COPD is or chronic obstructive airway disease is actually an umbrella term for a group of diseases that cause airway blockage and breathing problems in general. According to Higginson and Parry (2018), “COPD is a progressive obstructive lung disease that adversely affects the patient’s ability to both breathe and exchange gases between the alveoli and circulation due to loss of lung tissue” (p. 12). Those diseases included are emphysema, chronic bronchitis and asthma. According to the CDC, almost 15.7 million Americans or 6.4% reported having COPD (CDC, 2018). The rate of COPD was higher in people aged 65 and older, American Indians and Alaskan Natives, current or former smokers, and those with a history of asthma (CDC, 2018).
Follow up could be done on a monthly basis for the more unstable or critical COPD patient, or seen every six months for the stable patient, with testing such as the PFT being done on a yearly basis. The patients mental health must also be observed due to the fact that there is a link between having COPD and mental disorders. According to Hussain and Williams (2017), “Research suggests that quality of life is linked with COPD exacerbation frequency, and that a number of factors (practical adjustment, individual differences in emotional reactions) affect how a patient copes with living with COPD” (p. 1110). Follow up must include psychological or social work consult as well.
Physical Assessment and examination will identify certain risk factors through personal history such as smoking and lifestyle behavior, and identification of the diseases such as emphysema which presents with barrel chest and pursed lipped breathing. All of these patients can evaluated through lung sound evaluations, physical exam, and such tests as arterial blood gasses, chest x-rays, chest CT, pulmonary function testing.
Patient treatment can decrease symptoms and help to alleviate frequency of exacerbations, the first treatment for those who smoke would be for the patient to quit smoking. Coughing or wheezing can be treated with medications, and pulmonary rehab is an individualized treatment program that teaches COPD management strategies to increase quality of life. Flu and pneumonia vaccines are also important to COPD sufferers in order to reduce the chance of lung infections. Supplemental oxygen is also a common prescription for COPD patients and home oxygen use is prevalent.
References:
CDC (2018). Chronic obstructive pulmonary disease. Retrieved from: http://www.cdc.gov/copd/index/html.
Higginson, R., & Parry, A. (2018). Managing chronic obstructive pulmonary disease in the community setting. British Journal Of Community Nursing, 23(1), 6-12.
Hussain, F. A., & Williams, S. (2017). COPD: a proposed multidisciplinary approach to psychological issues. British Journal Of Nursing, 26(20), 1109-1115.