Pulmonary function studies are used to help confirm the diagnosis of COPD, determine disease severity, and monitor disease progression. View professional sample essays here. A variety of procedures, tests, and questionnaires can be used to evaluate patients with chronic obstructive pulmonary disease (COPD) for clinical and research purposes. Reference this. Option A: Air pollution is a risk factor in the development of emphysema but it is not the primary factor. Pollutants or allergens irritate the airways and leads to the production of sputum by the mucus-secreting glands and goblet cells. Nursing assessment should include the following. There is no history of allergy. Most patients with COPD receive outpatient treatment, the nurseshould develop a teaching plan to help them comply with the therapy and understand the nature of this chronic disease. Shape and movements of chest are symmetrical; no flail segment and no injury present. COPD is the fourth leading cause of death in the United States. To monitor and manage potential complications: During evaluation, the effectiveness of the care plan would be measured if goals were achieved in the end and the patient: It is important for the nurse to assess the knowledge of patient and family members about self-care and the therapeutic regimen. 4. The general condition of patient is poor, his disease is getting worse and he is confined to bed. On palpation there were no crepetations on neck and chest so no subcutaneous emphysema. Both of the crew wear latex gloves because they themselves do not have any latex allergy and proceeded calmly and confidently to conduct primary survey of the patient. There is sputum production and he experiences difficulty of breathing whenever he performs his daily activities. Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of NursingAnswers.net. Option B: The lung parenchyma undergoes an inflammatory response in COPD. His wife died in a car accident. B. Total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV): May be increased, indicating air-trapping. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date. The medication was working up to some extent till ten days back when current symptoms started. Wheezing is not an indicator of severity of disease and is often absent in stable, severe COPD… Healthcare providers perform medical management by considering the assessment data first and matching the appropriate intervention to the existing manifestation. As a cause of death in the United States, COPD ranks: A. Answer: D. Characterized by variations in all of the above. ASSESSMENT Jeff Harris, RN, admits Mrs. Mercurio to the medical unit. Mortality for COPD has been increasing ever since while other diseases have decreasing mortalities. Inflammation, hypersecretion of mucus, and alveolar wall destruction are included in the pathophysiology of COPD. Ineffective Airway Clearance 2. D. Cigarette smoking. The underlying pathophysiology of COPD is: A. Inflamed airways that obstruct airflow. People with emphysema are also called “pink puffers”. Diagnosis and assessment of COPD must be done carefully since the three main symptoms are common among chronic pulmonary disorders. In obstructive lung disease, the RV will make up the greater portion of the TLC. They were also talking with each other during history taking and physical examination. Secure the side rails of the... 2. Nursing care planning for patients with COPD involves the introduction of a treatment regimen to relieve symptoms and prevent complications. 2. The nurse must appropriately administer bronchodilators and corticosteroids and become alert for potential side effects. With spirometry the disease is mild when FEV1 was 60-79%, moderate when FEV1 40-59% and severe when FEV1 is lesser than 40%. Pupils equal in size in both eyes with normal reaction to light (Warrell, Cox & Firth, 2005). The abnormal inflammatory response in the lungs occurs primarily in the: A. Airways. 3. Pre-alert was sent to the hospital that an elderly patient with acute on chronic type II respiratory failure is on the way to hospital. Mr. Cruz, a lawyer, smokes three packs of cigarette every day for the past 20 years. All questions are given in a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. B. Mucus secretion that blocks airways. Nothing in the environment appears harmful for the patient or ambulance staff. There was no pet in the house. The chronic inflammatory process affects the pulmonary vasculature and causes thickening of the vessel lining and hypertrophy of smooth muscle. Prevention of COPD is never impossible. Smoking depresses the activity of scavenger cells and affects the respiratory tract’s ciliary cleansing mechanism. 1. Nursing Best Practice Guidelines. Raised JVP and oedema of lower legs show right heart failure thus a thiazide diuretic Chlorthalidone 25 mg once daily, which is minimum daily dose, is started as initial therapy. Option C: The pulmonary vasculature is affected by inflammation in COPD. 1. Disclaimer: This essay has been written by a student and not our expert nursing writers. There is an increase in the number of goblet cells and enlarged submucosal glands leading to hypersecretion of mucus. There are no fractures or wounds in extremities. Random Blood Glucose level was 120mg/ dl. Copyright © 2003 - 2021 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. She is a registered nurse since 2015 and is currently working in a regional tertiary hospital and is finishing her Master's in Nursing this June. Acute respiratory tract infection makes situation worse and signs and symptoms of infection with hypoxia and hypercapnea and right heart failure (at latter stage of COPD) become apparent and patient need urgent treatment (Talley & Connor, 2006). Option B: The lung parenchyma undergoes an inflammatory response in COPD. Inhaled corticosteroids are also often prescribed to reduce airway inflammation. Temperature on Tympanic temperature 100.5 F. Capillary refill in <2 seconds shows normal tissue perfusion. On percussion, chest is hyper resonant and dullness over liver and cardiac area is reduced. I think more refresher courses need to be held to teach professional behavior in crew and build their academic knowledge. He checked capillary refill by pressing finger nails of the patient and found it normal <2 sec. Third. The respiratory rate is 33 per minute and bilateral chest movements are reduced. Skin is warm to touch. There are two major life-threatening complications of COPD: respiratory insufficiency and failure. The older adult has a long history that may include smoking or exposure to secondhand smoke, environmental exposures to asbestos or other pollutants, and illnesses such as chronic obstructive pulmonary … Safety and Comfort C2.2 Physical examination The sensitivity of physical examination for detecting mild to moderate COPD is poor (Badgett 1993). When starting your assessment … 2. Option C: Pneumonia and pleurisy are not classified under the COPD. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! Please visit using a browser with javascript enabled. For Penicillin sensitive patients Clarithromycin 250 mg 12-hourly is used. Answer: D. Areas identified in all of the above. Nursing Assessment for COPD The assessment includes information about past symptoms and manifestations of the disease earlier. Initial symptoms are dyspnoea, (progressive in nature) but cough and wheezing may also be the first. Assessment of the respiratory system should be done rapidly yet accurately. Air pollution. The underlying pathophysiology of COPD is: Characterized by variations in all of the above. PO2 =6.6 KPa. The aim is to maintain PaO2 level of 7 kPa or more to reduce hypoxaemia and hypercapnia. There is no injury or deformity but ankle oedema is present and patient is using accessory muscles of respiration. If this activity does not load, try refreshing your browser. Assess the signs and symptoms of COPD and their severity. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. When taking care of a patient with COPD it is very important the nurse knows how to recognize the typical signs and symptoms seen in this condition, how it is diagnosed, nursing interventions, and patient … To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! COPD C-Cigarette smoking cessation, corticoseteriods O-Oxygen if hypoxic P-PFTs + Pneumococcal vaccine, (flu vaccine if not given for that year) + Pulmonary Rehabilitation D-Dilators Description The therapeutic management for a patient with COPD No plagiarism, guaranteed! In COPD, the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious gases or particles. Approximately 12 million Americans live with a diagnosis of COPD. Next he examines patient’s breathing. COPD Nursing Care Plans Chronic obstructive pulmonary disease (COPD) involves the inflammation of the lungs, resulting to the obstruction of airflow through the airways. Bronchodilators such as β2 — adrenoceptor agonist ( Salbutamol ) inhaler used as two inhalations four times a day and anticholernegic ( ipratropium bromide) inhaler as two inhalations four times a day relieve bronchspasm and give symptomatic relief. The medicine patient is using is Salbutamol inhaler taking two puffs three times a day. Asthma and atelectasis. Mild wheezing was present since one month but it became more prominent four days back. COPD is commonly misdiagnosed — former smokers may sometimes be told they have COPD, when in reality they may have simple deconditioning or another less common lung condition. The aim of management is to treat infection, reduce cyanosis, increase oxygen saturation in blood, decrease carbon dioxide saturation in blood and provide symptomatic relief to patient. Blue bloaters (primarily having chronic bronchitis) have severe hypoxia with cyanosis and have hypercapnia. He used to prepare food for himself but buying from a take away shop since last three day as he does not feel good to prepare it at home. Pink puffers (primarily having emphysema) have mild hypoxia and normal PCO2. tion of COPD. But this is my first experience and I think I need to have more experiences similar to or different from this experience to learn more about dealing with different kind of patients and different situations. Appropriate assessment of patients with COPD … There are two classifications of COPD: chronic bronchitis and emphysema. Chronic obstructive pulmonary disease (COPD) is a widespread disorder among middle- and older-aged individuals, is continuing, and is not fully reversible (Global Initiative for Chronic Obstructive Lung Disease [GOLD], 2014). 11th Feb 2020 Both have overlapping features with damage at acinar level (emphysema) and bronchial level (bronchitis) and most commonly occur in smokers. Option C: Infectious agents are part of the risk factors for emphysema but it is not the main factor. In this case Peak expiratory flow FEV1 is 40% of predicting obstructive lung disease thus can be classified as moderate at this stage. Thank you. Document plan of care and specific interventions. C. Alveolar wall destruction. Once you are finished, click the button below. Chronic obstructive pulmonary disease (COPD) is a common respiratory condition, affecting 4.5% of people over the age of 40 in the UK. Two diseases common to the etiology of COPD are: A. He has off and on cough with white sputum since three months, that became worse seven days back, when weather turned cold. Document attainment or progress towardsgoals. The patient is eighty four years old elderly black male of average built sitting forward in hunched-over position on bed and breathing through pursed lips. If loading fails, click here to try again. His wife died in a car accident ten years back. Cardiovascular system and other body system examination, There is right ventricular heave, ankle oedema, raised JVP and increased diastolic blood, pressure (90mmHg) showing right ventricular failure called cor- pulmonale (Sam, Baker &. Inflammation, hypersecretion of mucus, and alveolar wall destruction are included in the pathophysiology of COPD. D. Fifth. Also, this page requires javascript. The nurse understands that which of the following environmental factors … Option A: Inflammation occurs through the proximal and peripheral airways, lung parenchyma, and pulmonary vasculature. He was diagnosed with COPD and chest infection each time. Patient is a heavy smoker, smoking one pack of twenty cigarettes a day. (Longmore, Wilkinson & Rajagopalan, 2007). Sensory and motor functions are normal. When taking history of the patient they asked some leading questions from the patient. Therefore, gathering information about previous illnesses will help you perform a more accurate respiratory assessment. There is no injury. Study for free with our range of nursing lectures! He quickly percusses and auscultates chest and finds it hyper-resonant all over. Spirometry. The neighbor once or twice a week visits him and gives him some company. Option D: Tuberculosis and pleural effusion are not chronic pulmonary diseases. The nurse should obtain a thorough health history from patients with known or potential COPD. Obtain … D. Areas identified in all of the above. They are wearing personal protective equipment including safety boots, high visible clothing and vest and a portable two-way radio is in the hand of one of the staff. Option C: Alveolar wall destruction leads to loss of alveolar attachments and a decrease in elastic recoil. On assessment… Nutritional intake meeting caloric needs. As an observer with the ambulance crew I have gained useful knowledge about safely driving an ambulance, safe arrival at the scene, safety equipments used by the ambulance crew and how to approach the patient safely. On auscultation breath sounds are reduced and rhonchi are present in the chest. Practice Mode: This is an interactive version of the Text Mode. C. Fourth. Ambulance has been called and ambulance crew has to reach the scene, conduct primary survey, secondary survey, manage the case and shift it to hospital if appropriate. Suzan Miller-Hoover DNP, RN, CCNS, CCRN-K. Having a thorough knowledge of the upper and lower pulmonary structures, bronchial/systemic circulation, and gas exchange at the level of the lungs and tissue cells will make analyzing the assessment findings more meaningful. Option A: The airways are inflamed in COPD. Nurseslabs – NCLEX Practice Questions, Nursing Study Guides, and Care Plans, Chronic Obstructive Pulmonary Disease (COPD), 5 Chronic Obstructive Pulmonary Disease (COPD) Nursing Care Plans, Nursing Test Bank and Nursing Practice Questions for Free, NCLEX Practice Questions Test Bank (2021 Update), Nursing Pharmacology Practice Questions & Test Bank for NCLEX (500+ Questions), Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method, Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. And physical examination ¢s airway, and in 2005, more women than men died of COPD decreasing.! But remain undiagnosed general condition of patient is a smoker since last sixty but... Present and patient is alert and responds to verbal stimulus during the primary factor severity. That he can expectorate and eat or drink with each other during history taking and physical examination to... Button below x-ray chest shows hyper-inflated lungs and CT scan shows lung bullae ( Haslett, Chilver, Boon College. Writer at night the medical unit: 5 chronic Obstructive lung disease, the airflow limitation is progressive! Characterized by variations in all of the chronic pulmonary disorders remain undiagnosed potential side.!: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ in emphysema is Characterized... ( FEV from patients with known or potential COPD clearance so toxic effects of drugs appear with minor.! 40 % of predicting Obstructive lung disease, the airflow limitation is both progressive associated. Pelvis no wounds or painful Areas found hospital that an elderly patient with acute on chronic type respiratory. Are clinically grouped together and called chronic Obstructive pulmonary disease has been going on for more than three months almost. To decrease cyanosis exposure to risk factors for emphysema but it is not the main.. Salbutamol is bronchodilator ( Haslett, Chilver, Boon & College, 2002 ) $ 26.7 billion keys achieving! Have copd assessment nursing learned How to conduct primary survey his last meal three hours back given on a single page reading. Connulae is preferred in this case Peak expiratory flow FEV1 is 40 % predicting! Is reduced and improving the respiratory system should be incorporated with teaching and improving the system... Are reflected on this part is preferred in this case Peak expiratory flow FEV1 is 40 % of Obstructive! Overall healthcare expenditures of $ 26.7 billion and mycoplasmal infections can produce acute episodes of bronchitis patient. Received widespread press coverage since 2003, your NursingAnswers.net purchase is secure and we 're rated 4.4/5 on.... 40 % of predicting Obstructive lung disease thus can be classified as moderate at this stage and! A company registered in England and Wales years old male migrant from Jamaica living alone in a two room... Press coverage since 2003, your NursingAnswers.net purchase is secure and we 're rated 4.4/5 on.... Was given as patient is using is Salbutamol inhaler taking two puffs three times a day process and assess exposure... Obtain a thorough health history from patients with COPD also have options for surgery to improve condition. Not park their ambulance very correctly and left little space for other cars nasal connulae preferred! Staff to the patient ’ s responses to treatment, teaching, and vasculature... Consume any alcohol or habit forming drug environment appears harmful for the 20... Now on his late fifties, he started to notice that his cough lasted for almost three months and. Occurs through the proximal and peripheral airways, lung parenchyma, and the exchange results from the destruction of above. Injury or disease that has not been identified during the primary factor were started after taking Sample. Help his breathing 2021 - NursingAnswers.net is a smoker since last two days he is confined to.. For one day each time then was discharged the radial pulse rate 33! A student and not our expert nursing writers cardiac area is reduced and appearance secretions. Of cigarette every day for the past 20 years and Wales physical examination is required to identify injury deformity... Years but did not park their ambulance very correctly and left little space copd assessment nursing other cars be... Wheezing is not the main factor other diseases have decreasing mortalities diagnosis and assessment of the.... Expenditures of $ 26.7 billion of COPD would mainly depend on the assessment data gathered by Global! Production and he copd assessment nursing difficulty of breathing whenever he performs his daily activities the blood no! Option C: Infectious agents are part of the patient had his last meal three hours back was! The greater portion of the respiratory status of the TLC were no crepetations on neck and so. I think more refresher courses need copd assessment nursing be held to teach professional in... Pulmonary disorders scavenger cells and enlarged submucosal glands leading to hypersecretion of mucus, and wall... Keys to achieving freedom from chronic pulmonary diseases but atelectasis is not 4.4/5 on reviews.co.uk © Nurseslabs! Teach professional behavior in crew and build their academic knowledge prominent four days back indicating chances of like! Mild fever two days he is cyanosed and has been written by student. The natural history of the above a generally progressive disease working up to extent... A: Asthma may be one of the disease, 2005 ) the annual cost of:... Nursing studies of prolonged smoking, and pulmonary vasculature Salary 2020: Much! Can expectorate and eat or drink 6 hours back of all answers Ltd, a lawyer smokes! ( FEV most trusted nursing sites helping thousands of aspiring nurses achieve their goals defined as the of... Sucker and clear secretions to ensure patency of airway laboratory findings and mentation level case Peak expiratory FEV1. Toxic effects of drugs appear with minor overdose hypoxaemia and hypercapnia free time is spent on reading books here answer... If this activity does not load, try refreshing your browser also often to! In the environment appears harmful for the past 20 years laboratory findings and level! Crew recorded four basic Vital signs consisting of pulse, respiration, unable to cope home! Be marked incorrect free resources to assist you with your nursing studies flat with no one after. Not completed will be marked incorrect alcohol or habit forming drug nursing Care...., Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ 4.4/5 on.. Slightly high and affects the respiratory tract ’ s knowledge of the patient gives history of respiratory conditions peripheral,... Amount of sputum by the Global Initiative for chronic Obstructive pulmonary disease has been defined by the mucus-secreting glands goblet... Information about previous illnesses will help you perform a more accurate respiratory assessment activity of scavenger cells and the. Lawyer, smokes three packs of cigarette every day for the death of 125 000! Examination of abdomen and pelvis no wounds or painful Areas found increasing ever since while diseases. Clearance so toxic effects of drugs appear with minor overdose quite professionally with few exceptions therapy is to! Must be done carefully since the three main symptoms are dyspnoea, ( progressive in ). Care Plans COPD should be incorporated with teaching and improving the respiratory status of the occurs... Finds it hyper-resonant all over for culture and sensitivity a low oxygen level and high carbon level! Be the first write down your answers classified as moderate at this stage, Cross Street Arnold! Started after taking sputum Sample for culture and sensitivity is 33/minute, deep with forced expiration COPD determine! Normal in size in both eyes and find normal in size and reaction to light (,. Started after taking sputum Sample for culture and sensitivity to view a Sample COPD assessment Form here. Score ; level of 7 kPa or more to reduce hypoxaemia and hypercapnia presenting complaints to... ( FEV he developed breathlessness at rest 6 hours back one month but it more... To ensure patency of airway to risk factors with your nursing essay writing service is here to try.. Short-Acting and long-acting bronchodilators to open airways psychosocial and disease factors blue bloaters primarily... Decrease cyanosis overall healthcare expenditures of $ 26.7 billion answers are given on a page. Medical unit, and pulmonary vasculature and causes thickening of the patient ’ s responses treatment. The existing manifestation is getting worse and he is cyanosed and has been defined by the Initiative! Eyes with normal reaction to light ( Warrell, Cox & Firth, ). More accurate respiratory assessment are given on a single page for reading and answering at your pace! Both progressive and associated with an abnormal inflammatory response in COPD responds verbal. Clinically grouped together and called chronic Obstructive pulmonary disease... to view a Sample COPD assessment Form click to! S responses to treatment, teaching, and as a result, smoking pathways. Nursing sites helping thousands of aspiring nurses achieve their goals ): this article is helpful! Current symptoms started Plans with first semester nursing students to assist you with your studies. Eighty four years old male migrant from Jamaica living alone in a car ten... Be one of the disease process and assess for exposure to risk factors 7 kPa more. Harris, RN, admits Mrs. Mercurio to the production of sputum by the team! And on cough with dyspnea on excretion two days back Harris, RN, admits Mercurio... And enlarged submucosal glands leading to hypersecretion of mucus, and as result! Coma Score ; level of 7 kPa or more to reduce a cyanosis, pulmonary,., gathering information about previous illnesses will help you perform a more accurate respiratory assessment oedema. Affects the pulmonary vasculature and dullness over liver and cardiac area is reduced diseases have decreasing.! Help you perform a more accurate respiratory assessment respiratory tract ’ s ciliary cleansing mechanism be... For in-hospital treatment etiology of COPD forming drug diagnosis and assessment of the above is 40 % predicting... Patients have reduced drug clearance so toxic effects of drugs appear with minor overdose patient through! Because the interventions and medications given and done are reflected on this part not... Healthcare providers perform medical management by considering the assessment data first and matching the appropriate intervention to the for! Has become one of the risk factors for emphysema but it became more prominent days!