Palliative Care: Strategies for COPD Exacerbation Management

Running head: PALLIATIVE CARE
Palliative care
Name of the student:
Name of the University:
Author’s note

1PALLIATIVE CARE
Palliative care is a care provision that involves providing holistic care to people with life
threatening illness and focusing on fulfilling the unique physical, social, psychological and spirit
needs of patients. It is a type of care that involves optimization of quality of life for patient as
well as their family members using special measured to promote comfort and prevent suffering
(Seow & Bainbridge, 2017). The main purpose of this essay is to analyse the case study of Mrs.
Brown, a 62 year old retiree with acute exacerbation of chronic obstructive pulmonary disease
(COPD) and discuss two high priority nursing strategies to manage Mrs. Brown. These two
strategies give an idea regarding how palliative care is implemented for particular patient.
Mrs. Brown lives is a retiree who works with her husband. The current health issues
experienced by Mrs. Brown includes increase in coughing and shortness of breath. She has been
admitted to the hospital thrice before too because of increase in exacerbation of her COPD. The
difficulty for her has increased over the past 2 days because of chronic productive cough with
white sputum. Hence, as these symptoms are indicative of recurrence of COPD exacerbation, the
first nursing priority is to address these physical symptoms in patient by means of
pharmacological intervention. Focussing on addressing the physical health issues related to
COPD exacerbation is important to reduce the risk of respiratory failure and any further
complication in patient (Osadnik et al., 2017). Taking prompt action will also reduce the need for
supplemental oxygen for Mrs. Brown.
The first nursing strategy that will help to address the physical symptom of chronic
cough and breathlessness includes the use of corticosteroid for Mrs. Brown. The research by
Viniol and Vogelmeier (2018) supports that increase in inhaled corticosteroid in COPD patient is
associated with a decrease in rate of COPD exacerbation. Systemic corticosteroid is a standard
part of treatment of exacerbations and the main factors that leads to such benefits for COPD

2PALLIATIVE CARE
patient like Mrs. Brown includes improve in lung function and oxygenation rate thus
contributing to faster recovery time and time in hospital stay. Oral corticosteroid is beneficial for
COPD patient and nebulized corticosteroid may be needed only during severe exacerbation. The
research by Sethi and Desai (2016) argues that oral corticosteroid is recommended for treatment
of exacerbation. Another advantage associated with the use of corticosteroid treatment is that is
that it has good bioavailability and greater ease of administration. Hence, the main benefit of
initiating corticosteroid treatment for Mrs. Brown is that it will address the symptom of
breathlessness and chronic cough as well as reduce social and economic burden associated with
frequent hospitalization.
The research literature by Walters et al. (2018) gives the evidence that patients with acute
exacerbation must be treated with systematic corticosteroid for 7-14 days. The duration of
treatment also determines the outcome or risk of adverse effect for patient. The research study
investigating about the impact of short or long duration corticosteroid treatment revealed that
there is less likelihood of adverse effect for patient because of short course of systematic
corticosteroid compared to longer course of the same. Hence, it is planned to implement a short
course of systemic corticosteroid treatment for Mrs. Brown so that her physical symptoms
related to COPD exacerbation can be addressed and she can get physical comfort thus providing
her mental and emotional relief too.
As part of palliative care provision, it is also important to address physiological or
spirityal need of Mrs. Brown to ensure that she care experience is enhanced during hospital stay.
However, one of the mental health issues that can affect her overall health includes increase in
risk of anxiety due to illness. This is said because due to continue difficulty in breathing, she is
not able to mobilize or move around the house. She cannot take care of physical and domestic