Chronic obstructive pulmonary disease

Task 1
Mrs. Rose Caring Plan
Considering Rose's clinical history, she may be suffering from chronic obstructive pulmonary
disease. Chronic obstructive pulmonary disease is a lung inflammatory disease that blocks the
airways from the lungs and is familiar to older adults. The inflammation of the lungs may be
caused by loosening of air sacs elastic, the walls between the air sacks might be destroyed,
walls to the airwaves might be thickened hence become inflamed, or the airways might
produce more mucus than usual leading to clogging. COPD is mostly caused by tobacco
smoking, exposure to too much air pollution, or breathing of toxic chemicals in the
environment (Burkhardt, & Pankow, 2014). An earlier experience with respiratory infections
may also trigger COPD infection. Besides, it is also said that some genetic conditions of
Alpha-1 antitrypsin deficiency contribute to causing chronic obstructive pulmonary disease.
This is because individuals with such conditions have inadequate alpha-1 antitrypsin in their
blood levels, which can result in damage to the liver. Therefore people with ATT deficiency
and also smoke are more susceptible to COPD diseases. Like Rose, people experiencing
COPD may have an early manifestation of dyspnoea, productive or non-productive cough,
bronchial infections caused by the blockage of bronchus, loss of weight, and the patient may
produce a wheezing sound, tightening of the chest.
Similarly, Rose, from the assessment, she has a respiratory rate of 26 and oxygen saturation
at 89%, which is hypoxemic. This is a sign of a respiratory problem as a result of
inflammation of the lungs, causing an inadequate intake of oxygen in the blood vessels. The
blood pressure is Her blood vessels may be blocked, leading to reduced flow of the blood to
the heart reason why her heartbeat is 89 BPM, consequently resulting from increasing of
blood pressure. The sharp chest pain is due to inflammation of the lungs. The costochondritis
problem may be pain contributed by increased heartbeats.
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NUR250 Assessment 1 SS 2019 Assignment template

Rose smoking habit is the main contributor to the COPD problem. This is because smoking
results in abnormal inflammation, and macrophages infiltrate lung cells. Continuous
inflammation of pulmonary vessels results in the damage of pulmonary vessels, which allow
the flow of the blood to and from the heart ("Smoking cessation affects the natural history of
COPD," 2017). From Rose's history, she is said to have hyperlipidaemia and obesity, and
still, now, she is obese. Her body mass index is 30, which shows the amount of fat in her
body is a lot. The increase in fat content in the body increases the chances of getting COPD.
The fat may accumulate and block the blood vessels, which also inhibit the lung's function.
When there is much accumulation of cholesterol in her body may build up in the arteries and
cause atherosclerosis. The blood may not flow well to the heart making and may be
overworked. In addition, a plaque maybe builds up in the arteries altering the flow of
oxygenated blood to the heart (Galesanu et al., 2014). This may as well cause chest pains. It
is explaining why Rose may be having chest pains. Her drinking may also reduce the lung's
immune system making them more prone to infections.
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Task 2
Nursing Care Plan: (MRS. ROSE)
Nursing problem: Acute Pain
Related to: chest pain on inspiration
Goal of care Nursing interventions Rationale Evaluation
Chest expansion,
Pulmonary
rehabilitation
Rose to take a deep
breathing (Sharma &
Singh, 2011)
 Monitor the SpO2 and ABG of
Rose (Bruno et al., 2015)
 It may be essential to administer
O2.
 Educate Rose to have chest
expansion exercises
 Rose may be prescribed with an
analgesic.
 The administration of
analgesic drugs such as
morphineto Rose will
reduce her chest pain
(Parodi, 2015)
 Chest expansion
exercises will increase
chest mobility (Parodi,
2015).
 After the administration of
analgesic drugs, chest pain
reduces
Nursing problem: Risk of ineffective tissue perfusion
Related to: Breathing Problems and blocking of Blood vessels by the cholesterol and body fat
Goal of care Nursing interventions Rationale Evaluation
 Change in
lifestyle habits,
reduce much
 Create patient awareness to the
patient by educating her on the
effects of smoking on her health
(Bates et al., 2018), provide ways
on how the patient may avoid
 Measures reduce vessel
vasoconstriction. Eating food
with less calories and fat will
reduce body weight and reduce
blocking of blood vessels (Korp,
 Educating the patient on the dangers
of smoking and alcohol addition will
reduce the blockage of blood vessels
by the smoke. After two or three
weeks of exercising, the patient will
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