NUR2102: Viktor's COPD Medication Management Case Study

This paper analyzes the case of Viktor, a 63-year-old male patient diagnosed with COPD, hypertension, and obstructive sleep apnea. The analysis utilizes the clinical reasoning cycle to address medication management challenges and improve patient outcomes. Viktor's history includes a 40-year smo...Read More

Running head: NURSING
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Name of the Student:
Name of the University:
Author Note:

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Introduction:
Medicines are prescribed to patient in order to integrate wellness and alleviate their
living standard. Advancing age is associated with a number of physiological complications
that interfere with the normal physiological functioning of the body and gives rise to multiple
comorbidities for which medication is prescribed. In this context, it should be noted that
consuming the prescribed medication at the correct time is pivotal to ensure that the health
status does not deteriorate any further. As stated by Harrison et al. (2015), medication
management thus includes the procedure of educating the suffering patient to manage the
prescribed medication and consume them at the correct time in order to acquire positive
outcome.
This paper intends to analyse the case study of the patient Viktor and make use of the
clinical reasoning cycle in order to empower the patient with medication management
strategies such that overall health status of the patient is not negatively impacted
(Gummensson, Sunden & Fex, 2018). According to Hunter and Arthur (2016), the clinical
reasoning model equips nursing professionals to reflect upon the clinical status of a patient
and accordingly make use of effective decision making process to implement measures so as
to improve the holistic health outcome of the patient and facilitate recovery.
Discussion:
Upon analysing the case scenario, it can be mentioned that the 63 year old male
patient, Viktor has been diagnosed with COPD. The provided details within the case study
mentions that the patient has been a regular smoker and for the previous 40 years, the patient
had been smoking 20 cigarettes on an average. In addition to this, it should also be noted that
the patient had discharged from the hospital 3 weeks ago which followed his treatment for the
diagnosed lower lobe pneumonia. Four days ago, the patient had been diagnosed with a viral

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infection that caused an acute exacerbation of his COPD symptoms. The medical history of
the patient mentions that he had been suffering from hypertension and obstructive sleep
apnoea that required the use of CPAP. Also, lately the patient had been experiencing
breathlessness, dyspnea and is finding it difficult to cope with his COPD symptoms. He also
finds it difficult to speak in full sentences and his current vital assessment data suggests that
his respiratory rate is around 34 breaths per minute, blood pressure to be 132/88, Heart Rate
to be 90 Beats per minute and SpO2 to be 92% 2Lpm of O2. Further, his COPD symptoms
have been reported to worsen which is characterised by his constant productive cough
generating greenish and tenacious sputum. The patient further mentions to experience anxiety
and confesses to find it problematic to quit smoking. He further mentions to take his
medication only when he remembers and also states his aversion to take his oxygen outside
on account of feeling awkward in public.
On analysing the provided patient information it can be stated that the patient needs to
be educated about his prescribed medication along with the associated rationale so as to make
him understand about the significance of complying with the prescribed medication routine,
The primary goals for the patient would include the following (Harrison et al., 2015):
 Patient would be able to thoroughly follow the medication routine
 Patient would be able to demonstrate the required competencies to comply with
medication routine
 Patient would be able to represent continuous compliance with the prescribed
medication routine and the recommended treatment plan
The rationale for the articulation of the patient care goals can be stated as the increased
importance to comply with the prescribed medication routine to avoid the acute exacerbation
of the COPD symptoms (Mackey et al., 2016).

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The evidence base suggests that smoking is one of the major risk factors that worsens
the quality of the COPD symptoms (Bourbeau, Lavoie & Sedeno, 2015). Further, non-
compliance with the medication routine deteriorates the quality of the symptoms and
interferes with the positive effect of the prescribed therapeutic intervention (Bourbeau,
Lavoie & Sedeno, 2015). The nursing interventions that would be applied for reinforcing
compliance with the medication routine would include, imparting health literacy, imparting
health counselling and organizing a referral to a psychotherapist (Effing et al., 2016).
Research studies mention that imparting health literacy helps to disseminate awareness in
relation to the significance of complying with the medication regimen and provides a detailed
understanding about the risk factors triggered by non-compliance with medication routine
(Effing et al., 2016). He would also be taught mild breathing exercises that would help to
alleviate his symptoms of shortness of breath and coughing and ensure comfort (Lenferink et
al., 2016). Further, the patient would also be provided with a pill organizer box that would
contain his medications arranged in a date/time and dose specific manner (Gummensson,
Sunden & Fex, 2018). This would be done to assist the patient with his medication
management (Gummensson, Sunden & Fex, 2018). In addition to this, health counselling
would help to reinforce improved understanding about making positive lifestyle changes such
as giving up smoking and including mild physical exercise regimen so as to alleviate the
quality of health status (Lenferink et al., 2016). As the provided information suggests that the
patient has been experiencing increased anxiety and feels awkward to carry his oxygen
outside, he would be referred to a psychotherapist who would conduct motivational
counselling in order to improve his compliance with medication routine (Mackey et al.,
2016).
The effectiveness of the applied interventions would be evaluated on the basis of the
diagnostic test reports and the quality of the symptoms presented by the patient during the

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follow up session (Mackey et al., 2016). In addition to this, the vital assessment data of the
patient during the follow-up session would also help to estimate the compliance level with
medication management (Bourbeau, Lavoie & Sedeno, 2015). Also, the level of compliance
with medication routine would be assessed on the frequency of the recurrent hospital visit due
to the exacerbation of the COPD symptoms (Bourbeau, Lavoie & Sedeno, 2015).
Conclusion:
Therefore, to conclude, it can be mentioned the paper critically assesses the identified
care priorities of the patient in addition to the identification of the barriers that hinders the
compliance level with the prescribed medication routine. Further, appropriate nursing
interventions along with supporting rationales that can help to improve compliance with
medication routine has also been discussed. Also, appropriate evaluation measures that can
help to foster positive patient recovery has also been critically discussed in the paper.
Therefore, it can be expected that implementation of the discussed nursing strategies can help
to improve the quality of symptoms of the patient.

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References:
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strategies. In Seminars in respiratory and critical care medicine (Vol. 36, No. 04, pp.
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Effing, T. W., Vercoulen, J. H., Bourbeau, J., Trappenburg, J., Lenferink, A., Cafarella, P., ...
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