The paper mainly focuses on the concept of nursing care approaches and also at the same time talks about nursing based evidence when it comes to treating a patient having chronic obstructive pulmonary disease. The paper mainly talks about the various nursing principles that are there and also at the same time talks about the condition of the patient and provides the psychological, pharmacology and pathophysiology details of the patient. The paper focuses on all the nursing approaches that are essential and are required to treat the condition, chronic obstructive pulmonary disease. The paper provides necessary information about the patient and also talks about the accurate and right nursing strategies that need to be considered in this context. The present condition and also the future treatment plan are referred to in the paper so that it is helpful in getting all the relevant ideas and also at the same time it is helpful in formatting the appropriate nursing care plan and approaches. Other than this the paper also talks about the health condition and how the condition is deteriorating and how the condition can be put into normal.
The patient us 72 years old and has a medical history of chough and chain smoking. The patient lives with his son and his wife has died 2 years ago. He is capable of doing all his day to day activities but he has the issues of tough breathing and uses inhalers and is also on oral steroids (Morice & Hart, 2018). He experiences an uneasy feeling in his chest last night and that condition mainly leads to aggravating the situation and also leads to the present condition of COPD for which he has been admitted to hospital and also for which he has been brought to this emergency ward.
It is seen that the patient who has been admitted to the emergency ward has been having shortness of breath since last night and it is on the account of such condition that the patient is admitted to the emergency ward since in the morning the condition further deteriorated and the patient started feeling very uncomfortable and his breathing passage is totally blocked (Chong, Leung & Poole, 2017). It is also seen that the patient on being brought to the hospital is grasping for breath and the patient needs immediate help or medical care (Morice & Hart, 2018). The patient is however admitted to the emergency ward of the hospital and is given immediate medical aid and support. His vital signs and symptoms are also to be recorded and the will help in further assessments and nursing care approaches for the patient (Morice & Hart, 2018). The nursing care approach at this point of stage is primarily based on nursing assessment and that is all about vital signs and symptoms assessment and that is important here (Morice & Hart, 2018). The vital signs and symptoms include anxious feeling, heaviness of chest or chest tightness, increased shortness of breath, change of colour of the sputum, feeling of coldness and fluid retention (Chong, Leung & Poole, 2017).
These are the vital signs and symbols that are seen in the context and also at the same time refer to the severe and emergency condition or situation of the patient. The signs and symptoms are indicative of COPD that is chronic obstructive pulmonary diseases and is also indicative of obstructed airflow (Chong, Leung & Poole, 2017). However the nursing assessment and nursing care plan is also based on the pathophysiology of the patient and this mainly points out the reasons of the present condition of the patient. The health condition like chronic bronchitis has been there in the patient and that leads to the present condition of COPD. The pathophysiology of COPD includes wheezing cough, increased and excessive use of inhalers, use of over the counter oral steroids and breathing trouble. These are thereby the issues that mainly lead to the condition of COPD and also at the same time leads to the present severity of the situation (Pavord et al., 2017). Other than this it is also noted that how Evidence based nursing practice is important in this context since it helps in implementing ways and approaches that are self in this context and also that which has greater outcome and efficiency.
In this condition the first and the foremost approach is to provide oxygen therapy to the patient since he is short go breath and with the infusion of oxygen can take breath and also can response better (Chong, Leung & Poole, 2017). The nursing based evidence also states the fact that the sputum colour is to be observed very now and then so that the condition of the patient can be known and can be put into control (Pavord et al., 2017). It is important to note that in this case the colour of the sputum has changed and that is mainly greenish and this indicates the severity of COPD. The nursing based evidence approach here is putting the patient under artificial oxygen and also that the patient can be given a better nursing approaches and also can be provided with better and efficient ways of to treat him (Morice & Hart, 2018). The nursing evidence based approach is to assess the lungs and the trachea and these will help in giving a picture about the current condition of the lungs and also will give an idea about to which extent the cough has been disposed there. It is making the process of breathing very difficult for the patient and thereby continuous supply of oxygen is provided here (Chong, Leung & Poole, 2017). The nursing care plan is based on the vital signs and symptoms that are there in the patient and also that the vital signs and symptoms are based on his COPD condition a perfect and measurable nursing approach needs to be taken and that is significant and important in this context (Morice & Hart, 2018). Evidence based nursing practice also supports the fact that supportive care and continuous administration of the physical health condition of the patient must be treated.
The medical history of the patient is also important and being a registered nurse it is important to take care of the medical history so that the present condition can be accessed very effectively and also that the present situation can be verified very clearly (Morice & Hart, 2018). The medical history refers to the vital objectives such as the history of chain smoking, the history of using steroid and coughing or wheezing can be found and this history refers to the fact that COPD is not something very unusual and is something that is a result of the past condition (Chong, Leung & Poole, 2017). It is important to note that the registered nurse keeps on checking the vital statics such as body temp, heart rate, respiratory rate, fluid retention and others, it is found that the respiratory rate and also the body temp is beyond above and also that the blood glucose level is higher than usual (Chong, Leung & Poole, 2017). These signs and symptoms are not at well helpful or supportive of making the condition better and that leads to degrading condition of the patient’s health and that is something that is not at all desired at this condition or stage.
The nursing approaches also bring in the aspect of nursing standards and protocols or guidelines. The guidelines such as quality care, patient information security, therapeutic communication and others are all very important and those are necessary here. The nursing approaches must be based on advanced nursing technology as well and that is also one of the care plan approaches to be mentioned here and to be noted in this context (Chong, Leung & Poole, 2017). The care plan needs to be such that it directly helps in solving the issue that is there and is also related to the present condition and health status of the patient (Pavord et al., 2017). It is essential for the registered nurses to look after the optimum care approach for the patient and also at the same time it is important for the nurses to look after him in the best possible way (Morice & Hart, 2018). Other than this it is important to dwell on some of the medical history as well such as the condition of chronic bronchitis and chronic bronchitis is such that leads to making the airways and bronchial tubes inflamed and also leads to formation of more mucus and that is the reason why the assessment of the medical history is important and needs to be taken into consideration (Pavord et al., 2017). Other than this the condition such as emphysema is also referred to in this case and it is the condition that causes destruction of the fragile walls and airways and also hampers the alveoli (Chong, Leung & Poole, 2017). This is the way the condition is assessed and also this is the way the entire nursing care plan or approach for the present condition of COPD looked after.
Given the fact the patient is old and is above 70 years a special and acute care plan for him is necessary and that cannot be overlooked at any condition. The nursing assessment would also be based on his nutrition implementation (Morice & Hart, 2018). His nutrition is all about liquid diet since he is unable to chew or eat anything and there is an issue of heaviness of chest as well (Morice & Hart, 2018). The issue of heaviness of chest is important and that cannot be overlooked since if that is overlooked then it will lead to some severe condition and also to some deteriorating condition leading to degraded and worse condition of COPD.
Therapeutic relationship with the patient is also one of the nursing approaches here and that can be built through effective communication approach, effective bonding with the patient and also through positive communication (Chong, Leung & Poole, 2017). This therapeutic relationship will help the patient to deal with the health situation and will also help the patient to deal with the necessary medical condition. Patient care plan thereby is the focus here and that includes vital signs and symptoms assessment, patient care plan, patient assessment approach and nursing approach (Chong, Leung & Poole, 2017). These are all evidence based practices as well and needs to be highlighted.
The paper thereby talks about the nursing interventions that are required and also talks about the nursing approaches that need to be taken seriously. Other than this the nursing care plan, the assessment plan, the pathophysiology of the patient and others are all recorded. The approach of evidence based nursing practice is also referred to in this context and that is also important here. The nursing approaches in this case of COPD are all put into this paper and each of the approaches and each of the techniques of dealing with COPD had been mentioned and referred to and that significant here (Pavord et al., 2017). The nursing standards and guidelines and protocols are also important here and those are also a part of the paper (Morice & Hart, 2018). The paper helps in presenting the ideas and notions that are related to the nursing care approaches. The paper is systematically arranged and organized and gives all the necessary information that is there. The paper has different sections and sub-sections that are there and the paper is based on the important points in relation to the given idea.
Puhan, M. A., Gimeno‐Santos, E., Cates, C. J., & Troosters, T. (2016). Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane database of systematic reviews, (12).
Chong, J., Leung, B., & Poole, P. (2017). Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (9).
Pavord, I. D., Chanez, P., Criner, G. J., Kerstjens, H. A., Korn, S., Lugogo, N., ... & Harris, S. S. (2017). Mepolizumab for eosinophilic chronic obstructive pulmonary disease. New England Journal of Medicine, 377(17), 1613-1629.
Walters, J. A., Tan, D. J., White, C. J., & Wood‐Baker, R. (2018). Different durations of corticosteroid therapy for exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (3).
Martinez, F. D. (2016). Early-life origins of chronic obstructive pulmonary disease. New England Journal of Medicine, 375(9), 871-878.
Morice, A. H., & Hart, S. P. (2018). Increased Propensity for Pneumonia with Fluticasone in Chronic Obstructive Pulmonary Disease. American journal of respiratory and critical care medicine, 197(9), 1229-1230.
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