Chronic Obstructive Pulmonary Disease – COPD can come in many names like chronic obstructive airway disease, chronic obstructive lung disease or chronic bronchitis. This is one of the most common lung diseases that are encountered by nursing personnel.There are two forms of COPD; one for instance is composed of long-term occurrence of productive cough which is classified as chronic bronchitis. Emphysema on the other hand is the second form of COPD; it involves slow-moving destruction of the bronchioles.
A patient with COPD may have a long history of smoking. On rare situations, non-smokers can even develop emphysema when they lack the enzyme called alpha-1 antitrypsin. Work-related emphysema is also common for workers who work in gas-filled environment, secondhand smokers as well as utilization of fire for cooking without ventilation. An individual may manifest COPD if he or she has a cough either productive or non-productive, complains of easy fatigability and complains of shortness of breath or sometimes catches his or her breath whenever there are mild activities.
- To assess the patency of airway and provide means to maintain its patency throughout the nursing care.
- To expectorate secretions thus providing more means of comfort and oxygenation to the body.
- To provide ease in mobilization and provide additional knowledge for compliance.
Ineffective Airway Clearance-Nursing Care Plan for COPD
|Nursing Diagnosis||Patient Outcomes||Nursing Interventions||Rationale||Evaluation|
|Nursing Diagnosis: Ineffective Airway Clearance
1. Hyperplasia and hypertrophy of mucus-secreting glands
2. Increased mucus production
3. Smoke inhalation
4. Retained secretions
5. Airway spasm
2. Persistent cough
|1. The patient will maintain patency of airway.
2. The patient will effectively expectorate secretions.
3. The patient will be able to manifest signs of good oxygenation.
4. The patient will be comfortable in terms of ambulation and comply with the health regimen.
|1. Introduce yourself to the patient and folks at the first phase of care.
2. Place the patient in position wherein the head is midline with flexion.
3. Suction nasal or oral secretions as indicated.
4. Observe the patient and its pattern of breathing.
5. Teach the deep breathing and coughing exercises.
6. Administer pain medications as ordered.
7. Encourage increase fluid intake as not contraindicated.
8. Splint the chest for comfort.
9. Assist in mobilization and provide proper airway support.
10. Administer mucolytic, bronchodilators as ordered by the physician.
|1. This will help in the working relationship fostering trust.2. This will allow the proper alignment of the thorax thus opening the airway when at rest, especially when the client is weak.
3. This will mechanically help the patient breathe easier. Always observe sterile technique.
4. Assessing the manner and pattern of breathing may signal emotional or physical stressors which may compromise normal breathing.
5. This will help mobilize the secretions using the energy of the patient. In this way, the patient may know that he or she can help himself or herself.
6. Coughing can stimulate the pain receptors, it is better to provide analgesics before the coughing exercise so that excretions of mucus can be attained.
7. Hydration can also mobilize the secretions clearing the upper airway as well as the lower airway.
8. Proper positioning can ease the patient thus decreasing unnecessary effort.
9. Giving assistance may decrease the effort in the side of the patient, while moving it is important to provide proper oxygenation in order to attain the desired move.
10. Collaboration with the physician in terms of pharmacological intervention is also vital in providing better outcomes.
|*Refer to patient outcomes tab|