Comprehensive Disease Management Report: Mrs. Betty's COPD Case Study

This report presents a comprehensive case study of Mrs. Betty, an elderly patient suffering from chronic obstructive pulmonary disease (COPD) and pneumonia. It delves into the etiology of COPD, primarily linked to smoking, and discusses the disease's impact, including chronic bronchitis and emphysema. The report emphasizes nursing care strategies, including careful monitoring, bronchodilator use, and the importance of a strengthening approach for patient well-being. It outlines the significance of patient education, covering breathing techniques, avoidance of irritants, medication adherence, and healthy lifestyle choices. Furthermore, the report highlights the role of multidisciplinary care, discharge planning, and the involvement of a healthcare team to provide comprehensive support. The conclusion underscores the challenges in COPD management, advocating for self-management practices like exercise, smoking cessation, and a nutritious diet, with nurses playing a crucial role in patient care and support. The report references various studies and guidelines to support its recommendations.

Running Head: DISEASE MANAGEMENT
DISEASE MANAGEMENT
Name of the Student
Name of the University
Author Note

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Patient Presentation
Introduction
Mrs. Betty is an old woman with poor English language skills who has been admitted
to the ward for suffering from chronic obstructive pulmonary disease or COPD. She was also
suffering from pneumonia and no known allergies. She is widowed and lives all alone in
Melbourne. She is currently living in her own home and using the nursing services along with
assistance for domestic chores and also to change the dressings for her leg ulcers. She is very
thin with no appetite and very little exercise. This report will thus, discuss on the various
disease conditions that are being faced by Mrs. Betty and the scope of the nurses that can help
her to come out of the situations. The report will also suggest certain recommendations that
will help the patient to come out of the situation and also to know the exact line of treatment
that is needed and designed specifically for her.
Etiology of the disease
The significant reason for COPD is tobacco smoking. As the patient was an ex-
smoker throughout the previous 50 years as she used to smoke 3 packs each day. It is seen
that about 40% to 70% of COPD cases are caused due to smoking and applies its impact by
causing a provocative reaction, cilia brokenness, and oxidative damage. Air contamination
and work related presentation are other regular etiologies. Oxidative pressure and an
irregularity in proteinases and anti-proteinases are additionally significant factors in the
pathogenesis of COPD, particularly in patients with alpha-1 antitrypsin insufficiency, who
have panacinar emphysema that typically shows at an early age (Wang, Ni & Liu, 2016).
COPD has two main conditions chronic bronchitis and emphysema. In emphysema
the air sacs in the lungs is damaged and chronic bronchitis results in the swelling of the
airways along with mucus production. Asthma is a constant lung illness that aggravates and

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limits the aviation routes. Treatment ordinarily can switch the aggravation and narrowing that
happens in asthma. Few individuals have an uncommon type of COPD called alpha-1 lack
related emphysema (Nakawah, Hawkins & Barbandi, 2013). This type of COPD is brought
about by a hereditary (acquired) condition that influences the body's capacity to deliver a
protein (Alpha-1) that ensures the lungs. The foundations for COPD have inverse examples
as indicated by the geographic regions. Beforehand COPD was progressively normal in men,
but since of equivalently abnormal amounts of tobacco smoking among ladies in high-
¬income nations, and the higher danger of introduction to indoor air contamination, (for
example, strong fuel utilized for cooking and warming) for ladies in low-income nations, the
ailment presently influences people similarly (Andreeva et al., 2015).
Nursing and Education
Nursing Care
The nursing care for the older people who have co-morbid conditions, the most
important aspect of nursing is to remain alert and progressively cautious for observing the
negative impacts of the risk factors. For instance, there are certain bronchodilators that can
have an negative impact on the patient even if they are working fine with the other patients
The use of strengthening approach is vital for the wellbeing and advancement as well as for
empowering the older people with COPD to have overpower the sickness (Wang, Ni & Liu,
2016). In many cases it has been observed that the treatment of COPD requires numerous
techniques that help the patients to feel relieved and also helps the nurses to make the
intervention of the disease much easier. The objectives of the COPD treatment incorporate
soothing side effects, improving activity resistance and wellbeing status, decreasing the
danger of ailment movement, and counteracting compounding and mortality. Although rules
for the analysis and the board of COPD exist, numerous clinicians and nurses may not be

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comfortable with or may not actualize these rules in their practices, in this way trading off
patient consideration (Taffet, Donohue & Altman, 2014).
The nursing assessment that helps to deal with COPD depends on three fundamental
segments: non-pharmacological treatment of COPD that helps in diminishing the danger
factors by executing smoking suspension, lessening exposures to toxic improvements,
customary flu and pneumococcal inoculations, and the utilization of pneumonic recovery in
proper patients. Another approach is the pharmacological way of treatment of COPD; and the
executives of co-morbidities (Simpson & Jones, 2013). Thus, the most obvious assessment
for COPD involves smoking cessation that can be undertaken by the patient at any age
(Nakawah, Hawkins & Barbandi, 2013).
The nurses can also put emphasis on the other symptoms of the patients like
peripheral edema and productive cough that can be removed by the use of vaccines in
patients suffering from COPD (Kaptein, Fischer & Scharloo, 2014). However, the nurse
should ensure that the treatment must be centered on side effect control and should be
individualized dependent on patients' seriousness. The nurses can also care about the
potential threats that can intensify respiratory side effects, and decrease in the capacity of
breathing. Since they can evaluate these conditions, medical caretakers can help keep COPD
treatment a focal point of patient consideration (Kabrhel et al., 2013). The nurses thus, can
teach the patients about the importance of self-management that is very important for the
older patients like Mrs. Betty who lives alone.
Education
The steps that can be taken to manage the patients with COPD involves a number of
measures such as the breathing techniques that involves pursed-lip breathing, which help the
patient to breathe easily, especially at times when they feel short of breath. The patients can

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also be taught to stay away from dust, fumes, and smokes. The patient should also not go near
the places that is being painted or are using insecticide sprays. They should stay inside if the
temperature is very high outside the house and should always take COPD medicine in the
same the way as directed by the healthcare (Horton et al., 2013). The patient should also
exercise regularly under the guidance of the nurse so that the patient will not exhaust
themselves after heavy training or exercise. Another intervention that can be taken by the
nurse includes asking the patient to eat healthy food that will help them to keep fit and also
keep their weight under check (Mitchell et al., 2014). The patient should be advised to drink
a lot of nonalcoholic in order to keep the mucus inside the lungs from getting thick. The
nurse should keep a check on the fact that the patient is not near the sick people. The patients
should plan their rest periods and if they need help with chores and errands they should ask
their family and friends. The nurse should thus put emphasis on the fact that the patient learns
self-management in order to improve their ability to self-monitor and manage the changes in
chronic obstructive pulmonary disease (COPD). This will result in improved outcomes. The
patients can be provided with a COPD booklet with all the necessary information; their
primary care providers received a copy of COPD guidelines and were advised to manage
their patients according to these guidelines (Kruis et al., 2016).
Multidisciplinary Care
Discharge Planning
COPD is a very complex disease and in patients who suffer with severe emphysema
needs special assessment along with careful appraisal of the risks as well as the benefits that
is very critical to good outcomes. The plan includes not just the prescription of medicines but
also an assessment of the ability of the patient to use the devices and also to understand the
correct timing of using the medications. An assessment can be done that examines the
patient's ability to cope with the stressful situations. A nutritional assessment that focuses on

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the dietary habits should be included by the multidisciplinary team that examines the
condition of patients with COPD (Brandt, 2013). The regular check-up of patient and
communication among the team members is very critical for the management of the patient
suffering COPD. This approach provides the patient with the greatest chance to increase their
respiratory potential. The team consists of, nurses, a physician exercise specialists, dieticians,
and social workers. The team's focus is to provide education along with the reinforcement of
the medical plan. The team can have a approach for weight loss in the patients who are
overweight that might help to decrease the symptoms of breathlessness. The team should
prescribe the patient about pulmonary rehabilitation along with providing the patient with
information about advanced directives, smoking cessation, traveling and community
resources, and support groups (Bedra et al., 2013).
Conclusion
Thus, the conclusion that can be drawn from the report is that the care of the patient
with COPD offers challenges in management. The multidisciplinary model described in this
article defines the essential elements of a comprehensive plan. The report also suggests that
the patient should emphasize on the self-management of the diseases. This will include
various factors such as exercise, abstaining from smoking, and also to maintain a nutritious
diet. The nurses can take care of this aspect who tries to manage the patients as they are in the
close association with the patient.

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