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Learn about the nursing care management of patients with chronic obstructive pulmonary disease. What is Chronic Obstructive Pulmonary Disease?Nurses care for patients with COPD across the spectrum of care, from outpatient to home care to emergency department, critical care, and hospice settings.
ClassificationThere are two classifications of COPD: chronic bronchitis and emphysema. 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. Image source: medcomic.comChronic Bronchitis
Emphysema
PathophysiologyIn COPD, the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious gases or particles. Image source: pathophys.org
EpidemiologyMortality for COPD has been increasing ever since while other diseases have decreasing mortalities.
CausesCauses of COPD includes environmental factors and host factors. These includes:
Clinical ManifestationsThe natural history of COPD is variable but is a generally progressive disease.
PreventionPrevention of COPD is never impossible. Discipline and consistency are the keys to achieving freedom from chronic pulmonary diseases.
ComplicationsThere are two major life-threatening complications of COPD: respiratory insufficiency and failure.
Assessment and Diagnostic FindingsDiagnosis and assessment of COPD must be done carefully since the three main symptoms are common among chronic pulmonary disorders.
Medical ManagementHealthcare providers perform medical management by considering the assessment data first and matching the appropriate intervention to the existing manifestation. Pharmacologic Therapy
Management of Exacerbations
Surgical ManagementPatients with COPD also have options for surgery to improve their condition.
Nursing ManagementManagement of patients with COPD should be incorporated with teaching and improving the respiratory status of the patient. Nursing AssessmentAssessment of the respiratory system should be done rapidly yet accurately.
DiagnosisDiagnosis of COPD would mainly depend on the assessment data gathered by the healthcare team members. Planning & GoalsMain article: 5 Chronic Obstructive Pulmonary Disease (COPD) Nursing Care Plans Goals to achieve in patients with COPD include:
Nursing Priorities
Nursing InterventionsPatient and family teaching is an important nursing intervention to enhance self-management in patients with any chronic pulmonary disorder. To achieve airway clearance:
To improve breathing pattern:
To improve activity intolerance:
To monitor and manage potential complications:
EvaluationDuring evaluation, the effectiveness of the care plan would be measured if goals were achieved in the end and the patient:
Discharge and Home Care GuidelinesIt is important for the nurse to assess the knowledge of patient and family members about self-care and the therapeutic regimen.
Documentation GuidelinesDocumentation is an essential part of the patient’s chart because the interventions and medications given and done are reflected on this part.
Practice Quiz: Chronic Obstructive Pulmonary Disease (COPD)1. As a cause of death in the United States, COPD ranks: A. Second. B. Third. C. Fourth. D. Fifth. 2. Two diseases common to the etiology of COPD are: A. Asthma and atelectasis. B. Chronic bronchitis and emphysema. C. Pneumonia and pleurisy. D. Tuberculosis and pleural effusion. 3. The underlying pathophysiology of COPD is: A. Inflamed airways that obstruct airflow. B. Mucus secretion that blocks airways. C. Alveolar wall destruction. D. Characterized by variations in all of the above. 4. The abnormal inflammatory response in the lungs occurs primarily in the: A. Airways. B. Parenchyma. C. Pulmonary vasculature. D. Areas identified in all of the above. 5. The most important environmental risk factor in emphysema is: A. Air pollution. B. Allergens. C. Infectious agents. D. Cigarette smoking. Answers and Rationale 1. Answer: C. Fourth COPD is the fourth leading cause of death in the United States. 2. Answer: B. Chronic bronchitis and emphysema Chronic bronchitis and emphysema belong to the old classification of COPD.
3. Answer: D. Characterized by variations in all of the above. Inflammation, hypersecretion of mucus, and alveolar wall destruction are included in the pathophysiology of COPD.
4. Answer: D. Areas identified in all of the above The airways, parenchyma, and pulmonary vasculature undergo inflammation in COPD.
5. Answer: D. Cigarette smoking Cigarette smoking is the foremost factor in the development of emphysema.
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