nursing writing help online

Advantages and challenges of ordering nursing writing help online

Sometimes students find that they reach a mental roadblock and it is an unfortunate position when the deadlines for an academic paper or several of them are approaching. An assumption that students are in school and should always be in the right mental frame to handle academic assignment is not always right.

Everyone at times struggles to pick the right topic, plan the writing approach and find a credible source of materials. A work overload burnout the students that sometimes one more assignment becomes impossible to write. The deadline does not change, and students consider an option to hire professional academic writers who perform in-depth research and turn it into a high-grade paper rather than submit work late.

What are the pros of hiring a nursing writing company to undertake your assignment?

Opportunity to work with a professionalGetting help from a writing service does not mean that it will water down your educational skills. It does not prevent you from doing part of the work required to complete a nursing paper. You can, for example, delegate the task of writing but perform the background research. If your project involves creating scientific reports such as preparing a lab report, the chances are that all the necessary research is readyand with planning your writer will use the data to develop a presentation in the form of words.

Professional writers have a way with words to make it extremely appealing to read highly scientific or scholarly materials.It is essential to hire a writing service that matches customers with writers who specialize in the areas of the papers subjects. They are aware of the writing requirements and a good grasp of the matter thus can point out factual errors and gaps in research.

Satisfaction guaranteeNo one wants to submit academic work without confidence that it is the best. Otherwise, it risks getting a low grade. Fear of low-quality content and lack of satisfaction is the reason why you might put off thought to hire a nursing writing service.

Positive news about nursing writing services is that many offer a satisfaction guarantee and will write an academic paper to perfection. They even agree to offer a free revision to any customers who are unhappy about the quality of their work. It is an opportunity for customers to work with their writers to fine-tune the papers and rectify mistakes until they become happy with their products. The seconds chance should is a reason why students should be careful before making their payment by checking at the status of satisfaction guarantee. The credible writing service agrees to provide free revision or money back.

Challenges of ordering nursing writing help online

CostThe cost of hiring a nursing writer is one of the reasons why students fight it challenging. All the writing services are not costly, but it creates a fear that they are unable to retain a team of skilled writers at their cost.

Hiring a writing service should not rely on the cost alone without thinking about the quality of the product. It isnecessary to find a writing service with professional writers and plenty of experience in the subject of your paper. Make a point of asking for qualifications by a writer and a short sample of your work. You will find it a superb idea to pay a professional writer rather than save money on a writing service that might end up ruining the grades and creating a need to perform extensive corrections when the deadline is approaching quickly.

Risk of plagiarismPlagiarism in academic writing causes dire consequences. The fear among the students is that they might get a writer who generates content that is very similar to other pieces or lacks proper referencing. Such papers can put you at loggerheads with professors because they will think you deliberately stolework by other author and that you do not understand the subject. The faculty might decide you cannot graduate if your end of program projects has plagiarism that makes them doubt your knowledge.

Always search for a writer of professional writing service that believes in writing nursing academic content from sources in different words and proper referencing o0f direct quotes. Ask for a plagiarism report from a reliable checker to be sent with your completed order because a nursing writer who writes unique content will not have problems with the request.

A premium writing service with experience should be your target when searching for writing help rather than a company without a track record.

How to write a nursing case study essay

How to write a nursing case study essay

A nursing case study is a comprehensive report about a patient that students write during their encounter with the ill during everyday practice during the practicum. They provide essential learning experiences as students can apply their theoretical learning to actual situations to even make conclusions and conclusions. Writing a literature review takes much planning of a methodology, literature review, and accurate documentation while proceeding with the case study.

A well-written case study becomes a guide to care for patients as it shows the expectation as a prognosis, right questions to ask and ways to take care of the patient. You should present all cases is a realistic manner that helps to understand the realities of modern nursing practice.


Sections to Write In a Nursing Case Study Essay


A nursing case study has three large sections. The sections provide patient’s information, assessment of the status and a treatment plan that includes the recommendations. All the details in the case study relate, but they should be in these sub-sections.



Patient status


Patient information is the first portion of a case study paper. It begins by laying out personal information about:


    • Who the patient is
    • Reason for inclusion in the study
    • Demographic data such as age and age
    • Reasons for seeking medical attention
    • Subsequent diagnosis

A patient’s status section also discusses the role of a nurse in the care of a patient in the case study.

A follow-up step is to discuss any process of the disease by outlining causes, symptoms, observations and the way that preferred treatments might affect nursing care. Remember to describe if the patient has a history with the disease and the progression. Some of the essential questions to answer are:

  • The first indications of something wrong with the health
  • The symptoms that made a patient to get a conviction that it was right to seek medical help


Nursing assessment


A discussion of a nursing assessment of the patient should describe the problems according to nursing diagnoses. The writer should identify a specific reason for determining a particular diagnosis. A nursing diagnosis should help to form a nursing care plan. For example, are a patient’s irregular sleeping patterns as a result of frequent urination?



Current treatment and recommendations to improve it


A third section of a nursing care plan describes the care and treatment that a patient is receiving by medication or therapy. It further explains the appropriateness of each treatment by discussing the way care plans are improving the quality of life for the patient.


It is also essential to describe:

  • Expected positive changes to the patient life after treatment
  • Method of executing the care plan
  • A person responsible for delivering the care plan
  • Measurable goals to track and determine the success of a plan

The last discussion should be personal recommendations. Recommend other actions to take to improve the chances of patient recovery based on current health status, diagnosis, and prognosis and care plan. Supporting proposals with authoritative and well-cited sources is essential.



Highlights of a Nursing Case Study Essay


It is the role of a nursing student to document any treatment activities by recording information such as dose and track the presence or lack of improvement. Always start by analyzing data before making a decision about the efficacy of a treatment plan and making conclusions.


Instructors grade a nursing case study according to the content quality of the case study essay and formatting. You should take time to format everything in the required format.

Common Nursing Assignments

Common Nursing Assignments

The primary concern of nursing education is to train nurses about the provision of quality care to their patients and families. It demands the technical experience together with an appropriate expressing of ideas by presenting information in the written form. Writing in nursing will involve combining of terminology and general language, but it must follow the standards of scholarly writing. There are many assignments that nursing students write to exhibit their knowledge of the subject as well as showing their ability to express ideas.


The Most Common Nursing Assignments


There are different expectations for various nursing assignments, but these are the assignments that everyone in a nursing program will write.




An essay is a short assignment on a topic that a student or a lecturer chooses. Most essays are short comprising of five paragraphs with an introduction, the body, and a conclusion. It gauges knowledge of a topic and tests writing skills.


Term paper


A term paper is an extended essay that students write at the end f an academic term on a topic they covered during this time. Developing term papers requires researching for information from various credible sources to find evidence that supports the arguments.


Case Study


Case studies report of the investigations on one or more patients having an illness or a health condition to determine the circumstances behind the happening. Students write it is during practicum to reveal the patient’s demographic information, diagnosis, current care plan, and recommendations.


Nursing report


An analysis of a situation, its progress and the way it might change nursing practice. A report is the end product of an investigation and background research.



One of the most contributors to overall grade is a coursework paper as it covers the academic areas that student has covered during an academic year. It combines finding from experiments and research work that students write over days or weeks because it is long





PowerPoint assignment is information on a particular subject that is presented in the form of slides that a student creates with special software. The purpose is to create something that a student can present visually before an audience.





A thesis is a lengthy academic paper presenting research findings on a topic chosen by the student within a nursing specialty. This assignment is for students pursuing their Masters in nursing degree. The work should be original in the format as well as a citation that the nursing school uses.



Capstone project


This is a project is one of the last academic projects in a study program presenting evidence-based solutions to a real problem. Raw data derived from primary sources and published literature provides a new concept that is a problem solution ready for adoption by other people.





A dissertation is a project at the end of a PhD in nursing program assessing the knowledge that a student has about nursing and if it is enough to qualify for a terminal degree. It presents research findings from independent sources on a chosen topic in the instructed format.

Resources to use writing a nursing paper

Resources to use writing a nursing paper

A nursing paper is a piece that presents scholarly arguments, ideas, and solutions based on evidence from credible sources. It is not a personal opinion but a presentation of informed arguments.A well-written case study becomes a guide to care for patients as it shows the expectation as a prognosis, right questions to ask and ways to take care of the patient. You should present all cases is a realistic manner that helps to understand the realities of modern nursing practice.


Type of Resources to Use Writing A Nursing Paper



Primary research source


Primary sources are mixed materials that serve as a basis of various studies. They include surveys, interviews, diaries, records, fieldwork, and peer-reviewed research papers published in journals.



Secondary sources


These are resources that contain a description or analysis of the primary sources. Examples of secondary sources include:


  • Books that describe or analyze another resource
  • Articles
  • Textbooks
  • Encyclopedias




Resources that organize primary and secondary materials including: Abstracts-Provide a summary of different primary as well as secondary sources, Indexes-An index comprises of bibliographic information of various materials, Databases-A database serves as an online index. It might contain abstracts or digital copies of different reliable sources.



Different Resources to Use Writing a Nursing Paper



Peer-reviewed journals


Peers reviewed journals are one of the best places to find research resources for the nursing discipline. Journals are the publications where authorities in the field from scientists, researchers to clinicians publish their findings. Peer reviews journals are extremely reliable for research as content has gone through proper evaluation by professionals for quality and relevance by professionals in the field.


There are many journals on broad issues in the medical and nursing field. Some are on particular topics relevant to care giving or a particular area of medicine. Publine and Medline are some of the databases that maintain a wide range of journals.

Informational websites


There are many reliable websites with information on health topics, but the best are those with information or statistics that trace back to the source. Some of the reliable informational websites are by credible institutions including:

  • National Institutes of Health (NIH)
  • National Institute of Nursing Research
  • Medline Plus
  • World Health Organization


Professional societies


Professional societies and organizations are one of the best places to research for issues in nursing .some also publish journals, newsletters, and conference proceedings. It is simpler to find particular information from professional bodies than starting a larger database. Some of them maintain resources and job boards that help nursing students to get practicing opportunities after graduating. Some of the professional societies and organizations dealing with nursing issues include:


  • The American Association of Nurse Practitioners
  • American Nurses Association
  • Association of Women’s Health, Obstetric, and Neonatal Nursing
  • Oncology Nursing Society
  • Hospice and Palliative Nurses Association


Other Resources to Use Writing a Nursing Paper


  • Newspapers
  • Magazines and trade journals
  • Newsletters
  • Short articles of one or two pages
  • Electronic sources
  • Interviews


Evaluating Resources to Use Writing A Nursing Paper


Academic work should be factual. It is important to start by evaluating the sources. The quality of research will below as the data available might lead to some incorrect conclusions if the information that you rely on is from untrustworthy sources.


Take some time to investigate the credentials of the authors to determine if their education and experience give them the authority to discuss a topic. Other work by the same authors helps to determine if they are consistent in writing relevant works. Be careful about information from a source that does not list the names of authors.


Purpose and the audience of information is also a good indicator of its reliability. The best resources target the specific audience, and the content is from experts. Materials with the intention of educating readers without promotional or persuasion intention are likely to be more reliable as they present straight facts

How to get top marks in your nursing assignments

How to get top marks in your nursing assignments

A nursing assignment is a paper with a particular topic focusing on a particularly pertinent issue. The information in a nursing paper is research-based to support the arguments with credible facts.


Tips to Get Top Marks in Your Nursing Assignments


An assignment contributes to the grade that a student attains. Proper planning and writing are essential in enabling students to get a top grade. Getting a top grade depends on the way that a student handles the assignment even before writing the paper. These steps help to attain the top marks



Analyze the topic critically


Understand the topic question to answer before starting to write by reading and analyzing every word. Find the meaning of any unfamiliar word from a reliable dictionary or seek clarification from a knowledgeable source. It is essential to consider limiting words such as “provide an analysis of the scope” or “evaluate the advantages of the process.” Pay attention to everything that makes a nursing assignment to be more specific.



Understand the grading


It is essential for students to determine the way an examiner distributes marks. A good student will go through an assessment checklist that helps to resolve the issues that an examiner is testing. The action enables focusing on the fields that win more marks.



Proper time planning


Create a time table allocating adequate moment for all the activities that are necessary to completing an assignment such as research, writing the draft, revising and editing. Stick to the timelines.



Research for reliable information


The hunt for information that helps to support the points in a paper should start after understanding the topic and awarding of marks. Books and the internet are some sources of credible information. Online sources help to find relevant information when there is no time to visit a nursing school library. Get much information as possible about the subject.

Writing To Get Top Marks in Your Nursing Assignments


Writing requirement for assignment might differ, but it is essential to ensure that there is clarity by ordering the sections in the following manner:





The first paragraph in the assignment to give examiners a clear preview of your discussion and that you understand the subject. You can prove your understanding by writing the topic question in your words and state your stand in the thesis statement. You can skip writing the introduction until you complete writing the entire assignment for it to be an actual summary of everything in the paper.





The body is the point to present your arguments to support the thesis statement without deviation. Use the evidence from research to support the claims but cite the direct quotes when answering the topic question. Use different paragraphs for each idea, but they should have a similar structure.





A conclusion brings your assignment to a logical conclusion to prevent an abrupt stop. Restate the main ideas and highlight the areas that require further research in the future but do not introduce new ideas. Complete the first draft early as you can to leave time for taking a break and proofreading with a fresh mind.



Proofreading To Get Top in Your Nursing Assignments


Always proofread an assignment to ensure that the content answers the topic question. Remove or add something that will help to improve quality. Correct all the grammar and spelling errors as well as the citations.


The ability to get top marks in nursing assignments starts with understanding the topic, researching for credible information and adherence to instructions as well expectations be the examiner when writing.

Writing career for nurses

Writing career for nurses

Many people only think of nursing professionals as workers in healthcare facilities, but it is not the case always. Nurses can take different roles but still use their educational and skills. Nurses are also taking non-traditional roles and writing is one of them.


Joining a Writing Career For Nurses



Identify the writing platform


There are numerous writing opportunities for nurses, and they can be publications or online. Read various publications that specialize in writing on nursing and healthcare to determine the one that suits your interests. Extend your search online as it has become a great platform for writers to gain and reach thousands of readers.


Nursing publications have their audience and purpose your planned topics should fit. You should also pay attention to the formatting. Consider the issues such as headings and subheadings to help you in structuring an article according to the style.



Study writer guidelines


Determine the content layout guidelines and any other essential information for the authors. Chances of getting published improve by adhering to a particular style. Guidelines also provide directions on the way to submit articles. Some prefer that the writer pitches an idea through a query by a letter while others just require a manuscript.



Choose a compelling topic


Write and send an article or research on a topic that draws your passion to the editor of your chosen publication or online platform. Start by writing smaller pieces to prevent the risk of developing a writer’s block. You will be ready to write more content like a long journal article as you gain confidence and experience, Choose one compelling topic that you can adhere to without jumping back and forth to others. You should also create a suitable outline from the beginning. It is essential to get professional feedback from a friend or colleague to determine the erroneous sections.



Prepare to revise


If an online or offline publication expresses an interest in our contribution, it might have some conditions that require revising or even rewriting. You might also need to rectify small or intensive issues such as inconsistencies in terminology, adding more statistics or incorporating more references.

Common Opportunities to a Writing Career for Nurses



Magazines and journals


Nursing professionals have numerous opportunities to write for well-established journals and magazines. These types of publications are usually searching for writers of editorial content with industrial experience to provide compelling pieces for a nursing audience. Nurses can communicate better to the audiences than writers without any industrial experience. The knowledge and experience in the nursing industry allow nurses to provide informative details that nurses can read and apply in healthcare duties.



Medical writing


Nurses with a passion for writing can fulfill their desire by working as a medical writer in another way for. Medical writing involves covering different topics on research, general medication, and regulation. Different types of media accept the work of medical writers. These include:


  • Textbooks
  • Patient handbooks
  • Insurance documents
  • Marketing brochures and other marketing materials
  • Research and grant materials
  • Websites

Medical writing requires researching and writing about the findings in a manner that is informative to the industry specialists and still simple to understand by the average readers.



Nursing blog


A blog is a website or webpage that get regular updates. Nurses can use their professional knowledge to write frequent content for updating a nursing blog. They can also start their blogs. It requires creating an appealing name, identifying the host and an information gap that requires filing with well-researched content. A blog requires informative content with an appeal that makes readers to get a desire for visiting the blog frequently.

A writing career for nurses is possible even if it begins with part-time contributions. A nurse can efficiently provide health information and tips to readers. The role can also extend to editing and proofreading.

How to survive and thrive in a nursing career

How to survive and thrive in a nursing career

The primary role of nursing is to care of the patients to enable them to recover from their medical condition. Nursing can be hectic due to long shifts and working in stressful situations. These are difficult situation nut part of the job and should not prevent a nurse from surviving in the position and thriving.


Tips For Surviving and Thrive In a Nursing Career


Nursing can on certain occasions feel incredibly stressful, but there are ways for a nurse to combat the stressors and make their work to be more fulfilling.



Be positive


Staying positive about the job is one of the helpful ways for nurses to reduce stress levels and improve their mood. It is not difficult as it seems and is still very important because most of the experiences in life and reactions towards some conditions are beyond control. The way to handle experiences that are beyond is to change perception on them and improve the overall happiness. Having a positive attitude helps to pull through the difficult issues even when you do not have an immediate solution.



Set realistic goals


There is much to struggle about nursing especially for newly hired nurses. A useful way of adapting to nursing life or shift is to set small, realistic goals. Setting achievable goals helps to simplify the completion of tasks and builds confidence. Try to set a target that enables you to learn something new each day. Learning a new fact or task helps a nurse to feel successful rather than feel defeated for failing to understand some things.



Learn to prioritize


A nurse taking care of a high acuity patient or a few with different needs can be overwhelmed. These are everyday situations in nursing, and both lead to a multitude of tasks necessary to take care of the patient. It is essential to break down a shift into hourly portions. Start by determining the critical and least important task to complete within an hour. It is a method that helps in organizing tasks are reacting appropriately if something unexpected happens.

Create a rapport with coworkers


Take time to know new colleagues and interact with those you know. Memorize their names and make a habit of exchanging greetings. The habit enables you to develop a relationship over time and create a network of people you can trust. You fellow nurses will be supporting you during the difficult moments and emergencies which are essential for survival in nursing.


Ask questions when in doubt


One of the best ways to learn in nursing is to ask questions especially when you are new to an area of practice. It is natural to fear to ask questions because it is an admission of ignorance, but nobody knows everything. The courage to ask helps to increase the knowledge in a nurse. You can write a list of all questions you have when the situation does not allow deviation such as an emergency from the task at hand and ask them during downtime.



Create time to relax


Do not think about work when you get time off. Use the time to de-stress by relaxing to eliminate the fatigue accumulated over the working days. Engaging in a hobby or pursuing relaxing outdoor fun activities such as hiking helps. It is better if you can hang out with non-nursing friends who are unlikely to discuss your work.


You can survive and thrive in a nursing career if you organize your work well to prevent burnout, create relaxing time and develop the right attitude.

Joshua Case Study

Joshua Case Study

From the readings of the case study presented involving Joshua, it is clear that a psychiatric evaluation is needed. Developmental history is usually essential in any psychiatric assessment of patients across all the ages. Therefore, for Joshua’s case study, getting the developmental history from his parents is necessary. Included in the developmental history of Joshua is the prenatal stage, which usually influences the infancy and childhood stages of life to a significant extent. In addition to the developmental history, there is a need to include the family psychiatric history in the assessment data for this child.

Therefore, there are many additional questions that would result in obtaining comprehensive information about the mental health of this client. One of the leading questions is if the mother had any episodes or experience of psychiatric illness during the antenatal or the prenatal period. This question would be followed by inquiry of any psychiatric evaluation and treatment-experienced by the mother while pregnant for Joshua. Information obtained from these two questions will play essential roles in the understanding of the developmental process of Joshua. Fetal developmental in the uterus is subject to maternal emotional and psychological stresses. Treatment modalities to psychological disorders such as the use of antidepressants have significant negative impacts on how the fetus develops (Carlat, 2016). As a result, having the perinatal history and experiences of the mother is essential in determining the definitive cause and the status of the currently observed condition in Joshua.

Another important aspect of evaluating this child is asking the mother to provide a comprehensive past medical report of the child since he was born. The history will involve the onset of the illness, how it progressed and the types of treatment that the child received during the illness period. Having such information is essentials since some psychiatric illness occurs due to complications of some medical conditions and or adverse reactions of some medications (Carlat, 2016). The previous history of psychological assessment and the outcomes will also be asked to determine if there is any connection between previous mental disorders and the currently observed. Sally is a 7-year-old female child. At this age, she is expected to have developed both physical and social aspects. One of the physical aspects at this age is the falling out of the baby teach and the growth of permanent teeth to replace the lost ones. Social aspects range from language to learning skills. At the age of seven, Sally is expected to have developed better language skills and can communicate clearly. Learning skills such as spelling of words correctly and backwards is also expected. The child, at this age, also knows time and days. Identity of playing groups is expected as girls and girls play together, which is a similar case to the boys.



Bowen Family System Theory use during a family interview


Bowen’s Family System Theory is one of the psychoanalytic theory that tries to explain or describe a family as a unit joined together by emotions that form the basis of relationships. All members of the family have that emotional bond that acts to form both internal and external relationship. It is believed that emotional behaviour and actions of the individual usually influences the entire family according to this theory (Cepeda & Gotanco, 2016). Using this theory to evaluate the case of Joshua is, therefore, appropriate. The first approach would be to determine the extent or level of the impact on Joshua’s sickness on the general emotional aspect of the family. Questions would, therefore, focus on the state of family relationship both before and after Joshua become mentally sick.

Any cultural consideration to apply when working with the Jones family


Cultural aspects usually influence how members of the family relationship and also seek healthcare assistance. It is, therefore, necessary to take into consideration the cultural practices of this family. Child-parent attachment is usually influenced by culture. How children develop is also influenced by their relationship with their parents (Cepeda & Gotanco, 2016). Another consideration to consider in this case is communication and conflict -resolution. Different cultures have different communication process and conflict resolution strategies. It is, therefore, important to pay attention to these cultural factors and how they affected the developmental of Joshua.

Rusell Case Study

Rusell Case Study

Hypertension is one of the common cardiovascular diseases that affect many people in America. Statistics indicate that in every three adults, one is having hypertension that is either diagnosed or not. Hypertension is usually asymptomatic in its mild and moderate stages but can result in severe health complications with it reaches its advanced stages Cooper-Dehoff, R., & Johnson, J.A. (2016). It is also good to note that hypertension can be managed successfully with the use of medication and lifestyle modification.

For the above-mentioned patient, there is symptomatic hypertension, which is under pharmacological therapy. It is evident from the vital signs and the lab diagnostics that the condition is not well managed hence the need to develop a new plan of care to complement the current treatment strategies.



Treatment Goals for Mr. Rusell


The goal of treatment or management of Mr. Russel is to eliminate symptoms, prevent complications, and promote quality life. This will be achieved through the management of the underlying cause of the observed symptoms. Heart palpitations and lightheadedness are significant symptoms of hypertension that require immediate intervention. Therefore, to eliminate these alterations, there is a need to effectively treat hypertension. He has elevated blood pressure despite being on HCTZ 25mg daily; hence he is diagnosed with secondary hypertension. Treatment will, therefore, aim at introducing drugs that will lower blood pressure to the normal ranges and also do away with the edema of the legs, crackles in the lungs, and palpitations. It is also important to review the laboratory results by comparing the past and the present results with the standard levels of the electrolytes and nutrients such as lipoproteins. Antihypertensive drugs such as HCTZ have significant effects on electrolytes level; hence the patient should have regular electrolyte profile tests. The majority of these test result is borderline hence the need to monitor them. Lastly, the management of this patient will also aim at educating the patient on the proper lifestyle behaviors to promote recovery and prevent complications.

Pharmacological Plan for Mr. Rusell


Currently, the patient is on HCTZ 25mg daily, yet there are still symptoms of hypertension, meaning that drug therapy is not effective. There are two reasons for this phenomenon. One is that either she is not taking the drug as prescribed or the drug is not effective in reducing the blood pressure. There is a need to review the medication behaviors of the patient before making any other decision. Based on the symptoms, there is a need to add another drug to complement the roles of HCTZ. The appropriate drug of choice for the patient will be an ACE inhibitor. Lisinopril 10mg daily is the drug of choice, which works to reduce peripheral vascular resistance to blood flow (Parekh et al,. 2017). Combining this drug with HCTZ will result in better outcomes. The patient should be examined after a month to evaluate the effectiveness of drug therapy.


Health Education for the Patient.


Following the addition of a new drug, there are several health messages that the patient has to take home. First is that he need to learn the importance of adhering to drug therapy while it home. This is essential in ensuring that complications are prevented and promote quality life. Secondly, the patient has to learn how to monitor blood pressure regularly. He has to learn on the levels that require healthcare interventions (Cooper-Dehoff, & Johnson, 2016). Thirdly, the patient needs to learn on the side effects of the new drug and such as dry cough, headaches, and dizziness. He has to know when to seek healthcare interventions when symptoms persist. The fourthThe fourth health message necessary for the patient is the importance of proper nutritional practices and regular physical activity in the management of hypertension. He has to take diets without much sugars or lipids. Finally, the patient should quit smoke and alcohol consumption if he has such behaviors (American College of Cardiology, 2017).


How would your plan change if your patient is African American?


Racial difference influences the pathophysiology of diseases and response to therapy. If the client was African American, the risk of angioedema would be high. As a result I would have opted to channel blockers I place of ACE inhibitors. Studies show that calcium channel blockers are more effective than ACE inhibitors in African Americans (American College of Cardiology, 2017). Hence I would have chosen Amlodipine in place of Lisinopril.

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease

Some bugs also may occur together as primary entities or as secondary conditions to one another. Proper patient and disease management requires a comprehensive assessment of both objective and subjective clinical manifestation to come up with the correct diagnosis. Identification of patients disease is not only limited to primary diagnosis. Differential diagnosis has to be made since several diseases present with similar clinical symptoms. Differential diagnosis helps in preventing misdiagnosis and improper treatment. It, therefore, requires a proper assessment to identify the primary disease and make differential diagnoses for patients presenting with multiple signs and symptoms involving more than one system.

The patient mentioned above presents with both respiratory and cardiovascular symptoms. There is coughing, shortness of breath, sputum production, wheezing, increased anteroposterior diameter, flattened diaphragm, and increased blood pressure, history of smoking and peripheral vascular disease. To manage this patient properly, both primary and differential diagnosis has to be made based on the clinical presentation and diagnostic tests.



Differential Diagnosis



Chronic bronchitis


Chronic bronchitis is an inflammatory disease of the airways characterized by the presence of cough and production of sputum for over three months. Shortness of breath and increased respiratory rate are other primary characteristics of these conditions (Kim & Criner, 2015). It is common in children but also affects adults. Both the past and present history of smoking and pneumonia can lead to the development of bronchitis. The patient mentioned above in the case study presentation with a chronic cough, sputum production, shortness of breath, current history of smoking and history of pneumonia. With all these signs and symptoms, chronic bronchitis can be considered as one of differential diagnosis.



Asthma is an upper respiratory condition that is characterized by acute shortness of breath due to the narrowed airway. The narrowing of the airway is either due to obstruction by foreign objects such as secretions or inflammation of the airway structures (Postma, Dirkje, & Klaus, 2015). A cough and sputum are present in a patient with asthma, and any trigger can result in an increased rate of respiration. The disease is most common with a patient with a history of smoking and other pathological conditions involving both respiratory and cardiovascular systems. For the above case study, there is shortness of breath, coughing and sputum production. Smoking has also been reported with a history of pneumonia and hypertension. Therefore, asthma should be considered as a diagnosis for this patient.


Chronic Obstructive Pulmonary Disease


Chronic obstructive pulmonary disease is a disease defined by acute airway narrowing or total obstruction by either inflammation, different objective or secretions such as blood and mucus (Divo et al., 2015). The symptoms of this disease include chronic productive cough, shortness of breath, wheezing, prolonged respiratory phases, increased anteroposterior diameter and a higher rate of respiration (Bradstreet, & Parkman, 2016). History of smoking, respiratory conditions and cardiovascular disease increases the risk of developing this disease. The present case involves a patient with similar characteristics of the chronic obstructive respiratory condition and therefore should be considered during diagnosis.




Emphysema is a lower respiratory disease characterized by an abnormal enlargement, distention of the alveolar, and narrowing of the airway. This distention leads to increased dead space in the lungs reducing pulmonary capillary bed. This result in increased pulmonary blood supply, therefore, raising the blood pressure (Pahal & Sharma, 2018). Patients will have increased blood pressure, shortness of breath, cough and respiratory distress (Divo et al., 2015). The risk for alveolar impairment is increased by smoking and a history of respiratory disease. For the above patient, the signs of emphysema are present and therefore should be considered as one of the diagnosis.


Asthma-COPD Overlap Syndrome


This is a condition in which the symptoms of both asthma and COPD are present or overlapping. The symptoms include a cough, sputum production, tachypnea, apnea, and wheezing. The causes of these symptoms include infections, the presence of secretions in the airway or inflammatory obstruction due to an allergic reaction (Postma, Dirkje, & Klaus, 2015). Lifestyle practice such smoking can lead to these conditions. The present case has all the symptoms, and predisposing factors hence should be considered as one of the diagnosis.


Primary diagnosis


The primary diagnosis for the patient in the case study is emphysema. The characteristic symptom of this condition is damaged alveoli and narrowed airway resulting in impaired gaseous exchange in patients (Pahal & Sharma, 2018). Signs and effects of abnormal gaseous exchange are observed in patients such as shortness of breath, productive cough, increased respiratory rate, wheezing and respiratory distress (Bradstreet, & Parkman, 2016). Factors such as respiratory infections, and smoking increase the chance of one getting this disease (Tran et al., 2015). The presented case meets all the signs and symptoms of emphysema.


Diagnostic Tests


Diagnostic tests to confirm the presence of this condition include radiological and arterial blood gases. A chest X-ray is performed to visualize the patency of the airway and other pulmonary structures, and, to rule other chest conditions. (Hellbach et al., 2015). Arterial Blood Gases test are performed to measure the effectiveness of gaseous exchange in the lungs. Sputum analysis is done to identify the cause of pulmonary impairment. Pulmonary Function Test is done to assess the performance of the lungs.


Treatment and management


The goal of treating emphysema is to eliminate symptoms and prevent complications. Treatment involved both pharmacological and non-pharmacological approaches. The pharmacological approach includes the use of corticosteroid sand bronchodilators to clear secretions and prevent inflammations that cause airway narrowing (Pahal & Sharma, 2018). Antibiotics are also given to eliminate infectious agents from the respiratory system. Antihypertensive drugs are also provided to reduce elevated systolic blood pressure (Hillas, Perlikos, Tsiligianni, & Tzanakis, 2015). Non-pharmacological approaches are aimed at preventing the symptoms from progressing. They include suctioning of secretions if present. Advising the patient to quit smoking is also one of the methods of reducing the severity of the condition.