Copd

COPD

Melanie Varela

Career Care Institute

History

Patient A.F. is a 80-year-old, white male who resides at the Venturan Care Center since admitting date September 22, 2010 for skilled nursing services. He is alert and oriented to place, person, time, and event. He is able to communicate his needs. It is noted in his records that the patient is DNR. He wants comfort measures only. It was instructed by his daughter C.L. who is the spokesperson for the family that the patient would want IV antibiotics and IV fluids as indicated only. Mr. A.F. is widowed. Some family support. He completed some college education, speaks English. Religious affiliation is Christian. It appears the patient quit smoking more than 20 years ago. Patient is allergic to penicillin and codeine.

Past Medical History

• COPD

• Respiratory Failure

• Hypertension

• Osteoporosis

Diet Information

Regular, low fat, (NAS) no salt added diet. It has been demonstrated by previous studies that obesity, sodium intake, and alcohol consumption can influence and raise blood pressure. Sodium is essential to our bodies. Normally the kidneys control the level of salt. If there is too much salt, the kidneys pass it into the urine. When our salt intake levels are very high, our kidneys cannot keep up and the salt ends up in our bloodstream. The study found that a low-fat diet with reduced saturated and total fat combined with a diet rich in fruits and vegetables significantly lowered the blood pressure, especially those patients with hypertension.

COPD (Chronic Obstructive Pulmonary Disease)

Chronic obstructive pulmonary disease (COPD) is comprised primarily of three related conditions- chronic bronchitis, chronic asthma, and emphysema. In each condition there is chronic obstruction of the flow of air through the airways and out of the lungs, and the obstruction generally is permanent and may be progressive over time. 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.

Pathophysiology

The pathophysiology of COPD is very complex and is not clearly identified as yet. A resistance to the airflow can be attributed to many factors such as mucociliary disorders, inflammatory responses and structural changes. In short, the blockage and/or narrowing of the airways may be caused due to loss of elasticity of the airways, damage or inflammation in the walls of the airways, secretion of excess mucous in the airways and decrease in the surface area for the exchange of air. According to medical studies, it is revealed that chronic inflammatory responses of the airways are the major contributing factor to the development of COPD. It is stated that inflammatory responses resulted from COPD and those from asthma are different. Emphysema is the predominant lesion in most patients who have end- stage COPD, with bronchiolitis contributing to the reversible elements of airflow obstruction.

Etiology of COPD

Most cases of COPD occur as a result of long-term exposure to lung irritants that damage the lungs and the airways. In the United States, the most common irritant that causes COPD is cigarette smoke. Pipe, cigar, and other types of tobacco smoke also can cause COPD, especially if the smoke is inhaled. Breathing in secondhand smoke, air pollution, and chemical fumes or dust from the environment or workplace also can contribute to COPD. The main risk factor for COPD is smoking. Most people who have COPD smoke or used to smoke. People who have a family history of COPD are more likely to develop the disease if they smoke.

Nursing Physical Assessment

3-21-2011, 16:30. Vital signs are T.98.1 P90 R.17 BP. 168/80 (0,10). Patient is alert and oriented to person, place, time, and situation, verbal and able to make his needs known, responsive, PERRLA, sclera white, conjunctiva pink. Mouth clean, no lesions, gums, lips, and tongue pink and moist. No difficulty swallowing. Gross motor movement is intact. Apical pulse is 90 beats/per min. regular, strong. Pt is on oxygen