The most common symptoms of COPD are a cough with mucus, shortness of breath (dyspnoea) which gets more severe with any mild activity, fatigue, frequently respiratory infections such as colds and influenza, and wheezing. The symptoms of COPD usually develop slowly.
There are two major forms of COPD: chronic bronchitis and emphysema. Chronic bronchitis consists of a long term cough with mucus. Emphysema is a gradual destruction of the lungs. Most people who have COPD have a combination of these forms because smoking is a major cause of both of them.
Some severe symptoms may require hospital treatment. People should seek medical attention if they are having a hard time catching their breath or taking, see their lips or fingernails turning blue or gray (which is a sign of low COPD oxygen in their blood), are not mentally alert, or have a very rapid heartbeat. It is also important to seek medical attention when the treatment that has been recommended for a person's symptoms is no longer working.
Nursing Management of COPD
Nursing management of COPD begins with the assessment, the following
The assessment includes information about the symptoms last and previous disease manifestations. Here are some guidelines to get data question the health history of the disease process:
- How long the patient has trouble breathing?
- Does the activity increase of dyspnea?
- How much restriction of patients to tolerate the activity?
- When patients complain of the fatigue and shortness of breath?
- Are eating and sleeping habits are affected?
- History of smoking?
- Drugs used every day?
- Drugs used in acute attacks?
- What is known about the condition of the patient and his disease?
Additional data collected through observation and examination as follows:
- Patient's pulse rate and breathing?
- Is the same breath without effort?
- Is there a contraction of abdominal muscles during inspiration?
- Is there any use of accessory respiratory muscles during breathing?
- Barrel chest?
- Does seem cyanosis?
- Is there a cough?
- Are there any peripheral edema?
- Are the neck veins look bigger?
- What is the color, amount and consistency of sputum of patients?
- What is the status of patients sensorium?
- Is there an increase in stupor? Anxiety?
- Palpation:
- Reduction in the development of breast palpation?
- Is there a decreased tactile fremitus?
- Percussion:
- Are there any hyper-resonance on percussion?
- The diaphragm moves just a little?
- Auscultation:
- Is there a loud wheezing sound?
- Is there a sound ronkhi?
- Nomal or decreased vocal fremitus?
The purpose of nursing management of COPD are:
- Touch ups the ability of people with the symptoms not only in the acute phase, but also the chronic phase.
- Improve the ability of patients in performing daily activities.
- Reducing the rate of progression of disease if the disease can be detected early.
Nursing management of COPD in the elderly are as follows:
- Eliminate the etiologic factors / precipitation, for example, immediately stop smoking, avoid air pollution.
- Cleaning bronchial secretions, with the help of a variety of ways.
- Eradicate the infection with antimicrobial. If there is no antimicrobial infection need not be given. Provision should be appropriate antimicrobials according to the germs that cause infections according to the results of sensitivity testing or empirical treatment.
- Overcome bronchospasm with bronchodilator drugs. The use of corticosteroids to resolve the inflammatory process (bronchospasm) remains controversial.
- Symptomatic treatment.
- Treatment of the complications that arise.
- Oxygen treatment, for those who need. Oxygen should be administered with a slow flow of 1-2 liters / minute.
Rehabilitation actions that include:
- Physiotherapy, mainly aims to help the bronchial secret spending.
- Breathing exercises, to train the patient in order to make the most effective breathing.
- Exercise with weights given sport, in order to restore physical fitness.
- Vocational guidance, the work done against the patient can re-do their previous occupation.