NURSING105 Nursing in Practice

Introduction

Chronic obstructive pulmonary disease is known as COPD, where the individual finds it difficult to breathe, which gets worse over time (Pozzar et al., 2020). The air sacs in the lungs are very stretchy, and the air sacs are full when an individual breathes. An individual affected with COPD has less in and outflow of air because of the following problems, which are, 1. The elasticity of the air sacs becomes lost, 2. The airs sacs' walls are also destroyed and become inflamed and 3. The airway passage becomes full of mucus and becomes clogged, creating problems in the inhale and exhale experience of the individual (Jørgensen et al., 2021). COPD are of two types which are 1. Emphysema and 2. Chronic Bronchitis. Emphysema is a condition where the individual’s air sacs walls become damaged, and elasticity is also lost. Chronic bronchitis is a condition where the airway passage becomes irritated and inflamed, and the lining of the walls becomes filled with mucus causing problems in breathing (Higham et al., 2021). COPD is caused due to excessive smoking and or exposure to irritating substances such as pollen, cement, and sand for a long time.

The purpose of the essay - The study aims to describe respiratory disease (COPD) and understand the pathophysiology. The study also seeks to address the nursing intervention, which will help improve the patient’s care suffering from COPD.

An outline of the essay – The essay will briefly introduce the disease. The discussion consists of points elaborating the health issues related to COPD. The pathophysiology of Chronic obstructive pulmonary disease affects the lungs among the patient. With the help of literature, the management plan for COPD would be discussed, and a nursing intervention plan would be provided. The essay ends with a conclusion, concluding the entire essay.

Discussion 

Describe the health issues in detail of COPD

The patients develop COPD through four stages such as stage I- Mild COPD, where the lung function is found to decline; stage II- moderate COPD, where the symptom of breathing shortness is found to develop; stage III- Severe COPD, where the breathing shortness is found to worsen which the exacerbating symptom of COPD and Stage IV- development of severe COPD. The patients affected with COPD do not develop any symptoms until the damage done in the lungs is extreme (Xiang & Wu, 2020). COPD is directly linked with the function of the lungs. When the lungs get entirely damaged, the air passages block the entry of air into the lungs, and then after accessing the medical history, the patients can be detected with COPD. The air travels from the windpipe, which is commonly called the trachea and gets connected to the lungs with the help of the bronchi. A small air sac is present inside the lungs, widely called alveoli. The problems arise due to the thickening or swelling of the alveoli walls (Zhu et al., 2020). The primary signs and symptoms of COPD included severe breathing problems during the time of exercise, the individual also experienced wheezing and tightness in the chest while inhaling and exhaling air. Cough is another symptom associated with producing mucus that can be clear, yellow, or green (Widysanto & Mathew, 2021). The patient affected with COPD can also experience severe fatigue and deficiency in energy. There is also significant weight loss noticed in the individual. It can also be seen that the ankles, feet, and legs get swollen individual. The individuals can also experience several episodes of exacerbation. If started, this type of symptom leads to a worst-case scenario and lasts for many days.

Explain the pathophysiology of the COPD

COPD, or chronic obstructive pulmonary disease, is a lifetime problem that affects the airways and breathing abilities. Pathophysiology is the study of the progression of disease-related functional alterations. This begins with disruption to the bronchi and small air membranes in the alveoli in persons with COPD. Symptoms range from a mucus-filled cough to trouble breathing. COPD's consequences are irreversible. Apart from respiratory secretions, wheezing can be noted during breathing. Cardiac constriction can also be caused by mucus accumulation and contraction of the bronchial tubes and airways (Danahay et al., 2020). Most of these are not typical geriatric signs. The individual may experience light-headedness or exhaustion if the body isn't getting enough oxygen. Fatigue can be a sign of a variety of illnesses. Body problems can result in patients with severe COPD as their bodies demand more effort to inhale and exhale. COPD patients with a mild form of the disease show the following symptoms. 1. There is some limitation of airflow but no severe complications. 2. Coughing that produces sputum is also noticeable. 3. The circulatory system produces sputum, a combination of mucous and phlegm. 4. When rushing across the flat ground or walking up a bit of elevation, the person becomes out of breath. 5. The person has no over than once COPD aggravation annually and has never been admitted to the hospital due to COPD. 6. Several individuals will not have any sensations at all. COPD, notwithstanding this, is creating severe lung harm (Jolly et al., 2018). COPD patients with a moderate form of the disease show the following symptoms. 1. The obstruction in airflow increases more obvious. 2. There is often a noticeable upsurge in respiratory distress or heaviness of inhalation and exhalation. 3. The severity or regularity of hacking and phlegm output may worsen. 4. Throughout physical exertion, the person may have more severe difficulty breathing (Mohammed et al., 2018). COPD patients with severe forms of the disease show the following symptoms. 1. The person will appear tired and have much more noticeable respiratory problems. 2. Nasal passages that are much narrower or compromised try to accumulate phlegm. 3. The person may have one exacerbation per year and be admitted to hospitalisation due to COPD. 4. The airways are working at 30-49 per cent of their typical performance at this point (Zhu et al., 2018). COPD with a very severe form shows the following symptoms. 1. Although when relaxing, the individual has more severe respiratory issues. 2. The person has a lot of difficulty with household chores such as showering and eating. 3. Due to respiratory distress, the individual's standard of living has deteriorated significantly. 4. Exacerbations happen more frequently and can be fatal. 5. It's possible the individual needs to go to the hospital regularly. 6. The lungs operate at much less than 30% of their typical capacity if the individual has acute COPD (Singh et al., 2018).

Present the nursing management plans you found from the literature

The nursing management plans are implemented in a care setting to incorporate better patient outcomes and provide better care to the patients (Soukup et al., 2018). The care plan proposed in the assignment would focus on patients' holistic care. The care plan would be developed with the help of the evidence gathered from the electronic health records (EHR) collected from the patients admitted to the hospitals (Shawahna, 2019). The care plan is needed to envision critically how to achieve the desired patient outcome. However, it can be seen in a clinical setting that nurses often do not document the care provided to the patients, which can be ethically considered wrong for a clinical setting (Blackwood et al., 2019). The nursing plan has four segments which are: 1. Nursing diagnoses, 2. The desired outcomes and goals for the patients. 3. The nursing interventions, and 4. Evaluation. The nursing professionals reviewed the vital signs of the patients. They noticed that some COPD patients are exhausted and tired due to their interruption in their sleeping patterns, causing them physical distress such as coughing, Dyspnea, and significant fatigue (Zhang et al., 2018). The nursing care and management plan goals are to improve health conditions that can be noticed after 10 hours of the intervention implemented, which will be discussed in detail in the sections below. The goal is to reduce the Dyspnea and mitigate the coughing, which would also reduce the shortness of breath.

Provide more details on how to implement those nursing interventions.

The intervention for achieving the goals presented in the above section is the registered nurses need to assess or monitor the patients on a scheduled basis. The nurses would first monitor the patient's vital signs, which would include monitoring the respiratory rate, the rhythm of the heartbeat, movement of the chests, and evaluate if the patients are feeling any discomfort or distress in the environment. The nursing needs to provide a calm and quiet environment and limit the number of visitors when the patients show deteriorated signs. The nursing also needs to reduce the daily activities conducted by the patients and ensure that patients are getting adequate rest. The change the patients' sleep position to ensure that the patient is not developing any sores or infection. After implementation of care, the patients would be able to show improved signs of breathing and as well as would be more energized (De Godoy et al., 2016).

To incorporate such care, effective communication is essential, which can be enhanced with the adoption of standardized nursing language. The employment of a standardized nursing language (SNL) is seldom done solely since that would benefit the patients. According to the authors Adubi et al., (2018), adopting a standardized language has far-reaching implications for assessment and treatment and demonstrating the worth of patient care to the patients. Many folds would enhance exchange of information between nursing professionals and numerous different care services providers, provides an understanding of medical and as well as nursing interventions plans, ability to adhere to treatment, improved information compendium to properly evaluating the outcomes for the nursing care, significantly larger compliance to quality of practice, and helped facilitate the evaluation of advanced nursing practice are all advantages of normalized nursing terminology (Johnson et al., 2018).

Describe how the knowledge gained during assessment will help advance in the workplace.

The entire assignment helped me understand the respiratory disease and the impact of the condition upon the patient. The knowledge gained from pathophysiology helped me understand the stage of the disease. This knowledge will help me inpatient assessment within the workplace and provide emergency support to the patient. I have gained essential knowledge regarding COPD and the associated factor that enhances the chance of developing COPD exacerbation. I have learned about the different degree of COPD and how the symptom varies as the disease progress. In the nursing plan, I have gained knowledge regarding how the patients are diagnosed. I have also learned how goals and outcomes are set to achieve the desired result. I have understood that understanding the reason behind COPD development is essential for involving the patient in various programs and changing the behaviour. I have understood that smoking is one issue that increases the risk of developing COPD. It is the responsibility of the nurses to involve the patient in the smoking cessation programs. The intervention plan provided in the section is implemented after diagnosing the patient’s condition. I have also learned about the term SNL and how incorporating SNL would improve the effective communication among the nurses for providing care. Y et al., (2019) performed a study to determine COPD knowledge among internal medicine nurses. The result of the survey highlighted that the overall questionnaire score of nursing knowledge was 35.76 ± 5.49, and the ability was assessed based on breathlessness, epidemiology, inhaled steroids and symptoms. The result clearly defined that the nurses had limited knowledge and a proper educational system needed to be implemented. Hence, I will also involve myself in appropriate nursing educational programs to gain hands-on experience in delivering care and improving the patient’s condition.

Conclusion 

From the above analysis, it can be concluded that COPD occurs when the individual finds it difficult to breathe, which worsens with time. COPD is caused due to excessive smoking and or exposure to irritating substances such as pollen, cement, and sand for a long time. When the lungs get completely damaged, the air passages block the entry of air into the lungs, and then after accessing the medical history, the patients can be detected with COPD. Symptoms range from a mucus-filled cough to trouble breathing. COPD's consequences are irreversible. Apart from respiratory secretions, wheezing can be noted during breathing. Cardiac constriction can also be caused by mucus accumulation and condensation of the bronchial tubes and airways. Most of these are not typical geriatric signs. The individual may experience light-headedness or exhaustion if the body isn't getting enough oxygen. Fatigue can be a sign of a variety of illnesses. Body problems can result in patients with severe COPD as their bodies demand more effort to inhale and exhale.

References:  

Adubi, I. O., Olaogun, A. A., & Adejumo, P. O. (2018). Effect of standardized nursing language continuing education programme on nurses' documentation of care at University College Hospital, Ibadan. Nursing Open, 5(1), 37-44. https://doi.org/10.1002/nop2.108

Blackwood, D. H., Walker, D., Mythen, M. G., Taylor, R. M., & Vindrola?Padros, C. (2019). Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: a systematic review. Journal of clinical nursing, 28(23-24), 4276-4297. https://doi.org/10.1111/jocn.15049

Danahay, H., Fox, R., Lilley, S., Charlton, H., Adley, K., Christie, L., ... & Gosling, M. (2020). Potentiating TMEM16A does not stimulate airway mucus secretion or bronchial and pulmonary arterial smooth muscle contraction. FASEB BioAdvances, 2(8), 464-477. https://doi.org/10.1096/fba.2020-00035 

De Godoy, I., Nogueira, D. L., & Godoy, I. (2016). Nurses' knowledge and abilities gaps concerning health care of COPD patients: Window for improvement. DOI: 10.1183/13993003.congress-2016.PA1613

Higham, A., Beech, A., Wolosianka, S., Jackson, N., Long, G., Kolsum, U., Southworth, T., Pham, T. H., Sridhar, S., McCrae, C., Newbold, P., & Singh, D. (2021). Type 2 inflammation in eosinophilic chronic obstructive pulmonary disease. Allergy, 76(6), 1861–1864. https://doi.org/10.1111/all.14661

Johnson, L., Edward, K. L., & Giandinoto, J. A. (2018). A systematic literature review of accuracy in nursing care plans and using standardised nursing language. Collegian, 25(3), 355-361. https://doi.org/10.1016/j.colegn.2017.09.006

Jolly, K., Sidhu, M. S., Hewitt, C. A., Coventry, P. A., Daley, A., Jordan, R., ... & Fitzmaurice, D. (2018). Self management of patients with mild COPD in primary care: randomised controlled trial. bmj, 361. https://doi.org/10.1136/bmj.k2241

Jørgensen, L., Eikhof, K. D., Jensen, M. H., Størkersen, M. L., & Andreasen, J. (2021). Patients' experiences following acute admission due to COPD exacerbation. A qualitative interview study. International emergency nursing, 58, 101054. https://doi.org/10.1016/j.ienj.2021.101054

Ma, Y., Peng, Y., Chen, P., Nie, N., & Chen, Y. (2019). Assessment of COPD-Related Knowledge Among Internal Medicine Nurses: A Cross-Sectional Study. International Journal of Chronic Obstructive Pulmonary Disease, 14, 2917. DOI https://doi.org/10.2147/COPD.S232055

Mohammed, J., Derom, E., De Wandele, I., Rombaut, L., & Calders, P. (2018). Autonomic symptoms in patients with moderate and severe chronic obstructive pulmonary disease. Acta Clinica Belgica, 73(3), 182-190. https://doi.org/10.1080/17843286.2017.1379255

Pozzar, M., Volpato, E., Valota, C., Pagnini, F., & Banfi, P. I. (2020). How people with chronic obstructive pulmonary disease perceive their illness: a qualitative study between mind and body. BMC Pulmonary Medicine, 20(1), 1-10. https://doi.org/10.1186/s12890-020-1157-3

Santos. (2020). The Relationship between the COVID-19 Pandemic and Nursing Students’ Sense of Belonging: The Experiences and Nursing Education Management of Pre-Service Nursing Professionals. International Journal of Environmental Research and Public Health, 17(16), 5848. https://doi.org/10.3390/ijerph17165848

Shawahna, R. (2019). Merits, features, and desiderata to be considered when developing electronic health records with embedded clinical decision support systems in Palestinian hospitals: a consensus study. BMC medical informatics and decision making, 19(1), 1-21. https://doi.org/10.1186/s12911-019-0928-3

Singh, S., Verma, S. K., Kumar, S., Ahmad, M. K., Nischal, A., Singh, S. K., & Dixit, R. K. (2018). Correlation of severity of chronic obstructive pulmonary disease with potential biomarkers. Immunology letters, 196, 1-10. https://doi.org/10.1016/j.imlet.2018.01.004 

Soukup, T., Lamb, B. W., Arora, S., Darzi, A., Sevdalis, N., & Green, J. S. (2018). Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. Journal of multidisciplinary healthcare, 11, 49–61. https://doi.org/10.2147/JMDH.S117945

Widysanto A, Mathew G. Chronic Bronchitis. [Updated 2021 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482437/

Xiang, C., & Wu, G. (2020). SARS-CoV-2 pneumonia with subcutaneous emphysema, mediastinal emphysema, and pneumothorax: A case report. Medicine, 99(20), e20208. https://doi.org/10.1097/MD.0000000000020208

Zhang, Y., Morgan, R. L., Alonso-Coello, P., Wiercioch, W., Ba?a, M. M., Jaeschke, R. R., ... & Schünemann, H. J. (2018). A systematic review of how patients value COPD outcomes. European Respiratory Journal, 52(1). DOI: 10.1183/13993003.00222-2018

Zhu, B., Wang, Y., Ming, J., Chen, W., & Zhang, L. (2018). Disease burden of COPD in China: a systematic review. International journal of chronic obstructive pulmonary disease, 13, 1353–1364. https://doi.org/10.2147/COPD.S161555

Zhu, T., Wang, Y., Zhou, S., Zhang, N., & Xia, L. (2020). A Comparative Study of Chest Computed Tomography Features in Young and Older Adults With Corona Virus Disease (COVID-19). Journal of thoracic imaging, 35(4), W97–W101. https://doi.org/10.1097/RTI.0000000000000513

Are you stuck with an overly convoluted assignment based on a particular subject matter? Are you looking for a dedicated team of subject matter experts to help you through the hurdle? Take a look here. MyAssignmenthelp.co.uk is right here to back you up with the following services and beyond. 

• Finance assignment help
• Law assignment help
• Accounting assignment help
• Management assignment help
• Biotechnology assignment help 
• Engineering assignment help and more 

So, get in touch with us right away, place your order and have the best SME by your side to provide you with impeccable assignment help online.