The aim of this essay is to explore evidence based nursing intervention in the care and management of chronic obstructive pulmonary disease (COPD) in an acutely ill patient. The acutely ill patient involved in this essay was admitted to hospital due to cerebrovascular accident and had a past medical history of myocardial Infarction, left Ventricular failure, peripheral vascular disease and duodenal ulcer as well as chronic obstructive pulmonary disease. This essay will provide a rationale for the chosen aspect of care (COPD) and reason will be given why it is a priority. In particular the essay will examine the significance of the underlying pathophysiology of the disease relating to the acutely ill patient other conditions. The nursing intervention will focus on the measures in order to manage the acutely ill patient experiencing breathlessness. The involvement of other members of the multidisciplinary team, some of the relevant drugs, the common test and investigations will discuss as a part of the nurse holistic care process.
The author chooses chronic obstructive pulmonary disease (COPD) from a clinical perspective, as it is a long-term condition that is associated with impaired lung function and lung damage which interferes with gas exchange and ventilation in the respiratory tract, causing an acutely ill patient to experience severe difficulty with airway clearance, alterations in breathing patterns, and impaired oxygenation, as well as anxiety (Currie 2009). It also imposes a considerable burden on the acutely ill patient’s quality of life in terms of ability to live independently, financial losses due to absence from work, premature retirement and psychological well being which eventually leads to depression, and feeling of being trapped by the disease (Whittaker 2007). Chronic obstructive pulmonary disease (COPD) is estimated to be the third leading cause of mortality through out the world by 2020. The disease affected approximately 600 000 people and cause more than 26 000 death each year in the UK (Mannino 2001). On average the disease reduces life expectancy by nearly 2 years, which has out number the other advanced diseases. Since the mid-1990s, COPD increased emergency admissions to hospital due to worsening episodes (Currie 2009). This high prevalence is a Hugh burden on health services. Hospital stays for COPD exacerbation typically last about ten days, with patient occupying beds and slowing the admission of patients from primary care for operations or other procedures (Lynes2007).Therefore, prevention or optimal treatment of exacerbations is a global priority and the author will looks at measures to prevent an exacerbation of chronic obstructive pulmonary disease.
According to (Whittaker 2007) chronic obstructive pulmonary disease (COPD) is part of a large class of lung disease in the respiratory system and the pathophysiology is not clearly identified. Although, there is a growing bodies of evidence highlights that chronic inflammation is the underlying cause of narrowing and remodeling of the airways. The lung is an organ which transfers oxygen from the air into the blood and carbon dioxide from the blood into the air. The air we breathe enters the body through the nose and mouth leading into the airways to the tiny air sacs of the lungs, called the alveoli. In the air sacs, oxygen that we breathe passes through the walls of air into the bloodstream. Carbon dioxide passes in reverse direction, out of the bloodstream, back into the alveoli, and is then eliminated when we breathe out. Over a period of time emphysema and chronic bronchitis leads to shortness of breath, weakness, dizziness, fatigue and a persistent, productive cough (Rennard 2009). Airflow obstruction occurs as a result of loss...