INTERNAE NAME: AQSA SHAMEER

ROLL NO : 376308
SESSION: 2019-2023
DEPARTMENT: HUMAN NUTRITION AND DIETITION

DEGREE: BS (HONS) HND

PLACEMENT OF INTERNSHIP: SOUTH PUNJAB HOSPITAL MULTAN

COLLEGE: KINGS COLLEGE OF HEALTH AND SCIENCE

 WARD ROTATION REPORT
WARD NO: 1
WARD-1 PLACEMENT:

PULMONOLOGY

BAHAWALPUR VICTORIA HOSPITAL

 DISEASE-1
Coronary Obstructive Pulmonary Disease:-
INTRODUCTION:

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that
cause breathing difficulties. It includes: emphysema – damage to the air sacs in the lungs.
chronic bronchitis – long-term inflammation of the airways.

ETIOLOGY:

Over time, exposure to irritants that damage your lungs and airways can cause chronic
obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. The
main cause of COPD is smoking, but nonsmokers can get COPD too.

SIGN & AND SYMPTOM

 wheezing, coughing and chest tightness becoming severe and constant.

 increasing breathlessness – this may only happen when exercising at first, and you may
sometimes wake up at night feeling breathless.
 a persistent chesty cough with phlegm that does not go away.
 frequent chest infections.
 persistent wheezing.
MAJOR COMPLICATIONS:

 Lung Infections
 Collapsed Lung (Pneumothorax)
 Poor Gas Exchange

MEDICAL TREATMENT:

Treatment for COPD usually involves lifestyle changes such as not smoking, eating healthy and
exercising more. Sometimes, medications and procedures are needed.

Medications

There are many drugs available to treat coronary pulomnary disease, including:

 Bronchodilators

 Inhaled steroid

Oral corticosteroids

 Leukotrine modifiers

MEDICAL NUTRITION THERAPY:

In addition to medication, changes to your diet can lead to better outcomes.

Things to avoid in asthma:-

The most common foods associated with allergic symptoms are:

 Eggs
 Cow's milk
  Peanuts
 Soy
 Wheat
 Fish
 Shrimp and other shellfish
 Tree nuts

DIETARY GUIDELINES:

 Keep fruit and vegetables readily available. Keep fresh fruits and vegetables ready for
consumption in your fridge. Slice them ahead of time for a quick snack in between meals.

 Reduce food portions. Reducing your food portions can help you consume fewer
calories, fat, and sodium.

 Cook with herbs. Instead of seasoning your food with table salt, experiment with
different types of herbs, spices, and salt-free seasoning blends. When buying canned
goods and condiments, look for low-salt or reduced salt alternatives.

 Read food labels. Get into a routine of reading food labels to avoid consuming too much
fat and sodium.

 Eat foods with omega-3 fatty acids. Omega-3 fatty acids -- found in fish like salmon,
tuna, and sardines and some plant sources, like flaxseed -- are believed to have a number of
health benefits. Although the evidence that they help with asthma is not clear, it’s still a good
idea to include them in your diet.


DISEASE-2
ASTHMA:-
INTRODUCTION:

Asthma is a disease that affects your lungs. It is one of the most common long-term diseases of
children, but adults can have asthma, too. Asthma causes wheezing, breathlessness, chest
tightness, and coughing at night or early in the morning.
 ETIOLOGY:

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and
symptoms of asthma. Asthma triggers are different from person to person and can include:
Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of cockroach
waste.

SIGN & AND SYMPTOM

 wheezing, coughing and chest tightness becoming severe and constant.

 being too breathless to eat, speak or sleep.
 breathing faster.
 a fast heartbeat.
 drowsiness, confusion, exhaustion or dizziness.
 blue lips or fingers.
 Fainting.

MAJOR COMPLICATIONS:

Many of the signs, symptoms, and risk factors associated with asthma are the same in adults and
children. However, there are a few differences between pediatric and adult-onset asthma:

 Asthma is more common in boys than in girls until the onset of puberty. Adult-onset
asthma is more common in women than men.
 In some cases, childhood asthma may completely disappear before adulthood. Adults are
more likely to take prescription medications, more likely to relapse, and less likely to go
into “remission” from asthma.
 Childhood asthma is often caused by a combination of genetic and environmental factors.
Adult-onset asthma is usually more closely related to environmental causes, lifestyle
factors, and comorbidities (other conditions the person has).
 Children are more likely to experience difficulties in school and extracurricular activities
due to asthma-related sleep problems.
  Adults with asthma have higher rates of respiratory symptoms and depression. They may
miss work or struggle with professional obligations due to fatigue and other asthma
complications.

MEDICAL TREATMENT:

Treatment for coronary pulomnry disease usually involves lifestyle changes such as not
smoking, eating healthy and exercising more. Sometimes, medications and procedures are
needed.

Medications

There are many drugs available to treat coronary pulomnary disease, including:

 Rescue inhalers (or quick-relief inhalers)

 Short acting beta agonist
 Anticholinergic.
 Oral corticosteroid
 Leukotrine modifiers

MEDICAL NUTRITION THERAPY:

In addition to medication, changes to your diet can lead to better outcomes. Try to include the
following in your diet:

Fresh fruits and vegetables

Fruits and vegetables both contain a healthy amount of vitamins and nutrients, contributing to
heart health. Plus, these foods are low in calories, which can help you maintain a healthy weight.
Since they’re also a great source of fiber
Whole grains

Eating whole grains can also contribute to lungs health. Like fruits and vegetables, whole grains
are nutrient-dense and an excellent source of fiber.:

Healthy fats

Eating healthy fats in moderation can be good for heart health. Healthy fats can lower cholesterol
and protect against heart attacks and stroke.These include monosaturated fats and
polyunsaturated fats. cholesterol-lowering margarine

Lean protein

Eating protein also contributes to your overall health. However, be selective and choose proteins
that are low in fat.

Healthy options include types of fish that are rich in omega-3 fatty acids, which help lower
cholesterol and triglyceride levels. This includes salmon, herring, and other cold water fish.

What foods should you avoid with asthma?

The most common foods associated with allergic symptoms are:

 Eggs
 Cow's milk
 Peanuts
 Soy
 Wheat
 Fish
 Shrimp and other shellfish
 Tree nuts
 DISEASE-3
TUBERCULOSIS:-
INTRODUCTION:

Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the
air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain,
the kidneys, or the spine. A person with TB can die if they do not get treatment.

ETIOLOGY:

 Bad cough (lasting longer than two weeks).

 Pain in your chest.
 Coughing up blood or sputum (mucus).
 Fatigue or weakness.
 Loss of appetite.
 Weight loss.
 Chills.
 Fever.
 Night sweats.

SIGN & AND SYMPTOM

 a cough that lasts more than 3 weeks – you may cough up mucus (phlegm) or mucus with
blood in it.
 feeling tired or exhausted.
 a high temperature or night sweats.
 loss of appetite.
 weight loss.
 feeling generally unwell.

MAJOR COMPLICATIONS:
Acute and subacute complications of TB disease are attributable to structural damage or vascular
compromise caused by Mycobacterium tuberculosis, as well as metabolic abnormalities and host
inflammatory responses. TB-related sepsis is a life-threatening acute complication for which
current diagnostic and management approaches are likely inadequate

MEDICAL TREATMENT:

Treatment for coronary pulomnary disease usually involves lifestyle changes such as not
smoking, eating healthy and exercising more. Sometimes, medications and procedures are
needed.

Medication

TB infection and disease is treated with these drugs:

 Isoniazid (Hyzyd®).
 Rifampin (Rifadin®).
 Ethambutol (Myambutol®).
 Pyrazinamide (Zinamide®).
 Rifapentine (Priftin®).

MEDICAL NUTRITION THERAPY:

To give your body the vitamins, minerals, and other nutrients it needs to fight active tuberculosis
and regain your strength and stamina, you need to eat a diet containing a variety of healthy
foods, such as:

 Leafy, dark-colored greens like kale and spinach, for their high iron and B-vitamin
content
 Plenty of whole grains, like whole wheat pastas, breads, and cereals
 Antioxidant-rich, brightly-colored vegetables, such as carrots, peppers, and squash, and
fruits, like tomatoes, blueberries, and cherries — think of buying produce in a full
rainbow of colors
 Unsaturated fats like vegetable or olive oil, instead of butter

What to Avoid When You Have Active Tuberculosis

As is always the case for good health, there are certain foods you shouldn’t eat and substances
you shouldn’t use.

 Skip tobacco in all forms.

 Don't drink alcohol — it can add to the risk of liver damage from some of the drugs used
to treat your TB.
 Limit coffee and other caffeinated drinks.
 Limit refined products, like sugar, white breads, and white rice.
 Avoid high-fat, high-cholesterol red meat and instead load up on leaner protein
sources like poultry, beans, tofu, and fish.

Eating protein also contributes to your overall health. However, be selective and choose proteins
that are low in fat.

DIETARY GUIDELINES:

 Keep fruit and vegetables readily available. Keep fresh fruits and vegetables ready for
consumption in your fridge. Slice them ahead of time for a quick snack in between meals.

 Reduce food portions. Reducing your food portions can help you consume fewer
calories, fat, and sodium.

 Cook with herbs. Instead of seasoning your food with table salt, experiment with
different types of herbs, spices, and salt-free seasoning blends. When buying canned
goods and condiments, look for low-salt or reduced salt alternatives.

 Read food labels. Get into a routine of reading food labels to avoid consuming too much
fat and sodium.

 Eat foods with omega-3 fatty acids. Omega-3 fatty acids -- found in fish like salmon,
tuna, and sardines and some plant sources, like flaxseed -- are believed to have a number of
health benefits. Although the evidence that they help with asthma is not clear, it’s still a good
idea to include them in your diet.
 DISEASE-4
PNEUMONIA:-
INTRODUCTION:

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill
with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and
difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause
pneumonia.

ETIOLOGY

Viruses, bacteria, and fungi can all cause pneumonia. In the United States, common causes of
viral pneumonia are influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 (the virus
that causes COVID-19). A common cause of bacterial pneumonia is Streptococcus pneumoniae

(pneumococcus).

SIGN & AND SYMPTOM

The main symptoms of pneumonia include:

 Cough, which may produce greenish, yellow or even bloody mucus.
 Fever, sweating and shaking chills.
 Shortness of breath.
 Rapid, shallow breathing.
 Sharp or stabbing chest pain that gets worse when you breathe deeply or cough.
 Loss of appetite, low energy, and fatigue.

MAJOR COMPLICATIONS;-
Bacteremia and Septic Shock
 If bacteria caused your pneumonia, they could get into your blood, especially if you didn't see a doctor
for treatment. It's a problem called bacteremia.
Get medical help right away if you notice symptoms like:

 Fever
 Fast heart rate
 Fast breathing
 Chills that make you shiver
 Low blood pressure
 Stomach upset (nausea, pain, vomiting, or diarrhea)
 Confusion

Your doctor will test your blood for bacteria and treat you with antibiotics if you have bacteremia.
You may get treated in the hospital for bacteremia or septic shock

Pleural Effusions, Empyema, and Pleurisy

Poor Gas Exchange

MEDICAL TREATMENT:

Treatment for lung cancer usually involves lifestyle changes such as not smoking, eating healthy
and exercising more. Sometimes, medications and procedures are needed.

Medications

There are many drugs available to treat coronary pulomnary disease, including:

Glucocorticoids

The role of glucocorticoids in acute bacterial pneumonia has yet to be clearly elucidated. Classic
teaching warns that the use of glucocorticoids in infection may impair the immune response

Some other drugs:-

 Fluoroquinolones. Delafloxacin (Baxdela) ...
 Macrolides. Azithromycin (Zithromax) ...
 Monobactams. Aztreonam (Azactam) ...
 Antibiotics, Lincosamide. Clindamycin (Cleocin) ...
 Tetracyclines. Doxycycline (Bio-Tab, Doryx, Doxy, Periostat, Vibramycin, Vibra-Tabs) ...
 Carbapenems. Ertapenem (Invanz) ...
 Oxazolidinones. Linezolid (Zyvox) ...
 Aminoglycosides.

MEDICAL NUTRITION THERAPY:

In addition to medication, changes to your diet can lead to better outcomes. Try to include the
following in your diet:

Fresh fruits and vegetables

Eat a wide variety of fresh or frozen fruits and vegetables. If you can’t eat fresh selections,
choose low-sodium canned vegetables. You can also drain liquid from cans and rinse off the
vegetables before cooking to remove excess salt.

Whole grains

Eating whole grains can also contribute to lungs health. Like fruits and vegetables, whole grains
are nutrient-dense and an excellent source of fiber. oatmeal

Healthy fat

These include monosaturated fats and polyunsaturated fats. They’re found in:

 olive oil
  canola oil

 flaxseed

 avocados

 nuts and seeds

 cholesterol-lowering margarine

Lean protein

Healthy options include types of fish that are rich in omega-3 fatty acids, which help lower
cholesterol and triglyceride levels. This includes salmon, herring, and other cold water fish.

Eat foods with omega-3 fatty acids.

Omega-3 fatty acids -- found in fish like salmon, tuna, and sardines and some plant sources,
like flaxseed -- are believed to have a number of health benefits. Although the evidence that they help
with asthma is not clear, it’s still a good idea to include them in your diet.

DISEASE-5
LUNG CANCER:-
INTRODUCTION:

When cancer starts in the lungs, it is called lung cancer. Lung cancer begins in the lungs and
may spread to lymph nodes or other organs in the body, such as the brain. Cancer from other
organs also may spread to the lungs. When cancer cells spread from one organ to another, they
are called metastases.

ETIOLOGY:
 Tobacco is by far the leading cause of lung cancer. About 80% of lung cancer deaths are caused
by smoking, and many others are caused by exposure to secondhand smoke. Smoking is clearly
the strongest risk factor for lung cancer, but it often interacts with other factors.

SIGN & AND SYMPTOM

The main symptoms of lung cancer include:

 a cough that doesn't go away after 2 or 3 weeks.
 a long-standing cough that gets worse.
 chest infections that keep coming back.
 coughing up blood.
 an ache or pain when breathing or coughing.
 persistent breathlessness.
 persistent tiredness or lack of energy.

MAJOR COMPLICATIONS:

Higher risk of Infections

Some cancer treatments, such as chemotherapy, kill white blood cells along with cancer cells.
White blood cells fight off infection, and up to two-thirds of them are a type called neutrophils.

Collapsed Lung (Pneumothorax)

COPD can damage lung tissue. And if air leaks into the space between a lung and your chest wall, that
lung can collapse like a deflated balloon.

Poor Gas Exchange

Blood carries oxygen to cells throughout your body and carbon dioxide away from them. But because
you're not breathing in and out fully, you may have less oxygen than you need or more carbon dioxide
than you should in your blood. Either of these may be why you have shortness of breath. A high
carbon dioxide level can also give you a headache and make you woozing

MEDICAL NUTRITION THERAPY:

 Keep fruit and vegetables readily available. Keep fresh fruits and vegetables ready for
consumption in your fridge. Slice them ahead of time for a quick snack in between meals.

 Reduce food portions. Reducing your food portions can help you consume fewer
calories, fat, and sodium.

 Cook with herbs. Instead of seasoning your food with table salt, experiment with
different types of herbs, spices, and salt-free seasoning blends. When buying canned
goods and condiments, look for low-salt or reduced salt alternatives.

 Read food labels. Get into a routine of reading food labels to avoid consuming too much
fat and sodium.

 Eat foods with omega-3 fatty acids. Omega-3 fatty acids -- found in fish like salmon,
tuna, and sardines and some plant sources, like flaxseed -- are believed to have a number of
health benefits. Although the evidence that they help with asthma is not clear, it’s still a good
idea to include them in your diet.