Chronic Obstructive Pulmonary Disease

Introduction

Chronic Obstructive pulmonary Disease (COPD) refers to a set of illnesses that are typified by irreversible interferences with the flow of air. COPD is chronic condition which requires long-term care. This paper presents an analysis of this medical condition. Specifically, the paper examines the Pathophysiology of the disease, how the condition relates with the HFSON conceptual framework, as well as, nurse’s role, legal issues and evidence-based-practices in managing the disease.

Chronic Obstructive Pulmonary Disease

COPD is a progressive lung condition that is typified by an irreversible limitation in the flow of air (Flaschen, 2004). There are two chief categories of COPD; emphysema and chronic bronchitis. Emphysema occurs as a result of damage of the alveolar septa within the lung. Chronic bronchitis occurs when the airways are obstructed by mucus. COPD is among the leading cause of mortality and morbidity around the world. In the United States, medical expenditure for patients with COPD is two and a half higher than for patients without COPD (Mora & Hadjiliadis, 2008). There are different risk factors of COPD. However, smoking is the most noteworthy risk factor. Other risk factors include working in environments that are characterized with air pollution. Symptoms of the COPD include long-term coughing, fatigue, mucus production, shortness of breath, and wheezing. The COPD condition is diagnosed using various methods. Spirometry is one of the techniques used to diagnose the disease. This technique entails blowing out air into a machine that assesses the lung capacity. The disease can also be diagnosed using CT scans, x-rays, the use of a stethoscope, and a blood examination known as arterial blood gas. There is no cure for COPD. However, there are numerous treatment options for managing the condition. Lung-volume-reduction surgery and lung transplantation are among the treatment options available to COPD patients (Pompeo, 2014). Surgery enables the alterations of the disease mechanism by manipulating intervening structures.

Relationship with the HFSON Conceptual Framework

A conceptual framework is an analytical tool that can be used to make distinctions and organize ideas. Nursing process has a goal to promote, restore and maintain wholeness of client. This is achieved by conserving clients’ energy and integrates personal, social or structural (Makic 2013). This dynamic, humanistic and interactive process of nursing can be carried on in homes, hospitals, clinics and community. COPD is a lifelong disease that affects all aspects of the patient’s life (Elherif & Noble, 2011). The nursing process can aid in identifying and comprehending the individual needs of patients and assist in establishing patient-centered therapeutic care.

Nursing takes into account the conservation principles that are fundamental theories that nurse can apply in maintaining a proper balance between and the safety of client. These principles include; conservation of energy a principle that requires balancing of energy inputs and outputs in order to have the bio-psychosocial forces of the client in a constant state. The other concept is the conservation of personal integrity. In this principle, the cultural, ethnic, religious and socioeconomic influences upon which clients develop their sense of self-respect, self-image, self-with and sense of identity (Jones 2010). Conservation of social integrity is the third principle of conservation that associates clients’ behavior to the family groups, religion, traditions and nationality.

The concept applies in the nursing of COPD patients as nurses observe and respect clients’ religious beliefs, traditions and background. The nursing care for patients suffering from CODP aims at managing CODP symptoms, maximizing the body functioning and promoting self-care (Gerene 2012). The family of the patients should be included in the teachings as they are part of the caring team. The patients should be educated on Pathophysiology and how to observe changes in symptoms and notifying healthcare providers when symptoms worsen. CODP patients are likely to be admitted in ICU and stay there for long periods (Curtis 2007). Patients may have different beliefs on the on prolonged life by use life supporting machines. The individual beliefs of CODP patients on life supporting and termination should be respected.

Nursing Practice Role

Practice nurses are perfectly placed to work with individuals suffering from COPD. These nurses can take up a pivotal role in the management of the condition. Practice nurses can take up the role of coordinators in the treatment of patients with COPD. Since COPD is a long-term condition that entail administration of care in different environments including home, hospital and hospice (Fletcher & Dahl, 2013). The condition calls for the input of multidisciplinary teams comprising of radiologists, biochemists, and pulmonary experts among others. Therefore, a high level of coordination is required in order to promote the continuity of care. Practice nurses are better placed to play the role of coordinators. They can conduct follow-ups on patients, record progress, change prescriptions, and communicate progress to other team members among other tasks. They can also put together all elements of treatment to make a comprehensive approach of care.

Practice nurses can also play the role of educators in the treatment and management of COPD. COPD is a lifestyle condition that is caused by habit and environmental factors such as smoking (McHugh, Horne, Chalmers & Luker, 2009). Therefore, the management of this condition requires a change in lifestyle. Practice nurse can play the role of educators effectively. They can educate patients about diets, habits and activities that they need to adopt or avoid in order to manage the disease. COPD is also a life-changing disease. The patients and family members may need to amend their routines in order to accommodate the condition. The practice nurse can take up the role of educating patients about the changes that they need to make in their lives.

Practice nurses can also play the role of counselors in the management of COPD (McHugh, Horne, Chalmers & Luker, 2009). COPD is a life-threatening condition that exerts a significant psychological distress on the patient and family members. The chronic nature of the disease also exerts economic and social pressure on the patient and his family. Consequently, COPD patients and their family members need professional assistance in order to cope with this disease. Nurses can help patients and families to cope with the disease by providing counseling and advisory services. They can provide the much-needed psychosocial support to patients and their families. Most importantly, nursing practitioners can provide patients with smoking cessation counseling (Fletcher & Dahl, 2013). Smoking is the most substantial risk-factor for COPD. However, smoking is a habitual practice; hence, patients may find difficulties abandoning this behavior without professional assistance. The nurse can provide patient with the much-needed smoking cessation counseling.

Legal Issues

There are several legal issues relation to the diagnosis, intervention and management of COPD. A significant legal issue is the provision of a "reasonable standard of care." Laws that guide the nursing profession require practitioners to provide care that a reasonably prudent nurse would afford in a similar situation (Sheldon, 2009). This legal requirement is of particular importance when administering care to COPD patients in a home environment. While trying to minimize costs and provide the patient with a normal life, nursing practitioners must ensure that patients receive optimal care.

Anther important legal issue is protection of the patient’s confidentiality and privacy. Law requires nurses to protect the patient medical information from unauthorized access. They are also obligated to guard the privacy of patients (Sheldon, 2009). Since COPD may entail administering care to patients in remote environments, nurses have to employ telecommunication and digital technologies to monitor patients and administer care. This heightens threats to patients’ confidentiality and privacy. Information shared via telecommunication, or digital media may be easily interrupted. Similarly, the devices used to monitor patients’ condition may intrude into the patient’s privacy. It is the responsibility of the nursing practitioner to make certain that these fears do not materialize. Other legal issues include respect for patient autonomy and nonmalifecence.

Evidence-based practice

Several strategies for managing COPD have been developed. Pulmonary rehabilitating is one of the evidence-based practices that are used to manage the condition. Pulmonary rehabilitating is a comprehensive and multidisciplinary intervention for patients with COPD (Casey, 2012). The intervention targets to reduce symptoms and increase the patient’s participation in life activities. The intervention also seeks to reverse the systemic manifestation of the disease and reduce the cost of managing the disease. Evidence has shown that the pulmonary rehabilitating programs lead to improvements in the patient’s condition. However, the programs are not suitable for immobile patients or patients who have suffered a myocardial infarction. The program comprises of a patient assessment, exercise training, education and psychosocial support.

Conclusion

Chronic obstructive pulmonary disease is a killer disease that is caused by tobacco smoking and other air pollutants. The HFSON framework is applicable to the treatment and management of this disease. Practicing nurse need to take advance roles in caring for patients with CODP. They can take crucial roles such as coordinators, educators, and counselors. Nursing should also adhere to legal requirements such as reasonable care and respect for patients confidentiality when providing care to COPD patients.

References

Casey, D. (2012). Management approaches of COPD: the role of the practice nurse. Retrieved from http://www.lenus.ie/hse/bitstream/10147/281356/1/NURGENPRACMAR13art2.pdf

Curtis J. (2007) Palliative and end-of-life care for patients with severe COPD European respiratory journal UK

Elsherif, M. & Noble, H. (2011). Management of COPD using the Rope-Logan-Tierney Framework. British Journal of Nursing. 20 (1), 29- 33

Flaschen, J. (2004). Chronic Obstructive Pulmonary disease: End-of-Life Stage. Respiratory Care. 49 (1), 90- 98

Fletcher, M. & Dahl, B. (2013). Expanding nursing practice in COPD. Primary Care for Respiratory Journal. 22 (10), 222- 226

Gerene S. (2012). When breathing becomes a burden: How to assist patients with COPD. American Nursing Today. 13 (1), 145- 152

Jones R, Freegard S, Reeves M, Doobs F, (2010) The role of the practice nurse in the management of COPD. Primary care respiratory journal.4 (1), 237- 244

Makic F, Martin A, (2013) Putting Evidence into Nursing Practice: CriticalCareNurse Vol 33, No. 2, USA

McHugh, G. Horne, M. Chalmers, K. & Luker, K. (2009). Critical Analysis of Specialist Community Nurses in the management of Long-term conditions. Environmental Research and Public Health. 6 (1), 2551- 2567

Mora, J. & Hadjiliadis, D. (2008). Lung-volume-reduction-surgery and lung-transplantation in COPD. Chronic Obstructive Pulmonary Disease. 3 (4), 629- 635

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