CHRONIC OBSTRUCTIVE PULMONARY DISEASES

Chronic Obstructive Pulmonary Diseases

Chronic Obstructive Pulmonary Diseases

Introduction

Chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time. COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD.

The rational for choosing the topic

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualized programme of care will be discussed and critically analysed.

A Case Study: Chronic Obstructive Pulmonary Diseases

Jack, the patient presented through Accident and Emergency to Ward D3, an acute medical ward specialising in respiratory medicine. He was admitted due to an exacerbation of dyspnoea, which was more significant over the last twenty-four hours. The writer met Jack on admission to the ward. (Adriaanse, 1991, 375)

The Overview History of Journey

Jack, 88 years old. Jack is a smoker for the past thirty years; he smokes twenty cigarettes a day. He has a family history of lung cancer, his father died two years ago from lung cancer. Jack has a four-year history of dyspnoea. He has also experienced a persistent cough, productive of a small amount of yellow stained sputum. The cause of these symptoms had not been determined, as Jack has not visited his general practitioner in fifteen years. In the twenty-four hours prior to his admission, Jack noticed a considerable increase in his symptoms; he was now dyspnoeic at rest and could not mobilize as it caused him considerable respiratory distress. Jack called his daughter who in turn accompanied him to hospital.

The keys Issues of care and their challenges

The model used to plan Jack's care was the 'Activities of Living Model' developed by Nancy Roper, Winifred Logan and Alison Tierney (1980). It is the model used on the ward as it facilitates individualized and holistic nursing care. In conjunction with the nursing process it is possible for nursing interventions to be planned, implemented and evaluated following the initial assessment with the patient to identify actual and potential problems for each of the activities of living.

The initial assessment provides a baseline for future assessments, as assessment is an ongoing activity, beginning on admission and continuing until discharge. (Adriaanse, 1991, 375) From the initial assessment breathing was identified as a problem for the patient. Other problems were identified however; due to the confinements of this assignment breathing will be the only problem discussed.

Breathing is perhaps the only activity of living that most individuals perform independently throughout their entire lifespan (Roper et al., 1980). We inhale to obtain oxygen and exhale to expel ...