Medication Management Assignment- case study Viktor

This case study focuses on Viktor, a 63-year-old man with Chronic Obstructive Pulmonary Disease (COPD). The paper discusses his medical history, current symptoms, and nursing interventions to address his negligence in taking proper medication and quitting smoking. The goals of the nursing intervention include improving Viktor's understanding of his condition, assisting him in quitting smoking, and supporting his emotional well-being. The paper also emphasizes the importance of collaborative inter-professional care in improving the patient's condition.

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Title: Medication Management Assignment- case study Viktor
Student’s name:
Student’s id:

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Introduction
Clinical reasoning cycle is an important process in nursing which helps a nurse to
collect and process patients’ information, and then come to an understanding of the main
problem. According to the problem identified, the care interventions are implemented and
finally, evaluating the outcome, a nurse can reflect on the whole process. Here, in this paper,
a case study will be considered to implement nursing interventions according to the issue and
findings.
Collecting and processing information
Viktor is a 63 year old man with Chronic Obstructive Pulmonary Disease (COPD). He
is a smoker and smokes 20 cigarettes per day from last 40 years. He is diagnosed with a viral
infection. He suffers from hypertension and obstructive sleep apnoea for which he is using
continuous positive airway pressure (CPAP). He gets breathless with minimum exertion and
cannot easily perform his daily activities. He takes Trelegy ellipta 100/25/62.5 micrograms 1
puff /day mane, prn salbutamol 200 micrograms inhaled with spacer, Augmentin Duo Forte
875/125mg bd, Prednisolone 50mg daily for 5 days mane, Nicorette patches 15mg/16 hours
daily mane, also, he is on home oxygen 2Lpm min for 18 hours per day via NP. His SpO2 is
87% when off 02, 80% on waking and 92% on 02. Viktor noticed increasing dyspnoea with
minimal exertion. Upon his physical examination, it has been found that he was fatigue and
moderately breathless while speaking. His RR is 34 bpm, BP is 132/88, SpO2 92% on 2Lpm
of O2, and HR is 90 bpm. Viktor suffers from obstructive sleep apnoea which generally
occurs among the people with chronic lung disease and it stops the breathing of the patients
for short time while sleeping (Nabais & Sá, 2019). This syndrome interrupts the sleep and
causes daytime sleepiness and fatigue (Weldam et al., 2017). It also results in airflow
obstruction. Also, Viktor has smoking cessation that worsens asthma and increases the risk of

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cardiovascular disease and stroke. Being a patient of COPD it can be more harmful for
Viktor. According to studies, 27% COPD patients die due to smoking behaviour in Australia
(Lores et al., 2018). He is also noted to be coughing up green coloured, tenacious sputum
which indicates that Viktor is suffering from infection (Zwar et al., 2016).
Identifying problem and establishing goals of nursing intervention
Viktor identified that his main concern is anxiety regarding the COPD condition. He
also disclosed that he continue to smoke and does not use oxygen until he feels that
necessary. Also, he never uses oxygen when he is out of the house as other people stare at
him. He is not disciplined about taking medicines and he disclosed that he takes it when he
remembers. Therefore, the main issue identified is the negligence of the patient and lack of
interest in taking proper medicine. Also, it is important to take necessary steps in treating
obstructive sleep apnoea. Some treatment options to treat this issue include losing weight,
nasal patency or others. Identifying the problems, it is important for a nurse to assist the
patient. In this case, it is necessary to assist the patient in quitting his smoking habit. Also,
improving the emotional function of the patient along with the self-confidence and coping
strategies as well as improving adherence with medication is necessary. Breathing exercise
and light physical exercise is also important for his weight management (Houben et al.,
2019). Improving mood of Viktor by controlling anxiety is another prime nursing
intervention for him.
Analysing intervention, taking action and evaluating outcomes
In order to address the negligence of the patient about the treatment or use of
medication, it is important to collaborate with Viktor and establish realistic goals as well as
strategies to control his current symptoms. It will also help him to prevent further severe
exacerbation. The strategies should include increasing his understanding of his condition,

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also, the understanding of the interventions and rationales, and the benefits of using oxygen
and CPAP. Secondly, Viktor has smoking habit and it is deteriorating his current condition of
COPD. The nurse will follow the five steps of A’s to assist the patient in quitting the smoking
habit (Heath, Livingstone‐Banks, Hartmann‐Boyce & Rice, 2017). The first step will be to
ask about smoking and documenting the information. Then the nurse should advise on the
benefits of cessation and will help in making a successful attempt in this regard. The nurse
will also assess the level of nicotine dependence and interest of the patient in quitting the
smoking habit. Again, it is the duty of the nurse to assist the patient in making a plan of
action and also arrange for follow-up to review the complete progress and prevent any relapse
(Heath, Livingstone‐Banks, Hartmann‐Boyce & Rice, 2017). The nurse will also look after
the food and nutrition of the patient with the help of a dietician for the weight management of
Viktor. It is important to follow the diet chart in this regard. Another role of the nurse is to
provide care during acute exacerbations and support the self-management process of the
patient. Occupational therapy for modifications to home in order to assist with changes in
mobility is also important to perform (Coventry et al., 2019). To manage his COPD, nurse
should also educate the patient about some breathing exercises and in order to support his
emotional wellbeing, it is necessary to refer to a psychiatrist (Bastos, Vieira & Lima, 2019).
Following these processes, the patient will understand the necessity of using proper
medication regularly. He will also be aware of the adverse effects of smoking upon his COPD
condition and will try to reduce smoking habit. He will be able in following some self-
management processes to control his COPD and a healthy weight will also be maintained
with proper diet. The assistance of psychiatrist will help Viktor to avoid emotional issues.
Conclusion

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This case study is helpful in gaining experience. I have also learned about different
nursing interventions and its implementations according to the situation of the patient. I came
to know about the importance of collaborative inter-professional care and many other aspects
of healthcare. I will utilize this knowledge in future while working as a nursing practitioner in
clinical settings. It is clear that with proper interventions and strategies, it is possible to
improve the patients’ condition.

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References
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