Nursing Strategies in Palliative Care: COPD Patient Mrs. Brown's Case

This report presents a case study focused on Mrs. Brown, a 62-year-old retired woman suffering from chronic obstructive pulmonary disease (COPD), and analyzes effective palliative care strategies. The core of the report revolves around two primary nursing interventions: the use of corticosteroid therapy to manage physical symptoms, particularly shortness of breath, and the implementation of social support interventions to address emotional distress, anxiety, and potential depression. The report emphasizes the importance of addressing both the physical and psychological needs of the patient to improve the overall quality of life and prevent further complications. The analysis highlights the benefits of short-term corticosteroid treatment and the role of social support in reducing social isolation and enhancing the patient's ability to cope with the disease. The report concludes that a combination of these interventions is crucial in providing comprehensive palliative care for COPD patients. The provided references support the strategies. This report is contributed by a student to be published on the website Desklib, a platform providing all the necessary AI-based study tools for students.

Running head: PALLIATIVE LIFE CARE
PALLIATIVE LIFE CARE
Name of the Student:
Name of the University:
Author note:

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Palliative care is defined as a care endowment that comprises of providing complete
care to the people suffering from life threatening diseases and concentrating on achieving the
exclusive social, physical, spirit and psychological needs of the patients. Palliative care
involves optimizing the quality of life and care to the patient and the family members by
promoting comfort and relief to them, thus inhibiting the sufferings (Mousing et al., 2018).
This essay primarily focus to analyse the patient Mrs Brown, who is a 62 year old retired
women with severe issue of chronic obstructive pulmonary disease (COPD). This essay will
provide a detail discussion on the two major nursing strategies in order to manage the
patient’s condition. The strategies will give a detail idea concerning how the palliative care
and attention is executed for specific patient (Iyer, Benzo & Bakitas, 2018).
Mrs Brown is a retired women who lives with her husband and working as a part time
along with her husband. The patient is recently suffering from shortness of breath and
coughing, which is getting deteriorated day by day. She was hospitalised thrice previously
because of her increasing bad health condition due to COPD. From the preceding 2 days the
patient is facing severe health issue of chronic cough associated with white mucus. Therefore,
these symptoms of Mrs Brown is indicating reappearance of COPD, hence the foremost
nursing priority will be to report the physical symptoms of the patient using pharmacological
intrusion (Russo et al., 2018). It is crucial to address the physical issues of the patient related
to COPD in order to decrease the danger of respiratory catastrophe and thus avoiding any
further complication in the patient.
The primary nursing strategy will be to report the physical symptom of shortness of
breath that includes the consumption of corticosteroid. Agusti et al., (2018) supported the
incidence that the use of inhaled corticosteroid is related with a reduction in level of
exacerbation of the patient’s COPD. Total corticosteroid consumption is considered as a
standard portion of management and treatment of exacerbations. It is also considered as the

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main aspects, which leads to the welfares for patient suffering from COPD like Mrs Brown. It
includes improvement in rate of oxygenation and lung function thus donating to quick
recovery period and minimum stay in hospital. In case of COPD patient, oral corticosteroid is
most beneficial as compared to nebulized corticosteroid that is needed only in acute
exacerbation. Stolz et al., (2018) states that consumption of oral corticosteroid is highly
suggested for treatment and management of exacerbation with the major advantage of
corticosteroid treatment relating to good bioavailability and better comfort of administration.
Therefore, initiation of corticosteroid treatment is highly recommended for Mrs Brown as is
will help her to reduce the symptom of breathlessness and also reduce economic and social
burden related with repeated hospitalization.
Viniol & Vogelmeier (2018) provided an evidence stating that the patients suffering
from severe exacerbation should be cured with methodical corticosteroid for approximately
7-14 days. The total period of treatment will also define the threat of adverse outcome for
patient. The investigation regarding the effect of long or short period corticosteroid treatment
resulted that the patient with short period of corticosteroid treatment will have less possibility
of any adverse effect as compared with longer period of course. Hence, in case of Mrs
Brown, it is strategic to provide her with course of short period corticosteroid treatment to
address her physical symptoms associated with exacerbation of COPD and thus provide her
with emotional and mental relief with better physical health condition (Bostock, 2018).
As a portion of palliative care approach, it is essential to report the spiritual or
physiological need of the patient Mrs Brown in order to guarantee that the care practice is
improved throughout her stay in the hospital (Halpin, 2018). However, her mental condition
was affecting her health condition, which includes high risk of anxiety and depression. Due to
her continuous breathlessness she was feeling trapped and could not move around in the
house and she was totally dependent on her husband and family to take in charge of her

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domestic and physical needs in daily life. Hence, the above mentioned restriction in her daily
life resulted in emotional distress and anxiety and she was ultimately going in depression.
She felt like a burden to her husband and family and was mentally not at peace, which
ultimately led to depression. Hence, the second nursing priority will be to treat the symptom
of emotional distress and in Mrs Brown to decrease the threat of depression and bad
psychological health effects (Johnson et al., 2018). The previous medical history of Mrs
Brown’s states that she was analysed and diagnosed with depression. Hence, it was important
to address her emotional distress and anxiety to reduce or prevent depression.
According to complete care endowment, the second nursing strategy, which is
essential to reduce emotional distress and anxiety for Mrs Brown comprises of providing
adequate social support. The chief rationale for providing social support to Mrs Brown will
provide her an opportunity or chance to cope up with her disease and get involved in social
network, which will help her to reduce emotional distress and social isolation because of
deprived self-administration of COPD. In case of Mrs Brown, social support intrusion was
appropriate as the symptoms of COPD symptoms like dyspnea and cough is related with
some severe effect on psychological distress, daily living and social isolation (Miravitlles &
Ribera, 2017). Gardener et al., (2018) also supported the method of social support for
improving physical health condition, reducing functional injury and enhancing the social and
emotional well-being of the patient to manage the health condition. Social support
intervention can decrease the influence of social isolation and low mood to in order to
support the patient suffering from COPD by enhancing physical activity and also reducing
anxiety level. Hence, Mrs Brown should be intervened with social support through different
group sessions accompanied with other COPD patients to reduce her social isolation (Huang
et al., 2018).

4PALLIATIVE LIFE CARE
Other than reducing anxiety, social support also help the patient to overcome
loneliness and increase communication with different group members in order to reduce
negative opinion associated to self-management of COPD. Social support intervention is
important in palliative care as it helps to progress the health condition of the patient and
thereby increasing disease administration activities such as active contribution in various
social events through effective physical activity (Nguyen, 2019). Acute level of anxiety due
to COPD disorder is related with greater co-morbidities such as depression and social
isolation (Lenferink, Van & Effing, 2018). Mrs Brown was also experiencing few
psychosomatic morbidities such as emotional distress and anxiety that led to impairment in
her physical ability to obtain innovative skills and decrease self-confidence in supervision of
disease. Therefore, it is important for Mrs Brown to take up social support intervention and
reduce the level of disease burden.
The essay gave a detail insight regarding case study concerning the patient Mrs
Brown who was suffering from COPD and analysing the highest importance of nursing care
approach for disease management in a patient. COPD exacerbations exposed that the patient
suffering from this disorder goes through a trauma of physical health deterioration
accompanied by psychological health consequences. Shortness of breath could result in
respiratory catastrophe for Mrs Brown, the primary nursing care approach was to Mrs Brown
with efficient corticosteroid therapy as an intervention to reduce or decrease the frequency
and rate of forthcoming exacerbations. The second important nursing care approach to Mrs
Brown will be to provide her with effective social support in order to report social, emotional
and psychological need of the patient. Hence, the essay concludes that the combination of
these intervention will be effective in providing complete palliative care approach to the
patient.

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References
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exacerbations. The Lancet Respiratory Medicine, 6(9), 657-659.
Bostock-Cox, B. (2018). Stepping down therapies in COPD. Practice Nursing, 29(8), 383-
389.
Gardener, A. C., Ewing, G., Kuhn, I., & Farquhar, M. (2018). Support needs of patients with
COPD: a systematic literature search and narrative review. International journal of
chronic obstructive pulmonary disease, 13, 1021.
Halpin, D. M. (2018). Palliative care for people with COPD: effective but underused.
Huang, C. D., Goo, J., Behara, R. S., & Agarwal, A. (2018). Clinical Decision Support
System for Managing COPD-Related Readmission Risk. Information Systems
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Iyer, A. S., Benzo, R. P., & Bakitas, M. A. (2018). Easing the Tension Between Palliative
Care and Intensive Care in Chronic Obstructive Pulmonary Disease.
Johnson, K. M., Safari, A., Tan, W. C., Bourbeau, J., FitzGerald, J. M., & Sadatsafavi, M.
(2018). Heterogeneity in the respiratory symptoms of patients with mild-to-moderate
COPD. International journal of chronic obstructive pulmonary disease, 13, 3983.
Lenferink, A., van der Palen, J., & Effing, T. (2018). The role of social support in improving
chronic obstructive pulmonary disease self-management.
Mousing, C. A., Timm, H., Kirkevold, M., & Lomborg, K. (2018). Receiving home care and
communicating about COPD-related concerns and palliative care. Nordisk
sygeplejeforskning, 8(02), 107-121.
Miravitlles, M., & Ribera, A. (2017). Understanding the impact of symptoms on the burden
of COPD. Respiratory research, 18(1), 67.

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Nguyen, T. (2019). Evaluating Healthcare Providers’ Utilization of Social Support for COPD
Patients.
Russo, P., Lococo, F., Kisialiou, A., Prinzi, G., Lamonaca, P., Cardaci, V., & Fini, M. (2018).
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Stolz, D., Barandun, J., Borer, H., Bridevaux, P. O., Brun, P., Brutsche, M., ... & Geiser, T.
(2018). Diagnosis, prevention and treatment of stable COPD and acute exacerbations
of COPD: The Swiss Recommendations 2018. Respiration, 96(4), 382-398.
Viniol, C., & Vogelmeier, C. F. (2018). Exacerbations of COPD. European Respiratory
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