Altered Physiology and Emergency Nursing Care of Patient with Exacerbations of Copd

Altered physiology and emergency nursing care of patient with exacerbations of COPD within the first two hours in A&E

Introduction

The following essay will discuss the case of Mr Jones, who was admitted to the A&E department following a worsening of his symptoms of COPD. The focus of the essay is to provide a detailed plan of the management and emergency care of patients with exacerbations of COPD in A&E within the first two hours of their admission.
The essay will guide us through Mr Jones’ stay at the A&E department with regards to the altered physiology of COPD and its acute episodes of exacerbations. Mr Jones’ worsened health condition and physical symptoms will be assessed in the light of his medical history. The author will also analyse the relevant literature and relate the clinical management not only to pathophysiology but also to the evidence base and clinical practice.
The importance of providing patient-centered care will be emphasised in areas of consent and privacy and dignity of the patient. Responsibility and accountability in nursing profession will be underlined in the light of the NMC (2007) Code of Conduct for nurses and midwives. A summary of the main points of the discussed topic will be provided in the conclusion. All literature will be referenced with adherence to the Harvard Referencing System.

Pathophysiology of COPD in acute exacerbations

Exacerbations of COPD can be described as increased airway inflammation and oedema, leading to systemic inflammation causing even more airflow limitation and worsening of ventilation and perfusion (Aaron et al, 2001). It can also be characterised by increased oxygen consumption, altered hypoxic vasoconstriction, and systemic and pulmonary haemodynamic abnormalities (increased cardiac output and increased pulmonary artery pressure) (Bhowmik et al, 2000; Dentener et al, 2001).
The three main factors that contribute to the narrowing of the airways are peribronchial fibrosis,

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