Nursing Case Study on COPD

Running head: NURSING CASE STUDY
NURSING CASE STUDY
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Name of the university:
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NURSING CASE STUDY
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Consider the patient situation:
The case study represents pulmonary disease (COPD) of a 63 years old person who is a
chain smoker. His medical history includes pneumonia for which he was discharged from
hospital. He was diagnosed with a viral infection which facilitated acute exacerbation of the
disease. He had sleep apnoea and had hypertension. The currently he was experiencing
breathlessness and failed to manage his daily activities which are affecting her quality of life.
Collecting cues:
He had a history of hypertension, he takes trelegy ellipta 1 puff /day and prn salbutamol
which were breathe in with a spacer. He takes Nicorette patches 15mg/16 hours daily mane. He
had increased dysphonia and requires oxygen. His HR 90 bpm, Bp 132/88, RR is 34 bpm and
SpO2 92% on 2lpm of O2. His coughing was green and sputum tenacious sputum.
Process the information:
Chronic obstructive pulmonary disease (COPD) is considered as a condition where
irreversible airflow obstruction, as well as an abnormal inflammatory response in the lungs,
observed (Kelly et al., 2018). These are the innate and adaptive immune response for the long
term exposure to the toxic agent such as smoking cigarettes as observed in this case study
(Mitchell et al., 2017). The pollutants irritate the airway which further facilitates the production
of the sputum. The patient had a history of hypertension (BP 132/88) where the heart failed to
pump which clogs the blood into the lungs (Mitchell et al., 2017). On the other hand, airway
obstructions causes’ pulmonary vasoconstriction followed by hypoxia lungs tissues failed to gain
adequate oxygen-rich as observed in this case study. The patient had an oxygen saturation of
92% whereas for the normal patient it is 95%, indicated heart failed to pump adequate blood

NURSING CASE STUDY
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(Yang et al., 2017). Consequently, the heart rate of the patient also increased (90 bpm) whereas
for normal individuals, it is 60 to 100bpm. The obstructed airway also affect the breathing rate
observed in this case study where the patient had RR is 34 bpm (for the normal patient is 12 to
24 bpm). The patient is experiencing anxiety due to the COPD which is quite common as it is
associated with nervousness and shortness of breath (Jones et al., 2016).
In this case, while considering the self-management of the patient regarding the
medication, the first priority would be bronchodilator for improving breathing (trelegy ellipta)
along with salbutamol for improving the breathing in patients. For the management of his
infection Augmentin tablets along with immunosuppressant. The other priorities would the
management of his anxiety, frequent smoking, and medication adherence.
Identify the problem:
The patient is chain smoker which further increases his risk of execration of COPD as it can
cause respiratory failure. In this case, potential problems that are required to identify by nurses
include dysphonia, hypoxia, non-adherence to the medication and anxiety. The patient also had
poor self-management skills which further require improvement in order to improve decrease
prognosis of COPD and adherence to the medication that was provided him.
Establish goals:
The established first nursing goals in this case which was developed in the collaboration of
nurse include improvement of his shortness of breath by improving airflow and decreased air