COPD: Life Expectancy, Symptom Assessment, Fatigue, Constipation, and Social Considerations

This article discusses COPD life expectancy, multidimensional symptom assessment, functional impacts of fatigue, constipation assessment, and social considerations for COPD patients. It also provides insights on managing fatigue and constipation, and caring for COPD patients at home.

COPD
Table of Content
PART 1............................................................................................................................................1
1. Five-year life-expectancy........................................................................................................1
2 Multi dimension symptom requires multi dimension assessment............................................2
3 Functional impacts of fatigue..................................................................................................2
4 Constipation assessment...........................................................................................................3
5 Social element consideration when Marg return home............................................................3
PART 2............................................................................................................................................4
6. Multidisciplinary team during Marg's hospitalisation.............................................................4
7. Management of Marg's fatigue...............................................................................................4
8. Management of Marg's Constipation.......................................................................................5
9. Marg's discharge and care at home..........................................................................................5
REFERENCES................................................................................................................................6

PART 1
1. Five-year life-expectancy
COPD is stand for chronic obstructive pulmonary disease, it is a lung disease in which
the tissues in the lungs damage which result in constriction of airways and cause difficulty in
breathing. The life expectancy and severity of COPD is determined by Global Initiatives on
Obstructive Lung Disease or GOLD. The value of GOLD is determined by using an instrument
called spirometer. The procedure involve in GOLD are that how much air can forcefully exhale
in one second after blowing through spirometer. The classification of COPD severity is based on
GOLD and there has four stage such as:
GOLD 1: Mild COPD the FEV1 value is more than or equal to 80%.
GOLD 2: Moderate COPD the FEV1 value is in between 50 to 79%.
GOLD 3: Severe emphysema or chronic bronchitis the FEV1 value is in between 30 to 49%.
GOLD 4: Very severe COPD the FEV1 value is less than 30%.
From the given classification, it is concluded that the Marg's conditions is very severe
because she used to smoke a lot and smoking is the main cause of COPD. The person who
smoke or a habit of smoking may drop their life expectancy as:
 Stage 1: 0.3 years
 Stage 2: 2.2 years
 Stage 3: 5.8 years
 Stage 4: 5.8 years
Figure 1: Illustration of 5 year's life expectancy of COPD
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It is concluded that after 5years marg's will die because she was a habitual smoker (Rigby.,
(2021)).
2 Multi dimension symptom requires multi dimension assessment
The individual who experience multiple symptom can need a multiple assessment in
order to give proper treatment. In case of Marg's, she need multiple assessment as she experience
multiple symptom like shortness in breathing, experience chronic cough, weight loss,
constipation, tremors in hand and many other symptom she experienced. After diagnosis it is
concluded that she had a severe chronic obstructive pulmonary disease due to which she
experience difficulty in breathing as well as felt severe chest pain. But still there is need to assist
the patient if the symptoms explained by her are because prevalence of some other disorder like
chest pain occur may be due to cardiac arrest, coronary artery syndrome so there is need to do
ECG, chest x-ray. Weight loss may occur due to decrease in immunity, thyroid as thyroid
symptom also include weight loss or any additional effects, diagnosis of which is necessary to
conduct. Yellow productive may be due to bronchitis infection as it cause irritation and
infalmation in the lungs. Shortness in breathing may be due to cardiac arrest, asthma, covid-19.
She need multiple assessment because of multiple symptoms she experienced (DeMeo et.al.,
(2018)).
3 Functional impacts of fatigue
Fatigue is refers to tiredness which result from mental or physical exertion or illness.
Marg's is 80 year old patient, at her age person experience fatigue because their low immune
system. As person not able to consume enough food which is required for maintain health. Due
to low intake of food or nutrition person experience weakness or tiredness. In case of Marg's,
when she visited to general practitioner, she complained that she does not feel like to work or she
feel exhausted after working for a while. Even at rest she increased breathlessness as well as loss
her weight day by day. While proactive analysis of her symptom as she experience weight loss,
fatigue, difficult in breathing, decrease in muscle strength as well as airflow obstruction. These
all the most prevalent or prominent issue in chronic obstructive pulmonary disease. Fatigue
assessment can be done by identify consequences fatigue scale it is self-report tool in which the
assessment of fatigue is done by five domain and two summary. The domain includes feeling of
fatigue, feeling of forcefulness, impacts on concentration, impact on energy as well as impacts
on daily activities. The summary includes fatigue experience and fatigue impact.
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The functional impact of fatigue on her include physical function, cognition, emotional
state, social isolation and many additional things.
Physical function includes reduction in activities, increased or prolonged rest period, increased
falling risk as well as need assistance for doing daily activities.
Cognition includes reduction in alertness, concentration as well as in thought clarity (Louvaris
et.al., (2020)).
4 Constipation assessment
Constipation is conditions in which the person experience reduction in bowel movement
like lesser than three in a week. As in this conditions, the stool become hard, dry or lumpy form
which cause difficulty or painful in passing. In Marg's case, when she visited to general
practitioner, she complained that she experienced difficulty or pain in passing the stool as well as
complained that she experience chest pain, fatigue or breathing problem. In order to assessing
constipation some of the diagnosis test is recommended to Marg's such as blood- test, x-ray test,
evaluation of anal sphincter muscle function, x-ray of rectum during defecation along with some
other test were also recommended. From blood test the general practitioner examine the
condition like low thyroid or high calcium level in the body. From evaluation of anal sphincter
muscle function the general practitioner examine the muscles coordination which function is for
bowel movement. The element need to assess in Marg's bowel function is the inflammatory
conditions of the bowel. In order to examine the constipation the anorectal manometer
instrument is used. It is a flexible or narrow tube which are inserted into the anus or rectum.
After inserting, the tube get inflate a small tube at a tip which is then it pulled back through
sphincter muscle. This instrument measure the muscles coordination (Avitan et.al., (2021)).
5 Social element consideration when Marg return home
The social element need to considered when Marg's return home is avoid the
consumption of smoke as well as avoid working at open places where chance of dust or air
pollution could be more. As smoking is one of the primary cause of chronic obstructive
pulmonary disease. A harmful or dangerous chemical in smoke can impair or damage the lining
of lungs as well as the airways. In order to prevent this damage, there is need to stop the
consumption of smoke. Apart from this, there is need to stop hanging with those who consume
smoke on regular basis. Exposed to other people's cigarette smoke may also increased the risk of
chronic obstructive pulmonary disease. As well as exposure to certain types of dust or exposure
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to certain chemicals at work place may also impair or damage the lining of lungs which can
increase the chances of chronic obstructive pulmonary disease. Some of the dust or chemicals
which increase the risk of chronic obstructive pulmonary disease may be cadmium dust or their
fumes, grain or flour dust, isocyanate, coal dust or many other dust or chemicals. The risk of
chronic obstructive pulmonary disease is higher in case of person who breathing dust or fumes
continuously. Marg's need to avoid exposure of these things as continuous exposure to such
substances can worsen the case of chronic obstructive pulmonary disease (Breyer-Kohansal
et.al., (2018)).
PART 2
6. Multidisciplinary team during Marg's hospitalisation
Multidisciplinary team are refer to a group of people who work in health care department
of different disciplines such as psychiatrists, social workers, nurses, general physician or many
other. Each of the member in the team providing different particular services to the patient.
There are many multidisciplinary team member are involved in caring or assessment in case of
Marg's. but the two member from multidisciplinary team who can play essential role in caring or
in assessment of Marg's case are general physician and nurses. Marg's firstly visited to General
physician in order to complained about her shortness of breath as well as chronic cough. After
that General physician assessed her properly by suggesting some test or examine her history.
Marg's admitted that she had a smoking habit from a decades and her workplace was in chemical
industry. While proactive analysis from the test or from her history, general physician examine
that Marg's is experiencing chronic obstructive pulmonary disease and need to admitted in
hospital because of severe COPD. When Marg's admitted to hospital nurse take full care of
Marg's condition. Nurse do all activities of Marg's such as maintain the airway patency, increase
or enhance nutritional intake, provide the information about the disease process or their treatment
program (Jonik et.al., (2022)).
7. Management of Marg's fatigue
Fatigue is one of the common symptom of COPD. As people with COPD experiencing
difficulty in getting oxygen into their lungs as well as difficulty in getting out carbon dioxide
also. This reason make person tired or feel low energy. General physician prescribe some tips as
well as medication for Marg's in order to management of chronic obstructive pulmonary disease.
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The medication involve bronchodilator inhalers such as ventolin inhaler it helps in dilate or
widen the airways which make easier to breath. Steroids inhalers as well as some tips like
breathing exercise, having balanced diet, regular exercise, having adequate consumption of
liquids as well as having good sleep. As regular exercise can enhance tolerance or strengthen the
heart or lungs muscles. Keeping hydrated can prevent mucus thickness as well as prevent from
worsening of conditions (Kim et.al., (2019)).
8. Management of Marg's Constipation.
Constipation is most uncomfortable problem in COPD. As constipation decrease the
bowel movement times like fewer times or less than 3 times in a week. In order to manage the
constipation conditions in Marg's case, the general physician prescribe some medication as well
as some daily routine tip to Marg's during hospitalisation as well as on returning home. The
medication includes some laxative like senna , coloxyl tablet at night or increase dietary fibers as
fiber increase bulk and absorbs water or fluids in order to soften the stool which helps in passing
the stool easily. Fibres includes whole grain, bran, vegetables like carrots, broccoli, fruits like
apples, pears etc. Some tip to manage in daily routine in order to treatment of constipation
includes physical activity, increase consumption of fluids or water, regular exercise or many
other activities. Regular exercise can helps in improving the working area of colon which can
helps in ease the constipation. Pelvic physical therapy was suggested to do to Marg's as it helps
in relaxing the pelvic muscles during the bowel movement which can helps in relieving from
constipation (Campbell et.al., (2021)).
9. Marg's discharge and care at home
While discharging Marg's from the hospitals, the general physician of marg's discussed
her health conditions to her son helen because he lived near marg's home as well as he often
visited to the hospital as he has an affection or concern towards his mothers health or her nurse
who is being appointed by Helen to provide treatment to his mother at home. In discussion, the
general physician suggesting some management plan in order to treat Marg's chronic obstructive
pulmonary disease. The management plan includes that to avoid or stop the consumption of
smoking as well as provide clean or dust free places for stay because habitual cigarette
consumption or working in dusting environment is the main cause of marg's chronic obstructive
pulmonary disease. Provide medication on a specified time, increase the consumption of dietary
fibres, juice, fruits as well as increased the consumption of water. Marg's needed to be hydrated
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in order to reduced fatigue as well as for increasing bowel movement. Nurse provides helps to
marg's in pelvic physical therapy as well as provide guidance in daily routine exercise. Both
Helen or nurse need to monitor the marg's conditions as well as assist her always in doing certain
activities.
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REFERENCES
Books and Journals:
Avitan, I., Halperin, Y., Saha, T., Bloch, N., Atrahimovich, D., Polis, B., ... & Braitbard, O.
(2021). Towards a Consensus on Alzheimer’s Disease Comorbidity?. Journal of clinical
medicine, 10(19), 4360.
Breyer-Kohansal, R., Hartl, S., Burghuber, O. C., Urban, M., Schrott, A., Agusti, A., ... &
Breyer, M. K. (2018). The LEAD (Lung, Heart, Social, Body) study: objectives,
methodology, and external validity of the population-based cohort study. Journal of
Epidemiology, JE20180039.
Campbell, M. L., Donesky, D., Sarkozy, A., & Reinke, L. F. (2021). Treatment of Dyspnea in
Advanced Disease and at the End of Life. Journal of Hospice & Palliative
Nursing, 23(5), 406-420.
DeMeo, D. L., Ramagopalan, S., Kavati, A., Vegesna, A., Han, M. K., Yadao, A., ... &
COPDGene Investigators. (2018). Women manifest more severe COPD symptoms
across the life course. International journal of chronic obstructive pulmonary
disease, 13, 3021.
Jonik, S., Marchel, M., Pędzich-Placha, E., Pietrasik, A., Rdzanek, A., Huczek, Z., ... &
Mazurek, T. (2022). Optimal Management of Patients with Severe Coronary Artery
Disease following Multidisciplinary Heart Team Approach—Insights from Tertiary
Cardiovascular Care Center. International Journal of Environmental Research and
Public Health, 19(7), 3933.
Kim, S. H., Shin, M. J., Shin, Y. B., & Kim, K. U. (2019). Sarcopenia associated with chronic
obstructive pulmonary disease. Journal of bone metabolism, 26(2), 65-74.
Louvaris, Z., Chynkiamis, N., Spetsioti, S., Asimakos, A., Zakynthinos, S., Wagner, P. D., &
Vogiatzis, I. (2020). Greater exercise tolerance in COPD during acute interval,
compared to equivalent constant‐load, cycle exercise: physiological mechanisms. The
Journal of Physiology, 598(17), 3613-3629.
Rigby, D. (2021). Medicine in review: Frailty in COPD. AJP: The Australian Journal of
Pharmacy, 102(1204), 78-81.
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