Reference no: EM133912725
Question
Overview
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent and progressive airflow limitation. Clinical use of the term COPD encompasses two types of obstructive airway diseases: chronic bronchitis and emphysema. Chronic bronchitis is the presence of a productive cough for 3 months in each of 2 consecutive years, when other causes of chronic cough have been excluded. Emphysema is characterized by abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of the walls and absence of obvious fibrosis. Patients with COPD may have a predominance of one of these conditions, but clinically it is difficult to determine because the conditions usually coexist. Chronic lung irritation from smoking, infection, or inhaled irritants is the primary cause of COPD. Genetics and aging may also contribute to the development of COPD.
Although the pathogenesis of COPD is complex and involves many mechanisms, the underlying process is chronic inflammation. Inability to expire air is the main characteristic of COPD. Clinical manifestations typically develop slowly, beginning with a chronic, intermittent cough and can progress to dyspnea at rest in the late stages.
Interprofessional care focuses on preventing or slowing disease progression, relieving symptoms, improving exercise tolerance, preventing and treating exacerbations and complications, promoting patient participation in care, improving quality of life, and reducing the risk of mortality. Management of patients with COPD includes smoking cessation, drug therapy, oxygen therapy, respiratory therapy, physical therapy, nutritional therapy, and surgical therapy.
Objectives
1. Identify relevant assessment data for a patient with COPD.
2. Evaluate results of diagnostic studies for a patient with COPD.
3. Prioritize nursing interventions for a patient with an acute exacerbation of COPD.
4. Appropriately delegate care for a patient with an acute exacerbation of COPD.
5. Develop a nursing care plan for a patient with COPD.
6. Describe the appropriate treatment for a patient with complications of COPD.
7. Formulate an individualized teaching plan for a patient with COPD.
Case Study
M.B. is a 62-year-old male who is being admitted from the emergency department to the cardiopulmonary unit with an exacerbation of chronic obstructive pulmonary disease (COPD).
M.B. has been using ipratropium (Atrovent) and albuterol (Proventil HFA) metered-dose inhaler for control of his symptoms at home. His admission vital signs are as follows: BP 158/86 mm Hg, heart rate (HR) 118 beat/min, respiratory rate (RR) 36 breaths/min, temperature 101.4°F (38.4°C), and SaO2 85%. He is 5 ft 10 in tall, weighs 180 lb, and has a marked barrel chest.