Chronic Obstructive Pulmonary Disease Assignment

its an medication management assignment bases on case study. Read the case study of Hadden. The case study of Hadden is on case study pdf which i have included. there are two case study in that so please dont get mixed up. the case study of hadden starts from page 27 in case study pdf. again please don't get mixed up with the two case study. please let me know if you are confused. please use APA 6TH EDITION referencing from database likr CINAHL (https://www.usq.edu.au/library/referencing).

Running head: CASE STUDY
CASE STUDY
Name of the Student
Name of the University
Author Note

1CASE STUDY
INTRODUCTION
Chronic Obstructive Pulmonary Disease or COPD can be defined as a lungs disease
that makes breathing difficult by obstructing the airway. COPD occurs in two forms, which
are chronic bronchitis involving long term coughing with mucus and emphysema that causes
damage to the lungs. The main cause of developing COPD is smoking (Medlineplus, 2020).
In the given case study, Hadden is a 63 year old man having moderate COPD and a habit of
smoking 20 cigarettes per day since the last 40 years. He was diagnosed with lower lobe
pneumonia and received treatment in the hospital. He was discharged 3 weeks ago after
completing the treatment for pneumonia. However, during his check-up 4 days ago he was
diagnosed with an acute exacerbation of his existent COPD. In this essay, priorities of
Hadden’s health condition, the nursing interventions, strategies that can be used to evaluate
the outcomes and the application of clinical reasoning cycle will be discussed in details.
PRIORITIES OF MEDICATION SELF-MANAGEMENT
As a registered nurse in charge of Hadden, I would follow the clinical reasoning cycle
and collect cues at first. I would review the current available information about the patients
including his medical history, medication charts and the tendencies the patient has towards
taking medication and necessary other things. I would also gather newer information while
assessing his condition and also apply the knowledge I have to think of the medical priorities
that needs addressing and also a plan for his medication self management, which is an
extremely important thing to design (School of Nursing and Midwifery, 2020). As the trends
of the patient shows that he continues to smoke at the same rate and often goes out of the
house without his oxygen source and also takes the medicines when he recalls about them.
This implies to more harm that he has been causing to himself without much knowledge.
Smoking in this condition is very much harmful and I would suggest him to get rid of this

2CASE STUDY
habit as early as possible and would also offer him smoking cessation programs (Smoking
Cessation Guidelines, 2020). Coming to the medication front, it is crucial for him to take the
five medicines prescribed to him regularly on time so that his condition gets better and his
smoking addiction also gets reduced as his medicine list contains Nicorette patches, which
help in managing smoking addiction (Pešic et al., 2017). Apart from this, it is also necessary
for Hadden to use his oxygen support continuously as without the support his blood oxygen
saturation is reaching an abnormally low percentage of 87% and he is getting breathless even
after a little exhaustion.
NURSING INTERVENTIONS
It is necessary to apply few important nursing interventions to improve Hadden’s
health. The interventions are required to build and implement depending upon three phases of
the clinical reasoning cycle including problem identification, goals establishment and taking
actions (School of Nursing and Midwifery, 2020). Depending on the criticality of Hadden’s
health, many of the aspects are required to keep in the mind before implementing any nursing
intervention to support his medication self-arrangement. Hadden’s capacity to inhale oxygen
without any artificial oxygen support has been reduced considerably as his blood oxygen
saturation gets quite lower to 87% than the original percentage, which is 95-100% (Durlinger
et al., 2017). His respiration rate is 34 breaths per minute, which is also much higher than the
normal rate of 12-25 breaths per minute (Banet, McCOMBIE & Dhillon, 2020). It is also
seen that on applying external oxygen source his blood oxygen saturation level increases to
92%. As mentioned above, he has also mentioned about his habit of taking the medicines
when he recalls about them and also not carrying the oxygen support with him, it also causes
a plethora of problems. Therefore, it is very important to make Hadden aware about the
situation and his health condition. The most reliable intervention would be providing proper
knowledge to Hadden about COPD, his current condition and the consequences it might lead

3CASE STUDY
to. It might help him to be more aware of his situation and take medicines as per schedule.
Adherence towards medicine should be grown in him by the nurses so that he consumes the
medicines as per the schedule prescribed by the doctors for achieving better results. It can be
grown by making him understand about the medicines he take and when it is required to take,
by preparing a list of his medication and the time for its consumption, by setting alarms in
any electronic device that Hadden owns to make him remember the time for medicine
consumption (Philips et al., 2016). He should also be encouraged to take the oxygen support
as per the requirement to keep the level of oxygen in his blood sufficient for leading a healthy
life and avoid breathlessness.
STRATEGIES TO EVALUATE THE OUTCOMES
Evaluating the outcomes of the actions or interventions that have been implemented
on a patient is an important aspect of the clinical reasoning cycle. This step is followed to
observe if the interventions that have been implemented on a patient has proven successful or
not. It can be evaluated by looking at the patient’s condition. In the case of Hadden there are
quite a few interventions that should have been implemented as discussed in the previous
section. The strategies that can be used to evaluate Hadden’s condition include checking his
vitals, diagnostic tests and by asking him the difficulties, he has been experiencing. Checking
his vitals including heart rate, respiration rate, blood pressure and blood oxygen saturation.
The result of the vital check up would lead to the evaluation of improvement if any has taken
place by comparing with the previous vital values. The diagnostic test results would lead to
the understanding of the texture and consistency of his mucus and sputum, which would also
inform about the improvement of his condition, his breathing capability and the condition of
his bronchioles (Chen, Leung & Sin, 2016). Apart from the tests, he should also be asked
about the difficulties he has been facing currently and analyse the reasons for it as well as
thinking of a proper plan to corner that difficulty. His smoking habit should also be looked

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upon and evaluate if he has reduced smoking or not (Hunter & Arthur, 2016). These
strategies can be followed to evaluate the outcomes.
CONCLUSION
Thus, to conclude the paper it can be stated that COPD is a dreadful disease and prper
treatment should be ensured for Hadden to achieve the best outcome. He should be
enlightened about the harms of smoking and should also be helped to cease the addiction. The
nursing interventions implemented on him should be based on practicality and proper
knowledge should also be provided to him to become aware of his condition. The outcomes
should be properly evaluated as well to understand the improvement or any changes that have
taken place after the initiation of the treatment planning and according to the outcome further
treatment should be provided to him.

5CASE STUDY
REFERENCES
Banet, M., McCOMBIE, D., & Dhillon, M. (2020). U.S. Patent No. 10,595,746. Washington,
DC: U.S. Patent and Trademark Office. Retrieved from:
https://patents.google.com/patent/US10595746B2/en
Chen, Y. W. R., Leung, J. M., & Sin, D. D. (2016). A systematic review of diagnostic
biomarkers of COPD exacerbation. PloS one, 11(7).
https://doi.org/10.1371/journal.pone.0158843
Durlinger, E. M. J., Spoelstra-de Man, A. M. E., Smit, B., de Grooth, H. J., Girbes, A. R. J.,
Oudemans-van Straaten, H. M., & Smulders, Y. M. (2017). Hyperoxia: At what level
of SpO2 is a patient safe? A study in mechanically ventilated ICU patients. Journal of
critical care, 39, 199-204. https://doi.org/10.1016/j.jcrc.2017.02.031
Hunter, S., & Arthur, C. (2016). Clinical reasoning of nursing students on clinical placement:
Clinical educators' perceptions. Nurse education in practice, 18, 73-79.
https://doi.org/10.1016/j.nepr.2016.03.002
Medlineplus. (2020). Chronic obstructive pulmonary disease (COPD): MedlinePlus Medical
Encyclopedia. Retrieved 12 April 2020, from
https://medlineplus.gov/ency/article/000091.htm
Pešic, I., Gvozdenovic, B., Subotic, B. B., Zugic, V., & Lazovic, N. (2017). Medical
treatment effectiveness in smoking cessation.
https://doi.org/10.1183/1393003.congress-2017.PA4483
Phillips, L. A., Cohen, J., Burns, E., Abrams, J., & Renninger, S. (2016). Self-management of
chronic illness: The role of ‘habit’versus reflective factors in exercise and medication

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adherence. Journal of Behavioral Medicine, 39(6), 1076-1091.
https://doi.org/10.1007/s10865-016-9732-z
School of Nursing and Midwifery. (2020). Clinical Reasoning. Retrieved 12 April 2020, from
https://www.utas.edu.au/__data/assets/pdf_file/0003/263487/Clinical-Reasoning-
Instructor-Resources.pdf
Smoking Cessation Guidelines. (2020). Smoking Cessation Guidelines. Retrieved 12 April
2020, from
https://www1.health.gov.au/internet/main/publishing.nsf/content/21A287831207BB1
6CA257BF0001E0159/$File/smoking_flip.pdf