Chronic Obstructive Pulmonary Disease |
INTRODUCTION
We are doing a case study on medical, nursing, pharmacological management of COPD (Chronic Obstructive Pulmonary Disease). We took a COPD patient and assessed the patient for clinical manifestation, the medical, nursing, pharmacological care given to the patient. In our case study we will include the care Hawwa is receiving now and the care we can add to daily routine to help her recover faster.
Hawwa Ismail is admitted to Medical ward with diagnosis of COPD. She is 145cm tall, slim, with dark complexion. She is 79 years old. She said that she has difficulty in breathing, she cannot sleep in night time ,she do not feel like eating ...view middle of the document...
PAST HISTORY: known case of IgM multiple myeloma (II), NSTEMI (Non ST elevation myocardial infarction), upper lobe pneumonia with secondary bronchiectasis, oral candidiasis. Previously admitted in medical ward related multiple myeloma and NSTEMI, one year backand patient was diagnosed for COPD two years back.
FAMILY HISTORY:Nil significant informed.
DISEASE CONDITION
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
DEFINITION:group of pulmonary disorder characterized by air flow limitation that is not fully reversible. (Smeltzer,Bare,Hinkle&Cheever,2010,p.602)
TYPES:
1.
2. Emphysema
3. Bronchitis
CHRONIC BRONCHITIS
DEFINITION:a disease of the airway is defined as presence of cough and sputumproduction for at least 3 months in each 2 consecutive years.(Smeltzer,Bare,Hinkle&Cheever,2010,p.602)
INCIDENCE: The WHO estimates that in 2000, 2.74 million people died of COPD worldwide. Mortality of COPD among women has increased since 2nd world war in 2005, more women than men died of COPD. An additional 12 million Americans may have COPD but remain undiagnosed
PATHOPHYSIOLOGY:
Smoke or other environmental pollutant irritates the airways
(Smeltzer,et.al.,2010,p.602) |
Resulting in hyper secretion of mucus and inflammation
Constant irritation causes the mucus-secreting glands and goblet cells to increase in number.
Ciliary function reduces and more mucus is produced.
Bronchial walls become thickened; the bronchial lumen narrows and mucus plug the airway
Airway obstruction
RISK FACTOR:
* Exposure to tobacco smoke accounts for an estimated 80% to 90% COPD cases.
* Passive smoking
* Occupational exposure
* (Smeltzer,Bare,Hinkle&Cheever,2008,p.688)
Ambient air pollution
* Genetic abnormalities
RISK FACTORS IN HAWWA:
She is exposed to dust while cleaning the house, before she used to cook with wood so she was exposed to smoke regularly. She is exposed to cigarette smoke because many people in her house smokes.
CAUSES:
* Airway obstruction
* Diffuse airway injury
* Pulmonary infection and obstruction of the bronchus or complications of long-term pulmonary infections.
* Genetic factors
* Abnormal host defense
* Idiopathic causes
CAUSES IN HAWWA:
She had a history of pneumonia a pulmonary infection leading to chronic obstructive pulmonary disease.
SIGNS AND SYMPTOM
* COPD is characterized by three primary symptoms:
* Chronic cough
* Sputum production
* Dyspnea on exertion
* Weight loss is common, because Dyspnea interferes with eating the work of breathing is energy-depleting
* Use of accessory muscle
* Patients with COPD are at risk for respiratory insufficiency and respiratory infections, which in turn increase the risk of acute and chronic respiratory failure.
* Barrel chest
* Shortness of breath
* Wheezing
* Prolonged expiration
* Enlarged heart clubbing of nails.
* ...
