Nursing care - emphysema

Ineffective airway [blank_start]clearance[blank_end] due to emphysema The loss of [blank_start]supporting[blank_end] tissue increases risk of airway [blank_start]collapse[blank_end]. Air is trapped (increased residual vol.) Assess resp status every [blank_start]1[blank_end] - [blank_start]2[blank_end] hours or as [blank_start]indicated[blank_end] Depending on severity Assess ABG results & SpO2 readings Notify medical team of [blank_start]abnormal[blank_end] values/ change in status

Interventions for ineffective airway clearance: Place in [blank_start]Fowler’s[blank_end] or the [blank_start]tripod[blank_end] position to facilitate [blank_start]breathing[blank_end] & lung [blank_start]expansion[blank_end] (assists in reducing the [blank_start]WOB[blank_end]) Administer O2 as ordered Administer medications as ordered Provide referral to [blank_start]respiratory[blank_end] therapist Monitor patient’s fluid intake to reduce likelihood of airway [blank_start]collapse[blank_end] Provide [blank_start]rest[blank_end] between activities Teach breathing techniques to control breathing [blank_start]pattern[blank_end] (i.e [blank_start]pursed[blank_end] lip or abdominal breathing)

Inadequate nutrition In advanced COPD - fatigue due to [blank_start]hypoxaemia[blank_end] caused by any effort can lead to a lack of adequate intake. The increased [blank_start]metabolic[blank_end] demands of increased WOB leading to an increase in req’d energy [blank_start]input[blank_end]. Assess nutritional status - [blank_start]BMI[blank_end], [blank_start]diet[blank_end] history & skinfold if applicable Document input and liaise with [blank_start]dietitians[blank_end] re: higher energy diet Monitor lab values including serum [blank_start]albumin[blank_end] and electrolytes (the individual may not be getting enough protein) Provide frequent, [blank_start]small[blank_end] meals with between-meal supps Position patient appropriately for meals Assist to choose [blank_start]preferred[blank_end] meals; encourage family members to bring food from home if allowed Bedside snacks Provide mouth-care to increase [blank_start]appetite[blank_end] If oral intake is inadequate discuss [blank_start]enteral[blank_end] or parenteral feeding with medical staff

Compromised [blank_start]family[blank_end] coping Depending on the prognosis and individuals involved Assess interactions between individuals and family Assess the [blank_start]impact[blank_end] of the illness on the family Encourage expression of [blank_start]feelings[blank_end] between family members Initiate care conference involving the person, family and [blank_start]interdisciplinary[blank_end] team members Consider referral to [blank_start]social work[blank_end] if appropriate

Patient education: There may be a potential conflict if the person is disinclined to quit smoking even with a diagnosis of emphysema [blank_start]Education[blank_end] should be provided in [blank_start]written[blank_end] and verbal form re: [blank_start]risks[blank_end] associated with continuing to smoke and [blank_start]benefits[blank_end] from quitting These should be provided to the [blank_start]family[blank_end] also Educate family members that smoke about the dangers of [blank_start]passive smoking[blank_end] Demonstrate [blank_start]respect[blank_end] for decisions made in this area regardless