COPD also account for the death of 125, 000 Americans every year. Now on his late fifties, he started to notice that his cough has been going on for more than three months. On inspection ambulance crew noted a number of signs including pursing of lips, tachypnia, accessory muscles of respiration in use, tracheal tug and shortening of trachea, deepening of supraclavicular and suprasternal fossa, decreased movement of chest wall, audible wheeze and barrel shaped chest. The three types … The abnormal inflammatory response in the lungs occurs primarily in the: The airways, parenchyma, and pulmonary vasculature undergo inflammation in COPD. Option C: The pulmonary vasculature is affected by inflammation in COPD. Option A: Inflammation occurs through the proximal and peripheral airways, lung parenchyma, and pulmonary vasculature. Option A: The airways are inflamed in COPD. Spirometry. Diagnosis of COPD would mainly depend on the assessment data gathered by the healthcare team members. PO2 =6.6 KPa. Prompt treatment of respiratory tract infection is necessary because it leads to worsening of breathlessness and cause type II respiratory failure in COPD patient. Diagnosis and assessment of COPD must be done carefully since the three main symptoms are common among chronic pulmonary disorders. Mild wheezing was present since one month but it became more prominent four days back. On palpation there were no crepetations on neck and chest so no subcutaneous emphysema. Our ultimate goal is to help address the nursing shortage by inspiring aspiring nurses that a career in nursing is an excellent choice, guiding students to become RNs, and for the working nurse – helping them achieve success in their careers! The nurse should obtain a thorough health history from patients with known or potential COPD. Option B: Hypersecretion occurs due to the increase in the number of goblet cells. The annual cost of COPD is approximately $42.6 billion with overall healthcare expenditures of $26.7 billion. *You can also browse our support articles here >. temperature and blood pressure(Warrell, Cox & Firth, 2005). Free resources to assist you with your nursing studies! D. Tuberculosis and pleural effusion. Any items you have not completed will be marked incorrect. Respiration rate is 33/minute, deep with forced expiration. 4. 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. Wheezing is not an indicator of severity of disease and is often absent in stable, severe COPD… Provide information about disease process/prognosis and treatment regimen. Nursing Assessment for COPD The assessment includes information about past symptoms and manifestations of the disease earlier. Take this WebMD assessment to find out what you can do to manage and slow the progression of your COPD and get tips to help you live better. Posts related to Chronic Obstructive Pulmonary Disease (COPD): This article is very helpful with nursing plans with first semester nursing students. Patient used to do light house-hold work, but since last two days he is unable to do that due to weakness. In the nursing history,Mr.Harris notes that she denies ever smoking,but says that her husband and two sons have … 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. To monitor and manage potential complications: During evaluation, the effectiveness of the care plan would be measured if goals were achieved in the end and the patient: It is important for the nurse to assess the knowledge of patient and family members about self-care and the therapeutic regimen. D. Characterized by variations in all of the above. Option A: Inflammation occurs through the proximal and peripheral airways, lung parenchyma, and pulmonary vasculature. Chronic obstructive pulmonary disease (COPD) is a widespread disorder among middle- and older-aged individuals, is continuing, and is not fully reversible (Global Initiative for Chronic Obstructive Lung Disease [GOLD], 2014). You have not finished your quiz. Management of patients ith COPD takes a more reactive approach than a curative approach. If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! C. Pulmonary vasculature. Option C: Alveolar wall destruction leads to loss of alveolar attachments and a decrease in elastic recoil. After patient achieves good motivation, nicotine replacement therapy will be started that included Bupropion 150mg once daily for 6 days then doubling it to 150mg bid for seven weeks. 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. On assessment… Therapeutic Communication Techniques Quiz. He was diagnosed with COPD and chest infection each time. Disease process/prognosis and therapeutic regimen understood. View professional sample essays here. Ambulance crew decide to transport the patient to the hospital for in-hospital treatment. Safety and Comfort Sensory and motor functions are normal. Nursing assessment should include the following. Please visit using a browser with javascript enabled. This disease affects not only patients’ physical health but also their ps… Patient is a heavy smoker, smoking one pack of twenty cigarettes a day. Therefore, gathering information about previous illnesses will help you perform a more accurate respiratory assessment. They were also talking with each other during history taking and physical examination. Chronic bronchitis and emphysema. His history of these presenting complaints spans to last three months. Suzan Miller-Hoover DNP, RN, CCNS, CCRN-K. Having a thorough knowledge of the upper and lower pulmonary structures, bronchial/systemic circulation, and gas exchange at the level of the lungs and tissue cells will make analyzing the assessment findings more meaningful. Pulmonary function studies are used to help confirm the diagnosis of COPD, determine disease severity, and monitor disease progression. The nurse is completing a home visit for a client diagnosed with chronic obstructive pulmonary disease (COPD). COPD C-Cigarette smoking cessation, corticoseteriods O-Oxygen if hypoxic P-PFTs + Pneumococcal vaccine, (flu vaccine if not given for that year) + Pulmonary Rehabilitation D-Dilators Description The therapeutic management for a patient with COPD For Penicillin sensitive patients Clarithromycin 250 mg 12-hourly is used. He is cyanosed and has peripheral oedema indicating chances of co-morbidity like heart disease (Simon, Everitt & Kendrick, 2005). Health history. On examination of abdomen and pelvis no wounds or painful areas found. The crew gets consent from the patient and approaches patient for quick Primary Survey. He quickly percusses and auscultates chest and finds it hyper-resonant all over. 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. Option A: Air pollution is a risk factor in the development of emphysema but it is not the primary factor. All these signs are due to increased air-trapping in the lungs, narrowing of bronchi and use of accessory muscles of respiration (Talley & Connor, 2006). 2. In COPD there is chronic inflammation of airways, lung parenchyma and pulmonary vasculature. C. Alveolar wall destruction. 2. The patient is living alone, unable to cope at home and confused. D. Areas identified in all of the above. Third. Nothing in the environment appears harmful for the patient or ambulance staff. It within the expiratory date and has been taken correctly. Here are seven (7) nursing care plans (NCP) and nursing diagnosis (NDx) for Chronic Obstructive Pulmonary Disease (COPD): 1. I have also learned how to conduct primary survey in two minutes and then detailed secondary survey and plan to manage the case. If you leave this page, your progress will be lost. 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. 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. Option C: Alveolar wall destruction leads to loss of alveolar attachments and a decrease in elastic recoil. Plan in place to meet needs after discharge. 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. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. B. Causes of COPD includes environmental factors and host factors. 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 … 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. The ambulance crew behaved quite professionally with few exceptions. Optimization of bronchodilator medications is. 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. Assess the patient’s past and present medical history. Nurseslabs – NCLEX Practice Questions, Nursing Study Guides, and Care Plans, Chronic Obstructive Pulmonary Disease (COPD), 5 Chronic Obstructive Pulmonary Disease (COPD) Nursing Care Plans, Nursing Test Bank and Nursing Practice Questions for Free, NCLEX Practice Questions Test Bank (2021 Update), Nursing Pharmacology Practice Questions & Test Bank for NCLEX (500+ Questions), Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method, Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. There is an increase in the number of goblet cells and enlarged submucosal glands leading to hypersecretion of mucus. The ambulance crew arrives at the site safely. These two types of COPD can be sometimes confusing because there are patients who have overlapping signs and symptoms of these two distinct disease processes. 3. There are two major life-threatening complications of COPD: respiratory insufficiency and failure. B. On auscultation breath sounds are reduced and rhonchi are present in the chest. There is no injury or deformity but ankle oedema is present and patient is using accessory muscles of respiration. Text Mode: All questions and answers are given on a single page for reading and answering at your own pace. 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! Marianne is also a mom of a toddler going through the terrible twos and her free time is spent on reading books! The room is well lit but untidy. Pulmonary Emphysema is a pathologic term that describes an. Prevent complications, slow progression of condition. The most important environmental risk factor in emphysema is: Cigarette smoking is the foremost factor in the development of emphysema. COPD is characterized by a persistent limitation of airflow that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lungs to noxious particles or gases (GOLD, 2014). 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… In this case both FVC and FEV1 are reduced and ratio FEV1/FVC is decreased to 1.1 L / 3.0 L (Costanzo, 2007). Study for free with our range of nursing lectures! Due to the chronic inflammation, changes and narrowing occur in the airways. Other irritants include particles from fires used in the home for cooking or heating and workplace exposure to chemical fumes, dust, and particles. Document plan of care and specific interventions. The room is well lit but untidy. Healthcare providers perform medical management by considering the assessment data first and matching the appropriate intervention to the existing manifestation. Pharmacological interventions include both short-acting and long-acting bronchodilators to open airways. This site shares best practices on guidance of COPD device selection, symptom assessment, patient education and counseling, and related materials for various stages of care. Reference this. He stayed in the hospital for one day each time then was discharged. 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. Performs activities with less shortness of breath. He did not park their ambulance very correctly and left little space for other cars. Ask your patient specific questions to obtain a detailed … Initial symptoms are dyspnoea, (progressive in nature) but cough and wheezing may also be the first. Chlorthalidone dose may be increased if oedema is not relieved Physiotherapy of chest help expectorate and clear bronchial recreations (Haslett, Chilver, Boon & College, 2002). Option C: Infectious agents are part of the risk factors for emphysema but it is not the main factor. Temperature on Tympanic temperature 100.5 F. Capillary refill in <2 seconds shows normal tissue perfusion. If this activity does not load, try refreshing your browser. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. Cardiovascular system and other body system examination, There is right ventricular heave, ankle oedema, raised JVP and increased diastolic blood, pressure (90mmHg) showing right ventricular failure called cor- pulmonale (Sam, Baker &. The neighbor once or twice a week visits him and gives him some company. Nursing Best Practice Guidelines. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! His wife died in a car accident. Low dose steroid inhaler (Beclomethasone Dipropionate inhaler) two inhalations three times a day act as an anti inflammatory agent to reduce bronchial inflammation thus reducing symptoms. Next he examines patient’s breathing. Document attainment or progress towardsgoals. In COPD, the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious gases or particles. When starting your assessment … C. Fourth. Pulmonary function studies. 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). Option A: The airways are inflamed in COPD. Nurse Salary 2020: How Much Do Registered Nurses Make? In obstructive lung disease, the RV will make up the greater portion of the TLC. Pulse rate is 100/min, regular and bounding. Mortality for COPD has been increasing ever since while other diseases have decreasing mortalities. Prevention of COPD is never impossible. For respiratory tract infection broad spectrum antibiotics were started after taking sputum sample for culture and sensitivity. The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease ... To view a Sample COPD Assessment Form click here. The aim is to maintain PaO2 level of 7 kPa or more to reduce hypoxaemia and hypercapnia. There is no history of allergy. Be sure to grab a pen and paper to write down your answers. This has also occurred last year wherein his cough lasted for almost three months. The chronic inflammatory process affects the pulmonary vasculature and causes thickening of the vessel lining and hypertrophy of smooth muscle. The most important environmental risk factor in emphysema is: A. D. Fifth. Identifies resources for smoking cessation. C. Pneumonia and pleurisy. Option B: The lung parenchyma undergoes an inflammatory response in COPD. ASSESSMENT Jeff Harris, RN, admits Mrs. Mercurio to the medical unit. B. Parenchyma. All work is written to order. Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of NursingAnswers.net. An inflammatory response occurs throughout the proximal and peripheral airways, lung parenchyma, and pulmonary vasculature. There are two classifications of COPD: chronic bronchitis and emphysema. I think more refresher courses need to be held to teach professional behavior in crew and build their academic knowledge. Chronic Obstructive Pulmonary Disease has been defined by The Global Initiative for Chronic Obstructive Lung Disease as “a. Document client’s responses to treatment, teaching, and actions performed. Inflammation, hypersecretion of mucus, and alveolar wall destruction are included in the pathophysiology of COPD. With spirometry the disease is mild when FEV1 was 60-79%, moderate when FEV1 40-59% and severe when FEV1 is lesser than 40%. He introduces himself and carries staff to the patient. People with emphysema are also called “pink puffers”. Holistic nursing assessment has a key role in identifying anxiety and depression, and there is evidence to support the role of nurses in delivering a cognitive behavioural therapy approach to help patients with COPD … : Tuberculosis and pleural effusion are not chronic pulmonary disorders ; level of 7 kPa or more reduce... A broad description of COPD a chronic productive cough with dyspnea on excretion of overdistended alveoli or potential.! Is presenting with chronic Obstructive pulmonary disease... to view a Sample assessment... 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