Question

You are caring for Mr. Johnson, a 68 year old 2 pack per day smoker. He has been admitted for an acute exacerbation of COPD. He states, “The doctor says I have COPD because I smoke. I’ve smoked this much since I was 14 years old, it’s what we did then. We didn’t know it was this bad for us. I don’t know what those letters, COPD, stand for or what that means. Do I have lung cancer?”

What would be appropriate patient education in regards to Mr. Johnson’s statement?

Two common terms associated with COPD are chronic bronchitis and emphysema. Discuss the pathogenesis of these terms.

What are some hallmark findings you would expect to find with Mr. Johnson during your nursing admission physical assessment given the history and diagnosis?

What labs should be ordered for Mr. Johnson? Would they be elevated or decreased? Explain why you would expect these abnormalities.

What are the treatments and potential complications for Mr. Johnson?

Answer 1

Ans) Managing COPD:
Stop smoking and do not allow others to smoke around you.
Stay active.
Eat a healthy diet and maintain a normal weight.
Educate yourself about your disease and treatment options.
Take your medications.
If your COPD is moderate to severe, talk to your family and HCP about your wishes for end-of-life care.

- Emphysema and chronic bronchitis are both long-term lung conditions. They're part of a disorder known as chronic obstructive pulmonary disease (COPD). Because many people have both emphysema and chronic bronchitis, the umbrella term COPD is often used during diagnosis.

- The purpose of obtaining a health history is to gather subjective data from the patient and/or the patient's family so that the health care team and the patient can collaboratively create a plan that will promote health, address acute health problems, and minimize chronic health conditions.

- Quality-assured spirometry is the gold standard for COPD diagnosis, but the test requires adequate training in both performance and interpretation. Just as patients without AFO can be misdiagnosed with COPD, a correct clinical diagnosis of COPD might be overlooked by failure to demonstrate AFO.

- Pharmacological treatment of COPD is currently symptomatic and is based on inhaled bronchodilators such as anticholinergics, selective β2-adrenergic agonists and theophylline. In the absence of proven efficacy and due to higher costs and side effects, glucocorticoids are not generally recommended for stable COPD, though they are effective in the treatment of exacerbations. In the absence of drugs which reduce progressive decline in lung function, which is the hallmark of this disease, cessation of cigarette smoking, the main risk factor for COPD, is the most effective measure. Numerous studies are being carried out to define the pathophysiology of COPD, about which still relatively little is known. It is hoped that these studies will allow new and effective drugs to be discovered and developed, as the current pharmacological treatment of COPD is inadequate.