Client Education for COPD Patient: A Case Study

Introduction
Patients’ education in controlling and treating any disease is very much assistive.
Proper education about controlling any chronic disease helps a patient to live a better life by
managing it. Various chronic diseases are there and one of them is COPD. It stands for
Chronic Obstructive Pulmonary Disease. In this physical condition patients find difficulty in
breathing and completely emptying the air from the lungs (Sin et al. 2016). It is very common
health issue but can be very dangerous and it is considered as one of the biggest disease that
causes massive illness and deaths among the patients (Karrasch et al., 2016). This paper is
going to review a case study of a COPD patient. Considering the main health concern, topics
for client education will be discussed in the paper. Different appropriate educational
strategies to educate patient about the disease will also be described. Finally, the paper will
conclude with the evaluation of patient’s satisfaction and reflection on the study.
Overview of the patient
In the case study, the patient, Mr. George Polaris is an Italian who has been diagnosed
with Chronic Obstructive Pulmonary Disease and he has been admitted to the chest infection
department with fever and shortness of breath along with some productive cough. Due to his
illness he has lost several kilograms from his body and he is depressed that he might have got
old and will no longer be able to work anymore as he works as a labourer in a construction
industry. George is having a background of gastro-oesophageal reflux disease (GORD) and
he has been prescribed intravenous antibiotics, IV therapy as well as bronchodilators. George
is a smoker since when he was 14 years old and even he used to smoke 20 cigarettes per day.
However, he is not alcoholic and has no known allergies. From the assessment of his
condition, it has been found that his body temperature is 36.7 degree Celsius, his blood
pressure is 135/88 mmHg, pulse rate is 100 beats/min, and respiratory rate is 22 breathe/min.

He takes Esomeprazole magnesium (Nexium) 40 mg PO OD and now he has been prescribed
for Salbutamol (Ventolin)100 micrograms MDI, 2 puffs when required up to 4 times daily
and Tiotropium (Spiriva) 18 mcg inhaled by mouth OD.
Health concern
It is important to identify the primary health concern of any patient in order to begin
or prepare a proper nursing care strategy. From the various health issues, the main issue is
identified and after that, the nursing plan is set as per the priority. The client in this case has
different types of health problems and he is already under medication for his gastro-
oesophageal reflux disease. But, the main issue, for which he has been admitted to the
hospital, is his shortness of breath along with fever and cough. He has been diagnosed with
COPD. His smoking pattern is mostly associated with his disease and his professional life can
also be hampered if it is not controlled properly (Marks, 2018). He has also been prescribed
with many new medicines which needs some knowledge about how to use that. So, keeping
the main health concern regarding the COPD in mind, some topics of client education will be
provided.
Treating COPD
Removing the root cause of lung inflammation is the main method of treating COPD.
For most of the people, the main cause of COPD is smoking cigarettes. There is no good way
to recover the lung damage, but stopping the bad habit of cigarette can slower down the loss
of lung function (Corsonello et al., 2015). It is important for all the patients of COPD to stop
smoking as soon as they have been diagnosed with the disease. Medicines can also help a
COPD patient to control the disease and in such case, medicines are provided in the form of
inhaler which directly helps to reach the medication at a good amount in the lungs. Several
types of medications are used in this disease and they are bronchodilators, steroids,

phosphodiesterase , antibiotics, oxygen therapy, and others. Apart from that, vaccination,
pulmonary rehabilitation program can help a COPD patient in managing the disease
(Mendoza & Cooper, 2016). In some extreme cases, lung volume reduction surgery and
transplantation can be helpful in the condition of the patients with severe COPD. However,
the condition of COPD worsens slowly and it causes permanent lung damage and even heart
failure which can take the lives away too (Von Nussbaum et al., 2016). So, controlling COPD
is highly recommended and it helps a patient to live a better life. Simultaneously, with the
medication process some self-management techniques are required too. These techniques can
be achieved with a proper knowledge and education. In this case, topics of client education of
George as per his condition will be described.
Two topics of client education
George has been admitted to the ward of chest infection and he is suffering from the
issues of COPD and considering his health condition, two different topics of client education
can be included. These topics can be helpful in the self-management process for this disease
and it can provide knowledge to the patient which will be helpful in getting some relief also.
From many studies, it has been found that COPD patients are educated with various programs
and plans that can address the primary health concern (Melzer et al., 2017). These topics
generally form the education component of a pulmonary rehabilitation program and at the
very beginning of the programs the topic are included. However, various factors are
associated with the disease which requires knowledge and education to control but from those
the main issues are chosen as per their priority and effectiveness. So, for this patient, two
different topics for client education can be,
1. The role and correct use of medication
2. Breathing techniques to manage breathlessness.

The following section discusses how these topics can address the health concern for the client
with COPD and how this can assist the patient in the self-management for his chronic illness
will also be discussed (Melzer et al., 2017).
Role of each topic in addressing the health concern
Breathing techniques
Pulmonary rehabilitation program is highly beneficial for the COPD patients. In this
multidisciplinary approach, breathing exercise training and education about the proper usage
of medicines can be extremely helpful for the patients in improving functional capacity and
lowering the mortality rate of the disease (Hyland et al., 2016). The breathing exercise
technique includes pursed lip breathing and diaphragmatic breathing.
In pursed lip breathing, the patient will be more focused and stay calm which should
be used during and after any action or exercise (de Araujo, Karloh, Reis, Palú & Mayer,
2015). In this method, a patient needs to blow out through the lips pursed as if he is blowing
out a candle (Damle, Shetye & Mehta, 2016). In a study that compared health-related
equality, it has been found that after eight to twelve weeks of training and execution, pursed
lip breathing showed a significant improvement among the patients in the dyspnea domain
(Roberts, Schreuder, Watson & Stern, 2017). Diaphragm breathing technique helps the
patient to use their abdominal wall instead of using the chest wall (Lee, Cheon & Yong,
2017). Studies revealed that, after four weeks of training, the method improved dyspnea and a
six minute walk test also proved that this technique improves the functional capacity among
the patients (Roberts, Schreuder, Watson & Stern, 2017).
Usage of inhaler devices