Critical Evaluation Of COPD

History of Present Illness: Mr. Magnuson is a very pleasant 77-year-old gentleman who was previously seen in this office by Elvira Aguila, MD for COPD and hypoxic respiratory failure. He is here today for routine followed up. He was last evaluated in January 2015. Since that time, he states that his dyspnea is worse. He feels that it is related to the weather. He does state that he works around the house, although he does have significant functional limitations because of shortness of breath. His wife also confirms that he is able to do less and less. He has a stable, minimal cough. He is using 4L of oxygen at night as well as, as needed throughout the day. He continues to smoke three to four cigarettes on

History of Present Illness: Ms. Babula is a very pleasant 76-year-old woman who was previously seen in this office by Elvira Aguila, MD for moderate COPD by pulmonary function testing in 2010. She is currently on monotherapy with Atrovent p.r.n. and she has not used her bronchodilators for quite some time. She does have some stable dyspnea on exertion, which does not limit any of her activities. She does take care of an 18-month-old child as well. She denies any cough, though she does feel that she has some chest congestion in the morning. She denies any chest pain or wheezing.

History of Present Illness: Ms. Manock is a very pleasant 60-year-old woman with a history of severe COPD. She was previously seen by Elvira Aguila, MD. Her last office visit was in February 2015. Since that time, she states that over the last few weeks, she feels her dyspnea has worsened which is a result of increased humidity, which is normal for her. She has had a stable cough over the last six months, which is intermittently productive of sputum. She is using her supplemental oxygen at 2 L/minute with exertion and with sleep. She also notes postnasal drip, which is related to seasonal allergies.

The study began with 32 patients having stages II to IV COPD. They had to meet the criteria pertaining to the Global Initiative for Chronic Obstructive Pulmonary Disease; total lung capacity >120%, (FEV1/FVC) <70%, FEV1 <80%, RV/TLC >140% and >40% of predicted values in stable conditions. Patients were removed from the study if they had asthma, heart failure, orthopedic impairments of the shoulder girdle, recent surgery, past thoracic fractures, pneumothorax, and claustrophobia.

Mr. HS is a 78-year-old retired male, who presented to the emergency room at Northeast Methodist Hospital initially on February 11, 2011, with complaints of shortness of breath and coughing. He was diagnosed as having a COPD Exacerbation and was placed on antibiotic therapy and was released home. He was also advised at that time to complete the entire course of antibiotics and return to his primary treating physician if his condition did not improve.

This is a case study on a 76 year old man.Mr Alan Chari(pseudonym used to protect the identity of a patient),was admitted over night in my department.He is a divorcee who stays with son.He is a retired teacher and his son is permanently employed by a local company as an electrician.He is independent with activities of daily livings but is occasionally limited by his ill health.He used to be a heavy smoker .After realising the burden COPD has on general New Zealand population ,affecting about15% of the adult population over the age of 45 years according to asthmanz( 2010) ,l took this case study to gain in-depth understanding.

In this reflective piece of writing I will be explaining how chronic obstructive pulmonary disease (COPD) affects the patient physically, psychologically ,and socially ,I will also explain how the disease affects his daily routine and how it impacts on his family life. I will give an overview of the clinical signs and symptoms, how the disease alters the pathphysiology of the lungs, and what these changes cause within the body.

Through the convenience sampling, 90 clients were recruited as research participants were in the waiting room of the respiratory clinic. 60 subjects agreed to attend a support group for socialization with each other. 30 of 60 clients were assigned to participate in the presentation and therapeutic exercises by the instructor. The instructor group divided into halves: 15 clients received instructions with family caregiver and the other clients without a caregiver. The second 30 clients received written materials and allowed to access the website for video presentation and exercises. Half of website group assigned to the family caregiver and the other half without a caregiver. The last 30 subjects were assigned as a control group, and half of these clients received usual care with family caregiver and other 15 clients without a family caregiver. The data was collected by the pulmonary functional status survey, 30 items, five points, Likert-type scale.

The audience to which the tool is directed is the general public, with a focus on individuals currently experiencing COPD. The families of these individuals could also benefit from the information presented in the brochure. The tone and readability of the text in the brochure is appropriate for the general public, as technical and scientific jargon is not used and the content is presented in a non-formal conversational tone. The content and presentation of information in no way is directed to any one race or cultural background. Individuals from all cultures would find the information in the brochure appropriate, understandable and accessible.

This assignment will explain the pathophysiology of the disease process chronic obstructive pulmonary disease (COPD). It will examine how this disease affects an individual looking at the biological, psychological and social aspects. It will accomplish this by referring to a patient who was admitted to a medical ward with an exacerbation of COPD. Furthermore with assistance of Gibbs model of reflection (as cited in Bulman & Schutz, 2004) it will demonstrate how an experience altered an attitude. In accordance with the Nursing and Midwifery Council, (NMC) Code of Professional Conduct (NMC, 2005) regarding safeguarding patient information no names or places will be divulged. Therefore throughout the assignment the patient will be referred to

The major goals of treatment are to ease the symptoms, to slowdown disease progression, and to improve the quality life of the patients. Patients with mild to moderate COPD can be adequately managed in the primary care setting by the family physician, whereas patients with more severe COPD and multiple comorbidities need a multidisciplinary approach to treatment. Family physicians should perform spirometry on all patients over 40 years old for early diagnosis, especially if one falls into to the risk group and have history of smoking, chronic cough, shortness of breath, and even frequency of cold (Eeden & Burns, 2008). Smoking cessation remains the single most important factor in slowing the decline in lung function in patients with COPD. Pulmonary rehabilitation (PR) is recommended for the patients with moderate and severe COPD.

Complications surrounding life support can lead to legal and ethical issues. Ventilation support might not be the best options for everyone and some will get to the point where they may be considered ventilator-dependent, despite no improvement in signs and symptoms (ATS, 2015). Eventually, patients and caregivers need to deliberate the benefits and burdens in deciding to initiate life supportive care (ATS, 2015). In summary, it is important to educated patients about the challenges facing COPD and about lifestyle modifications needed to improve the quality of life. As stated previously, patients with COPD can live an independent and semi-active lifestyle as long as they are ready to make the necessary

Some of the laboratory testing used to identify COPD are arterial blood gas and increased hematocrit levels. Arterial blood gas testing will reveals hypoxemia and hypercarbia due to the retention

The ‘APIE’ framework consists of Assess, plan, implement and evaluate, the nursing process should include nursing diagnosis and recheck (Barrett et al 2009). Therefor the ‘ASPIRE’ framework was used to create Kora’s care plan, which is as follows assess, systematic nursing diagnosis, plan, implement, re-check and evaluate (Wilson et al, 2014). The problem of SOB had affected Kora’s oxygen saturation level assessment and this needed to be acted upon promptly as it could quickly be detrimental to the patient’s health. The nurse caring for Kora completed the local trust single assessment process (SAP) holistic assessment document to gather a range of information about Kora and her medical history, if the patient had any dependant relatives, “presenting complaint, concerns, current medications and social history” (Bennett et al, 2009). This enabled the nurse to gather information which could be incorporated into Kora’s care plan. Furthermore, it highlighted that the patient was worried about the care of dependant grandchildren, which could impact on the patient’s wellbeing. Treatment and care should take into account patients' needs and preferences. People with COPD should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals (Nice, 2010).The SAP 1 documentation the nurse involved in Kora’s care completed incorporated RLT

Nurses are a vital component in patient care. The importance of conducting efficient nursing assessments is critical in order to provide both patient-centered care and safe, effective patient healing. Nurses are often responsible for taking care of patients with very complex disease processes. They frequently provide care to patients with illnesses such as Chronic Obstructive Pulmonary Disease (COPD). According to the Centers for Disease Control and Prevention, in 2014, approximately 6.8 million adults were diagnosed with COPD within the Unites States. The completion of proper assessments and initiation of interventions for these patients are crucial in order to prevent further complications of the illness.