"COPD Patient Care Analysis" is an incredible example of a paper on care. Caused by smoking or genetic factors such as α 1-antitrypsin deficiency, COPD affects the patient’ s airflow (Wise, 2010; Bissonnette et al. , 2005). Airflow obstructed by emphysema, chronic bronchitis or both could lead to airway hyperactivity and sputum production resulting in narrowing of the peripheral airways causing dyspnea (Johnson, 2004, p. 253). Airway obstruction and excessive loss of elastic lung recoil trigger physiological changes in the ventilation-perfusion ratio (Johnson, 2004, pp. 253 – 254). In response to smoking, lungs produce sticky mucus which works together with the cilia to protect the lungs from chemical irritants (Marieb, 2004, p.
420). Production of mucus increases by continuous irritation of the lungs. To expel sputum like phlegm or mucus from the respiratory tract, the patient coughs, and wheezes. Comparison between Actual and Proposed Theoretical Medical-Surgical Treatment Actual administered medication includes albuterol, azithromycin, furosemide, prednisone, montelukast, spironolactone, and oxygen. Similar to the proposed theoretical medical-surgical treatment administered to patients with COPD, Azithromycin – an antibiotic used in treating bronchitis and pneumonia is given to the patient to treat bacterial infection (Klausner et al. , 1998).
As compared to erythromycin, Azithromycin is administered to the patient orally on an empty stomach (Noedl et al. , 2006). Likewise, Spironolactone is administered to the patient to prevent the body from absorbing excessive salt (eMedicine, 2011). Albuterol inhalers treat the patient’ s bronchospasm (wheezing) (FDA, 2009) whereas Furosemide is inhaled to treat dyspnea (Leader, 2008). Unlike the actual administration of these drugs, several studies revealed that inhaling Furosemide before exercising could increase their endurance since the drug decreases dyspnea by 0.9 Borg units (Leader, 2008; Ong et al. , 2004).
Combined with inhalation of albuterol 4 times a day, Aaron et al. (2003) revealed that patients who were administered with 40mg of oral Prednisone experienced lower relapses of dyspnea. To prevent hypoxemia or nocturnal desaturation, oxygen is given to the patient while sleeping (Cutaia, 2000). Combined with the use of bronchodilators, Sposato et al. (2006) revealed that Montelukast is effective in improving the patient’ s overall lung function and nocturnal hypoxemia. In fact, patients who were given 10mg of Montelukast each night could result in improvements in dyspnea, sputum production, wheezing sound, and nocturnal symptoms (ibid). Comparison between Nursing Theory and Actual Nursing Intervention Nursing theory and actual nursing intervention given to a patient with COPD is the same.
Because of impaired gas exchange, Nurses should regularly monitor signs of dyspnea and hypoxia to prevent further health complications. Aside from administering the prescribed medication at the right dosage at the right time, the nurse should ensure that the patient’ s airway is clear all the time. Oxygen is administered to avoid hypoxemia or nocturnal desaturation. To prevent oxygen toxicity associated with hyperoxia, the nurse should monitor the prescribed oxygen level using pulse oximetry or arterial blood gas (ABG) analysis (Johnson, 2004, pp.
255 – 256).
Aaron, S., Vandemheen, K., Hebert, P., et al. (2003). Outpatient oral prednisone after emergency treatment of chronic obstructive pulmonary disease. New England Journal of Medicine , 348: 2618-2625.
Bissonnette, J., Logan, J., Davies, B., & Graham, I. (2005). Methodological Issues Encountered in a Study of Hospitalized COPD Patients. Clinical Nursing Research , 14(1): 81-97 .
Cutaia, M. (2000). New Insights Into the Temporal Pattern of Hypoxemia in COPD. Chest , 118(6):1521-1522.
eMedicine. (2011). Retrieved February 3, 2011, from Brand Names: Aldactone. Generic Name: spironolactone: http://www.emedicinehealth.com/drug-spironolactone/article_em.htm#whatis
FDA. (2009, June 18). Retrieved February 3, 2011, from FDA Advises Patients to Switch to HFA-Propelled Albuterol Inhalers Now * Home: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116903.htm
Johnson, J.Y. (2004). Medical-Surgical Nursing. 10th Edition. Lippincott Williams & Wilkins.
Klausner, J., Passaro, D., Rosenberg, J., Thacker, W., Talkington, D., Werner, S., et al. (1998). Enhanced control of an outbreak of Mycoplasma pneumoniae pneumonia with azithromycin prophylaxis. Journal of Infectious Diseases , 177(1): 161–166.