COPD - Gordon's Functional Health Patterns

Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease that is progressive, meaning that the disease lasts a lifetime and is slowly getting worse from year to year. In the course of this disease are the phases of acute exacerbation. Various factors play a role in the course of the disease, among other risk factors are factors that cause or aggravate diseases such as smoking, air pollution, environmental pollution, infections, genetics and climate change.

The degree of airway obstruction occurs, and the identification of components that allow for reversibility. Phase course of the disease outside the lung and other diseases such as sinusitis and chronic pharyngitis. That ultimately these factors make further deterioration occurs sooner. To undertake the management of COPD should be considered these factors, so that the better treatment of COPD. Chronic obstructive pulmonary disease is a broad classification of disorders that includes chronic bronchitis, bronchiectasis, emphysema and asthma, which is an irreversible condition associated with dyspnea on exertion and a decrease in the flow of air in and out of the lungs.

Lately the disease is more interesting to talk about because of the prevalence and mortality rate continues to increase. The increasing age of human life and to overcome other degenerative diseases, COPD is very disturbing quality of life of advanced age. Industry that can not be separated by air pollution and the environment as well as the habit of smoking is a major cause.



COPD - Gordon's Functional Health Patterns

Health Perception-Health Function
1) Past medical history, history of productive cough more than 2 weeks.
2) Smokers, examine shelter, ventilation, sunlight, pollution sources around the home, contact with smokers.
3) Difficulty mobilization and expenditure sputum, presence haemoptoe.
4) inadequate treatment.


Nutritional Metabolic Pattern
1) Anorexia
2) Nausea
3) Weight loss
4) Difficulty in eating or digestion


Activity Exercise Pattern
1) Weakness
2) Muscle cramps
3) Shortness of breath, cough


Sleep-Rest Pattern
1) Disruption of sleep patterns
2) Shortness of breath at night


Cognitive-Perceptual Pattern
1) Headache


Role-Relationship Pattern
1) Changes in the role.
2) Depression


Sexuality-Reproductive Pattern
1) Decrease in sexual activity because of shortness of breath


Coping-Areas Management Pattern
1) Sometimes the negative emotions that arise because of shortness of breath
2) Manipulation.
3) Isolation
4) Increased dependency

Nursing Management of COPD

COPD (Chronic Obstructive Pulmonary Disease) is one of the most common lung diseases. It generally defines the conditions which consist of regular difficulty in expelling or exhaling air from the lungs.

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:

1. How long the patient has trouble breathing?
2. Does the activity increase of dyspnea?
3. How much restriction of patients to tolerate the activity?
4. When patients complain of the fatigue and shortness of breath?
5. Are eating and sleeping habits are affected?
6. History of smoking?
7. Drugs used every day?
8. Drugs used in acute attacks?
9. What is known about the condition of the patient and his disease?

Additional data collected through observation and examination as follows:

1. Patient's pulse rate and breathing?
2. Is the same breath without effort?
3. Is there a contraction of abdominal muscles during inspiration?
4. Is there any use of accessory respiratory muscles during breathing?
5. Barrel chest?
6. Does seem cyanosis?
7. Is there a cough?
8. Are there any peripheral edema?
9. Are the neck veins look bigger?
10. What is the color, amount and consistency of sputum of patients?
11. What is the status of patients sensorium?
12. Is there an increase in stupor? Anxiety?
13. Palpation:
    • Reduction in the development of breast palpation?
    • Is there a decreased tactile fremitus?
14. Percussion:
    • Are there any hyper-resonance on percussion?
    • The diaphragm moves just a little?
15. 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:

1. Touch ups the ability of people with the symptoms not only in the acute phase, but also the chronic phase.
2. Improve the ability of patients in performing daily activities.
3. Reducing the rate of progression of disease if the disease can be detected early.

Nursing management of COPD in the elderly are as follows:

1. Eliminate the etiologic factors / precipitation, for example, immediately stop smoking, avoid air pollution.
2. Cleaning bronchial secretions, with the help of a variety of ways.
3. 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.
4. Overcome bronchospasm with bronchodilator drugs. The use of corticosteroids to resolve the inflammatory process (bronchospasm) remains controversial.
5. Symptomatic treatment.
6. Treatment of the complications that arise.
7. Oxygen treatment, for those who need. Oxygen should be administered with a slow flow of 1-2 liters / minute.

Rehabilitation actions that include:

1. Physiotherapy, mainly aims to help the bronchial secret spending.
2. Breathing exercises, to train the patient in order to make the most effective breathing.
3. Exercise with weights given sport, in order to restore physical fitness.
4. Vocational guidance, the work done against the patient can re-do their previous occupation.

Sample Nursing Care Plan (ncp) for COPD

Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. It generally defines the conditions which consist of regular difficulty in expelling or exhaling air from the lungs. 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.

There are a few signs of COPD that a healthcare worker may detect although they can be seen in other diseases. Some people have COPD and have none of these signs. Common signs are :

• tachypnea, a rapid breathing rate
• wheezing sounds or crackles in the lungs heard through a stethoscope
• breathing out taking a longer time than breathing in
• enlargement of the chest, particularly the front-to-back distance (hyperaeration)
• active use of muscles in the neck to help with breathing
• breathing through pursed lips
• increased anteroposterior to lateral ratio of the chest (i.e. barrel chest).

Sample Nursing Care Plan (ncp) for COPD

NANDA Chronic Obstructive Pulmonary Disease

1. Ineffective Airway Clearance related to bronchoconstriction, increased sputum production, ineffective cough, fatigue / decreased energy and bronkopulmonal infection.

2. Ineffective Breathing Pattern related to shortness of breath, mucus, bronchoconstriction and airway irritants.

3. Impaired Gas Exchange related to ventilation perfusion inequality.

4. Activity Intolerance related to imbalance between supply with oxygen demand.

5. Imbalanced Nutrition: Less than Body Requirements related to anorexia.

6. Disturbed Sleep Pattern related to discomfort, the setting position.

7. Self-Care Deficit Bathing / Hygiene, Dressing / Grooming, Feeding, toileting related secondary fatigue due to increased respiratory effort and the insufficiency of ventilation and oxygenation.

8. Anxiety related to threat to self-concept, the threat of death, unmet needs.

9. Ineffective Individual Coping related to lack of socialization, anxiety, depression, low activity levels and inability to work.

10. Knowledge Deficit related to lack of information, do not know the source of information.


Sample Nursing Diagnosis and Nursing Intervention for COPD

Ineffective airway clearance related to the disruption of production increased secretions, retained secretions

Goal : Ventilation / oxygenation to the needs of clients.

Outcome : Maintain a patent airway and breath sounds clean

Intervention

• Review / monitor respiratory frequency, record the ratio of inspiration / expiration.
• Assess the patient to a comfortable position, such as raising the head of the bed, seat and backrest of the bed.
• Auscultation for breath sounds, record the sound of breath for example: wheezing, and rhonchi krokels.
• Note the presence disepnea, for example: complaints restlessness, anxiety, respiratory distress
• Help the abdominal breathing exercises or lip.
• Observation of the characteristic cough, for example: persistent, hacking cough, wet, auxiliary measures to improve the effectiveness of the airway.
• Increase fluid intake to 3000 ml / day according to tolerance of the heart.
• Bronchodilators, eg, β-agonists, efinefrin (adrenaline, vavonefrin), albuterol (Proventil, Ventolin), terbutaline (brethine, brethaire), isoeetrain (brokosol, bronkometer).