Case Study #1: Chronic Obstructive Pulmonary Disease (COPD)

Health condition of the patient in the scenario.

 Erin Johns is 74 years old came to the Emergency Department at 18h00. She has difficulties in breathing
when he called her son Thomas to take her in the ED clinic.
 The patient has exacerbation of COPD (Chronic Obstructive Pulmonary Disease), is characterized by
persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities
usually caused by significant exposure to noxious particles or gases and influenced by host factors
including abnormal lung development.

Nursing Care Plan COPD

CUES NURSING OBJECTIVES NURSING RATIONALE EVALUATION

DIAGNOSIS INTERVENTION
SUBJECTIVE: SHORT TERM
“I feel awful, can’t Ineffective After 1 hour of After 1 hour of nursing
catch my breath”-as Breathing Nursing Intervention the
verbalized by the patient. Pattern, related Intervention the Patient has improved
To shortness of Patient will have In her breathing
OBJECTIVE: Breath as improvement in patter as evidence by
- Pursed lip Evidence by, Breathing pattern increase of O2 Sat
Breathing Pursed lip breath- As evidence by from 85% to 92%.
- Blue tinge on Ing, blue tinge on increase of O2
Her lips Her lips and can sat from 85% - 92 -Assess the -To established *Goal met
At 18:h00 not catch her %. vital sign of the Baseline data.
- PR 96 Breath. Patient and O2 sat.
- BP 180/190
- RR 28 -Give oxygen as -to supplement *Goal met
- T 36.5C ordered by the oxygen needed by
- O2 sat 85% doctor. the patient.
At 19:30h
- PR 112 -
- BP 190/84
- RR 28
- T- LONG TERM
- O2 sat 84% at RA After 1 day of
nursing
- Slight wheezing intervention the
In upper fields of Patient will meet
lungs the needs
after discharge -Teach the patient -This will help *Goal met
on how to do Improve the
inspiratory muscle Breathing pattern.
Training

-Teach the client -It helps slow *Goal met

How to do proper Expiration, prevents
Pursed lip breathing Collapse of small
Airways and control
the rate and depth
of respiration.

-Remind his son and -It helps reduce the *Goal met
Mrs. Johns, Risk of exacerbations,
the importance of Through increased
Puffers for taking her Symptom’s control,
Medication regularly and improving
outcomes for the
patient.
-Health educate the - for ensuring *Goal met
Patient about the they're moving
importance of forward with the
follow-up checkup. prescribed
treatment plan, such as
undergoing testing
and taking their
medications

Drug Study COPD

Necessary Assistive Devices

Positive expiratory pressure therapy (PEP)

 This type of device requires you to inhale through a mask or mouthpiece and then exhale against a one-
way valve that provides some level of resistance.

Pulse oximeter

 A pulse oximeter is a small device, usually made of plastic, which clamps comfortably on to a fingertip. It
has an easily readable display window on the front. Within seconds, your pulse and oxygen-saturation
level are measured and posted in this window.

Spirometer

 Measure airflow and how well lungs are working. When you breathe into this device, it measures the
amount of air you are breathing in and out, as well as how fast you are able to inhale and exhale.
Spirometers are useful in tracking how your lungs work overtime and in picking up deterioration and
progression of your illness.
 Oxygen concentrators

 are electronic machines that extract pure oxygen from room air and transport it to your lungs via tubing
and either a nasal cannula or face mask. Because oxygen, especially at higher flow rates, is extremely
drying, the tubing is usually directed through a water bottle.

Nebulizers

 Nebulizers are machines that convert liquid medicine in suspension into aerosol droplets that can be
inhaled into the lungs. They use compressed air, ultrasonic power or even oxygen to do this.

Liquid oxygen reservoirs

 These are the big silver tanks that hold oxygen and are usually used when people first go on oxygen. They
also have water bottles to humidify the oxygen and tubing that carries the gas to your airways.
Journal Related with Reflection

Analyze the scenario for a case presentation at the end of the rotation

References:

https://www.healthcentral.com/slideshow/9-important-medical-devices-managing-copd