terminal COPD patients

fab4fan · Jan 15, 2004

Are you taking care of this pt as a student or as an aide? That might change how I answer your question.

ktwlpn, LPN · Jan 15, 2004

Originally posted by fab4fan
Are you taking care of this pt as a student or as an aide? That might change how I answer your question.

Good point....I find COPD'ers among the most challenging of patients......as an aide you'll have to perform your patients care in steps,allowing frequent rest periods between activities...You can be very comforting to someone with extreme shortness of breath.....Help them practice the techniques the nurses will have taught them to try to control their breathing.....A good one is to hold your finger in front of their mouth and have them pretend it is a candle and they are blowing it out through pursed lips...Some find breathing easier sitting up with their shoulders back-some feel better slumping forward....goodluck

aimeee, BSN, RN · Jan 15, 2004

I have noticed that patients with COPD often have very exacting ways of doing things or wanting things done. If you can learn their rituals and perform them without them having to waste extra breath guiding you, they are grateful and they begin to relax and trust you.

obeyacts2 · Jan 15, 2004

I am working my way thru an ADN program doing aide work. I mainly have hospice type pts. I guess I should have been more clear, sorry. My main question was really how will COPD death be any different than others I have handled (CA IDDM ESHD or whatever). So far I havent noticed much difference from my other pts, except that he does have O2.

Laura

ktwlpn, LPN · Jan 15, 2004

Originally posted by obeyacts2
I am working my way thru an ADN program doing aide work. I mainly have hospice type pts. I guess I should have been more clear, sorry. My main question was really how will COPD death be any different than others I have handled (CA IDDM ESHD or whatever). So far I havent noticed much difference from my other pts, except that he does have O2.

Laura

You can seldom predict how a patient will experience death-it does not matter what their diagnosis is because often some other complication sets in and takes them first....Hopefully this hospice has some great nurses that can manage this patients symptoms=air hunger is an awful thing to experience and and very hard for the patient's loved ones to watch....

fab4fan · Jan 15, 2004

See if you can get hold of a small fan for your terminal COPD pts.; it helps relieve some of that "air hunger."

You will definitely need to space the activities for these pts. That can sometimes be frustrating when you have a lot to do in so little time, but these pts. cannot tolerate having everything done at once.

Cool compresses are sometimes helpful, too.

As far as how the death will be, that's something that you really can't predict. I've found that people tend to die the way they live...if someone was a relatively calm person, they often die peacefully. This isn't anything scientific, it's just something that I (and some other hospice nurses I know) have observed.

Good for you for asking this, and best wishes for school!

obeyacts2 · Feb 19, 2004

thank you all for responding to my post regarding end stage COPD. the gentleman passed quietly and peacefully. he didnt show much sign of air hunger and seemed quite comfortable. he was A/O up to the last 8 hrs or so. the only difference I noticed from the other deaths I have been around was the Cheyne Stokes breathiiing wasnt as obvious as is normally is with other pts.

Laura

ktwlpn, LPN · Feb 19, 2004

thank you all for responding to my post regarding end stage COPD. the gentleman passed quietly and peacefully. he didnt show much sign of air hunger and seemed quite comfortable. he was A/O up to the last 8 hrs or so. the only difference I noticed from the other deaths I have been around was the Cheyne Stokes breathiiing wasnt as obvious as is normally is with other pts.
Laura

Thanks for the update.He was lucky to have you and the rest of the home health care team....