(MNC, 2018). Nursing. Current complaint is a direct result exacerbation of previously existing COPD (Longmore, Wilkinson & Rajagopalan, 2007). Nothing in the environment appears harmful for the patient or ambulance staff. Patient developed mild fever two days back, before that he gives no history of fever. Other tool, less known is the Mini Assessment Tool, known as MNA, common in assessment in older adults (Nestle Nutrition Institute, 2009). Exacerbation can often be caused by viruses and bacterial infection, patient with frequent exacerbation have an increased risk of decline in their lung function what and consequently impairs quality of their life, as well as putting a pressure on family, carers (Lung Institute,2017). The Code: Professional standards of Practice and Behaviour for Nurses and Midwives. With this essay, the names and setting will not be disclosed in order to protect confidentiality. The patient is able to identify coping mechanisms that are effective and those that are ineffective. A patient profile will be provided, along with a description of COPD, including epidemiological data on incidence and prevalence and information on the causes and prognosis of the condition. Nurse needs to assess how the patient usually deals with his COPD, HTN, GERD, and DMT2. COPD patients often need supportive treatment of 2 litres of oxygen to maintain oxygen saturations normally acceptable for that specific patient. He is a pensioner and poor man. American Family Physician. On auscultation breath sounds are reduced and rhonchi are present in the chest. The room is well lit but untidy. The nurse, and other health professionals should be aware that effective nutritional assessment begins on first contact with the patient. In addition, looking at nutrition it also important to select an appropriate nutritional screening tool   to be used during the assessment, for example the Malnutrition Universal Screening Tool, known as MUST (BAPEN, 2011). This documentation was used to deliver a consistent standard of care for patients … In this scenario, the condition can develop during acute or critical illness because of metabolic demand (Price,2008). It is estimated between 10-45% of those with COPD within the community are at risk of malnutrition (Stratton et al, 2003). He introduces himself and carries staff to the patient. Edinburgh: Churchill Livingstone. Oxygen saturation levels is found 88% (Normal=95%) ECG shows tachycardia, P- pulmonale and Right axis deviation (right ventricular failure). Profiles of older Medicare decedents. His history of these presenting complaints spans to last three months. Both have overlapping features with damage at acinar level (emphysema) and bronchial level (bronchitis) and most commonly occur in smokers. Willis (2017) observed and noted that in an essential element of any assessment, nurse’s ability to identify the sings and symptoms of malnutrition will develop with increased interaction with the patient. Respirology 18(4): 616-29. Emphysema and chronic bronchitis are clinically grouped together and called chronic obstructive pulmonary disease (COPD). This assessment is similar to what you will be required to perform in nursing school. A careful family history in reference to close relatives with COPD is important because COPD runs in families. Currie, G.P. Nursing Interventions. All work is written to order. Diagnosis and assessment of COPD must be done carefully since the three main symptoms are common among chronic pulmonary disorders. The best interventions for COPD are smoking cessation to decrease damage, nebulizers, and inhalers to open the lungs and decrease inflammation, careful oxygen supplementation, and a BIPAP or CPAP to blow off built-up carbon dioxide from the body. Malnutrition Screening tools: comparison against two validated methods in older medical inpatient. Looking for a flexible role? To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on UKEssays.com then please: Our academic writing and marking services can help you! Being able to self-manage, not least because COPD is specific to the individual and can change on daily base, because of that educating a patient is key. It causes 115,000 admissions to hospital every year. On palpation there were no crepetations on neck and chest so no subcutaneous emphysema. Global Initiative for Chronic Obstructive Lung Disease (2011). References: His wife died in a car accident ten years back. Available at: https://www.mna-elderly.com/forms/mini/mna_english.pdf Downloaded 22st May, 2019. This is a preliminary assessment of the patient. Global Initiative for Chronic Obstructive Lung Disease (GOLD). A patient is presenting with chronic obstructive pulmonary disease. Nasal connulae is preferred in this patient so that he can expectorate and eat or drink. Introduction. K (2014). Cardiovascular system and other body system examination, There is right ventricular heave, ankle oedema, raised JVP and increased diastolic blood, pressure (90mmHg) showing right ventricular failure called cor- pulmonale (Sam, Baker &. Evidence-based information on nursing of copd patients from hundreds of trustworthy sources for health and social care. Occupational exposures often are overlooked and underdiagnosed. SL (2016). SAGE: London, Blamires S, Hodson M (2015) Malnutrition in COPD: meeting patients’ nutritional needs. Although COPD is a bracket name given to multiple lung conditions such as emphysema and chronic bronchitis the two conditions are very similar and often present with similar symptoms. It will locate the point of the trajectory of the disease, as well as the care environment the assessment takes place with, and why these are important in relation to the relevance of the chosen assessment. It lists all the potential symptoms of COPD. Patient pathway and treatment protocol. The content within this essay is generalised across a patient group and does not relate to any specific patient, staff member or trust (NMC, 2018). In healthy patients their levels are usually between 95%- 100%. The Council of Europe (2003) developed a resolution on food and nutritional care in hospitals, which identified ten characteristics of optimal nutritional care in hospital, including the requirement for screening for malnutrition on admission and weekly thereafter, and the development of a care plan which highlights the patient’s nutritional requirements and how to put them in live. COPD may continue to get worse despite treatment, eventually having a significant impact on their quality of life and leading to life limiting prognosis. Health history. The medication is prescription only and the patient been taking it since three years. According to Rice (2006) nutritional support is a vital part of nursing care because many patients with COPD are malnourished. National Institute for Health and Care Excellence (2016). Chronic obstructive pulmonary disease (COPD) is an umbrella term for people with chronic bronchitis, emphysema, or both. The patient has certain Presenting complaints (PC).These include worsening cough with sputum since seven days, breathlessness on Exertion since four days, Wheezing since four days, generalised weakness since two days, temperature since two days and breathlessness at rest since six hours. Our academic experts are ready and waiting to assist with any writing project you may have. Expanding nursing practice in COPD: is it key to providing high-quality, effective, and safe patient care? A further focused history and physical examination is required to identify injury or disease that has not been identified during the primary survey. Assessment and management of an exacerbation of COPD Written by: Beverley Bostock-Cox | Published: 15 April 2013 Matthew is a 72-year-old retired policeman with a complex medical history, including type 2 diabetes, a myocardial infarction eight years ago and moderate/severe COPD … Pupils equal in size in both eyes with normal reaction to light (Warrell, Cox & Firth, 2005). The patient is alert and responds to verbal stimulus. The nurses should use a structured approach to assess the patient’s nutritional status. However, accurate predictions of life expectancy for individual patients with COPD remains extremely difficult. His wife died in a car accident. Reference this. Antibiotics to treat signs of infection; 3. Nurse care and patient education is vital to prevent episodes of panic in COPD patients (Willgoss et.al, 2011). Diagnosis. Ineffective Airway Clearance 2. 1. The amount of sputum is increasing day by day. 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