Chronic Obstructive Pulmonary Disease (COPD) | Case Study Analysis.

Case Study Analysis
University
Task
Name
Unit
Date

Task 1
Chronic obstructive pulmonary disease-COPD refers to a lung disease
that is characterized by chronic obstruction of the airflow to the lungs
affecting and altering the normal breathing pattern. More often, it refers
to an umbrella of diseases which entail progressive lung diseases such as
chronic bronchitis, refractory asthma, and emphysema (Martinez, 2016). It
is characterized by an elevated occurrence of breathlessness. COPD is
commonly confirmed by simple spirometry tests which entail an
assessment of how a patient can breathe and the seed of air in and out of
the lungs. These diagnosis symptoms are considered for patients who
have symptoms of sputum production, dyspnoea, history of risk factors
and cough. A diagnosis of low peak flow is often consistent with COPD and
can be from other lung diseases. COPD occurrence is a progressive
disease and requires the right diagnosis and treatment to effectively
manage the state of the disease (WHO, 2019). The patient state depicts
an exacerbated state which is signified by the presence of risks factor
association linked to tobacco smoking. The characteristic smoking pattern
of the patient can illustrate underlying lung diseases that are
compounding the Chronic obstructive pulmonary disease state.
The chronic obstructive pulmonary disease results in an incompletely
reversible airflow and difficulty in breathing. The decline flow of air is due
to the lung tissue breakdown referred to as emphysema and diseases of
the airway referred to as obstructive bronchitis. The net effect of these
states often varies among patients (Decramer, Janssens & Miravitlles,
2012). Damage to the small airways often leads to the formation of focal
lung pneumatics which replace the lung tissue. This state leads to bullous
emphysema disease (Vestbo, 2013).
The occurrence of COPD occurs due to significant inflammatory
responses due to the inhaled irritants; further existence of bacterial
infections can exist and increases the inflammatory state (Barnes, 2016).
The inflammations are characterized by the macrophages and neutrophil
granulocytes. Among smokers, Tc1 lymphocyte occurs and the occurrence
2
Double click here to fill in this footer
Last name__ _student number_NUR250 SS 2019 Assessment 1

of asthma-related aspects is occasioned. The cell response is due to
chemotactic factors and oxidative state due to the presence of high levels
of free radicals in the inhaled tobacco smoke, released by inflammatory
cells and connective tissue breakdown. This breakdown leads to
emphysema state which signals a declined breathing pattern and poor
release of respiratory gases (Vestbo, 2013).
Narrowing of the airways leads to reduced ability breath effectively
reducing the flow of air, leading to an imbalance in gaseous exchange in
the lungs resulting in hyperinflation. Reduced level of oxygen leads to
high carbon dioxide in the blood. The patient is experiencing exacerbation
state leads to increased inflammation; reduces the flow of air and poor
gaseous exchange and eventually low levels of blood (Beasley et al.,
2012). This is occasioned by patient elevated levels of breathing at RR 26
against normal levels of between 12-20 breaths per minute. Further, there
are lower levels of saturation depicting the stress levels of the heart.
Moreover, the patient exhibited a chest pain score of 2/10 indicating
airways narrowing due to the inherent inflammation and difficulty in
breathing out effectively.
3
Double click here to fill in this footer
Last name__ _student number_NUR250 SS 2019 Assessment 1

Task 2
Nursing Care Plan: Mrs. Rose Wilson
Nursing problem: Acute Pain
Related to:
To the inflammation process in the lungs lining area
Goal of care Nursing interventions Rationale Evaluation
To reduce the
level of pain
Expected
outcomes entails
patient
assessment on
reduction of pain
and relaxed state
of facial
expression
Determination of the pain
characteristics such as
sharp pain stabbed pain.
Further, an investigation of
the intensity of pain and
location is vital.
Monitoring vital signs
Provision of comfort
measures to the patient
such as back massage,
change position, breathing
exercise, and relaxation.
The occurrence of chest pain is often to
some decree emanating from
pneumonia and other complications
such as endocarditis and pericardia.
(HajGhanbari, Yamabayashi,& Reid,
2014)
Heart rate changes and blood pressure
illustrates changes in the pain
experience of the patient.
Nonanalgesic treatment to touch offers
to relieve and discomfort and increases
analgesic therapy to the patient.
(Overington
et al., 2014)
Acute pain assessment will be
evaluated through a review of
respiratory status, depression levels,
and anxiety. Further clinical data that
illustrates exacerbation will be
evaluated.
Nursing problem: Risk of ineffective tissue perfusion
Related to: Poor inspiration and expiration which do not provide adequate and necessary tissue perfusion and retained
secretions in the lungs
Goal of care Nursing interventions Rationale Evaluation
The goal of care
is to ensure that
Patient assessment of
respiratory status in a
period of every 2 hours
and any abnormal findings
This can signify distress on the
respiratory process which entails
shortness of breath, mental state,
tachypnoea, and usage of accessory
Ensuring that there are effective
breathing process and reduction of
cough.
The patient can ventilate the air
4
Double click here to fill in this footer
Last name__ _student number_NUR250 SS 2019 Assessment 1