COPD stands for Chronic Pulmonary Obstructive Disease. COPD
is generally found to be occurring in patients of 40 years age or more. This is
a kind of disease accompanied by chronic bronchitis, shortening of breath,
wheezing, pus and mucus in sputum. Some patients suffer from some of these
symptoms and some people have all of them. The patient here is of 65 years and
has a history of smoking. He has been suffering from bronchitis infections for
a long time. Patients like these who have chronic symptoms; they generally face
an early relapse even if treated. So, even after treatment patient needs to be
cautious at home. Apart from this, the medical needs, dietary requirements, at
home care and daily habits to follow are provided here.
COPD is a complex disease which is usually unrecognizable by
symptoms at an early stage. People, who are diagnosed with COPD, generally face
certain symptoms which are chronic and prolonged. There are three main changes
associated with COPD. These are inflammation of the airways, structural changes
in the airways and mucus gland dysfunction.
The inflammation of the airways is generally caused due to
some irritants like air pollutants, active or passive smoke and so on. These
pollutants cause inflammatory cells like B cells, neutrophils to accumulate.
Here, Bill, the patient has a smoking history for a long time. Long-term
smoking has triggered the accumulation of inflammatory cells in case of Bill
and worsened the air flow. The structural changes in the airways are caused due
to the inflammatory process. The accumulation of inflammatory cells narrows the
airways. Abnormal multiplication of epithelial cells, deposition of damaged
tissues and peribronchiolar fibrosis are also responsible for narrowing of
airways and collapses during exhalation. This also reduces lung capacity
causing breathlessness as Bill is suffering.
Mucociliary dysfunction causes the mucus glands to
accumulate in the air tracts and prevents air flow. Here the patient is
suffering from a cough associated with pus and mucus in sputum. Excess deposition
of mucus glands in the airways is responsible for a chronic cough with mucus in
it.
Symptoms
As per Sirey, Raue & Alexopoulos (2016), the general
symptoms include Cough, mucus with sputum, shortness of breath, wheezing and
lethargy. Three main symptoms include chronic bronchitis which generally
includes a persistent cough with mucus filled sputum, Asthma which is caused
due to allergens which trigger inflammation of airways and Emphysema which
literally means shortness of breath. The patient here, named Bill, suffers from
all of these.
Figure 1: Symptoms of COPD
(Source: Lipson & Dibble, 2010)
Risk factors contributing the
symptoms
As stated by Agusti, Hurd, Fabbri et al. (2013), the main and primary risk factor for developing this
disease is smoking. According to survey reports, smoke has been found as the
main factor in about 39% of the cases reported.
As mentioned in the case of Bill, he has a long and persistent smoking
history.
Air pollution is the next important risk factor according to
reports. Any kind of pollution like gases released from automobiles, chemical
factory gases, and even the gases produced in an unclean environment are
responsible. According to Gibson, Loddenkemper, Lundback et al. (2013), findings suggest that burning of mosquito coils can
also lead to this disease as it releases the same amount of smoke produced from
a pack of cigarettes if burnt for 8 hours or more.
We are generally exposed to air pollution on a daily basis
which cannot be avoided fully. Here Bill has been exposed to the environment
pollution and smoking both which played as contributing factors of developing
COPD in Bill.
Medical management
As mentioned by Lipson & Dibble (2010), medicinal
measures that can be taken for people like Bill with chronic bronchitis may be,
use of bronchodilators and inhalers. Bronchodilators help in the relaxation of
airway muscles and promote healthy breathing. Corticosteroids are sometimes
found beneficial in case of people with acute exacerbation of this disease like
in the case of Bill McDonald.
According to Fischer, Scharloo, Abbink et al. (2013), use of
mucolytic medications is found to be beneficial in case of people who suffers
from an acute cough with mucus in sputum. These medicines help to break the
mucus deposition and allow the mucus to get cleared. As specified in case of
Bill, he suffers from a persistent cough and purulent sputum. Patient like him
can be treated by these mucolytic medications.
As per Halpin, Reilly, Connellan et al. (2014), antibiotic therapy is generally used for patients
with acute exacerbating COPD and purulent sputum. Here, Bill McDonald qualifies
for taking this treatment as he suffers from these symptoms.
As per the opinion of Hurd (2013), Oxygen therapy is
generally referred for those patients, who has PaO2 less than 55 mmHg or
patients with O2 saturation 88% or less and PaO2 within 55-59 mmHg. As
mentioned in the case of Bill McDonald, he has PaO2 less than 55 mmHg and O2
saturation less than 88%. Patients like Bill must be referred to take oxygen
therapy.
Nursing management
Nurses play the most important role in the management of
COPD patients. As opened by Vrijhoef, Diederiks & Spreeuwenberg (2014),
they are the one who stays in direct contact with patients for a most of the
time. If they take alert in case of these patients, they can prevent the
patient from getting into a worse situation.
Nurses in the rehab centres can advise the patients to quit
smoking and help them getting rid of the nicotine addiction. Patients like
Bill, who has a long history of smoking, find it difficult to quit smoking and
thus enter into a severe COPD stage. Experienced healthcare people in the
rehabs and nurses help the patient stay away from smoking.
Nurses are also in charge of the nutrition need of the
patients. As specified by Cruz, Brooks & Marques (2014), in this disease
condition, people tend to lose weight gradually. So, nurses must take care of
their proper and healthy diet. In the
case of Bill, as specified here, he even feels shortness of breath and has a
wheezing problem at rest. This often occurs due to less amount of energy. For
this condition, a proper diet must be maintained and observed by a nurse.
Nurses are also responsible for taking care of patients who
need continuous oxygen supply. As stated here in Bill McDonald’s case, he needs
to take oxygen on a daily basis. A nurse is responsible for keeping track of
the oxygen flow and must check the reading and check patient’s condition on an
hourly basis.
There are no
remedies for the disease of Chronic Obstructive Pulmonary Disease (COPD) but
some precautions can be taken by proper exercising, using therapy and regular
meditations. Extra care for the lungs and maintain a healthy life. Smoking
should be stopped as it because breathing problem. Breathing rate gets reduced
due to the presence of smoke in lungs. Nutrition food is required which will
give them energy and active. Chemicals should be avoided while cleaning such as
hairspray or strong smells scents Smith et
al. (2016). Scent-free, the natural product should be used so that the
fragrance does not affect their breathing. Need fresh air to breath and stay
away from the pollution. Harmful lingers present in the air will cause
breathing problem. The person who is affected
by lungs infection needs to take vaccination every year which will prevent them
from influenza and different respiration problems Prescot et al. (2014). Apart from this, the measures which are very
important for this disease are:
Exercise: Mr.
Bill uses to have one pack of cigarettes in a day. This makes his respiratory
system weak and causes COPD. Such that he required a routine exercise or it
will become more difficult to breathe properly. Therefore a regular exercise is
a needed to strengthen his muscles which will improve and maintain the lungs in
proper condition. He will feel confident and independent to do his own work
completely. It is important for the person to do daily exercise but there is no
need to maintain proper steps. He applies his own steps like walking, dancing,
and yoga without using any types of equipment.
Therapy of
oxygen: The volume of the oxygen get
reduced therefore supplement of oxygen is needed to them. This will increase
the amount of pure oxygen and make them active without any problem. Mr. Bill
has been provided with the supplement as he is unable to breathe properly. His
lungs and rest of the body need more oxygen for absorption. Therefore, by this
therapy, his body will get most possible oxygen and can perform actively
without any fail to breathe.
Medication
therapy: It prescribed with three types of COPD Viegi et al. (2014); first one is bronchodilators, which normally
designed for the patients of airways for breathing properly. The second one is
steroids in flights to reduce swelling. Lastly, for the treatment of
infections, some antibiotics are also available. Most of the patients of COPD
have medications on daily basis to make their breathing easier Halbert et al. (2016). This reduces infection on
lungs and stays healthy.
As a result, as
time goes the disease become worse, therefore he needs to monitor by time and
date. Keeping the list of their symptoms will help to monitor them and manage
COPD on control.
Chronic obstructive pulmonary
disease (COPD) can be managed properly by taking effective and in a safe
manner. The entire community can encourage them to develop the services to
provide care and provide them a traditional by the hospital. For some patients
this care is appropriate but who are in the danger condition they need proper
guidance from the hospital. The current symptoms are to be analyzed and
specialized treatment is to followed by them. Awareness regarding smoking in
community and make the others to avoid it Lusurdi, et al. (2016). They to maintain pollution free environment so that
they can breathe easily. Toxic gasses need to be stopped as this also causes
the respiratory problem. Firstly, the patients need to be tested frequently.
Breathing rate needs to count regularly as diagnoses of them regularly
required. This required clinical experience that depends on the different test.
Radiographs of a chest for analyzing the rate of the lungs, this test are to
done on the routine basis Farrero (2014).
Unlike homecare, community cares
for the patients for stabling the diseases. Trained staff is required for the
safe and manageable care. Increasing the facilities of medicines and staff for
the community to advice them. If proper facilities are not given and proper
care not done this will be widespread. For developing generic, different
schemes are to be managing the mental and discover the problem Bourbean et al. (2016). Around the world, this
needs to be changed in a significant way. Training, experiences of staff that
are properly trained by the nursing proper health care. They remind the
management technique and a proper plan to help the patients with high health
care. The department of health says the community would able to be interpreted
by managing, necessary skilled Halpin (2013). Apart from this, the coordination
between the primary and secondary planning need to operate to produce similar
symptoms. The diet of the patient should also be taken care. Good food makes
them healthy as well as gives energy. Their energy gets reduced as they behave
more forceful breath. They need to maintain a diet chart where all the healthy
components are required for their health.
As a result, Mr. Bill needs full
attention for that his condition does not get degraded. The hospital and the
nursing community need to be saturated in which it provided on the regular
basis. As he getting the discharge, therefore, he needs a follow-up care for
the home care.
Patients dealing with COPD suffer severe health problems
like asthma, wheezing, shortage of energy, extreme weight loss and so on. In
the case of Bill McDonald, he is suffering from all these things and is in a
vulnerable condition. In his case, the main role for developing this disease
was smoking and it is also considered as the main cause of COPD. To prevent
this disease, one should stay away from smoke or allergens present in the air.
People diagnosed with this disease should quit smoking, wear masks on exposure
to pollutants, take healthy diet and should be given proper emotional, medical,
domestic support. People should also be provided with adequate education
regarding the disease.
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