COPD Management: Therapeutic Approaches and Clinical Decision Making

This presentation focuses on the case of Ngarla Kngwarreye, a COPD patient, and identifies two therapeutic approaches: ipratropium via nebulizer and pulmonary rehabilitation. It provides the rationale for selecting these interventions, discussing their benefits, risks, and guidelines. The presentation explains the pathophysiological basis of pneumonia, outlining symptoms like fast and shallow breathing. Ipratropium is highlighted for its ability to control wheezing and shortness of breath by relaxing airway muscles, while pulmonary rehabilitation involves lung exercises to reduce coughing and improve overall quality of life. The clinical decisions, including medication provision and the use of ipratropium, are justified based on their effectiveness in improving breathing and reducing hospitalization risks. Desklib provides more solved assignments and study resources for students.

HOSPITALITY

INTRODUCTION
 This presentation will be focusing upon a patient named Ngarla Kngwarreye who is
suffering from COPD.
 So, in this presentation identification two therapeutic approaches for this patient will be
identified with rationale of selecting both the approaches, benefits of selecting those
interventions and guidelines to be followed for the same. Other than this, justification
of any kind of clinical decisions taken for bringing changes within her condition were
also provided.

Explain the pathophysiological basis for the
patient’s health condition
 Ngarla Kngwarreye is suffering from pneumonia which is a kind of COPD. Its signs
are: fast breathing, shallow breathing, shortness of breath, coughing etc. Pneumonia is a
kind of condition in which body’s natural defense allows germs to invade and multiply
within lungs.
 Some of the main symptoms of pneumonia are as follows: cough, production of
greenish, yellow or even bloody mucus, expansion of longs causing pain in chest.

Rationale for therapeutic approaches for the
patient
In order to bring improvement within her health two main therapeutic interventions can be
selected so that improvement within her current condition can be brought.
 Therapeutic intervention 1: ipratroprium 500 mcg by nebulizer with air as required was
used as Therapeutic intervention for Ngarla. It is one of the best solutions that can be
used with routine management of pneumonia. It can be directly used for treating her
current conditions as a conventional therapy.
 Use: its main use is to bring control in severe acute pneumonia. With the help of
ipratroprium 500 mcg symptoms and sings of wheezing and shortness of breath can be
controlled directly which is caused by COPD. With the help of ipratroprium, muscles
around her airways can be relaxed easily, opened up so that she can breath easily.
 Risk: risk associated with nebulizer are quite lower or minimum but it can result in rapid
heartbeat, nausea, irritation in nose. In case of serious signs general practitioner should
be consulted.
 Special considerations: there are no such special considerations but it should be inhaled
only through mouth.

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 Therapeutic intervention 2: pulmonary rehabilitation is another kind of therapeutic
intervention that can be used in which different kinds of exercises of lungs were
explained to Ms Kngwarreye so that she can learn different exercise for dealing with
shortness of breath.
 Physiological effects or benefits: it can directly help in reducing coughing, enhance
quality of life, bring improvement within overall quality of life, learn to deal with short
breath.
 Guidelines: to maintain gains made in respiratory function, exercise tolerance and
QOL. Two years follow up can be developed for people with moderate COPD so that
improvement within overall condition can be brought. It can be used to provide
breathing techniques education to patient, promotion of physical activity can be done
so that overall quality of life of patient can be enhanced.
 Effectiveness of this therapy: Pulmonary rehabilitation is one of the most effective
programs when maintenance of Chronic Obstructive Pulmonary Disease comes into
picture. It is effective when enhanced effectiveness of respiratory and non- respiratory
symptoms comes into picture.

Justified clinical decisions
 Some of the most important clinical decisions taken for bringing improvement within
her condition are: provision of medications as medication can directly help in bringing
control within her overall condition. Some of the most important medication provided
to her were: Trelegy inhaler, spironolactone daily 20 mg, alendronate 70 mg weekly,
calcium carbonate 600 mg x 2 daily, fluoxetine 20 mg daily.

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 Use of ipratroprium 500 mcg by nebulizer with air is one of the best clinical decision that can
be taken for bringing improvement within current and existing condition of Ms Kngwarreye
comes into picture.
 This is because with the help of nebulizer lungs muscles can be loosened up which can further
make breathing much easier for Ms Kngwarreye. It is one of the best and most appropriate
option for bringing improvement within her breathing.
 Not only this, it will further help Ms Kngwarreye to reduce thickness of Sputum and makes
coughing much easier. Whereas selection of pulmonary rehabilitation intervention was a
justified clinical decision for breathing improvement within her overall condition this is because
it can directly help in increasing her tolerance level and reduce changes of getting hospitalized.