Exacerbation Of Chronic Obstructive Lung Disease (COD)

This assignment will examine the case of a man admitted to hospital with an exacerbation of chronic obstructive pulmonary disease (COPD). Firstly there will be a definition of COPD and COPD exacerbation. Then there will be a short discussion of how the patient’s data relates to pathophysiology of COPD exacerbation. This information is used to decide what the patient’s first two priority problems are, and two nurse interventions used to best treat those problems.

Chronic obstructive pulmonary disease (COPD) is an umbrella term used to refer to chronic, progressive diseases affecting the respiratory system including chronic bronchitis and emphysema. COPD is characterised by inflammation, loss of muco-ciliary clearance, fibrosis and loss of elastic recoil in the lung parenchyma. Inflammation increases mucous secretions that cannot be efficiently cleared from the airway due to the destruction of cilia. Damage to lungs and excessive mucous reduces airflow, gas exchange and expiratory volume leading to gas trapping. These changes cause the patient to develop the dyspnoea, cough and sputum production characteristic of COPD (Burt & Corbridge, 2013, p. 34-35).

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines COPD exacerbation as an acute event characterised by an aggravation of the above symptoms beyond normal variations resulting in changes to the patient’s medications. Furthermore, an exacerbation is often indicative of disease progression (2014, p. 40). COPD exacerbation is most commonly caused by bacterial and/or viral infection (GOLD, 2014, p. 40).

The patient in the case study has been admitted to hospital with an infective exacerbation of his COPD. Respiratory infection causes increased inflammation an...

... middle of paper ...

...n assisting sputum production and relieving breathlessness (2008, p. 54).

The second intervention to improve gas exchange related to ineffective airway clearance is the use of a positive expiratory pressure device (PEP). PEP devices work by providing constant backwards pressure on the airways during expiration.

In review conducted by the Cochrane Collaboration, it was found that performing airway clearance techniques on patients with an acute episode of COPD reduced the likelihood of mechanical ventilation, as well as the length of time ventilation was needed (2012, p. 2).

While secretion clearance alone may not offer the patient long-term benefit, it is clearly important for maximising patient comfort.

- The patient will continue to secrete mucous due to medical condition exacerbated by infection, however it will provide patient comfort in the short term.