Chronic Obstructive Pulmonary Disease

CHRONIC OBSTRUCTIVE PULMONARY DISEASE 3

Running head: CHRONIC OBSTRUCTIVE PULMONARY DISEASE 1

Chronic Obstructive Pulmonary Disease

Tanaesa Costa

University of North Florida

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease is an inflammatory disease of the lungs that disrupts the free flow of air in the lungs. Some of the main symptoms include; difficulty in breathing, wheezing, mucus production, and coughing. The disorder is mainly caused by long-term exposure to particulate matter or irritating gases, especially from tobacco smoke. Chronic Obstructive Pulmonary Disease also increases the risk of developing lung cancer, heart disease, and other various conditions. The most common type of illness that contribute to Chronic Obstructive Pulmonary Disease is chronic bronchitis and Emphysema. Chronic bronchitis results in inflammation of the bronchial tubes characterized by mucus production and severe cough. On the other hand, Emphysema is a condition in which the alveoli of the bronchioles of the lungs are destroyed as a result of exposure to particulate matter or irritating gases, especially from tobacco smoke. Even though the disorder is not treatable, proper management can be effective in suppressing the symptoms of the disease as well as reducing the risk factors getting other associated conditions. Nursing diagnosis for ‘Chronic Obstructive Pulmonary Disease is often viewed as a nursing process or an outcome of the assessment from both objective and subjective information. Nursing diagnosis is generally a statement of health assessment that the nurse can treat. In most cases, a victim’s medical diagnosis alerts the nurse to be wary of certain problems, these problems are put forward in the nursing diagnosis nomenclature. Thus, the paper endeavors to provide a nursing diagnosis of Chronic Obstructive Pulmonary Disease, evaluate the available interventions which might lead to effective outcomes that may help out people suffering from the condition.

There are a number of nursing diagnosis for patients with Chronic Obstructive Pulmonary Disease as it involves introduction into a treatment program to prevent complications and relieve symptoms. In these cases, I have chosen to look into Coping Deficient Knowledge Social Isolation Powerlessness Family Caregiving Grieving Self-care nursing diagnosis. This diagnosis involves a lack of information resources, lack of cognitive limitations and misinterpretation of information. Nurses often have a significant role in patient education as a way of providing nursing care in order to come up with the best outcomes for the patients. It is also the responsibility of the nurse and the patient to determine what to teach.

To begin with, assessment of the patient in deficient knowledge entails, identifying the patient since most of adults or patients with chronic illnesses view themselves dependent on the caregiver and there cannot consider themselves to be part of educational process. The nurse should also examine the ability of the patient to do health-related care because cognitive impairments must be identified so that the nurse can come up with an appropriate teaching plan. Deficient knowledge diagnosis would also involve evaluating the willingness of the patient to learn in order to identify the needs to be discussed particularly if the patient has background information about the disorder. The nurse should also allow the patient to open up about previous experiences since learning always borrows a lot from previous knowledge experiences. Deficient knowledge diagnosis also puts more emphasis on the existing misconceptions about the topic since when an assessment creates a significant starting point to education, knowledge serves the purpose of correcting faulty ideas. It is also important for the nurse to learning needs priorities in the overall diagnosis in order to identify the needs to be looked into especially if the patient has gone through the process before. This would be critical since it would cut on time wasted repeating the same procedures.

Furthermore, the nurse ought to identify the cultural influence in health teaching. This is attributed to the fact that interventions always need to be custom made for the patient suffering from Chronic Obstructive Pulmonary Disease putting the patient’s background into consideration. In regards to culture, the nurse ought to acknowledge the ethnic and racial differences at the onset of the diagnosis in order to establish a rapport, enhance communication and promote treatment outcomes. It is also important to consider the learning style of the patient particularly if the patient has already learned new information in the past. Thus, the learning style must be a critical factor when planning for coming up with an education program. For instance, some may prefer individual instructions over group sessions while others may prefer visual materials over written material. The nurse should also determine the self-efficacy of the patient to learn and apply new knowledge. Since self-efficacy implies the patient’s ability to perform a behavior, improving the confidence of the patient’s ability to learn the desired information can be an important step in learning. Lastly, Deficient knowledge diagnosis also involves identifying the barriers to learning such as financial concerns, patterns, acceptance from peers, or change of lifestyle. This is attributed to the fact that a new patient brings a unique social interaction pattern, cultural norms, personality, and environmental influences.

Interventions and outcomes

In order to facilitate the desired outcomes, various interventions have to be employed in the diagnosis. The begin with, the nurse should explain the disease process of Chronic Obstructive Pulmonary Disease and encourage the patient to ask questions in order to reduce anxiety which in return can result to improved participation to the diagnosis. Another intervention can be explaining to the patient the importance of breathing exercises and general conditioning exercises since diaphragmatic or Pursed-lip, and abdominal breathing exercises help reduce the destruction of airways, strengthens respiratory muscles, and consequently provide the patient with a means to control dyspnea. Additionally, conditioning exercises increase muscle strength, sense of well-being and activity tolerance. The patient should also be advised to avoid people with active respiratory infections and emphasize the need for pneumococcal vaccinations and routine influenza. This would reduce the exposure to acquired acute URIs. The nurse also ought to discuss the individual factors that may aggravate the condition such as extreme environmental temperatures, excessively dry air, aerosol sprays, tobacco smoke or pollen. These environmental factors can accelerate bronchial irritation which might result in increased airway blockage and secretion production.

Another important intervention would be discussing with the patient the harmful effects of tobacco smoking especially to a patient with Chronic Obstructive Pulmonary Disease. It is therefore advisable for the patient to quit smoking since such a measure would slow down the progression of the disorder. Even though the patient takes up the challenge of quitting smoking, medical monitoring may be needed since second-hand smoking may be as dangerous as actual smoking. The nurse should also advise the patient on the significance of medical-follow up care, sputum cultures and regular chest x-rays. Monitoring the process of the disease enables the patient to come up with informed decisions to maximize activity level, prevent complications, perform most desired activities and reduce dyspnea. It is also important to discuss respiratory adverse reactions, and side effects since most of these patients are constantly on various respiratory drugs that have potential drug interactions and similar side effects. It is also significant for the patient to know the differences between adverse side effects and nuisance side effects. Lastly, the patient should avoid sedative antianxiety agents unless they are approved by a qualified physician. This would reduce the improper use of the drug and overdose. Even though the patient might feel extremely nervous and feel the need to take some sedatives, the same drugs can depress protective cough mechanisms and the respiratory drive.

The desired outcomes of the diagnosis are to identify the relationship of the disease process to the current signs and symptoms. These factors should also be related to the causative factors in order to establish the progress of the disease and the best strategies to suppress these symptoms. Additionally, Deficient knowledge diagnosis also aims at verbalizing understanding of Chronic Obstructive Pulmonary Disease, the disease process, and treatment. The diagnosis also initiates the patient to participate in the treatment program and change in lifestyle. The patient should also show the motivation to learn and able to list the resources that can be used for support after discharge. Lastly, the patient should be able to identify the learning needs, recognize the need for medication, explain the state of the disease and understand treatments.