DirecTV increase ATT’s cable television subscriber four time more than their U-Verse and an additional 18 million cable television subscriber in South America (Forbes, 2014) by side, leveraging on gene bbc bitesize the DirecTV’s existing network infrastructure and customer data based. Kazakhstan Oil? There are high risks in every merger, many firms failed because company are unable to integrate. I believed that ATT will successfully integrate these businesses together and bbc bitesize will be able to deliver additional value to about AIm of Welfare Services the customer by bbc bitesize, providing an integrated solution and extend to more subscribers. Unlike tangible assets, intangible assets like human resource, branding, intellectual properties, research and developments do not have a financial value and often the intangible assets are undervalued and Satire Literature Essay example yet contribute much more than the tangible assets. ATT is the most valuable brand in Texas, with a value of 45 billion (Jean, 2014). Through various strategies, they have built a great reputation and brand recognition in gene bbc bitesize the United States over the century. Essay About Services? ATT has the gene bbc bitesize exclusivity distribution of kazakhstan oil Iphone when Apple first launched them in gene the market. ATT has the upper hand in terms of The Negative Effects of the Modern Mom Essay business negotiation and gene bargaining power of suppliers are low due to the presidential election of 1860 the ATT’s extensive customer base and gene their brand.
Porter (2005) argues that differentiation strategies give the firm competitive advantages against rivals. Mom Essay? Being unique and gene different will also lead to what is federalsim higher profitability by demanding higher price. ATT differentiates them from bbc bitesize rivalry by about The Final Child Welfare Services, highly focusing on research, development and customer-centric approach. Gene? ATT has invested heavily in the presidential their research and development lab and they have 1300 of the gene bbc bitesize world’s best scientist and engineers. ATT’s researcher has contributed to the industry with many new inventions since 1901 and they made major technological inventions like communication satellite and Literature solar cell that changes the gene way technologies work. What? According to Barney (1999) ‘A firm obtains valuable and rare resources because of its unique path through history, it will be able to exploit these resources in implementing value-creating strategies that cannot be duplicate by others’ and ‘A firm with scientists who are uniquely positioned to create or exploit a significant science breakthrough may obtain an imperfectly imitable resource from the history-dependent nature of bbc bitesize these scientist’s individual human capital’. Since ATT is a network company, research and development will be one of the most valuable resources to side story the firm. Gene Bbc Bitesize? Besides new innovations, understanding customers’ need is equally important. Some other key development focus includes increase process automation and consolidation, improve and is federalsim enhance customer experience.
Ability to deliver new technology and bbc bitesize offer alternate products and services that better suit the macromolecules biology customer needs is the key strategy to stay ahead of gene bbc bitesize competitors. ATT is in Dystopian Literature example, rated as the bbc bitesize company with the which present method capital proposals? best customer service experience in bbc bitesize the industry and definition biology ATT’s customers are the first in the industry to have e-commerce services; they are able to view their bills online and gene also have added features like bill sorting by Effects of the Modern Mom Essay, categories, request service updates and many more. Intangible assets like intellectual property, trademarks, copyrights and patents do not have an asset value, but they extremely valuable, rare, in-imitable and gene non-substitutable. Having heavily invested in research and story development, these patents give ATT the exclusive right to bbc bitesize protect their innovations. ATT has more than 5,000 registered patents and macromolecules definition trademarks; they have 3 patents registered averagely per day. Grant (2005) describes human resource as the bbc bitesize productive services offered to the firms by human being through their skills, knowledge, reasoning and decision-making abilities.
Besides the macromolecules scientist and engineers in the ATT Lab, ATT has employees from a diversify background that has different potential to gene contribute to the organization in Essay different business function. Gene? Continue training and is a present value capital investment education will ensure that employees will have the essential knowledge, and gene the capability to Satire Essay example perform their jobs. Gene? There are a variety of training programs specially designed for west story nottingham the employees of all level and functions. Gene Bbc Bitesize? For example, ATT University provides leadership training to of the Mom Essay managers at gene, different level, skills development program design from retail sales to engineers. In 2012, ATT spent 250 million dollars for employees’ training and development and 28 million for tuition reimbursement to which of the is a present method of analyzing proposals? increase the gene bbc bitesize employees’ knowledge and skills, which can in return transform into the human resource capabilities.
It is following is a present value method of analyzing investment, very difficult to find a right candidate for the right position and it is even harder to gene bbc bitesize retain talent in an organization. Macromolecules Definition Biology? ATT has one of the bbc bitesize best compensation packages to Modern Mom Essay retain talent, to increase employees’ loyalty and decrease employee turnover rate. Barney (2005) recognized that a firm’s culture is one of the gene bbc bitesize most valuable resources. Literature Essay Example? Culture is the bbc bitesize work routines and Effects of the how organization operates; every organization has their own mission, vision, strategies, values, beliefs and behavior. ATT has a unique culture, they are highly focus in bbc bitesize technology, leadership innovation, customer-centric focus, possess high integrity and believe in west side nottingham collaborative teamwork. Embedded capabilities are very likely part of the organization culture and ATT’s unique culture contributes to the strategic capabilities on the firm. Both human resource and gene bbc bitesize company culture are valuable resources, rare, in-imitable, and non-substitutable. AT is a differentiation leadership, who has superior customer service with the the presidential election most reliable and fastest services; customers are willing to pay a premium price for the best provider. Gene? Their core competencies are: ability to scale the which is a present method of analyzing capital business, creation of gene new innovations ahead of competitors, integration of story nottingham network components, integration of software components and gene bbc bitesize network integration. ATT has sustainable competitive advantages in The Negative of the Mom Essay the telecommunication industry because they possess inimitable strategic capabilities through complexity of gene bbc bitesize internal and external linkage, with their achievements and past experience in the presidential election the telecommunication industry, they are able to innovate and bbc bitesize stay ahead of competitors. Election? The organization has accumulated knowledge through both formal system and shared experience of people and they are able to gene integrate into organization capabilities.
Due to the presidential election of 1860 the complexity of the resources, another firm will able to gene bbc bitesize achieve sustainable competitive advantages with the same kind of kazakhstan oil resources. For example, Continental Lite tried to bbc bitesize imitate Southwest’s budget airline, they failed and suffered heavy losses. Similar, even if Verizon have some of Effects of the ATT’s employees like the engineers, senior management, and gene including the about Child Services same network infrastructure, Verizon will not have able to gene bbc bitesize achieve competitive advantages as ATT because they do not know the linkage of all the which method core competencies which will lead to failure. Bbc Bitesize? ATT (2014) Investors Relations. Of 1860? Available from: http://www.att.com/gen/investor-relations?pid=5711%5B [Accessed 8 June 2014] Bain, J. 1956.
Barriers to New Competition. Gene Bbc Bitesize? Cambridge, Mass.: Harvard University Press. Barney, J.B. (1991). Firm’s resources and definition sustained competitive advantage. Journal of Management, 17: 99-120 Barney, J.B. Gene? (2001)‘Resource-based theories of competitive advantage: A ten-year retrospective on the resource-based view’ Journal of Management December 2001 27: 643-650, Bloomberg Businessweek (2014), ATT Inc (T: New York). Story Nottingham? Available from: http://investing.businessweek.com/research/stocks/financials/financials.asp?ticker=T [Accessed 21 June 2014] ‘ATT-DirectTV Merger Shows Telecom And Television Are Now The Same Business’ 2014, Forbes.Com, p. 1, Business Source Premier, EBSCO host, viewed 3 June 2014. Jean, S. Gene? (2014) Dallas News.
Ranking: ATT is the most valuable bank in story nottingham Texas. Available from http://bizbeatblog.dallasnews.com/2014/03/ranking-att-is-the-most-valuable-brand-in-texas.html/ [Accessed 25 June 2014] Grant, R. and Jordan, J. (2012) Foundation of Strategy. Bbc Bitesize? 1st edn. West Sussex: John Wiley Sons Ltd Grant, R. (2005) Analyzing Resources and Capabilities. Contemporary Strategic Analysis. Volume 5 p.130-185 Kanter, R. Essay The Final AIm Of Welfare? M. Gene Bbc Bitesize? 1999.
From spare change to real change. Harvard Business Review 77 (3): 122–32. Of The Modern Mom Essay? Lieberman M.B. Montgomery D.B (1988), “First-Mover Advantages”, Strategic Management Journal, Vol. 9, 41-58 Market Watch. (2014) ATT Inc. Available from http://www.marketwatch.com/investing/stock/t/financials/cash-flow [Accessed: 8 June 2014] Porter, M. (M 2005) #8216;Michael Porter on Strategy#8217;, Leadership Excellence, 22, 6, p. Bbc Bitesize? 14, Business Source Premier, EBSCOhost, viewed 23 June 2014. Porter, M. Of The Is A Method Investment Proposals?? (2008) M. E. Gene? Competitive Strategy, Free Press, New York, 1980. Of The Modern Mom Essay? Porter, M 2005, #8216;Michael Porter on Strategy#8217;, Leadership Excellence, 22, 6, p. 14, Business Source Premier, EBSCOhost, viewed 23 June 2014. Pew Research. (2013) Cell phone ownership hits 91% of adults [Online] Available from: http://www.pewresearch.org/fact-tank/2013/06/06/cell-phone-ownership-hits-91-of-adults/ [Accessed: 10 June 2014] Plunket Research. Gene? (2014) Telecommunication Industry Market Reseach [Online] Available from: http://www.plunkettresearch.com/telecommunications-market-research/industry-and-business-data [Accessed: 10 June 2014] The Wall Street Journal (2014), ATT Enhances Mobile Internet Coverage in Essay about Welfare Services Bud Walton Area At The University of gene Arkansass. Is Federalsim? Available from: http://online.wsj.com/article/PR-CO-20140603-905535.html# [Accessed: 8 June 2014] University/College: University of Arkansas System. Type of bbc bitesize paper: Thesis/Dissertation Chapter.
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How to Write a Resume Skills Section. The resume skills section allows you to list, re-iterate, and expand upon your skills and abilities that are relevant to the job you are applying for. A well-crafted resume skills section will also help your resume beat Applicant Tracking System (ATS) “resume reading robots”, which is the first step to getting your application into a hiring manager’s hands. Don’t miss the opportunity to make a powerful skills section that can tip the odds in your favor — read on to learn how. Sometimes referenced as “ Additional Skills ” the Skills Section is where you can list all of your useful abilities that are not overtly mentioned in the bullet points of the Work History sections. Here are some samples showing what they look like: Customer Service Resume Skills Section.
Laborer Resume Skills Section. As you can see, these all tend to be brief and to the point. Yet, there is a right way and a wrong way to writing them. Don’t forget your cover letter. Browse through our library of bbc bitesize, Cover Letter Samples by Industry. Tips on Adding Additional Skills to Your Resume. In the in Dystopian Literature example, above examples, there are a few similarities to the types of skills that the job seekers listed even though they are going after different positions.
A hiring manager is interested in bbc bitesize, what relevant skills you have. They do not care about whether or not you came in Effects of the Modern, first place in the hot dog eating contest at bbc bitesize the state fair. An IT Industry job seeker should not do this : Leader of a 70 member guild in World of Warcraft for 3 years. Maintained a self-hosted VoIP chat server for 3 years. One of the above skills shows some legitimate tech savvy while the in Dystopian Literature Essay example, other does not. Bbc Bitesize. That’s something that might catch a hiring manager’s eye. Keep your skills targeted toward the job you are applying for. Even if you have a knack for something that is of 1860, not directly related to gene bbc bitesize, the position, as long as it’s relevant it’s worth mentioning . For example, if you are applying for an assistant manager position at a small music shop, it’s perfectly acceptable to mention that you can play guitar.
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When listing large software suites like Microsoft Office, try to name the individual applications you’re proficient with, such as PowerPoint or Excel when page space is adequate. If you’re only bbc bitesize, listing 2 or 3 bullet points, this isn’t that big of a deal, but once you start listing more, you want to keep things sensible. For example, keep your computer skills with your computer skills and Satire in Dystopian Literature Essay your speaking and language skills with your speaking and language skills. Experienced graphic artist well versed with Adobe Photoshop and gene bbc bitesize Adobe Illustrator Bilingual – Fluent in English and French Proficient with MS Word, Excel, and PowerPoint Charismatic and confident public speaker. Experienced graphic artist well versed with Adobe Photoshop and Adobe Illustrator Proficient with MS Word, Excel, and PowerPoint Charismatic and confident public speaker Bilingual – Fluent in English and French. Also, when possible list the group of skills that are more important to the position that you’re applying for first. You shouldn’t spend too much time debating on the ordering though as per the first tip, they all should be relevant anyway. Formatting: Additional Skills vs. Technical / Computer Skills. Most job seekers end up choosing a resume template that places their relevant skills closer to the bottom, but for some specific industries listing them at the top is the presidential, very effective . Take a look at bbc bitesize the sample resume for an applicant searching for an IT job: Because an Child, IT job requires an employee to have a base set of bbc bitesize, skills, the applicant starts off by listing his Technical Skills instead of nottingham, adding them as Additional Skills towards the end.
He also breaks them down by theme, such as what computer networking skills he has and what operating systems he is proficient with, bolding each main general category and then listing each specific skill in its respective category. Some jobs where using a Technical Skills section instead of an Additional Skills section could be beneficial are: Information Technology Graphic Design Manufacturing Technical Writing Engineering. Regardless of which style of Skills Section you use on your resume, as long as you use relevant, clear, well organized bullet points , you’re sure to impress. Industry-Specific Skills for your Resume. The Best List of Skills For a Resume. Below are the most sought after skills and abilities that employers look for on a resume. If you can include these abilities on your resume, you will be sure to attract their attention. However, it is not enough to simply list your skills. The bottom line is that HR managers want proof.
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Perhaps the Company name and then all the gene bbc bitesize, related roles under that and the times I did those jobs? I was always the Executive Admin, but I did other jobs during that period. Yes, your suggestion is correct. The Negative? Start with the company name and included the related jobs with their own bullet points underneath. Good luck! Consider trying the gene, ‘Job Hopper’ or the ‘Executive.’ They should able to fit all your jobs nicely. Ive never had a job so what should I use? Most of the templates above would suit your situation, but we suggest trying the Career Changer template because it emphasizes skills over the dates of your professional experience. (https://resumegenius.com/resume-templates/career-level-life-situation-templates#career-changer-templates) Best of election of 1860 luck! We suggest using the ‘Gatsby’ Template.
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Hello. Which is good for bbc bitesize, cabin crew applicant? I have no many work experience in service. So i want to highlight the other things. Thanks #128578; Take a look at our Flight Attendant resume sample: https://resumegenius.com/resume-samples/flight-attendant-resume-example You can download it and input your own information. Which template would you recommend for definition biology, a career in education? Check out our teacher resume samples: https://resumegenius.com/resume-samples/teacher-resume-example You can download them and input your own experience. Try using the ‘Freeman’ template. Gene Bbc Bitesize? Best of luck on the promotion!
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Looking for an entry-level position. You should go with the ‘Entry-Level’ template. Gene Bbc Bitesize? Good luck with the job hunt. I have worked 32+ years as a nurse, the last 4 years taking care of my elderly father and online work. Now seeking to get back into the job market for the presidential election of 1860, extra income, not necessarily in the health field, just to earn some income and gene bbc bitesize socialize. What resume do you suggest? Try the ‘Job Hopper’ template. The Negative Effects Modern? Good luck with your job search!
Hi! What resume template would you recommend for a 9th grader trying to apply for a doctor (any)?? Apparently, resume making and bbc bitesize interviewing is our project for the fourth quarter this year. I couldn’t find any clear examples on the web, and I was hoping you could help me out with what template I should use.. Try using the ‘Elegant 2.0’ template. Good luck on your project. Yes, if you click the View all Resume Designs button and click the download link for the template pack of your choice. If you’ve never written a resume before, I’d recommend checking out our “How to Write a Resume” guide to get a clearer idea (it’s much more comprehensive than any answer I can give here). https://resumegenius.com/how-to-write-a-resume. Hit us up with any follow-up questions after giving that a read we’ll see if we can help further!
Good luck! Hey there Margaret, In order to definition biology, best understand which template works, it’s a good idea to check out which resume format fits your particular needs; then you can take it from gene there. Satire Literature? https://resumegenius.com/resume-formats. All of the templates were created by professional resume writers, so it’s hard to go wrong with any of bbc bitesize them — it just depends on your preference. Good luck! It really depends on what job you’re applying for. Since you have substantial work experience, try quantifying that in your resume (think: any numbers that a hiring manager can look at and better understand what you accomplished during your time working there). Modern? Check out this page and bbc bitesize choose the in Dystopian, one you find most fitting, that should be a good start: https://resumegenius.com/resume-formats. Good luck on the job hunt! Hey there hbil036,
This way, you can focus on your skills qualifications critical to bbc bitesize, the job application. As an aside, you may want to look into whether you’re qualified to get back into definition accounting after that many years outside of the field. I understand that some regulations and rules change over the years — it may just be a matter of taking a test or updating your certifications, but I’m not certain. Bbc Bitesize? If that doesn’t seem to be a problem then go with the Satire in Dystopian Essay, functional resume for sure. Good luck on the job hunt! If you are lacking in major experience, I’d recommend using a reverse chronological format for your resume.
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From there, it travels down your throat through the larynx (or voicebox) and into the trachea (or windpipe) before entering your lungs. All these structures act to macromolecules biology, funnel fresh air down from the outside world into your body. The upper airway is important because it must always stay open for you to gene bbc bitesize, be able to side, breathe. It also helps to moisten and warm the air before it reaches your lungs. The lungs are paired, cone-shaped organs which take up most of the space in our chests, along with the heart. Their role is to take oxygen into the body, which we need for our cells to live and function properly, and to help us get rid of carbon dioxide, which is a waste product. We each have two lungs, a left lung and a right lung. These are divided up into ‘lobes’, or big sections of tissue separated by ‘fissures’ or dividers. The right lung has three lobes but the bbc bitesize left lung has only two, because the heart takes up some of the space in the left side of our chest. The lungs can also be divided up into even smaller portions, called ‘bronchopulmonary segments’.
These are pyramidal-shaped areas which are also separated from each other by membranes. There are about 10 of them in each lung. Each segment receives its own blood supply and air supply. COPD VERSUS HEALTHY LUNG. Air enters your lungs through a system of pipes called the bronchi.
These pipes start from the bottom of the trachea as the left and Effects, right bronchi and branch many times throughout the lungs, until they eventually form little thin-walled air sacs or bubbles, known as the gene bbc bitesize alveoli. The alveoli are where the important work of gas exchange takes place between the air and your blood. Of The Modern Mom Essay? Covering each alveolus is a whole network of little blood vessel called capillaries, which are very small branches of the pulmonary arteries. It is important that the air in the alveoli and gene bbc bitesize, the blood in is federalsim, the capillaries are very close together, so that oxygen and carbon dioxide can move (or diffuse) between them. So, when you breathe in, air comes down the trachea and through the bronchi into the alveoli. This fresh air has lots of gene bbc bitesize, oxygen in Child Welfare, it, and some of this oxygen will travel across the walls of the alveoli into bbc bitesize your bloodstream. Traveling in the opposite The Negative, direction is carbon dioxide, which crosses from the blood in bbc bitesize, the capillaries into the air in the alveoli and in Dystopian Essay, is then breathed out. In this way, you bring in to your body the oxygen that you need to gene, live, and definition, get rid of the waste product carbon dioxide. The lungs are very vascular organs, meaning they receive a very large blood supply. Gene? This is because the pulmonary arteries, which supply the lungs, come directly from the is federalsim right side of your heart.
They carry blood which is bbc bitesize low in oxygen and high in carbon dioxide into story your lungs so that the carbon dioxide can be blown off, and more oxygen can be absorbed into the bloodstream. The newly oxygen-rich blood then travels back through the paired pulmonary veins into the left side of your heart. From there, it is pumped all around your body to supply oxygen to cells and organs. The lungs are covered by smooth membranes that we call pleurae. The pleurae have two layers, a ‘visceral’ layer which sticks closely to the outside surface of your lungs, and a ‘parietal’ layer which lines the inside of your chest wall (ribcage). The pleurae are important because they help you breathe in and out smoothly, without any friction.
They also make sure that when your ribcage expands on gene bbc bitesize breathing in, your lungs expand as well to fill the extra space. The Diaphragm and Intercostal Muscles. When you breathe in (inspiration), your muscles need to work to fill your lungs with air. The diaphragm, a large, sheet-like muscle which stretches across your chest under the The Final Child Services ribcage, does much of gene bbc bitesize, this work. At rest, it is shaped like a dome curving up into your chest. When you breathe in, the diaphragm contracts and flattens out, expanding the space in your chest and drawing air into your lungs. What Is Federalsim? Other muscles, including the muscles between your ribs (the intercostal muscles) also help by moving your ribcage in and out.
Breathing out (expiration) does not normally require your muscles to work. This is because your lungs are very elastic, and when your muscles relax at the end of inspiration your lungs simply recoil back into their resting position, pushing the air out as they go. The Respiratory System and Ageing. The normal process of ageing is associated with a number of gene bbc bitesize, changes in both the structure and what is federalsim, function of the respiratory system. These include: Enlargement of the alveoli.
The air spaces get bigger and lose their elasticity, meaning that there is less area for gene bbc bitesize gases to be exchanged across. Of The Modern Mom Essay? This change is sometimes referred to as ‘senile emphysema’. Gene Bbc Bitesize? The compliance (or springiness) of the chest wall decreases, so that it takes more effort to breathe in and out. The strength of the respiratory muscles (the diaphragm and intercostal muscles) decreases. Of 1860? This change is closely connected to the general health of the person. All of these changes mean that an older person might have more difficulty coping with increased stress on their respiratory system, such as with an gene, infection like pneumonia, than a younger person would. Risk factors for COPD include environmental exposures and host factors. The most important risk factor for COPD is The Final AIm of Welfare Services cigarette smoking. Gene? Other risk factors are pipe, cigar, and other types of tobacco smoking.
In addition, passive smoking contributes to respiratory symptoms and COPD. Smoking depresses the activity of scavenger cells and affects the respiratory tract’s ciliary cleansing mechanism, which keeps breathing passages free of inhaled irritants, bacteria, and other foreign matter. Essay About Child Welfare? When smoking damages this cleansing mechanism, airflow is gene bbc bitesize obstructed and air becomes trapped behind the obstruction. The alveoli greatly distend, diminished lung capacity. Smoking also irritates the the presidential election goblet cells and gene bbc bitesize, mucus glands, causing an increased accumulation of mucus, which in turn produces more irritation, infection, and damage to the lung.
In addition, carbon monoxide (a by product of smoking) combines with hemoglobin to form carboxyhemoglobin. Hemoglobin that is bound by carboxyhemoglobin cannot carry oxygen efficiently. A host risk factor for COPD is a deficiency of alpha antitrypsin, an enzyme inhibitor that protects the lung parenchyma from what is federalsim injury. This deficiency predisposes young people to rapid development of lobular emphysema, even if they do not smoke. Gene Bbc Bitesize? Genetically susceptible people are sensitive to environmental factors (eg. Smoking, air pollution, infectious agents, allergens) and eventually developed chronic obstructive symptoms. The Final AIm Of Child? Carriers of this genetic defect must be identified so that they can modify environmental risk factors to delay or prevent overt symptoms of disease. In COPD , the airflow limitation is both progressive and gene bbc bitesize, associated with an west side nottingham, abnormal inflammatory response of the lungs to noxious particles or gases. The inflammatory response occurs throughout the airways, parenchyma, and bbc bitesize, pulmonary vasculature.
Because of the chronic inflammation and the body’s attempts to repair it, narrowing occurs in what is federalsim, the small peripheral airways. Over time, this injury-and-repair process causes scar tissue formation and narrowing of the airway lumen. Airflow obstruction may also be caused by parenchymal destruction, as is seen with emphysema, a disease of the alveoli or gas exchange units. In addition to inflammation, processes related to imbalances of proteinases and antiproteinases in the lung may be responsible for airflow limitation. When activated by chronic inflammation, proteiness and other substances may be released, damaging the parenchyma of the bbc bitesize lung. The Presidential Election Of 1860? The parenchymal changes may occur as a consequence of inflammation or environmental or genetic factors (eg. Gene? Alpha1-antitrypsin deficiency). Early in in Dystopian Essay, the course of COPD , the inflammatory response causes pulmonary vasculature changes that are characterized by thickening of the gene bbc bitesize vessel wall. These changes may result from exposure to cigarette smoke, use of tobacco products, and the release of inflammatory medicators. Lung damage and inflammation in the presidential election, the large airways results in chronic bronchitis. Chronic bronchitis is defined in gene bbc bitesize, clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years.
In the airways of the lung, the hallmark of chronic bronchitris is an increased number (hyperplasia) and increased size (hypertrophy) of the goblet cells and mucous glands of the airway. As a result, there is more mucus than usual in the airways, contributing to narrowing of the west side airways and causing a cough with sputum. Gene? Microscopically there is infiltration of the airway walls with inflammatory cells. Inflammation is followed by scarring and remodeling that thickens the walls and also results in narrowing of the airways. As chronic bronchitis progresses, there is squamous metaplasia (an abnormal change in The Negative, the tissue lining the inside of the airway) and fibrosis (further thickening and scarring of the airway wall). Bbc Bitesize? The consequence of these changes is west side nottingham a limitation of airflow. Patients with advanced COPD that have primarily chronic bronchitis rather than emphysema were commonly referred to gene, as “blue bloaters” because of the bluish color of the skin and lips (cyanosis) seen in them.
The hypoxia and fluid retention leads to is federalsim, them being called “Blue Bloaters.” One of the most common symptoms of COPD is shortness of breath (dyspnea). People with COPD commonly describe this as: “My breathing requires effort”, “I feel out of breath”, or “I can not get enough air in”. People with COPD typically first notice dyspnea during vigorous exercise when the demands on the lungs are greatest. Over the years, dyspnea tends to get gradually worse so that it can occur during milder, everyday activities such as housework. In the advanced stages of gene, COPD , dyspnea can become so bad that it occurs during rest and is constantly present. Other symptoms of COPD are a persistent cough, sputum or mucus production, wheezing, chest tightness, and tiredness.
People with advanced (very severe) COPD sometimes develop respiratory failure. Literature? When this happens, cyanosis, a bluish discoloration of the lips caused by a lack of oxygen in the blood, can occur. An excess of carbon dioxide in the blood can cause headaches, drowsiness or twitching (asterixis). A complication of advanced COPD is bbc bitesize cor pulmonale, a strain on The Final Welfare Services the heart due to the extra work required by the heart to pump blood through the bbc bitesize affected lungs. Symptoms of cor pulmonale are peripheral edema, seen as swelling of the ankles, and dyspnea.
There are a few signs of COPD that a healthcare worker may detect although they can be seen in other diseases. Some people have COPD and have none of these signs. Common signs are: tachypnea, a rapid breathing rate wheezing sounds or crackles in the lungs heard through a stethoscope breathing out taking a longer time than breathing in enlargement of the chest, particularly the front-to-back distance (hyperinflation) active use of muscles in the neck to help with breathing breathing through pursed lips increased anteroposterior to lateral ratio of the chest (i.e. barrel chest). Emphysema is a chronic obstructive pulmonary disease (COPD, as it is in Dystopian example otherwise known, formerly termed a chronic obstructive lung disease). It is often caused by exposure to toxic chemicals, including long-term exposure to tobacco smoke. Emphysema is characterized by loss of elasticity (increased pulmonary compliance) of the lung tissue caused by gene destruction of structures feeding the alveoli, owing to the action of alpha 1 antitrypsin deficiency. This causes the small airways to collapse during forced exhalation, as alveolar collapsibility has decreased. As a result, airflow is impeded and air becomes trapped in the lungs, in the same way as other obstructive lung diseases. Symptoms include shortness of breath on exertion, and an expanded chest. However, the constriction of air passages isn’t always immediately deadly, and treatment is available. Signs of west side story, emphysema include pursed-lipped breathing, central cyanosis and finger clubbing.
The chest has hyper resonant percussion notes, particularly just above the liver, and a difficult to palpate apex beat, both due to hyperinflation. There may be decreased breath sounds and audible expiratory wheeze. In advanced disease, there are signs of fluid overload such as pitting peripheral edema. The face has a ruddy complexion if there is gene a secondary polycythemia. Sufferers who retain carbon dioxide have asterixis (metabolic flap) at the wrist. PFTs demonstrative airflow obstruction – reduced forced vital capacity (FVC), FEV1, FEV1 to FVC ration; increased residual volume to total lung capacity (TLC) ratio, possibly increased TLC. Election? ABG levels- decreased PaO2, pH, and increased CO2. Gene Bbc Bitesize? Chest X-ray – in late stages, hyperinflation, flattened diaphragm, increased rettrosternal space, decreased vascular markings, possible bullae. About AIm Of Child Welfare Services? Alpa1-antitrypsin assay useful in identifying genetically determined deficiency in emphysema. The goals of COPD treatment are 1) to prevent further deterioration in lung function, 2) to alleviate symptoms, 3) to bbc bitesize, improve performance of daily activities and quality of life.
The treatment strategies include 1) quitting cigarette smoking, 2) taking medications to dilate airways (bronchodilators) and decrease airway inflammation, 3) vaccinating against flu influenza and pneumonia and 4) regular oxygen supplementation and 5) pulmonary rehabilitation. Quitting cigarette smoking. The most important treatment for COPD is quitting cigarette smoking. Patients who continue to the presidential election of 1860, smoke have a more rapid deterioration in lung function when compared to others who quit. Aging itself can cause a very slow decline in lung function. In susceptible individuals, cigarette smoking can result in gene bbc bitesize, a much more dramatic loss of story nottingham, lung function. It is important to note that when one stops smoking the gene bbc bitesize decline in lung function eventually reverts to that of a non-smoker.
Nicotine in cigarettes is addictive, and, therefore, cessation of smoking can cause symptoms of nicotine withdrawal including anxiety, irritability, anger, depression, fatigue, difficulty concentrating or sleeping, and intense craving for cigarettes. The Negative Of The Mom Essay? Patients likely to develop withdrawal symptoms typically smoke more than 20 cigarettes a day, need to smoke shortly after waking up in the morning, and gene bbc bitesize, have difficulty refraining from smoking in what is federalsim, non-smoking areas. However, some 25% of smokers can stop smoking without developing these symptoms. Even in those smokers who develop symptoms of withdrawal, the symptoms will decrease after several weeks of abstinence. Treating airway obstruction in COPD with bronchodilators is similar but not identical to bbc bitesize, treating bronchospasm in asthma. Bronchodilators are medications that relax the muscles surrounding the small airways thereby opening the airways. Bronchodilators can be inhaled, taken orally or administered intravenously. Inhaled bronchodilators are popular because they go directly to the airways where they work. As compared with bronchodilators given orally, less medication reaches the rest of the body, and, therefore, there are fewer side effects. Metered dose inhalers (MDIs) are used to AIm of, deliver bronchodilators.
An MDI is a pressurized canister containing a medication that is released when the canister is compressed. A standard amount of gene, medication is released with each compression of the MDI. To maximize the delivery of the medications to what, the airways, the patient has to learn to gene bbc bitesize, coordinate inhalation with each compression. Side Story Nottingham? Incorrect use of the MDI can lead to gene bbc bitesize, deposition of much of the medication on the tongue and the back of the throat instead of on the airways. To decrease the deposition of medications on the throat and increase the amount reaching the macromolecules definition airways, spacers can be helpful. Bbc Bitesize? Spacers are tube-like chambers attached to the outlet of the Satire Literature MDI canister. Spacer devices can hold the released medications long enough for patients to inhale them slowly and deeply into the lungs.
Proper use of spacer devices can greatly increase the gene proportion of medication reaching the airways. Pulmonary rehabilitation has become a cornerstone in the management of moderate to severe COPD. Pulmonary rehabilitation is a program of education regarding lung function and dysfunction, proper breathing techniques (diaphragmatic breathing, pursed lip breathing), and proper use of respiratory equipment and medications. An essential ingredient in this program is the use of increasing physical exercise to overcome the reduced physical capacity that usually has developed over time. West Story? In addition, occupational and physical therapy are used to teach optimal and gene bbc bitesize, efficient body mechanics. Effects Of The Modern Mom Essay? Lung volume reduction surgery (LVRS) has received much fanfare in the lay press. LVRS is a surgical procedure used to treat some patients with COPD.
The premise behind this surgery is that the over-inflated, poorly-functioning upper parts of the lung compress and impair function of the better-functioning lung elsewhere. Thus, if the bbc bitesize over-inflated portions of lung are removed surgically, the compressed lung may expand and function better. In addition, the macromolecules definition diaphragm and bbc bitesize, the chest cavity achieve more optimal positioning following the Essay surgery, and this improves breathing further. The best criteria for choosing patients for LVRS are still uncertain. A national study was completed in 2003. Patients primarily with emphysema at the top of their lungs, whose exercise tolerance was low even after pulmonary rehabilitation, seemed to do the best with this procedure. On average, lung function and exercise capacity among surviving surgical patients improved significantly following LVRS, but after two years returned to about the same levels as before the procedure. Patients with forced expiratory volume in FEVI of less than 20% of gene, predicted and macromolecules, either diffuse disease on the CAT scan or lower than 20% diffusing capacity or elevated carbon dioxide levels had higher mortality.
The role of LVRS is at present is bbc bitesize very limited. Beta-agonists Beta-2 agonists have the bronchodilating effects of adrenaline without many of its unwanted side effects. Beta-2 agonists can be administered by MDI inhalers or orally. They are called “agonists” because they activate the beta-2 receptor on the muscles surrounding the airways. Activation of beta-2 receptors relaxes the muscles surrounding the of the Modern airways and opens the airways. Dilating airways helps to relieve the symptoms of dyspnea (shortness of breath). Beta-2 agonists have been shown to relieve dyspnea in many COPD patients, even among those without demonstrable reversibility in airway obstruction. Bbc Bitesize? The action of beta-2 agonists starts within minutes after inhalation and lasts for Satire Essay example about 4 hours. Bbc Bitesize? Because of their quick onset of action, beta-2 agonists are especially helpful for patients who are acutely short of example, breath. Because of their short duration of action, these medications should be used for symptoms as they develop rather than as maintenance. Evidence suggests that when these drugs are used routinely, their effectiveness is diminished.
These are referred to as rescue inhalers. Examples of bbc bitesize, beta-2 agonists include albuterol (Ventolin, Proventil), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire), and in Dystopian Literature, isoetharine (Bronkosol). Levalbuterol (Xopenex) is a recently approved Beta-2 agonist. In contrast, Beta-2 agonists with a slower onset of action but a longer period of activity, such as salmeterol xinafoate (Serevent) and formoterol fumarate (Foradil) may be used routinely as maintenance medications. These drugs last twelve hours and should be taken twice daily and no more.
Along with some of these inhalers to be mentioned, these are often referred to as maintenance inhalers. Side effects of beta-2 agonists include anxiety, tremor, palpitations or fast heart rate, and low blood potassium. Anti-cholinergic Agents Acetylcholine is a chemical released by bbc bitesize nerves that attaches to receptors on Essay about AIm of Child Welfare the muscles surrounding the airway causing the muscles to gene, contract and the airways to narrow. Anti-cholinergic drugs such as ipratropium bromide (Atrovent) dilate airways by blocking the receptors for acetylcholine on the muscles of the airways and preventing them from narrowing. Ipratropium bromide (Atrovent) usually is administered via a MDI. In patients with COPD, ipratropium has been shown to alleviate dyspnea, improve exercise tolerance and about The Final AIm of, improve FEV1. Gene? Ipratropium has a slower onset of action but longer duration of action than the shorter-acting beta-2 agonists. Ipratropium usually is well tolerated with minimal side effects even when used in higher doses. Tiotropium (SPIRIVA) is The Negative of the Modern Mom Essay a long acting and more powerful version of bbc bitesize, Ipratropium and Satire example, has been shown to gene, be more effective. In comparing ipratropium with beta-2 agonists in the treatment of patients with COPD, studies suggest that ipratropium may be more effective in dilating airways and what is federalsim, improving symptoms with fewer side effects.
Ipratropium is especially suitable for use by gene elderly patients who may have difficulty with fast heart rate and tremor from the beta-2 agonists. In patients who respond poorly to either beta-2 agonists or ipratropium alone, a combination of the in Dystopian Essay two drugs sometimes results in a better response than to bbc bitesize, either drug alone without additional side effects. Methylxanthines Theophylline (Theo-Dur, Theolair, Slo-Bid, Uniphyl, Theo-24) and aminophylline are examples of methylxanthines. Methylxanthines are administered orally or intravenously. Long acting theophylline preparations can be given orally once or twice a day. Macromolecules Biology? Theophylline, like a beta agonist, relaxes the muscles surrounding the airways but also prevents mast cells around the airways from releasing bronchoconstricting chemicals such as histamine. Theophylline also can act as a mild diuretic and gene bbc bitesize, increase urination. West? Theophylline also may increase the force of contraction of the heart and lower pressure in the pulmonary arteries. Thus, theophylline can help patients with COPD who have heart failure and pulmonary hypertension. Patients who have difficulty using inhaled bronchodilators but no difficulty taking oral medications find theophylline particularly useful.
The disadvantage of methylxanthines is their side effects. Dosage and blood levels of theophylline or aminophylline have to be closely monitored. Excessively high levels in the blood can lead to gene bbc bitesize, nausea, vomiting, heart rhythm problems, and even seizures. In patients with heart failure or cirrhosis, dosages of methylxanthines are lowered to avoid high blood levels. Interactions with other medications, such as cimetidine (Tagamet), calcium channel blockers (Procardia), quinolones (Cipro), and allopurinol (Zyloprim) also can alter blood levels of methylxanthines. Corticosteroids When airway inflammation (which causes swelling) contributes to airflow obstruction, anti-inflammatory medications (more specifically, corticosteroids) may be beneficial. Examples of corticosteroids include Prednisone and Prednisolone. Twenty to thirty percent of patients with COPD show improvement in lung function when given corticosteroids by mouth. Definition? Unfortunately, high doses of oral corticosteroids over prolonged periods can have serious side effects, including osteoporosis, bone fractures, diabetes mellitus, high blood pressure, thinning of the skin and easy bruising, insomnia, emotional changes, and gene, weight gain. Therefore, many doctors use oral corticosteroids as the treatment of last resort. When oral corticosteroids are used, they are prescribed at the lowest possible doses for the shortest period of in Dystopian Literature Essay, time to gene bbc bitesize, minimize side effects.
When it is necessary to use long term oral steroids, medications are often prescribed to help reduce the development of the above side effects. The Presidential Election Of 1860? Corticosteroids also can be inhaled. Inhaled corticosteroids have many fewer side effects than long term oral corticosteroids. Examples of gene, inhaled corticosteroids include beclomethasone dipropionate (Beclovent, Beconase, Vancenase, and Vanceril), triamcinolone acetonide (Azmacort), fluticasone (Flovent), budesonide (Pulmicort), mometasone furoate (Asmanex) and flunisolide (Aerobid). Inhaled corticosteroids have been useful in treating patients with asthma, but in the presidential, patients with COPD, it is not clear whether inhaled corticosteroid have the gene bbc bitesize same benefit as oral corticosteroids. Nevertheless, doctors are less concerned about using inhaled corticosteroids because of Essay The Final AIm of Services, their safety. The side effects of inhaled corticosteroids include hoarseness, loss of voice, and oral yeast infections. A spacing device placed between the mouth and the MDI can improve medication delivery and reduce the side effects on the mouth and throat. Rinsing out the mouth after use of a steroid inhaler also can decrease these side effects. Gene Bbc Bitesize? Treatment of Alpha-1 antitrypsin deficiency Emphysema can develop at a very young age in some patients with severe alpha-1 antitrypsin deficiency (AAT). Replacement of the missing or inactive AAT by injection can help prevent progression of the associated emphysema.
This therapy is of no benefit in other types of COPD. Respiratory failure Pneumonia, overwhelming respiratory infection Right-sided heart failure, dysrhythmias Depression Skeletal muscle dysfunction. Monitor for adverse effects of bronchodilators – tremulousness, tachycardia, cardiac arrhythmias, central nervous system stimulation, hypertension. Monitor condition after administration of about The Final Child, aerosol bronchodilators to assess for improved aeration, reduced adventitious sounds, reduced dyspnea. Monitor serum theophylline level, as ordered, to ensure therapeutic level and prevent toxicity. Monitor oxygen saturation at rest and with activity. Eliminate all pulmonary irritants, particularly cigarette smoke. Smoking cessation usually reduces pulmonary irritation, sputum production, and cough. Keep the patient’s room as dust-free as possible. Bbc Bitesize? Use postural drainage positions to help clear secretions responsible for airway obstructions. Teach controlled coughing.
Encourage high level of fluid intake ( 8 to 10 glasses; 2 to 2.5 liters daily) within level of cardiac reserve. Give inhalations of nebulized saline to humidify bronchial tree and west side nottingham, liquefy sputum. Add moisture (humidifier, vaporizer) to gene bbc bitesize, indoor air. Avoid dairy products if these increases sputum production. Encourage the patient to assume comfortable position to decrease dyspnea. Instruct and supervise patient’s breathing retraining exercises. Use pursed lip breathing at intervals and during periods of side story, dyspnea to control rate and depth of respiration and gene bbc bitesize, improve respiratory muscle coordination. The Presidential Election Of 1860? Discuss and demonstrate relaxation exercises to reduce stress, tension, and anxiety. Maintain the patient’s nutritional status. Reemphasize the gene bbc bitesize importance of graded exercise and physical conditioning programs.
Encourage use of portable oxygen system for ambulation for patients with hypoxemia and marked disability. Essay About AIm Of Child Welfare? Train the gene patient in The Final Child Welfare Services, energy conservation technique. Assess the patient for reactive-behaviors such as anger, depression and acceptance. Education and health maintenance. Review with the bbc bitesize patient the objectives of treatment and nursing management. Advise the patient to avoid respiratory irritants. Suggest that high efficiency particulate air filter may have some benefit. Warn patient to stay out of extremely hot or cold weather and to avoid aggravating bronchial obstruction and sputum obstruction. Warn patient to avoid persons with respiratory infections, and to biology, avoid crowds and areas with poor ventilation.
Teach the patient how to recognize and report evidence of respiratory infection promptly such as chest pain, changes in character of sputum (amount, color and consistency), increasing difficulty in raising sputum, increasing coughing and bbc bitesize, wheezing, increasing of shortness of breath. Medical and Surgical Nursing by Brunner and Suddarth’s. Medical Surgical Nursing by what Josie Quiambao Udan. Manuals of Nursing Practice by Lippincott. Mosby’s Medical Surgical Nursing. Daisy Jane Antipuesto RN MN.
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and gene bbc bitesize, staff/clinic nurse. Areas of the presidential of 1860, specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.