Chronic Obstructive Pulmonary Disease has been defined by The Global Initiative for Chronic Obstructive Lung Disease as “a. Disclaimer: This essay has been written by a student and not our expert nursing writers. Some laboratory signs for this patient include Glasgow Coma Score; level of consciousness is 14/15, with patient little confused. His wife died in a car accident ten years back. Anti-smoking program started that have anti-smoking advice and encouragement of change of attitude towards quit smoking. Obtain … Nursing Management Nursing Assessment. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! There are two classifications of COPD: chronic bronchitis and emphysema. Assess the patient’s knowledge of the disease. There is impaired carbon dioxide and oxygen exchange, and the exchange results from the destruction of the walls of overdistended alveoli. The patient is alert and responds to verbal stimulus. Goals to achieve in patients with COPD include: Patient and family teaching is an important nursing intervention to enhance self-management in patients with any chronic pulmonary disorder. Allergens. Chronic bronchitis is a disease of the airways and is defined as the presence of. The underlying pathophysiology of COPD is: Characterized by variations in all of the above. COPD Nursing Care Plans Chronic obstructive pulmonary disease (COPD) involves the inflammation of the lungs, resulting to the obstruction of airflow through the airways. The patient had his last meal three hours back. He used to prepare food for himself but buying from a take away shop since last three day as he does not feel good to prepare it at home. There are two main types of emphysema: panlobular and centrilobular. Third. No time limit for this exam. Two diseases common to the etiology of COPD are: A. He did not park their ambulance very correctly and left little space for other cars. Option B: Allergens may contribute to the development of emphysema but it is not the main factor. This oxygen therapy is aimed to reduce a cyanosis, pulmonary hypertension, cerebral hypoxia, hypotension and tachycardia. He is eighty four years old male migrant from Jamaica living alone in a two bed room flat with no one looking after him. Option C: Alveolar wall destruction leads to loss of alveolar attachments and a decrease in elastic recoil. Next he examines patient’s breathing. Option B: Hypersecretion occurs due to the increase in the number of goblet cells. 2. 2 Assessment Education Centre Pulmonary Rehabilitation Access Centre Dietitian Social Worker Psychologist Other: Signature: Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD… Raised JVP and oedema of lower legs show right heart failure thus a thiazide diuretic Chlorthalidone 25 mg once daily, which is minimum daily dose, is started as initial therapy. They are wearing personal protective equipment including safety boots, high visible clothing and vest and a portable two-way radio is in the hand of one of the staff. On palpation there were no crepetations on neck and chest so no subcutaneous emphysema. On examination of abdomen and pelvis no wounds or painful areas found. On assessment… Inhaled corticosteroids are also often prescribed to reduce airway inflammation. Company Registration No: 4964706. In COPD there is chronic inflammation of airways, lung parenchyma and pulmonary vasculature. The older adult has a long history that may include smoking or exposure to secondhand smoke, environmental exposures to asbestos or other pollutants, and illnesses such as chronic obstructive pulmonary … If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! The most important environmental risk factor in emphysema is: Cigarette smoking is the foremost factor in the development of emphysema. Option D: Tuberculosis and pleural effusion are not chronic pulmonary diseases. The nurse should obtain a thorough health history from patients with known or potential COPD. 2. Pre-alert was sent to the hospital that an elderly patient with acute on chronic type II respiratory failure is on the way to hospital. Asthma and atelectasis. C2.2 Physical examination The sensitivity of physical examination for detecting mild to moderate COPD is poor (Badgett 1993). The amount of sputum is increasing day by day. Bronchodilators such as β2 — adrenoceptor agonist ( Salbutamol ) inhaler used as two inhalations four times a day and anticholernegic ( ipratropium bromide) inhaler as two inhalations four times a day relieve bronchspasm and give symptomatic relief. Ambulance crew decide to transport the patient to the hospital for in-hospital treatment. The patient gives history of medication prescribed by local general practitioner. Document assessment findings including respiratory rate, character of breath sounds; frequency, amount and appearance of secretions laboratory findings and mentation level. As an outpatient department nurse, she is a seasoned nurse in providing health teachings to her patients making her also an excellent study guide writer for student nurses. Option C: The pulmonary vasculature is affected by inflammation in COPD. When taking care of a patient with COPD it is very important the nurse knows how to recognize the typical signs and symptoms seen in this condition, how it is diagnosed, nursing interventions, and patient … The most important environmental risk factor in emphysema is: A. The radial pulse rate is 100 per minute, regular but bounding; blood pressure 125/90. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! C. Infectious agents. The abnormal inflammatory response in the lungs occurs primarily in the: A. Airways. Pulmonary function studies. Provide information about disease process/prognosis and treatment regimen. Secure the side rails of the... 2. If this activity does not load, try refreshing your browser. He is cyanosed and has peripheral oedema indicating chances of co-morbidity like heart disease (Simon, Everitt & Kendrick, 2005). Unmanaged COPD can lead to death due to respiratory acidosis, coma, right sided heart failure and massive collapse of lungs due to pneumothorax (Kumar, Abbas & Fausto, 2005). The patient has certain Presenting complaints (PC).These include worsening cough with sputum since seven days, breathlessness on Exertion since four days, Wheezing since four days, generalised weakness since two days, temperature since two days and breathlessness at rest since six hours. He has off and on cough with white sputum since three months, that became worse seven days back, when weather turned cold. Diagnosis and assessment of COPD must be done carefully since the three main symptoms are common among chronic pulmonary disorders. The neighbor once or twice a week visits him and gives him some company. Document attainment or progress towardsgoals. If you leave this page, your progress will be lost. 3. All work is written to order. Chlorthalidone dose may be increased if oedema is not relieved Physiotherapy of chest help expectorate and clear bronchial recreations (Haslett, Chilver, Boon & College, 2002). B. Now on his late fifties, he started to notice that his cough has been going on for more than three months. He was diagnosed with COPD and chest infection each time. Pharmacological interventions include both short-acting and long-acting bronchodilators to open airways. Reference this. Then he assesses if patient has any disability and finds no disability. There is an increase in the number of goblet cells and enlarged submucosal glands leading to hypersecretion of mucus. Identifies resources for smoking cessation. Marianne is also a mom of a toddler going through the terrible twos and her free time is spent on reading books! The aim is to maintain PaO2 level of 7 kPa or more to reduce hypoxaemia and hypercapnia. If loading fails, click here to try again. Therapeutic Communication Techniques Quiz. Both have overlapping features with damage at acinar level (emphysema) and bronchial level (bronchitis) and most commonly occur in smokers. He gives patient oxygen through nasal cannulae to decrease cyanosis. Assessment of the respiratory system should be done rapidly yet accurately. I have also learned how to conduct primary survey in two minutes and then detailed secondary survey and plan to manage the case. Pulse rate is 100/min, regular and bounding. He examines pupils of both eyes and find normal in size and reaction to light. In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz. For Penicillin sensitive patients Clarithromycin 250 mg 12-hourly is used. Chronic Disease. Also, this page requires javascript. Here are some guidance questions to obtain data on the health … Pulmonary Emphysema is a pathologic term that describes an. COPD risk increases when those e… Low oxygen therapy (24-28% of O2) was given to the patient by using nasal cannulae to deliver 1-2 litres of oxygen per minute. Impaired Gas Excha… Option B: Hypersecretion occurs due to the increase in the number of goblet cells. Current complaint is a direct result exacerbation of previously existing COPD (Longmore, Wilkinson & Rajagopalan, 2007). A further focused history and physical examination is required to identify injury or disease that has not been identified during the primary survey. Amoxicilline 250 mg 8-hourly for seven days was given as patient is not sensitive to penicillin. Thank you. But this is my first experience and I think I need to have more experiences similar to or different from this experience to learn more about dealing with different kind of patients and different situations. The patient is eighty four years old elderly black male of average built sitting forward in hunched-over position on bed and breathing through pursed lips. Option B: The lung parenchyma undergoes an inflammatory response in COPD. There is sputum production and he experiences difficulty of breathing whenever he performs his daily activities. Oxygen saturation levels is found 88% (Normal=95%) ECG shows tachycardia, P- pulmonale and Right axis deviation (right ventricular failure). The nurse is completing a home visit for a client diagnosed with chronic obstructive pulmonary disease (COPD). Patient used to do light house-hold work, but since last two days he is unable to do that due to weakness. D. Characterized by variations in all of the above. Copyright © 2003 - 2021 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. Document conditions that interfere with oxygen supply. As an observer with the ambulance crew I have gained useful knowledge about safely driving an ambulance, safe arrival at the scene, safety equipments used by the ambulance crew and how to approach the patient safely. B. Inflammation, hypersecretion of mucus, and alveolar wall destruction are included in the pathophysiology of COPD. Assess the patient’s past and present medical history. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date. Document client’s responses to treatment, teaching, and actions performed. Other irritants include particles from fires used in the home for cooking or heating and workplace exposure to chemical fumes, dust, and particles. The underlying pathophysiology of COPD is: A. Inflamed airways that obstruct airflow. The ambulance crew has considered a number of psychosocial and disease factors. All questions are given in a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. Likewise, many people who have COPD may not be diagnosed until the disease is advanced and interventions are less effective.To diagnose your condition, your doctor will review your signs and symptoms, discuss your family and medical history, and discu… 1. The medication is prescription only and the patient been taking it since three years. Assess patient’s exposure to risk factors. The ambulance crew arrives at the site safely. Do you have a 2:1 degree or higher in nursing or healthcare? COPD is the fourth leading cause of death in the United States. 11th Feb 2020 We're here to answer any questions you have about our services. No plagiarism, guaranteed! Breathlessness on exertion started four days back that gradually increased and he developed breathlessness at rest 6 hours back. Marianne is a staff nurse during the day and a Nurseslabs writer at night. As a cause of death in the United States, COPD ranks: Two diseases common to the etiology of COPD are: Chronic bronchitis and emphysema belong to the old classification of COPD. Nutritional intake meeting caloric needs. Answer: D. Characterized by variations in all of the above. Patient developed mild fever two days back, before that he gives no history of fever. Prevent complications, slow progression of condition. Discipline and consistency are the keys to achieving freedom from chronic pulmonary diseases. Recently, sever… Nothing in the environment appears harmful for the patient or ambulance staff. A variety of procedures, tests, and questionnaires can be used to evaluate patients with chronic obstructive pulmonary disease (COPD) for clinical and research purposes. The ambulance crew recorded four basic vital signs consisting of pulse, respiration. In this case both FVC and FEV1 are reduced and ratio FEV1/FVC is decreased to 1.1 L / 3.0 L (Costanzo, 2007). There are two major life-threatening complications of COPD: respiratory insufficiency and failure. Prompt treatment of respiratory tract infection is necessary because it leads to worsening of breathlessness and cause type II respiratory failure in COPD patient. This disease affects not only patients’ physical health but also their ps… Air pollution. This project is based on the nursing care provided to a patient with Chronic Obstructive Pulmonary Disease (COPD), with specific focus on holistic assessment and identification of patient care needs. ASSESSMENT Jeff Harris, RN, admits Mrs. Mercurio to the medical unit. According to protease-antiprotease and oxidant-antioxidant theories heavy smoking results in imbalance between these enzymes result in damages to lung parenchyma and alveolar wall (Kumar, Abbas & Fausto, 2005). The patient is eighty four years old elderly black male of average built sitting forward in hunched-over position on bed and breathing through pursed lips. 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