Comprehension Of Pathophysiology In Nursing

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According to The Department of Health (DH) (2011) in England and Wales Chronic Obstructive Pulmonary Disease kills about 25,000 people in a year. Current figures showed that 4.8% of all deaths in England between 2007 and 2009 was caused by COPD.
The aim of this essay is to critically explore the health care journey of a fictitious patient by the name of Mrs Fryth who was diagnosed with (COPD) 8 years ago, therefore will not breach confidentiality as required by Nursing and Midwifery Council (NMC) (2015). The essay will demonstrate comprehension of pathophysiology in relation to COPD, Chronic Bronchitis and Emphysema.
An assessment of Mrs Fryth will be done within the first 24 hours following admission, during her acute point of illness. The
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This could be to enable sufficient oxygenation and ventilation due to COPD. The use of accessory muscles will also be observed as this indicates that Mrs Fryth is not able to use intercostal muscle for ventilation (Brooker & Nicol 2007). Due to the elevation of Mrs Fryth respiratory rate this has generated a score of 3 National Early Warning Score (NEWS) (RCP) (2012). Listening for any wheezing, rattling sounds to detect any airway obstruction and feeling using therapeutic touch to feel for warmth for circulation or if cold and clammy that might be due to hypotension RC (UK), (2016). Mrs Fryth skin colour was observed for blueness of the lips and tongue as this can be an indication of central cyanosis causes by hypoxaemia. Oxygen saturation was done, using a pulse oximetry, this is to check the oxygen level in the blood as this can give an indication of hypoxaemia. Pulse oximetry has its limitation as it may not show the correct reading if the patient is wearing nail varnish, or have poor perfusion (WHO 2011). Mrs Fryth is showing signs of hypoxia caused by reduction of oxygen saturation which is 88% (Jevon 2007). She has been prescribed supplementary oxygen at 36% using a venture mask, this is to maintain adequate oxygenation (Alexander, Fawcett, Runciman 2006). This has scored 2 on NEWS. Patients with COPD should aim for oxygen saturation of 88- 92% as recommended by (BTS) (2009). Precaution should be taken as high level …show more content…
Mrs Fryth could be pyrexia so will need continuous monitoring. Top to toe assessment will be done while maintaining privacy and dignity, this is to check her pressure areas as to see if there is any break down in skin tissues. Assessment of Mrs Fryth on the NEWS has triggered a score of 8 so the nurse will monitor vital signs and inform medical team RCP (2012). Whilst in hospital she was prescribed bronchodilator therapy and commence on oral corticosteroids. Several issues were identified, she lives alone, has no toilet facilities on the ground so patient is reluctant to drink fluids, so may at risk of becoming dehydrated. She also has restricted mobility due to breathlessness which make managing her house work difficult. She has been smoking since the age of 16 and is now 58 years old. This shows she has pack years of 60 and this may be a contributory factor for COPD. She has shown signs of anxiety and is fearful for her future. The nurse will give support by way of reassurance, explain the care being given and truth in progress expected (Alexander, Fawcett & Runciman 2006). The nurse has also identified that Mrs Fryth has two grown up children and grandchildren who lives

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