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Process Paper Copd

3374 words - 14 pages


Student Name: Date of Care: 10/14/09
Date of Admission: 10/10/09
I. HEALTH STATUS | Admitting Dx: COPD Exac/Chest Pain |
Pt. Init.D.R | Rm No.353 | Age60 | SexM | RaceCaucasion | ReligionCatholic | OccupationDisabled |
Surgery: Medical Treatment: Back Surgery/ Coronary Artery Bypass Grafting COPD Exac/Chest Pain |
Chief Complaint/Reason for Hospitalization & Hx. of Present Illness (with 1-8 critical characteristics, Jarvis pg. 85) Chest Pain | |
1.Location: Midsternal chest pain radiating to left arm. 2. Quality/characteristics: Squeezing, tightening, felt like chest was going to explode. 3. ...view middle of the document...

* Provide information on side effects of all medication and possible interactions. * Advise pt to notify physician if increase in pain above 5 or more. Environment – Returning to 1 floor home. No foreseen safety issues. Bathroom, bedroom and living room all on same floor. Therapy- Refer for physical therapy for back. Health Education- * Instruct on nonpharmacological methods of pain management and anxiety. * Reinforce importance of staying on medication schedule. Outpatient needs- * Denies need or concern for discharge help even though lives alone with no close family. * Reinforce counseling on reducing risk factors for coronary heart disease – hypertension, tobacco use, stress, nutrition * Reduce or eliminate smoking by use of smoking cessation. Diet – Continue cardiac diet at home by reducing sodium. |

Pathophysiology of ALL major diseases or conditions (use extra paper if necessary) |
Health problem #1: Pathophysiology | COPD |
1.Chronic inflammation of airways, bronchioles, alveoli and pulmonary vasculature, loss of elasticity of lung tissue. |
Expected signs and symptoms | |
1.Cough, sputum production, dyspnea, prolonged expiratory phase of respiration, wheezed, decreased breath sounds, barrel chest. |
Expected treatment & outcome | |
1.Goals of treatment are preventing disease progression. Symptom relief and improved exercise tolerance, prevention and treatment of complications, improved quality of life. Treatment my include smoking cessation, bronchodilator therapy, breathing exercises and pulmonary rehabilitation. |
Health problem #2: Pathophysiology | Anxiety |
2. Definitive pathophysiologic mechanisms have not yet been determined, but anxiety symptoms and the resulting disorders are believed to be due to disrupted modulation within the central nervous system. Physical and emotional manifestations of this disregulation are the result of heightened sympathetic arousal of varying degrees. |
Expected signs and symptoms | |
2. Symptoms include chest pain, dizziness, and shortness of breath, feelings of apprehension, trouble concentrating, feeling tense and jumpy, irritability and restlessness. | |
Expected treatment & outcome | |
2. A variety of medications, including benzodiazepines and antidepressants, are used in the treatment of anxiety disorders. But medication is most effective when combined with behavioral therapy. When compared to those who use medication alone, anxiety sufferers treated with both therapy and medication benefit from a greater reduction in symptoms and a lower risk of relapse. |
Health problem #3: Pathophysiology | Depression |
3. A psycholpathological state involving a triad of symptoms with low or depressed mmod, anhedonia and low energy or fatigue. There is thought to be a biochemical basis of the condition. |
Expected signs and symptoms | |
3. Depressed mood, loss of interest or pleasure, significant weight or appetite...

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