The Treatment of the Patient with Exacerbation of Chronic Obstructive Pulmonary Disease

Vincent Brody

67 years old. Has a 50-year history of smoking 2 packs a day. Admitted with exacerbation of chronic obstructive pulmonary disease (COPD).

Related to stress and pain experienced as a result of COPD exacerbation

Priority Nsg Diagnosis # 1

Risk for respiratory distress symptoms:

• Subjective data: “This cough is killing”
• Objective data: No improvements in oxygen saturation levels;
• Resp: 23;
• SpO2: 94%;
• Elevated HCO3 and PCO2.

Current information

• Medical diagnosis: respiratory alkelosis
• Risk factors: COPD, old age, smoking, prior history of respiratory conditions
• Diagnostic tests: Chest X-ray, lung pulmonary function test, ABGs, CT scan
• Treatments: administration of opioid pain relieve medicine, providing a sufficient amount of oxygen to stop hyperventilation
• Medications: oxycodone, codeine, or morphine

Nsg interventions

Nursing interventions:

1. Increase inspired carbon dioxide (rebreathing)
2. Relieve pain and limit the sources of anxiety

Short-term goal: stop hyperventilation:

Long-term goal: limit the impact of the underlying condition (COPD) on alkelosis

Contributed to heightened anxiety and hyperventilation

Priority Nsg Diagnosis # 2

Emotional Distress:

• Subjective data: audible chest wheezes, shortness of breath
• Objective data: Difficulty breathing;
• Chest pain;
• HR-21;
• BP: 198/80

Current information

• Medical diagnosis: sinus tachycardia
• Risk factors: COPD, old age, excessive nicotine consumption, prior history of respiratory conditions
• Diagnostic tests: ECG, thyroid function tests
• Treatments: administration of the necessary medicine
• Medications: calcium channel blockers, ivabradine

Nsg interventions

Nursing interventions:

1. Administering anti-arrhythmic medication
2. Preventing cardiac emergencies

Short-term goal: slow the heart rate, stabilize the patient

Long-term goal: ensure there is no need for invasive therapy such as catheter ablation