COPD Case Study: Mary Gyne, Diagnosis, Symptoms, and Management

This case study presents a detailed analysis of a 56-year-old female patient, Mary Gyne, diagnosed with COPD. The case study begins with an introduction outlining the patient's symptoms, including shortness of breath, persistent cough, and chest tightness, along with her medical history, including smoking habits and family history of COPD. The diagnostic process is discussed, highlighting the use of CT scans and blood tests to confirm emphysema and elevated eosinophil levels, leading to the diagnosis. The symptoms experienced by the patient are explored, including chest tightness, wheezing, and ankle swelling, with a focus on the prescribed medications like theophylline and Phosphodiesterase-4 inhibitors to manage the symptoms. The psychosocial impact of the diagnosis is examined, considering the potential effects on the patient's personal life, family relationships, and financial situation. The case study then delves into the management of exacerbations, emphasizing the importance of self-management strategies, medication adherence, and the role of family support and team nursing. Finally, the assessment tools used, such as CT scans and laboratory tests, are evaluated for their validity and reliability, and the effectiveness of the prescribed medications is discussed. The study concludes by summarizing the key findings and emphasizing the need for comprehensive care, including home-based care and smoking cessation, to improve the patient's quality of life.

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COPD CASE STUDY
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COPD Case Study
Introduction
Mary Gyne is a female aged 56 years old. She comes to the health facility complaining of
shortness of breath, a persistent cough and chest tightness. She says that she is married and has
three children; two daughters and one son. The children have moved out of the home and she
now only lives with her husband, Jared. Mary states that she has experienced chest pains before,
only that the current ones are severe. They also do not seem to even after taking a cough syrup
based on self-prescription bought over the counter. Prior observation of the patient indicates that
she may be having COPD, yet to be proven with further lab tests. There is the need to highlight
the history of the patient, that led to her contraction of COPD. There is also the need to establish
some of the deep symptoms associated with the health problem. It is also important to take note
of the psychosocial effects of the health problem as well as how the problem could be well
managed. Throughout the case study, anonymity of the patient by the NMC code of ethics. The
paper provides a thorough discussion of the patient.
History taking resulting in a diagnosis of COPD
Taking note of the history of the patient was important. It was determined that she has
been a frequent smoker and has been engaged in the habit for the last 15 years. She also has a
history with COPD, her paternal grandfather having experienced the health problem before his
demise. The family history of COPD, therefore, showed that there was a high likelihood of the
patient having the health problem. The physician, therefore, had a health problem in mind and
further tests would aim to confirm whether it was actually the health problem.

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The patient was also asked whether she has ever experienced any symptoms consistent
with COPD before (van Boven et al., 2015). It was determined that save for occasional chest
pains and coughing; she had not experienced any major problem that may be tied to the
development of the health problem. Since the patient is of advanced age, above 40 years, she
happens to be at a point where she faces the risk of developing the health problem. Although she
does not mention to have asthma, the consistent smoking may have had played a major part in
the development of COPD. A CT scan was conducted on the patient in which it was determined
that she had emphysema. There was a depiction of the inflammation of the alveoli, a condition
that is consistent with emphysema in a patient. The inflammation of the airsacs leads to the
impairment of the lung tissue, thereby, reducing upon its capability to function appropriately.
While the emphysema is not a sole determinant of COPD, it is still an indication of chances of
the problem in a patient (Rasmussen et al., 2017). Use of laboratory tests conducted a differential
analysis. The blood tests showed that there was a high level of eosinophil in the blood of the
patient. A sputum test was also conducted which provided positive indications of large
eosinophil deposits. The results of the tests were, thus, imperative in confirming that the patient
had COPD.
Owing to the accuracy of the findings that were obtained with the use of family history,
symptoms of the patients as well as the CT scan and the differential analysis, there was no need
to conduct further tests. The results available had already showed that the patient had the health
problem that the physician had suspected. Some of the tests that were, therefore, not conducted
included the depression score, the MRC score the CAT score and spirometry test.

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Explanation of Patient’s Symptoms
Mary appeared to have some symptoms that are an indication of the presence of COPD.
Some of them include chest tightness, wheezing, shortness of breath and constant energy lapse,
in the recent times. It was also noted that the ankles of the patient were swollen (van Boven et
al., 2015). Given the concept of self-management that the patient may adopt to take good care of
herself, there is the need for the facility to prescribe to her drugs that are likely to ease on the
chest pains. There is also the need to administer drugs that reduce the chances of edema that may
lead to the swelling of the ankles (Magnussen et al., 2014). Some of the drugs that may be
prescribed for the patient include theophylline, which has a chance of improving upon the
breathing rate. There may also be the need for the administration of Phosphodiesterase-4
inhibitors which bear a chance to reduce the chances of inflammation of the airways. Being fully
aware of the symptoms holds a huge chance of establishing the specific measures that may be
applied to improve the health of the patient.
In regards to the acute symptoms, such as shortness of breath, there is the need to
establish their frequency of occurrence. The measure is imperative in determining the right drug
that may be used to deal with the health problem. As it relates to the chronic symptoms,
associated with COPD, there is the need to determine some of the drugs that are associated with
low chances of side effects on the patients (Toren et al., 2017). The prescription of such drugs to
the patient will be important in ensuring that she has the willingness to follow through taking it
to ease on some of the sufferings that she may be experiencing, as a result of the COPD. The
patient will be in charge of determining some of the ways through which she could reduce the
continued development of the health problem to levels that may be worse. The patient may also

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have the chance to report where it is clear that the situation has worsened and, therefore, in need
of more specialized care.
Psychosocial Impact Associated with the Diagnosis of COPD
Mary may need to be under hospital care for COPD for some time until her condition has
eased up. The situation will, therefore, be important in enabling her to go back to her earlier
duties that she was used to. However, the diagnosis of the health problem bears some level of
psychosocial impact upon her (Clark et al., 2015). For instance, there is a chance that she could
miss being with her family, for some time, especially where she stays at the hospital for long.
The continuous intake of drugs may also impact on her personal life. For instance, there may be
the need for her to adjust her time for waking up (Apps et al., 2016). She may, therefore, need to
start waking up much earlier than she has been used to take her drugs. The fact that she has been
diagnosed with a chronic health problem is likely to take a heavy psychological bearing upon
her. She may, therefore, need to go through some moment of denial, before being able to come to
terms to her new situation (Chapman et al., 2018). Granted, there is the need for constant
counseling of Mary to ensure she can follow the treatment regimen accorded for the health
problem. The counseling will be important towards reducing the risk of depression in the patient.
Where there is stronger family support from her husband and children, there is a high
chance that she may be in a good position to deal with her problem much better. For instance,
they could inform her that she can deal with the new challenge that she experiences (Criner et
al., 2015). They are also likely to guide her on the right mechanisms that she may seek to apply
in a bid to adhere to the different drugs that she has been prescribed to in regards to dealing with
her problems.

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The health problem may also take a toll on her finances. She may, therefore, need to pay
higher premiums for her insurance, since she has a chronic health challenge that needs to be
addressed (Kirby et al., 2016). Granted, she may, therefore, some level of financial support from
other family members concerning ensuring that she can deal with her situation better.
The Management of Exacerbations
There is the need for both self-management and hospital-based care. Self-management of
the patient will be based on Mary ensuring that she takes drugs consistently and on time. She
may also be willing to open up on some of the persistent symptoms that she might be having
(Ancy et al., 2016). The patient may need to continue taking theophylline and
Phosphodiesterase-4 inhibitors. The drugs will be important in reducing the chances of shortness
of breath and chest pains in the patient. The patient will also need to share with her family,
consistently ((Kirby et al., 2016). The family will, therefore, be keen to share with the physician
on some of the areas that may need immediate attention. The use of team nursing in the care of
the patient will be important in providing varied information as it relates to some of the
developments that may be noted on her. The strategy will also be imperative in providing a more
holistic approach as the different health professionals have a chance to provide their ideas in
regards to some of the changes that may need to be adopted while caring for Mary.
Mary also needs to stop smoking cigarette. The measure will be important in reducing
upon the chances of increase of the extent of the current problem that she experiences. She also
needs to set up a plan for taking the drugs prescribed by the physician. The action will ensure
that she takes the right dosage that is required of her and consistently. Thus, there is a high
likelihood of reduction of the extent of the pain and discomfort that she could be experiencing.
Mary also needs to share information regarding some of the complications that may come from

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the different drugs that she has been prescribed. The action will be important in making the
necessary adjustments that will be important in reducing the suffering that she could be
experiencing.
Reflection of the diagnostic and Assessment Tools
The use of CT Scan and laboratory tests are important in the diagnosis and review of
ongoing treatment of Mary. The assessment tools are deemed to be both valid and reliable,
owing to the high level of attention that has been used for their development. The use of
Phosphodiesterase-4 inhibitors and Theophylline for easing on the suffering of the patient is also
deemed appropriate in ensuring that the problem of COPD is well handled.
Conclusion
To sum up, Mary is a 56-year old lady who has been diagnosed with COPD. CT scan and
laboratory tests were used as the main methods for diagnosing the health problem. At the time of
visiting the health facility, Mary Gyne had been complaining of chest pain and shortness of
breath. Although she had experienced the health problem before, it was not in the same level of
severity as it currently is. She has a history of smoking, and her maternal grandfather had COPD.
The use of Theophylline and Phosphodiesterase-4 inhibitors were determined as the best
approaches to the drug. More home-based care needs to have been used for the patient.

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