Nursing Diagnosis for Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease or COPD is a disease that causes destruction of airways in the lungs. In the United States, it's the fourth highest cause of death. Every year, more than 85,000 people die from 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.
In most of cases, the root cause for COPD is smoking or consumption of tobacco. Naturally, COPD causes a number of health problems and reduces the life expectancy of those who suffer from it. If detected and treated early, life expectancy can be greatly increased, and if smoking is stopped immediately, lung has the capacity to recover dramatically. This, in turn, increases the life expectancy.
The pathophysiology of COPD is not entirely understood. Chronic inflammation of the cells lining the bronchial tree plays a major role. Smoking and, seldom, other inhaled irritants, perpetuates an ongoing inflammatory response that results in airway narrowing and hyperactivity. Airways become edematous, excessive mucus production occurs and cilia function weakly. Patients face increasing difficulty clearing secretions with disease progression. Accordingly, they develop a chronic productive cough, wheezing and dyspnea.
The basic pathophysiologic process in COPD consists of increased resistance to airflow, loss of elastic recoil and decreased expiratory flow rate. The alveolar walls frequently break because of the increased resistance of air flows. The hyper inflated lungs flatten the curvature of the diaphragm and enlarge the rib cage. The altered configuration of the chest cavity places the respiratory muscles, including the diaphragm, at a mechanical disadvantage and impairs their force-generating capacity. Consequently, the metabolic work of breathing increases, and the sensation of dyspnea heightens.
In many cases, when COPD is in its final stages, even oxygen therapy may not help the patient. In such cases transplantation of the lungs may be the only way of increasing life expectancy. Transplantation is suggested to those patients whose life expectancy is felt to be less than two to three years. However, at this stage, there is no average to determine the life expectancy of a patient.
If COPD is detected in a person, giving up smoking is the best way to increase life expectancy. Other treatments like oxygen therapy, exercise and transplantation will also help, but you cannot fight COPD unless you quit smoking.
Nursing Diagnosis for COPD
Chronic Obstructive Pulmonary Disease
Ineffective Airway Clearance related to bronchoconstriction, increased sputum production, ineffective cough, fatigue / decreased energy and bronkopulmonal infection.
Ineffective Breathing Pattern related to shortness of breath, mucus, bronchoconstriction and airway irritants.
Impaired Gas Exchange related to ventilation perfusion inequality.
Activity Intolerance related to imbalance between supply with oxygen demand.
Imbalanced Nutrition: Less than Body Requirements related to anorexia.
Disturbed Sleep Pattern related to discomfort, the setting position.
Self-Care Deficit Bathing / Hygiene, Dressing / Grooming, Feeding, toileting related secondary fatigue due to increased respiratory effort and the insufficiency of ventilation and oxygenation.
Anxiety related to threat to self-concept, the threat of death, unmet needs.
Ineffective Individual Coping related to lack of socialization, anxiety, depression, low activity levels and inability to work.
Knowledge Deficit related to lack of information, do not know the source of information.