Case Study of Patient with COPD

This essay presents a case study of a patient with chronic obstructive pulmonary disease (COPD) and discusses two high-priority strategies for managing the condition: pulmonary rehabilitation and patient education. The essay explores the symptoms and risk factors associated with COPD and highlights the importance of palliative care in providing relief and support to patients. The strategies discussed include exercise, breathing techniques, nutrition, clearance of secretions, energy conservation, and rehabilitation during exacerbations. The essay also emphasizes the role of emotional support and involvement of the patient's family in the treatment process.

Running Head: PATIENT WITH COPD
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Case Study of patient with COPD
Essay
student
4/11/2019

PATIENT WITH COPD
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Case Study of a patient with COPD
COPD or chronic obstructive pulmonary disease is the chronic inflammatory lung
disorder that results in the obstructive airflow from the patient’s lungs (Zwerink, et al., 2014). It
is generally caused by tobacco smoking and exposure to burning fuels. Risk factor associated
with this particular health issues is age, genetics, exposure to dust and chemicals (Sethi, & Desai,
2016). Mrs Brown has been diagnosed with these health conditions and developed symptoms
like acute breathlessness, feeling trapped, cough with productive white sputum, rhinorrhoea, and
some mental issues like depression. In this particular essay, two different high priority strategy
will be discussed to manage Mrs Brown.
Palliative care is the interdisciplinary approach specific to the specialized medicinal and
nursing care for an individual with life-limiting diseases. This particular approach can be
beneficial in case of Mrs Brown since it is focused on providing the relief from the symptoms
and the stress related to the serious disorder (Vermylen, Szmuilowicz, & Kalhan, 2015). As
discussed in the case study Mrs Brown has developed both physical and mental symptoms due to
the COPD related problems. Therefore this particular approach might be effective. Palliative
approaches integrate both psychological and spiritual factors of care and offer the support system
to the patient to help them live as actively as possible until their death (Beernaert, Cohen,
Deliens, Devroey, Vanthomme, Pardon, & Van den Block, 2013). Two different strategies can
be implemented for the patient by using palliative care such as pulmonary rehabilitation, and
patient education and emotional support. Pulmonary rehabilitation is the evidence-based
approach for the patients with the chronic respiratory disorders are often not able to perform
daily life tasks (McCarthy, Casey, Devane, Murphy, Murphy, & Lacasse, 2015) similar to Mrs
Brown. This program is effective in reducing symptoms and optimizing functional status. These

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programs might be beneficial to reduce the breathing issues and built the patient’s fitness. This
particular interventions can be performed by the nurses and include different other strategies like
exercising, using breathing techniques, healthy nutrition, clearance of secretion, energy
conservation, and rehabilitation in exacerbation. Exercise is the key component of any
rehabilitation program to enhance the functioning of the lungs. It has been recognised that nearly
30 per cent of the muscle mass is generally wasted in the COPD patient. Poor muscle mass
results in early fatigue and decreased tolerance of exercises. Muscle training replaces the type 2
muscle fibres with category 1 fibres, therefore physical activities build up the muscle mass and
strength (Corhay, Dang, Van Cauwenberge, & Louis, 2014). Some of the exercise includes leg
exercise like stair climbing, turning a crank against the resistance or just lifting the arms against
the gravity. These exercises will enhance the physical activity of Mrs Brown as she is not able to
move. Since cough and sputum were the key symptoms in the case of Mrs Brown, therefore
clearing the patient's airways from secretions might be a helpful strategy for reducing breathing
problems. This can be done by good hydration, avoidance of the irritants, and implementing
bronchodilator therapy. Chest physiotherapy is also found to be effective in clearing the
secretions. Controlled cough and forced expirations are the two different techniques established
helpful. Breathing techniques like breathing slowly and deeply are helpful to reduce the dead
spaces and enhance CO2 removal. As discussed that Mrs Brown is suffering from weakness and
decreased lung functioning, therefore energy conservations activities should be implemented and
proper rest must be provided to her. Exacerbation of COPD may reduce the gains of pulmonary
rehabilitation, therefore post exacerbation rehabilitations approach has been found to be useful in
enhancing the exercise capacity (McCarthy et al., 2015).

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Patient education and emotional support is another strategy of palliative care (Beernaert et al.,
2013) that can be beneficial for Mrs Brown. Patients with long treatment processes or increased
hospital admittance often develop psychological problems like depression as the same happened
in the case study; Mrs Brown is diagnosed with depression. She also felt trapped due to lack of
physical activity, and she also had no idea about palliative care. As COPD is the chronic health
condition and its treatment process is lengthy and frustrating for the patient, therefore emotional
support and education is more helpful as other treatment options (Sari, & Osman, 2015). As Mrs
Brown felt trapped and thinks that she is a burden on her family, therefore her family should be
involved in the treatment process to provide her additional emotional support. Nurses should
build therapeutic communications with the patient in order to make a therapeutic relationship
with the patient. It can be done by addressing the patient with empathy and respect and using the
touch method. The therapeutic relationship might help the patient to express herself more easily
and develop a sense of carefulness (Stoilkova, Janssen, & Wouters, 2013). Mrs Brown is an old
lady who suffers from chronic illness, therefore it is the responsibility of nurses to make her
realise that they care for her. As her GP recommended her to move towards palliative care, she is
confused about it. Therefore the nurses should educate Mrs Brown about the effectiveness and
benefits of palliative care. As mentioned in the case study the patient is also nourished poorly,
therefore encouraging her to have a diet full of nutrients might benefit her. Nutrition can play a
key role; caloric supplementation can be used to increase the energy requirement. Foodstuffs rich
in protein also recommended to the patient with COPD to build the fat-free mass (Howcroft,
Walters, Wood‐Baker, & Walters, 2016). Mrs Brown should also be educated about the
exercises; how to perform on her own, which type of exercises, and when she should perform
those physical activities. She must be educated to understand her medication treatment plan

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including using the inhalers in the right manner and regularly. Different scientific investigations
identified that patients who learn about their chronic obstructive pulmonary disease and
treatment plans are more able to spot their symptom on time and take the right actions
immediately (Stoilkova, Janssen, & Wouters, 2013). For the self-management of chronic
obstructive pulmonary disorder, the nurse should educate the patient about the risk factors
associated with this particular health condition. She must be educated about how she can get
access to the emergency services in case of stroke. Educating her, regarding the premonitory
symptoms earlier can help in escaping the severe exacerbations. The psycho-social support from
nurses and family is also obligatory because of the chronic and progressive features of the COPD
disorder (Sari, & Osman, 2015).
The chronic obstructive pulmonary disorder is the long-lasting condition of lungs that
leads to the obstructive airflow. The symptoms associated with the health condition include
weakness, breathlessness, cough, and rhinorrhoea. Two different nursing strategies can be
implemented in the case of Mrs Brown by using palliative care: pulmonary rehabilitation, and
patient education. Pulmonary rehabilitation if the set of other beneficial approaches like exercise,
breathing techniques, consuming nutrition-rich diet, clearance of secretions, energy conservation,
and rehabilitation in the exacerbation. Patient education must include nutritional education, using
exercises, medication treatment plan, and the risk factors and symptoms of COPD. Emotional
support should also be provided to her as she developed depression due to the long treatment
process. Her family should also be involved in the treatment process to provide her additional
emotional support so that she can manage her symptoms more effectively.

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References
Beernaert, K., Cohen, J., Deliens, L., Devroey, D., Vanthomme, K., Pardon, K., & Van den
Block, L. (2013). Referral to palliative care in COPD and other chronic diseases: a
population-based study. Respiratory medicine, 107(11), 1731-1739.
Corhay, J. L., Dang, D. N., Van Cauwenberge, H., & Louis, R. (2014). Pulmonary rehabilitation
and COPD: providing patients with a good environment for optimizing therapy.
International journal of chronic obstructive pulmonary disease, 9, 27.
Howcroft, M., Walters, E. H., Wood‐Baker, R., & Walters, J. A. (2016). Action plans with brief
patient education for exacerbations in chronic obstructive pulmonary disease. Cochrane
Database of Systematic Reviews, (12).
McCarthy, B., Casey, D., Devane, D., Murphy, K., Murphy, E., & Lacasse, Y. (2015).
Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane database
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Sari, N., & Osman, M. (2015). The effects of patient education programs on medication use
among asthma and COPD patients: a propensity score matching with a difference-in-
difference regression approach. BMC health services research, 15(1), 332.
Sethi, S., & Desai, H. (2016). Exacerbations of Chronic Obstructive Pulmonary Disease.
In Respiratory Infections (pp. 63-79). CRC Press.
Stoilkova, A., Janssen, D. J., & Wouters, E. F. (2013). Educational programmes in COPD
management interventions: a systematic review. Respiratory medicine, 107(11), 1637-
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Vermylen, J. H., Szmuilowicz, E., & Kalhan, R. (2015). Palliative care in COPD: an unmet area
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Zwerink, M., Brusse‐Keizer, M., van der Valk, P. D., Zielhuis, G. A., Monninkhof, E. M., van
der Palen, J., & Effing, T. (2014). Self-management for patients with chronic obstructive
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