Today there are various treatment options for those that suffer from mild, moderate, and severe chronic obstructive pulmonary disease (COPD). Staging COPD is the first step in treatment and in order to make a proper diagnosis physicians use the GOLD standard. GOLD stands for Global Initiative for Chronic Obstructive Lung Disease and this staging method uses forced expiratory volume in one second (FEV1) to classify the varying severities of COPD. FEV1 greater than 80% of their total exhaled breath or forced vital capacity (FVC) is considered to be mild, between 50% and 80% is moderate, between 30% and 50% is severe, and less than 30% is very severe. These are also signified by stages, stage I being the best and stage IV being the worst (Spencer and Hanania 2013). Once the severity of COPD has been discussed and tested for, treatment options can then be assessed. …show more content…
Non-pharmacological include smoking cessation, diet, change in routine, and exercises that can be performed at home. Of these, one stands out above the rest, smoking cessation. Smoking is the number one association with COPD and quitting is the only current therapy proven to decrease mortality (Spencer and Hanania 2013). Therefore one of the first things that should be discussed with your patient is their smoking habits and the importance of quitting immediately no matter the stage at which they have been diagnosed. Patient education should become a constant focus in your clinic in order to improve patient compliance and
Additionally, some of the general diagnostic and pulmonary function tests are distinct in emphysema in comparison to chronic bronchitis. In the case of R.S. the arterial blood gas (ABG) values are the following: pH=7.32, PaCO2= 60mm Hg, PaO2= 50 mm Hg, HCO3- = 80mEq/L. R.S.’s laboratory findings are indicative of chronic bronchitis, where the pH and PaO2 are decreased, whereas PaCO2 and HCO3- are increased, when compare to normal indices. Based on the arterial blood gas evaluation, the physician can deduce that the increased carbon dioxide is due to the airway obstruction displayed by the hypoventilation. Furthermore the excessive mucus production in chronic bronchitis hinders proper oxygenation leading to the hypoxia. On the other hand, in emphysema the arterial blood gas values would include a low to normal PaCO2 and only a slight decrease in PaO2 which tend to occur in the later disease stages.
It incorporates dietary advising, exercise training, and mental guiding. There are also numerous surgical treatment alternatives. For example, the removal of nasal polyps that block breathing, oxygen treatment to prevent pulmonary hypertension, endoscopy and lavage to suction mucus from airways, the surgical insertion of a feeding tube may be important to convey supplements while sleeping. In cases where life-threatening lung complexities arise, a lung transplant may be viewed as an option.
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
This exacerbation of her COPD revealed the need for inhaler re-education. This education holds more importance due to her exacerbation that possibly could have been prevented with proper inhaler use. An education plan should be developed to assess her readiness to learn and to map out a schedule of sessions. Several sessions over an extended period of time with continuous re-evaluations is essential. Research has shown that this approach has better long term outcomes (M., Duerden & D., Price, 2001).
CF is a chronic condition therefore the patients are either seeking medical attention or receiving (sometime involuntarily) a great deal of medical scrutiny and intervention during their lifetime.
Previous research used noninvasive ventilation to help those with COPD improve their altered level of consciousness by allowing the alveoli to be ventilated and move the trapped carbon dioxide out of the lungs. When too much carbon dioxide is in the blood, the gas moves through the blood-brain barrier and causes an acidosis within the body, because not enough carbon dioxide is being blown off through ventilation. The BiPAP machine allows positive pressure to enter the lungs, expand all the way to the alveoli, and create the movement of air and blood. Within the study, two different machines were used; a regular BiPAP ventilator and a bilevel positive airway pressure – spontaneous/timed with average volume assured pressure support, or AVAPS. The latter machine uses a setting for a set tidal volume and adjusts based on inspiratory pressure.
Chronic obstructive pulmonary disease is a lung disease that affects millions of United States citizens. It is the third leading cause of death because there is no cure for the disease. The best way to fight COPD is to make sure that people that have high risk factors, such as smoking and AATD get tested immediately to slow down the process of the disease.
To effectively manage COPD it is essential for patients to monitor themselves by writing a list of dates and times when experiencing symptoms and reactions to treatments. (Lung Chicago Managing COPD, 2016). Understanding a patient’s personal disease characteristics will help in determining treatment to prevent exacerbations. To maintain stable condition of the disease, COPD patients need to understand and reduce risk factors. Counseling programs such as smoking cessations need to be available for COPD patients as part of their treatment. Pharmacotherapy for the disease is also used to reduce its symptoms and difficulties on
Carone M, D. C. ( 2007). Clinical Challenges In COPD[e-book]. (Oxford: Clinical Pub) Retrieved March 24, 2014, from (EBSCOhost).
The patient that stimulated the interest in this subject was a 57-year-old male admitted with an acute exacerbation of COPD. The patient also had a history of hypertension, pulmonary embolism, and deep vein thrombosis. The patient is a smoker as well as his family. He has had many problems with trying smoking cessation for years. The patient also has a history of depression and anxiety. The patient has been on many medications to control his hypertension, but it is still out of the normal range. This man was in great need of nonpharmacological intervention and education.
Below will be looking into the progression of the disease and effects it will have on bill and his family, also will look into the pathophisology of COPD, nursing considerations, treatment management and the community services available to Bill so he can return home safely.
Patients with advanced COPD are prone to develop secondary complications of the disease. The goal of treatment is to restore functional status as quickly and as much as possible and to alleviate distress and discomfort. The main diseases associated with pulmonary arterial hypertension are that anemia Osteoporosis and coronary heart disease. Cor Pulmonale refers to altered structure or function of the right ventricle, resulting from pulmonary hypertension (PH) associated with chronic lung disease In the course of COPD endothelial dysfunction occurs in the pulmonary artery, which has a decreased secretion of Vasoactive mediators such as nitric oxide and Prostacyclin come, this leads, also enhanced by the hypoxia to
COPD GOLD Grade A: A bronchodilator (short or long acting), titrating or switching to another as
Vestbo, J., (2011), Clinical Assessment of COPD, COPD: a Guide to Diagnosis and Clinical Management, pp. 21-33, New York: Springer Science & Business Media
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.