Exam question on copd please help!

  1. 0 Hi there im a student and i don't know if i am posting this in the correct place but i was wondering if anyone would be kind enough and offer a few pointers on a possible exam question..

    Q) Discuss the immediate nursing care required for the care of a COPD patient who has been admitted with breathlessness etc..


    So far, i have said do an overall assessment such as airway (try to maintain airway by sitting patient upright), observe breathing and encourage pursing of lips and slow breaths. Take temperature to obtain whether the patient has a possible chest infection (observe any evidence of sputum). Commence oxygen therapy if sats are below a certain level.. (This is where i am stuck as i am unsure what sort of oxygen therapy would be best)

    Many thanks!
    Last edit by Kirstybop on Jan 2, '13
  2. Visit  Kirstybop profile page

    About Kirstybop

    Joined Jan '13; Posts: 7; Likes: 1.

    14 Comments so far...

  3. Visit  Stephalump profile page
    0
    What do you have so far so I can help fill in any holes?
  4. Visit  Kirstybop profile page
    0
    Hi there! Well i have said do an overall assessment such as airway (try to maintain airway by sitting patient upright), observe breathing and encourage pursing of lips and slow breaths. Take temperature to obtain whether the patient has a possible chest infection (observe any evidence of sputum). Commence oxygen therapy if sats are below a certain level.. (This is where i am stuck as i am unsure what sort of oxygen therapy would be best)

    I know i havent got much there lol I would appreciate any help
  5. Visit  littlebear23 profile page
    0
    Quote from Kirstybop
    Hi there im a student and i don't know if i am posting this in the correct place but i was wondering if anyone would be kind enough and offer a few pointers on a possible exam question..

    Q) Discuss the immediate nursing care required for the care of a COPD patient who has been admitted with breathlessness etc..


    So far, i have said do an overall assessment such as airway (try to maintain airway by sitting patient upright), observe breathing and encourage pursing of lips and slow breaths. Take temperature to obtain whether the patient has a possible chest infection (observe any evidence of sputum). Commence oxygen therapy if sats are below a certain level.. (This is where i am stuck as i am unsure what sort of oxygen therapy would be best)

    Many thanks!
    Because a COPD'er is breathing on a hypoxic drive, you will need to give them the lowest possible oxygen delivery via a nasal cannula for example. I don't mean to sound arrogant, but if you look in your book, there should be a full chapter and section on the respiratory system and the different oxygen delivery systems as well as outlining the patient with COPD and other noninfectious respiratory diseases.
  6. Visit  littlebear23 profile page
    2
    I would like to elaborate on my last comment. It seems very harsh after re-reading it. It is easy to forget that a COPD'er breathes on a hypoxic drive and therefore, his labs are going to be off from a "normal person" and requires a different treatment plan than a person who doesn't suffer from COPD. You must remember, that if you give the pt. O2 above 3 L/min they can potentially die. You are absolutely correct when you said to sit the patient upright, checking for fever, and checking his/her sputum. You will also need to check respiratory rate, and blood pressure. Look for any ordered medications that the HCP may have prescribed that you can give to help your patient breathe a little easier. I hope this helps. Again, I HIGHLY recommend that you go over the section or chapter that discusses this. The questions are only going to get harder and it's very important that you cover your basis and get as much information as you can.
    LSiravo and x_factor like this.
  7. Visit  Esme12 profile page
    0
    We are happy to help but we won't do it for you....a huge part of being a nurse isn't knowing everything but it is about knowing where/how to find what you need and utilizing resources to use your critical thinking skills and lateral thinking abilities to find the answers that you sek. You may find this helpful.....When breathing is a burden: How to help patients with COPD
    http://www.americannursetoday.com/article.aspx?id=9352...



    Google is your friend.
  8. Visit  Kirstybop profile page
    0
    Thank you very much for you're help.. I was just slightly confused at how many litres of oxygen to give as the book i have is quite wishy washy in this aspect. thanks again!
  9. Visit  dcochran6255 profile page
    0
    Hello there all! First year male nursing student here. This is my first post, but I have been browsing the forums for quite some time. I love just being involved and continually increasing my knowledge. School for me does not start back up until January 14th, but I still feel the urge to learn. As I am assessing the questions I here, I think Kirsty that your overall intial assessments and interventions are along the lines of what my answer would consist of.

    But I have one question, and it involves a little critical thinking: How does COPD affect blood pressure?
  10. Visit  Kirstybop profile page
    1

    COPD can cause hypoxia and hypercapnia over a long period of time, so in order to boost the oxygen delivery, the body tries to compensate by causing the blood vessels in the lungs to constrict. This forces more blood and oxygen through. Therefore leading to high blood pressure within the lungs (pulmonary hypertension)


    LSiravo likes this.
  11. Visit  GrnTea profile page
    1
    Ummm, YOU do not just give oxygen. It is a drug and the dose (liter flow) must be ordered by a physician.

    I liked your initial plan, with good parts of assessment and nursing interventions. Was there something else in your textbook that looked reasonable, but that you questioned?
    KelRN215 likes this.
  12. Visit  medicmatt44 profile page
    1
    I am presuming that this is a NCLEX test question... your priority nursing intervention is 2-3 L/M O2 via NC.

    One of the above posters is correct that O2 is a drug, which requires a physicians order to administer. However (in the realm of the NCLEX) if you selected notify the physician (to obtain an order), you would get this question wrong as you are delaying care.

    Additionally, you must auscultate the patient to ensure that adequate ventilation is present.

    COPD pt's will tend to run on the HTN side of the house due to chronic arteriolar vasoconstriction, along with concurrent pulmonary HTN.
    Last edit by medicmatt44 on Jan 3, '13 : Reason: more info required
    Kirstybop likes this.
  13. Visit  LSiravo profile page
    2
    This is my first time on this website. I will be starting Nursing 2 on January 22. I am finding this very helpful and hope to see more questions and answers like this to help me along my journey.
    Kirstybop and medicmatt44 like this.
  14. Visit  nurseymama profile page
    2
    Im not sure if hospitals have standing orders or not but most LTC's in my area have SHO for O2
    Kirstybop and GrnTea like this.


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