Question

Nursing care plan for COPD.

Extra information: patient had respiratory failure and UNSP hypoxia and had cancer in the past, also had lobectomy.

Nursing care plan needed for COPD as the main patient concern everything else is just extra information just to keep everything is mind for the person answering the question.

Thank you.

Answer 1

Nursing care plan for a patient with COPD are :-

1. Impaired respiratory function including the following main problems :-

Nursing diagnosis :-

- Ineffective breathing pattern

- Ineffective airway clearance

- Impaired gas exchange

All these related to hypersecretion of mucous and narrowing of airways .

Nursing interventions :-

- Monitor the patient for dyspnea and hypoxemia.

- Encourage patient to eliminate or reduce all pulmonary irritants , particularly smoking

- Administration of bronchodilator and corticosteroid to open the narrowed airways and gas exchange

- Increase fluid intake to make the secretions thin so that it can be easily secreted out .

- Chest physiotherapy with postural drainage , intermittent positive pressure breathing and bland aerosol mists

- Inspiratory muscle training and breathing retraining help in improving the breathing pattern.

- Teaching diaphragmatic breathing and pursed lip breathing helps slow expiration and prevent collapse of airways . It helps to control the rate and depth of respiration and promotes relaxation .

- Suctioning to remove the secretions and open the airways .

2. Nursing diagnosis - Activity intolerance related to disease condition

Nursing interventions :-

- Evaluate the patients activity tolerance and limitations and use teaching strategies to promote independent activities of daily living.

- Identify if patient is a candidate for exercise training to strengthen the muscles of upper and lower extremities and to improve exercise tolerance and endurance.

- Encourage use of Wal aids like Walker etc to improve activity levels and ambulation .

- Consult with other healthcare departments like rehabilitation ,physical therapy , occupational therapist etc as needed to improve the activity .

3. Nursing diagnosis - Altered nutrition less than body requirement

Nursing interventions :-

- Provide soft liquid diets to the patient so that it can be easily swallowed and digested.

- Increase fluid intake in the diet , it will make the secretions thin

- Provide small frequent diet at proper interval

- Keep the patient in Semi Fowler's position after giving the feed for 30 mins

- Avoid eating oily and cold foods .

4. Nursing diagnosis - Anxiety related to knowledge deficit regarding disease and treatment

Nursing interventions :-

- Encourage the patient to express their feelings and doubts

- Explain the patient about the disease and treatment methods in a language which is understood by the patient .

- Provide emotional and psychological support

- Involve family in patient care .

- Use of recreational methods like guided imagery ,etc to divert the attention of patient

5. Nursing diagnosis - Monitoring and managing potential complications

Nursing interventions :-

- Assess the patient's vitals

- Assess patient for complications like respiratory failure , respiratory infection and atelectasis

- Monitor for cognitive changes , increase in dyspnea , tachycardia and tachypnea

- Monitor pulse oximetry values and administer oxygen as prescribed

- Instruct patient and family about signs and symptoms of infection or other complications and report the changes to the doctor

- Encourage patients to be immunized against influenza and streptococcus pneumoniae

- Caution patients to avoid pollen ,air pollutants , high temerature and smoking

- If there is a rapid onset of breathing difficulty ,then quickly evaluate the chest movement symmetry ,breath sounds and oxygen saturation .