It is suggested by Henderson (1998) that breathlessness in the UK today is a common and complex subjective set of symptoms. A vast range of medical and lifestyle choices cause and exacerbate breathlessness, which can be a frightening and sometimes a painful experience for the patient. A nurses interaction with a patient can help alleviate and reduce these episodes and make a substantial difference to patients both in the community and hospital setting.
For many people, becoming breathless after normal exertion is nothing to be concerned about as commented on by Madge and Esmond (2001) and is the expected physiological response to increased activity. However for those who become breathless after minimal exercise or simple daily activities such as walking, going up and down stairs or shopping this can have a significant impact on quality of life for both the person and their family.
This assignment will identify some of the impacts, interventions and outcomes in relation to patient’s quality of life measured against activities of living from Roper, Logan and Tierney.
Whilst looking at the impact that breathlessness can have on patient the author will look at the physical, psychological and social health implications and how this can affect the overall (holistic) quality of life for these patients. Often these three areas overlap and the physical implications of breathlessness can have a direct effect on the patient’s social health, financial ability to provide for themselves and others, which in turn affects the person physiological well-being or vice versa.
The author will also discuss the nursing care required in each area (physical, psychological and social health) and some of the evidence that has supported this in relat...
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Thirteen years of working as a nurse in the UK has provided the author a vast experience in her speciality. Included in this practice was eight years of working before in High dependency
Parker M. E., & Smith M. C. (2010). Nursing theories and nursing practice (3rd ed.).
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Thorne, S. (2010). Theoretical Foundation of Nursing Practice. In P.A, Potter, A.G. Perry, J.C, Ross-Kerr, & M.J. Wood (Eds.). Canadian fundamentals of nursing (Revised 4th ed.). (pp.63-73). Toronto, ON: Elsevier.
The purpose of this essay is to explore nursing care priorities for a patient with a common health condition. A common health condition is a disease or condition which occurs most often within a population. The author has chosen scenario 3 for this essay and will describe the nursing assessment and care planning provided to a patient with Chronic Obstructive Pulmonary Disease (COPD). The WHO definition of COPD is a lung disease which has a chronic obstruction of the airways that impedes normal breathing and is not fully reversible (). According to), there are estimated to be over 3 million people in the UK with COPD. It is common in later life and there are approximately 25,000 deaths each year, with 15% of COPD being work related (The identity of the patient will remain anonymous in adherence with the Nursing and Midwifery Council, Code of Conduct on patient confidentiality (). However, the patient will be referred to as Mr B in this essay. The author has chosen the priority of eating and drinking for Mr B. Patients with COPD are at increased risk of malnutrition and nurses must make certain they screen patients and offer advice or refer as necessary (). If this priority is managed well it will have a positive effect on the other priorities (, 2012). In accordance with NICE Guideline 101 (), the treatment and care provided should consider each persons’ individual requirements and preference. Care and treatment should take into account people’s individual needs and choices. To allow people to reach informed decisions there must be good communication, supported by evidence-based practice (). This essay will provide an evidence based discussion on how care will be implemented in relation to Mr B and his eating and drin...
One of the pivotal roles of a nurse is the ability to recognise patient deterioration. The skill of identifying crucial elements of deterioration and acting appropriately is fundamental for positive patient outcome. A vital skill performed primarily by nurses is the act of respiratory rate measurement. This skill is performed in addition to five other physiological parameters, which form a basis for a scoring system. The scoring systems commonly used are known as NEWS (National Early Warning Score) and EWS (Early Warning Score). As many adverse events are preceded by a period of time where by the patient exhibits physiological dysfunction, there is often time to correct abnormalities. This has significance for nurses, as they are responsible
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
Mrs S. is an 88 years old female patient who lives on her own, and was admitted into a rehabilitation ward following a hip operation due to a fall at home. She has a past medical history of Congestive Cardiac Failure (CCF), diverticulitis, and asthma. Also, Mrs S presented with rapid weight loss, palpitation, feeling tired, peripheral oedema, fatigue, difficulty breathing when lying flat in the bed, waking up at night with shortness of breath and anxiety. In addition to all that she had a pressure sore in her bottom that was not broken. In order to have good holistic care of Mrs S, the nursing process was used as identified by Sibson. Sibson (2010) identifies four key steps to the nursing process, which are assessment, planning, implementation and evaluation; which are important for ensuring a quality standard of nursing care.
McEwen, M., & Wills, E. (2011). Theoretical Basis for Nursing (3 ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
I am writing this reflection because of an incident that happened during activity time. When a resident became upset saying she has chest pain and cant breath. The resident was able to take herself to her
Masters, K. (2012). Chapter 2: Framework for Professional Nursing. Nursing Theories: A Framework for Professional Practice (56, 57). Sudbury, MA: Jones & Bartlett Learning.
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...
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