Case Study of Chronic Obstructive Pulmonary Disease

Case Study of Chronic Obstructive Pulmonary Disease

Assignment- Case study of COPD

James,  has been recently diagnosed with Chronic Obstructive Pulmonary Disease (COPD). The patient is a chronic smoker with comparatively lesser number of cigarettes consumed per day basis. The patient work-life balance is negligible and he is having a hectic work schedule and is unable to make time for physical activity. The patient is well aware of his current situation and although his current clinical status is not so good, he is still at a higher risk of developing complexities from his COPD. Sandra, James wife, wants to make a meeting with the healthcare professional so as to motivate James to undergo treatment. However, the patient knowingly, is reluctant to take any treatment intervention to manage his diseased condition. The health care professional is able to sense the reluctance and has challenged staged in front of him, to provide the patient with the required care as per his comfort and ease.

Types of COPD

There are three major types of COPD as following:

1. Chronic bronchitis- This is caused by prolonged inflammation of the lung passages such as bronchi that leads to increased mucus production in the lung passages. In chronic conditions, there is a severe restriction of airflow in the lung capacity due to these changes. These changes in the patients tend to result in recurrent chest infections as well as productive cough production (Kesimer, 2017).
2. Pulmonary emphysema- This condition is mainly marked by injury to the alveoli, which are the air sacs in the lungs. These are the main structures responsible for gaseous exchange. The alveoli tend to either destroy completely or get collapsed. In few of the cases, the alveoli gets narrowed or inflamed as well. This narrows the passages for gaseous exchange resulting in severe breathlessness and in some cases irreversible changes in the patient (Nakashima, 2019).
3. Refractory asthma- It is chronic lung condition which is marked due to hyper responsiveness of the lung passages. The lining of the lung passages tend to get inflamed and thus there is a major restriction observed in gaseous exchange. It is also marked by the inflammation of the respiratory structures responsible for gaseous exchange and also brings about an increased mucus production which is irreversible in nature (Carpaij, 2019).

Pathophysiology of COPD

COPD is developed due to a combination of peripheral inflammation and slow progressive narrowing of the air passages. This is also brought by the airflow limitation to the lower lung passages involving the alveoli and terminal bronchioles, which are the main structures involved in smooth conduction of airflow throughout the lung passages (Kesimer, 2017). This causes an abnormality in the alveolar structures in a slow progressive manner and also destructs the pulmonary vascular bed. The surrounding structure near to the vascular bed also inflames over the due course of time, leading to the extent of airflow limitation from lower passages to the higher lung passages. There is a reduced influx as well as efflux of the air from the lung airways (Radovanovic, 2018). This eventually leads to reduced inspirational capacity and might also bring about severe breathlessness in the patient. Whereas, the reduced exhalation process increases the air trapping in the lungs which eventually again lead to reduced inspiratory capacity. Due to this abnormality in the gaseous exchange, there are low levels of saturated oxygen measured in the patients in the form of hypoxemia (Radovanovic, 2018).  This impaired gaseous exchange then worsens the patient status leading into slow progressive development of COPD.

Step taken for self-care management by the patient

James can take up the following steps on so that he can manage his own condition

1. Quit smoking- This can be done by James with the help of medications, counselling, and nicotine replacement therapy and so on. Smoking is an underlying risk factor for COPD that promotes lung degeneration in the patient (Hayes, 2017).
2. Proper diet and exercise- James can take up for a balanced diet. This will help in promoting his health and undermine the complications associated with COPD condition. Exercise can be helpful for the patient to help him develop his functional capacity and can also be helpful in improving his overall muscle strength. Exercises regimen like aerobics as well swimming can be opted out, which will be good for enhancing cardiovascular training for the patient (Pierobon, 2017).
3. Adequate rest- The patient in the case study has a busy work schedule and therefore, he is unable to make time for other activities. Taking proper rest will help in providing his body the required relaxation and will also be helpful in promoting a good sleeping pattern in the patient.
4. Breathing pattern- Patient can make use of various breathing techniques such as deep breathing, diaphragmatic breathing and purses lip breathing, which will be helpful for the patient in promoting a healthy ventilator patter in times of breathlessness.
5. Bronchial hygiene- James can make use of steam inhalation in the morning. This will be helpful in removing the additional secretions and maintaining a clear chest cavity. This will also be helpful in reducing the chances of chest infections (Jolly, 2016).

Importance of communication

During the conversation with the health professional, I realize that James being treating as  awkward and defensive personality during the meeting. Foremost I tried him to be calm and  enjoy the meeting in an informal way. This helped him to be a good listener and good speaker while discussion. Tried him to know the importance of communication with the health professional so as it will help James to know about the amplified vision of the specific situation and discover the proper potential in dealing with the conditions before it could be severe. Communication is mainly helpful in channelizing the thoughts from one person to another. His behavioral display might be due to some of the myths and preconceived notions attained by the patient. James may be unaware of his present medical condition and may be able to get confused with the medical terminology (Reinke, 2017). I will make him aware about the lethality of disease and how it affects the world. As according to World Health Organisation, the global burden of disease study report a prevalence of 251 million cases of COPD globally in 2016 (World Health Organization, 2016). It is also estimated that 3.17 million deaths were caused due to COPD in 2015. The patient might also be reluctant for treatment due to his unspoken fears and perceptions regarding the condition of COPD. I will make him realize about the importance of health practice that could help him to know about the reality and circumstances, which could affect his health in future.  I will guide him that the communication with the healthcare professionals can be very helpful in the given scenario that could be helpful for the individual with clearing his myths and doubts regarding the condition. They can also provide educational information on how to manage their conditions in their own personal surroundings. As a healthcare professional, I will judge the nature of the patient and should be able to act in accordance with the same. The personal values and beliefs of the patient should also be given due importance and should be considered as an integral part while planning for treatment intervention for the patient. I will educate James regarding the importance of information exchange, exacerbations management, and practical counseling. The body language of the counselor should be of empathy and that of a welcoming nature. Effective communication channels between the patient and the care giver as crucial from the point of view of managing for medical care and coordination of the patient and also ensuring the smooth facilitation of these services for the patient as well (Stokes, 2019).

Strategies of intervention

• Collaborative – Sandra find difficulty in getting James to make changes his lifestyle. The collaborative approach help James adopting the complementary roles and cooperative working strategies. The strategy would provide him to make a effective decision maker and problem solver. As James is quite agitated and aggressive by his condition and require further management for the same. As a healthcare professional I can work in close coordination with the James patient and his family to provide him with detailed information regarding his present clinical condition (Collinsworth, 2018). This will be helpful in providing the patient with the useful information, but will also be helpful in providing the patient with a sense of re-assurance and confidence to manage his condition.
• Accomodating – With the accommodating strategy, I would be able to maintain the health and social needs of James. This would help me take care of his health problems while considering the implications for quality, equity, equality, and other beliefs he has. It will help him to preserve his rights, harmony beliefs, and assertiveness. This will be helpful in gaining confidence of the patient and providing him with a sense of authorization over his own personal life. This will impede the process by the means of promotion of effective communication between the care coordinator and the patient (Jany, 2019).

Conclusion

COPD is a commonly occurring respiratory condition which can hamper the daily routine of the patient, leading up to them developing disability in severe cases. However, with the right help this condition can be very well detected in early stages and can also be effectively managed conservatively. The healthcare professionals play a major role in not only clearing the myths of the patient regarding their condition, but can also help in providing them with a treatment intervention. They can also work in coordination with the patient to provide them the required care as per their individual needs, which will be helpful in obtained improved status of quality of life for the patient.

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