Dear Ms.

Bloomfield,

I am glad to hear about your further inquiries into alleviating your struggles with Chronic

obstructive pulmonary disorder. To best address your concerns, I’ll begin by educating your

further on the condition that you have, as this letter progresses I will talk about multiple aspects

of your disease. For your convenience I will list those aspects in this paragraph and then title

each paragraph with an overview of what will be discussed. The following is a list of what this

letter will convey. Causes of your condition, the incidences and risk factors of this disease,

COPD’s impact on yourself and your family, factors that effect your ability to control the

disease, a care plan, interventions to help you maintain safety and independence, and lastly a few

health goals will be set.

Understanding COPD

According to the Medical Surgical Nursing book (2017), COPD is a very preventable and

treatable condition. COPD is manifested by a persistent airflow limitation and is characterized by

an enhanced chronic inflammatory response specifically in the airways and lungs. This disorder

is typically caused by cigarette smoking and other noxious particles or gases. (p. 557) While

tobacco smoke is the primary cause of COPD the CDC lists a few other factors that also

contribute to or cause this disorder. Namely, exposure to air pollutants, genetic factors, and

respiratory infections also cause the development of this disease (Center for Disease Control

[CDC], 2017).

Incidences

According the CDC, COPD is a prominent issue within the United States. 15.7 million

Americans (6.4%) have reported a diagnosis of COPD (CDC, 2017). if this number is averaged
across the United States there would be about 314,000 people in every state with this disorder.

The CDC also provides data on those who are most likely to report with COPD, these individuals

include the following.

 People aged 65–74 years and ≥ 75 years.

 American Indian/Alaska Natives and multiracial non-Hispanics.

 Women.

 Individuals who were unemployed, retired, or unable to work.

 Individuals with less than a high school education.

 Individuals who were divorced, widowed, or separated.

 Current or former smokers.

 People with a history of asthma.

According to another page by the CDC for every 100,000 individuals with COPD there are on

average 39.3 deaths (CDC, 2016).

Risk Factors

Although many different people acquire COPD, there are six very common risk factors

for acquiring this infirmity. The Mayo Clinic includes the following as the most prominent risk

factors, exposure to tobacco smoke, those who have asthma and smoke, occupational exposure to

dusts and chemical, exposure to fumes from burning fuel, being at or above the age of 40, and

genetic factors (Mayo Clinic, 2018). According to MD Judith Marcin there are also risk factors

for causing an exacerbation of your disorder. One of the most common causes of these
exacerbations are a viral or bacterial infection. Other risk factors include exposure to allergies,

inhaling irritating substances, excessive activity, inadequate sleep, and high levels of stress

(Marcin, 2017). Now, and if there is any progression of your disease, it will be of the utmost

importance to avoid these exacerbation risks. As you avoid these causes of exacerbation you can

remain safe and maintain your health.

Impact on self and Family

COPD can be a limiting disease, and if not managed well, is a life altering and controlling

disease. As stated in the book Medical Surgical Nursing, individuals who acquire COPD

frequently deal with many lifestyle changes, these changes involve the following

 a decreased ability at self-care,

 a loss or change in job,

 and decreased energy for social activities.

It is important for yourself and your potential caregiver to be aware of these and other aspects of

the effects of COPD. Other affects to be mindful of are within everyday life. From this point

onward, it is more important to conserve energy, especially if there is a progression in the

disease. Examples of this are discontinuing work or finding a career more suitable to your

decreased energy levels (p. 574). In a study presented by the website, Consultant 360, a list of

daily activities most affected by COPD were determined. The following graph represents

activities most affected by COPD.

(Consultant 360, 2011). COPD can also affect family in the following ways. It can impede a

healthy sex life with a spouse or loved one, limit one’s ability to help with household chores, and

potentially cause financial strain on the family due to an inability to work (Medical Surgical

Nursing, 2017).

Controlling Disease Factors and Independence

I would also like to discuss a few home and social factors that may impact your ability to

control your disease. Within your social environment if you are ever exposed to chemical fumes

or dust it is suggested to discontinue your career as soon as possible to better manage your

condition. Also, if you currently reside in an area that has a large amount of toxins, fumes, or

pollutants you should do your best to relocate to an area without these lung irritants (Mayo

Clinic, 2018). Referring to the Consultant 360 article, home factors that may affect your ability

to control COPD are stairs in the home, and your bed (Consultant 360, 2011). If you reside in a

home with stairs, cesate your need to use them by having others move all needed items to the
main floor. If you own a bed that is difficult to get out of in the mornings, purchase a new bed

that provides enough stability and support that getting up in the mornings does not cause fatigue

and decreased energy. By intervening in these ways this will help you retain more independence

in daily life as you will prevent unneeded expenditure of energy.

Safety and Independence Interventions

Along with the two interventions discussed in the prior paragraph that help maintain your

independence, I will present 3 more that will assist you to maintain your safety and independence

with your condition. One method that can be implemented to maintain increased independence is

via the use of a mobile oxygen cannister and a nasal cannula. This will prevent low oxygen

levels and allow you to continue many normal activities (Medical Surgical Nursing, 2017). Two

more interventions that can be implemented into your life to maintain safety is ensuring that

open flames and smoking are nowhere near your use of Oxygen as they can cause combustion

resulting in significant burns. One last safety intervention to be aware of is to not increase your

oxygen levels beyond the prescribed amount. Many COPD patients develop hypercapnia and if

oxygen above the prescribed amount is continually administered it may lead to detrimental and

dangerous consequences (Medical Surgical Nursing, 2017).

Health Promotion Activities

Two important health promotion activities you can perform are exercising regularly, and

frequent hand washing using proper techniques. Hand washing aids in preventing respiratory

infection. As previously discussed, respiratory infection can lead to exacerbations and worsening

of your condition. Exercising regularly is important for multiple reasons. Among these reasons is

to control one’s weight and promote improved breathing (Medical Surgical Nursing, 2017).
Weight gain is detrimental for COPD because it increases the difficulty to breathe. If you are

interested in further health promotion activities and specifics on exercise, contact me via email or

appointment and we can discuss these topics more in depth.

Disease Prevention, acute episode management, and Treatment

For this last paragraph a labeled bullet pointed list is used to improve your understanding of

prevention, acute episode management, and treatment options available for COPD.

 Prevention

o Avoid inhaling tobacco smoke and air pollutants (CDC, 2017).

o To prevent exacerbations frequently wash your hands to prevent respiratory

infection and obtain pneumonia and influenza vaccines. Also, avoid respiratory

irritants such as smoke and smog. (Medical Surgical Nursing, 2017).

 Acute Episode Management

o Acute episodes are managed using short-acting bronchodilators, oral systemic

corticosteroids, and antibiotics

o Hospital therapies are similar except the implementation of supplemental oxygen

is also utilized.

o Consult with your physician on the specifics of managing acute episodes in your

condition.

o (Medical Surgical Nursing, 2017)

 Treatment Options

o Smoking Cessation

 For anyone experiencing the effects of COPD the most important measure

to treat this disease is smoking cessation.

 o Pharmacological Approach

 Medications used for COPD have several positive effects such as reducing

symptoms, increasing one’s exercise capacity, reducing the number of

exacerbations you may experience, and improving your overall health.

 The following are some of the medications that may be used in the

treatment of COPD but before taking any of them, a medication consult

should be arranged with your physician.

 Beta 2 adrenergic agonists, anticholinergic agents,

methylxanthines, and Inhaled corticosteroids,

o Oxygen Therapy

 This is also considered a prescribed medication, and at this point is the

only one proven to improve survival of COPD patients.

I hope that this letter helps you manage your COPD and that you will find much direction from

this care plan that I have created for you.

Sincerely,

-Daniel Meyers, SN
 References

Bucher, L., & Harding, M.M., & Heitkemper, M.M., Kwong, J., Lewis, S. L. (2017). Medical-

Surgical Nursing. (10th ed.). St. Louis, MO: Mosby.

Chronic Obstructive Pulmonary Disease. (2017). In Center for Disease Control. Retrieved June

2, 2018, from https://www.cdc.gov/copd/index.html

Chronic Obstructive Pulmonary Disease. (2017). In Center for Disease Control. Retrieved June

2, 2018, from https://www.cdc.gov/copd/data.html

Chronic Obstructive Pulmonary Disease: Impact of Symptoms on Activities of Daily Living and

Quality of Life. (2011). In Consultant 360. Retrieved June 2, 2018, from

https://www.consultant360.com/articles/chronic-obstructive-pulmonary-disease

impact-symptoms-activities-daily-living-and-quality

COPD. (2018). In Mayo Clinic. Retrieved June 2, 2018, from

https://www.mayoclinic.org/diseases conditions/copd/symptoms-causes/syc-20353679

Marcin, J. (2017). What to know about an exacerbation of COPD. Retrieved June

2, 2018, from https://www.medicalnewstoday.com/articles/315611.php