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). The patient is alert and responds to verbal stimulus. Recently, sever… As a cause of death in the United States, COPD ranks: A. Identifies the hazards of cigarette smoking. 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 &. This updated definition is a broad description of COPD and its signs and symptoms. Option B: Allergens may contribute to the development of emphysema but it is not the main factor. Nasal connulae is preferred in this patient so that he can expectorate and eat or drink. Nursing Essay Thank you. D. Cigarette smoking. Any items you have not completed will be marked incorrect. C. Infectious agents. Prompt treatment of respiratory tract infection is necessary because it leads to worsening of breathlessness and cause type II respiratory failure in COPD patient. 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. Chronic bronchitis and emphysema belong to the old classification of COPD. He is a smoker since last sixty years but did not consume any alcohol or habit forming drug. 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. Skin is warm to touch. 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. Optimization of bronchodilator medications is. The nurse must appropriately administer bronchodilators and corticosteroids and become alert for potential side effects. Chronic Obstructive Pulmonary Disease has been defined by The Global Initiative for Chronic Obstructive Lung Disease as “a. B. Acute respiratory tract infection makes situation worse and signs and symptoms of infection with hypoxia and hypercapnea and right heart failure (at latter stage of COPD) become apparent and patient need urgent treatment (Talley & Connor, 2006). 2. The most important environmental risk factor in emphysema is: A. Ventilation/oxygenation adequate to meet self-care needs. 2. Diagnosis and assessment of COPD must be done carefully since the three main symptoms are common among chronic pulmonary disorders. C. Pneumonia and pleurisy. Plan in place to meet needs after discharge. There is an increase in the number of goblet cells and enlarged submucosal glands leading to hypersecretion of mucus. 3. Air pollution. B. Mucus secretion that blocks airways. Shape and movements of chest are symmetrical; no flail segment and no injury present. 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. Inhaled corticosteroids are also often prescribed to reduce airway inflammation. Option A: The airways are inflamed in COPD. On percussion, chest is hyper resonant and dullness over liver and cardiac area is reduced. Pulmonary Emphysema is a pathologic term that describes an. Cigarette smoking is the foremost factor in the development of emphysema. There are two main types of emphysema: panlobular and centrilobular. All work is written to order. Option A: Asthma may be one of the chronic pulmonary diseases but atelectasis is not. Option A: Air pollution is a risk factor in the development of emphysema but it is not the primary factor. People with emphysema are also called “pink puffers”. Nursing Management Nursing Assessment. Now on his late fifties, he started to notice that his cough has been going on for more than three months. Nursing assessment should include the following. Marianne is a staff nurse during the day and a Nurseslabs writer at night. 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. Option A: Inflammation occurs through the proximal and peripheral airways, lung parenchyma, and pulmonary vasculature. 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. Anti-smoking program started that have anti-smoking advice and encouragement of change of attitude towards quit smoking. Then ambulance crew examines patient’s airway, and find lips and tongue blue due to cyanosis and secretions in the throat. View professional sample essays here. Registered Data Controller No: Z1821391. 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. 4. On palpation there were no crepetations on neck and chest so no subcutaneous emphysema. The three types … 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. Pharmacological interventions include both short-acting and long-acting bronchodilators to open airways. 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). The airways, parenchyma, and pulmonary vasculature undergo inflammation in COPD. Then crew then exposes patient from head to toe examination. Nutritional intake meeting caloric needs. Next he examines patient’s breathing. For Penicillin sensitive patients Clarithromycin 250 mg 12-hourly is used. The nurse is completing a home visit for a client diagnosed 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. Document assessment findings including respiratory rate, character of breath sounds; frequency, amount and appearance of secretions laboratory findings and mentation level. Pulmonary function studies. C. Fourth. tion of COPD. 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. B. Parenchyma. Option C: Pneumonia and pleurisy are not classified under the COPD. 3. The Past medical history, given by the patient provides information that he was hospitalised five time in the past during winter season ( 2001, 2003, 2005, 2008,2009) for breathlessness and respiratory infection. Also, this page requires javascript. This has also occurred last year wherein his cough lasted for almost three months. Our nursing and healthcare experts are ready and waiting to assist with any writing project you may have, from simple essay plans, through to full nursing dissertations. Second. Answer: D. Characterized by variations in all of the above. Secure the side rails of the... 2. Hameed, 2003). COPD Nursing Care Plans Chronic obstructive pulmonary disease (COPD) involves the inflammation of the lungs, resulting to the obstruction of airflow through the airways. Option C: Infectious agents are part of the risk factors for emphysema but it is not the main factor. Practice Mode: This is an interactive version of the Text Mode. Sensory and motor functions are normal. His history of these presenting complaints spans to last three months. Answer: D. Areas identified in all of the above. Many cases of COPD are the result of prolonged smoking, and as a result, smoking cessation pathways are usually required. Assist with measures to facilitate gas exchange. COPD also account for the death of 125, 000 Americans every year. When taking history of the patient they asked some leading questions from the patient. The underlying pathophysiology of COPD is: Characterized by variations in all of the above. Disease process/prognosis and therapeutic regimen understood. On auscultation breath sounds are reduced and rhonchi are present in the chest. Both of the crew wear latex gloves because they themselves do not have any latex allergy and proceeded calmly and confidently to conduct primary survey of the patient. Discipline and consistency are the keys to achieving freedom from chronic pulmonary diseases. There is no history of allergy. Text Mode: All questions and answers are given on a single page for reading and answering at your own pace. If loading fails, click here to try again. Approximately 12 million Americans live with a diagnosis of COPD. We've received widespread press coverage since 2003, Your NursingAnswers.net purchase is secure and we're rated 4.4/5 on reviews.co.uk. Document plan of care and specific interventions. He introduces himself and carries staff to the patient. The medicine patient is using is Salbutamol inhaler taking two puffs three times a day. 1. The neighbor once or twice a week visits him and gives him some company. Chronic bronchitis and emphysema. Option A: Inflammation occurs through the proximal and peripheral airways, lung parenchyma, and pulmonary vasculature. Here are some guidance questions to obtain data on the health … 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). 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. He did not park their ambulance very correctly and left little space for other cars. Oxygen saturation levels is found 88% (Normal=95%) ECG shows tachycardia, P- pulmonale and Right axis deviation (right ventricular failure). B. Emphysema and chronic bronchitis are clinically grouped together and called chronic obstructive pulmonary disease (COPD). She is a registered nurse since 2015 and is currently working in a regional tertiary hospital and is finishing her Master's in Nursing this June. Option A: Air pollution is a risk factor in the development of emphysema but it is not the primary factor. 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. Current complaint is a direct result exacerbation of previously existing COPD (Longmore, Wilkinson & Rajagopalan, 2007). 1. (Longmore, Wilkinson & Rajagopalan, 2007). Ask your patient specific questions to obtain a detailed … Option C: Pneumonia and pleurisy are not classified under the COPD. The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease ... To view a Sample COPD Assessment Form click here. Initial symptoms are dyspnoea, (progressive in nature) but cough and wheezing may also be the first. Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. They were also talking with each other during history taking and physical examination. In COPD there is chronic inflammation of airways, lung parenchyma and pulmonary vasculature. Company Registration No: 4964706. He checked capillary refill by pressing finger nails of the patient and found it normal <2 sec. 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. Assessment of the respiratory system should be done rapidly yet accurately. Pulse rate is 100/min, regular and bounding. On assessment… Do you have a 2:1 degree or higher in nursing or healthcare? Respiration rate is 33/minute, deep with forced expiration. Ineffective Airway Clearance 2. 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. There is no injury. A variety of procedures, tests, and questionnaires can be used to evaluate patients with chronic obstructive pulmonary disease (COPD) for clinical and research purposes. On examination of abdomen and pelvis no wounds or painful areas found. 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… Marianne is also a mom of a toddler going through the terrible twos and her free time is spent on reading books! Pulmonary function studies are used to help confirm the diagnosis of COPD, determine disease severity, and monitor disease progression. Mr. Cruz, a lawyer, smokes three packs of cigarette every day for the past 20 years. There is sputum production and he experiences difficulty of breathing whenever he performs his daily activities. Both have overlapping features with damage at acinar level (emphysema) and bronchial level (bronchitis) and most commonly occur in smokers. X-ray chest shows hyper-inflated lungs and CT scan shows lung bullae (Haslett, Chilver, Boon & College, 2002). No plagiarism, guaranteed! Start off by positioning your patient upright to help his breathing. COPD risk increases when those e… Prevention of COPD is never impossible. Amoxicilline 250 mg 8-hourly for seven days was given as patient is not sensitive to penicillin. 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. Please visit using a browser with javascript enabled. Assess the signs and symptoms of COPD and their severity. 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. Chlorthalidone dose may be increased if oedema is not relieved Physiotherapy of chest help expectorate and clear bronchial recreations (Haslett, Chilver, Boon & College, 2002). Obtain a clear history of the disease process and assess for exposure to risk factors. Mortality for COPD has been increasing ever since while other diseases have decreasing mortalities. He has off and on cough with white sputum since three months, that became worse seven days back, when weather turned cold. 11th Feb 2020 Copyright © 2003 - 2021 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. The forced expiratory volume over 1 second (FEV. Several questionnaires exist for the assessment of both symptoms and quality of life in COPD patients, namely the modified Medical Research Council (mMRC), the Clinical COPD Questionnaire (CCQ), the COPD Assessment … The medication was working up to some extent till ten days back when current symptoms started. We're here to answer any questions you have about our services. Then he assesses if patient has any disability and finds no disability. D. Tuberculosis and pleural effusion. The aim of management is to treat infection, reduce cyanosis, increase oxygen saturation in blood, decrease carbon dioxide saturation in blood and provide symptomatic relief to patient. Option C: The pulmonary vasculature is affected by inflammation in COPD. The amount of sputum is increasing day by day. 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. With spirometry the disease is mild when FEV1 was 60-79%, moderate when FEV1 40-59% and severe when FEV1 is lesser than 40%. I have also learned how to conduct primary survey in two minutes and then detailed secondary survey and plan to manage the case. He quickly percusses and auscultates chest and finds it hyper-resonant all over. This disease affects not only patients’ physical health but also their ps… 1. Two diseases common to the etiology of COPD are: A. Nothing in the environment appears harmful for the patient or ambulance staff. Salbutamol is bronchodilator (Haslett, Chilver, Boon & College, 2002). Nothing in the environment appears harmful for the patient or ambulanc… If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! The nurse understands that which of the following environmental factors … 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. 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). Patient used to do light house-hold work, but since last two days he is unable to do that due to weakness. Temperature on Tympanic temperature 100.5 F. Capillary refill in <2 seconds shows normal tissue perfusion. Disclaimer: This essay has been written by a student and not our expert nursing writers. In this essay this process is described. 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. 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. Nursing care planning for patients with COPD involves the introduction of a treatment regimen to relieve symptoms and prevent complications. 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. For respiratory tract infection broad spectrum antibiotics were started after taking sputum sample for culture and sensitivity. Document client’s responses to treatment, teaching, and actions performed. temperature and blood pressure(Warrell, Cox & Firth, 2005). Clinical manifestations appear when one third of lung parenchyma is already damaged. If you leave this page, your progress will be lost. Breathlessness on exertion started four days back that gradually increased and he developed breathlessness at rest 6 hours back. Mild wheezing was present since one month but it became more prominent four days back. The room is well lit but untidy. Option B: Hypersecretion occurs due to the increase in the number of goblet cells. Pupils equal in size in both eyes with normal reaction to light (Warrell, Cox & Firth, 2005). The patient has a chronic productive cough with dyspnea on excretion. He was diagnosed with COPD and chest infection each time. 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 crew gets consent from the patient and approaches patient for quick Primary Survey. The purpose of the assessment is twofold: first, to recognize changes in the patient’s pulmonary status that necessitate nursing or medical intervention, and second, to determine the ways in which the … 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… Prevent complications, slow progression of condition. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! Study for free with our range of nursing lectures! The abnormal inflammatory response in the lungs occurs primarily in the: The airways, parenchyma, and pulmonary vasculature undergo inflammation in COPD. Option B: The lung parenchyma undergoes an inflammatory response in COPD. 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. Occupational exposures often are overlooked and underdiagnosed. Option A: The airways are inflamed in COPD. He gives patient oxygen through nasal cannulae to decrease cyanosis. D. Fifth. The ambulance crew recorded four basic vital signs consisting of pulse, respiration. The patient gives history of medication prescribed by local general practitioner. D. Characterized by variations in all of the above. There are no fractures or wounds in extremities. He stayed in the hospital for one day each time then was discharged. A comprehensive respiratory assessment includes gathering a medical history that may impact or explain physical assessment findings. Free resources to assist you with your nursing studies! The ambulance crew arrives at the site safely. The ambulance crew quickly examines patient for any injury. Pink puffers (primarily having emphysema) have mild hypoxia and normal PCO2. COPD is commonly misdiagnosed — former smokers may sometimes be told they have COPD, when in reality they may have simple deconditioning or another less common lung condition. He is eighty four years old male migrant from Jamaica living alone in a two bed room flat with no one looking after him. Long-term exposure to irritants that damage the lungs and airways is the most common cause of COPD, and cigarette smoke (from smoking or secondhand smoke) is the most common irritant. If this activity does not load, try refreshing your browser. The medication is prescription only and the patient been taking it since three years. SpO2 i.e. The abnormal inflammatory response in the lungs occurs primarily in the: A. Airways. Healthcare providers perform medical management by considering the assessment data first and matching the appropriate intervention to the existing manifestation. C. Pulmonary vasculature. The sputum has gradually become purulent. Chronic bronchitis is a disease of the airways and is defined as the presence of. Due to the chronic inflammation, changes and narrowing occur in the airways. The nurse should obtain a thorough health history from patients with known or potential COPD. Therapeutic Communication Techniques Quiz. Patients who have a respiratory complaint may have a history of respiratory conditions. Causes of COPD includes environmental factors and host factors. Inflammation, hypersecretion of mucus, and alveolar wall destruction are included in the pathophysiology of COPD. A further focused history and physical examination is required to identify injury or disease that has not been identified during the primary survey. Impaired Gas Excha… Be sure to grab a pen and paper to write down your answers. Diagnosis and assessment of COPD must be done carefully since the three main symptoms are common among chronic pulmonary disorders. Once you are finished, click the button below. Blood pressure is 125/90, diastolic blood pressure slightly high. Ambulance crew decide to transport the patient to the hospital for in-hospital treatment. There is no injury or deformity but ankle oedema is present and patient is using accessory muscles of respiration. The respiratory rate is 33 per minute and bilateral chest movements are reduced. Option D: Tuberculosis and pleural effusion are not chronic pulmonary diseases. The underlying pathophysiology of COPD is: A. Inflamed airways that obstruct airflow. 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. Assess the patient’s past and present medical history. Some laboratory signs for this patient include Glasgow Coma Score; level of consciousness is 14/15, with patient little confused. Appropriate assessment of patients with COPD … The patient is living alone, unable to cope at home and confused. The patient had his last meal three hours back. D. Areas identified in all of the above. The chronic inflammatory process affects the pulmonary vasculature and causes thickening of the vessel lining and hypertrophy of smooth muscle. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. You have not finished your quiz. C. Alveolar wall destruction. The nurse caring for the patient with COPD must assess for var-ious complications, such as life-threatening respiratory insuffi-ciency and failure and respiratory infection and atelectasis, which … Option C: Infectious agents are part of the risk factors for emphysema but it is not the main factor. Option B: The lung parenchyma undergoes an inflammatory response in COPD. The room is well lit but untidy. Patients with COPD also have options for surgery to improve their condition. Chronic obstructive pulmonary disease (COPD) is a common respiratory condition, affecting 4.5% of people over the age of 40 in the UK. Vessel lining and hypertrophy of smooth muscle management nursing assessment are dyspnoea (... Copd, the RV will Make up the greater portion of the patient gives Family history of the is! Twos and her free time is spent on reading books essay should not be as... Through the proximal and peripheral airways, parenchyma, and pulmonary vasculature and most commonly occur in.., NG5 7PJ production of sputum is increasing day by day articles here > you assistance... Of pulse, respiration held to teach professional behavior in crew and their... Portion of the patient they asked some leading questions from the destruction of the chronic inflammatory process the. 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