The patient, G. B., is a 50-year-old female who was diagnosed with chronic obstructive pulmonary disease (COPD) for the first time. She addressed the clinic with frequent coughing, shortness of breath, fatigue, and excess sputum. She reported her history of smoking for the last 20 years and an insignificant increase in heart rate from time to time. She is hypertensive, but she controlled her blood pressure with Lisinopril. However, G. B. does not like to go to hospitals and thinks that medications are not necessary all the time. She came alone as she is a widow, and her children live far away in another country, so she did not want to bother them but check her condition independently. She defined herself as an isolated person after her husband’s death in an accident. She has a close circle of friends who visit her sometimes, but there is no regular person to discuss her problems or concerns.
Pathophysiology
COPD is a common diagnosis in many adults who have a history of smoking. Besides, this disease is one of the leading causes of morbidity and mortality today (Yawn et al., 2021). Thus, much attention is paid to its management and prevention through education and early detection. In addition to prolonged coughing, COPD patients experience fatigue, and the quality of life is significantly decreased (Early et al., 2019). In most cases, people who smoke suffer from dyspnea or shortness of breath, and clinicians ask to inhale and exhale a portion of volume to check their ability to get air in (Yawn et al., 2021). When the mucosal surface is exposed to microbial pathogens, the lungs’ airways get inflamed and narrowed (Restrepo et al., 2018). Being untreated for some period, bronchial tubes may collapse because of formations clogged with mucus. The airflow is reduced, and airway obstruction occurs, making it problematic and painful to breathe in and out.
With time, COPD patients observe new symptoms like swelling and wheezing. They cannot eat well and report a loss of appetite, which results in fatigue and dizziness. In older patients, COPD may provoke heart problems and increase the risks for pneumonia and the development of other infectious diseases. Therefore, nursing preventing and therapeutic interventions are critical for all people who smoke and put themselves at risk for COPD.
Assessment
When G. B. addressed the clinic, a general therapist made a decision to ask several questions in-person to gather enough facts about the disease history. The duration and severity of symptoms should be estimated to learn the patient’s condition. The next stage of the assessment was her physical examination and her vital signs (blood pressure – 145/90, pulse – 100, respiration rate – 20, body mass index – 28, and O2 saturation 90%). Her HEENT assessment was within the normal limits, except for her mouth and throat that had moist mucous membranes. When the doctor listened to her heart and lungs, some sounds were revealed to order chest X-rays and define emphysema or other formations that provoked COPD. It was also important to take the pulmonary function test and check to inhale and exhale qualities. The patient’s forced expiratory volume (FEV1) was 65, which meant that her COPD stage was moderate, but being untreated, the results could get worse.
During communication, the patient was anxious about her status and the inability to avoid health complications. There was no support group in her life to discuss her life and share her thoughts. Her poor awareness of COPD risks among smokers was evident, and the recommendation to visit support groups for pulmonary patients was given. It was necessary to show her some relaxation techniques and breathing activities to stabilize her breath and remove her shortness of breath and fatigue. The patient was educated about the importance of changing her lifestyle, keeping a balance between rest and activity, and using professional support in household initiatives (Hashem & Merritt, 2018). Antibiotics were prescribed to minimize the growth of infection in the body. At the end of the interventions, positive results were observed. G.B.’s breath sounds were not as severe as they were during the first visit, no infection that could affect her heart was in the body, and she began wondering about her further options with a support group. It was obligatory to continue education about COPD and smoking cessation in the future to predict pulmonary and cardiovascular problems.