COPD In Relation To Hospice August 22, 2016 Tia Michaud, Lisa Zook Agency Halifax Health Hospice 1625 Veterans Memorial Parkway Orange City, Florida 32763 Telephone: 386-851-7600 Fax: 386-851-7625 Philosophy Caring that assists those nearing the end of life and in need of refuge. It is a system of caring designed to restore dignity and provide a sense of personal fulfillment to the dying. Mission Statement The mission of family Hospice and Palliative Care is to provide compassionate, quality comfort care that enhances the lives of people with life-limiting illness and their families. Goals of Patient Care Hospice patient are not “giving up”. They still have a lot of things they are fighting for. Their focus has changed, …show more content…
The symptoms may worsen with lying down in the night, and the patient may be Cyanosed in chronic bronchitis (Rice, 2012). The symptoms may be similar to those of other conditions, and the severity may depend on upon the amount of damage that has been caused to the lungs. There may be other symptoms in severe COPD such as swelling in the ankles, feet or legs with lower muscle endurance. After the doctor has explored the symptoms in a patient and diagnosed it as COPD, several treatment procedures are available depending on the severity of the condition. There are medications, surgeries and other therapies that are available for treatment of the management of the condition where I as the nurse would be involved in choosing the best of option together with the …show more content…
Goals include: Note use of accessory muscles, pursed-lip breathing, and inability to speak or converse by end of shift (Cooper, 2015). Demonstrate improved ventilation and adequate oxygenation of tissues by ABGs within patient’s normal range and be free of symptoms of respiratory distress. Nursing interventions with rationales include- Assess and routinely monitor skin and mucous membrane color (Stress, 2012). Rationale- Cyanosis may be peripheral (noted in nailbeds known as capillary refill), or central, this is indicative of advanced hypoxemia. Palpate for fremitus, the rationale incudes Decrease of vibratory tremors suggests fluid collection or air-trapping (Cooper, 2015). Monitor level of consciousness and mental status, investigate changes, rationale includes, restlessness and anxiety are common manifestations of hypoxia (Stress, 2012). Worsening ABGs accompanied by confusion/ somnolence are indicative of cerebral dysfunction due to hypoxemia (Cooper, 2015). Evaluate sleep patterns. Provide quiet environment, group care or monitoring activities to allow periods of uninterrupted sleep; limit stimulants such as caffeine. Rationale includes Multiple external stimuli and presence of dyspnea may prevent relaxation and inhibit sleep (Cooper, 2015). Encourage sputum, thick, tenacious, copious secretions are a major source of
R.S.’s clinical findings as a consequence of his chronic bronchitis are likely to include: being overweight, experiencing shortness of breath on exertion, producing excessive amount of sputum, having a chronic productive cough, as well as edema and hypervolemia just to name a few. (Copstead & Banasik, 548) Some of these signs and symptoms would be different if R.S. had emphysematous COPD. In emphysema (or “pink puffers”), there is weight loss, the cough is absent or negligible, and edema is not present. While central cyanosis and jugular vein distention are present in late chronic bronchitis, these pathologic manifestations are absent in emphysema. . (Copstead & Banasik, 549)
God tells his children, “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away” (Revelation). Death is one of the most frightening and confusing times a person can go through. Watching a loved one pass away is also one of the hardest trials a person can experience. Many people assume that death is a time of pain and the only thing that they can do is mourn and watch their loved one fade away from the earth. This is wrong. There are ways that people can turn a bad situation to good. Dying doesn’t have to be painful and full of suffering. The County Hospice staff makes sure of this. The Hospice staff not only takes care of passing patients physically, but they also take care of the patients emotionally and spiritually. Hospice staff also plays a key role in helping families during the grieving process.
Mrs. Jones has a history of COPD. She was already taking albuterol for her illness and it was ineffective when she took it that day. Mrs. Jones had been a smoker but had quit several years ago. According to Chojnowski (2003), smoking is a major causative factor in the development of COPD. Mrs. Jones's primary provider stated that she had a mixed type of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was established to address the growing problem of COPD. The GOLD standards identify three conditions that contribute to the structural changes found in COPD: Chronic bronchiolitis, emphysema, and chronic bronchitis. A mixed diagnosis means that the patient has a combination of these conditions (D., Chojnowski, 2003). Mrs. Jones chronically displayed the characteristic symptoms of COPD. "The characteristic symptoms are cough, sputum production, dyspnea on exertion, and decreased exercise tolerance." (D., Chojnowski, 2003, p. 27).
Chronic obstructive pulmonary disease or COPD is a group of progressive lung diseases that block airflow and make it hard to breathe. Emphysema and chronic bronchitis are the most common types of COPD (Ignatavicius & Workman, 2016, p 557). Primary symptoms include coughing, mucus, chest pain, shortness of breath, and wheezing (Ignatavicius & Workman, 2016, p.557). COPD develops slowly and worsens over time if not treated during early stages. The disease has no cure, but medication and disease management can slow its progress and make one feel better (NIH, 2013)
Being in hospice care is a better alternative than being stuck in the hospital to try to avoid the unavoidable. Common misconceptions about Hospice could include that hospice makes life more miserable; however, a physician expressed his findings in Hospice,“You can only fail a patient if you fail to understand and respond to their needs. We may not be able to cure all of our patients, but if we can make them comfortable in the last moments of their lives, we will not have failed them”..Hospice care gradually emerged in the 1970s, when groups like the National Hospice Organization were formed “in response to the unmet needs of dying patients and their families for whom traditional medical care was no longer effective.”Herbert Hendin, an executive director of the American Suicide Foundations illustrates a story of a young man diagnosed with acute myelocytic leukemia and was expected to have only a few months before he died. He persistently asked the doctor to assist him, but he eventually accepted the medical treatment. His doctor told him he can use his time wisely to become close to his family. Two days before he died, Tim talked about what he would have missed without the opportunity for a
Carone M, D. C. ( 2007). Clinical Challenges In COPD[e-book]. (Oxford: Clinical Pub) Retrieved March 24, 2014, from (EBSCOhost).
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
Hospice always patient and families the automaty to decide a choice of end of life care. It allows who prefer to end life in their homes, pain free, surrounded by family and loved ones: Hospice works to make this happen. The focus in on caring, not curing. Hospice utilizes an interdisciplinary team of healthcare professionals and trained volunteers that address symptom control, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes. Hospice is not “giving up,” nor is it a form of euthanasia or physician assisted
Someone diagnosed with COPD must understand that the damage done to the lungs by this disease is not reversible. The prognosis is one of stopping further damage to the lungs. To minimize this damage the person is treated for symptoms of the disease and not healing of it. The symptoms of COPD usually show up after the lungs have been significantly damaged and due to this late formation of symptoms and their inability to ...
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
Palliative care is essentially end of life care. It specializes in keeping the patient as comfortable
Cancer patients often wonder if going through treatments like chemotherapy and radiation are worth the risk of the side effects, in addition to the cancerous side effects. They feel that they can’t enjoy or relax in what a short amount of time they have left because they are bedridden from the nausea and pain that treatments put them through. Patients tell their loved ones to just let them die so long as they don’t have to go through any more pain. Those who are too old, are unable to recover from the effects, or are just too far in the grips of cancer, should refuse the more harsh treatments like chemo and radiation. On the positive side, refusing treatments after a certain point can save their families from the stress and cost of hospital bills. If caught early enough, patients can opt for safer and easier routes to getting rid of cancer like surgery or by doing a stem cell transplant.
I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.