Introduction

Emphysema is directly related to lung. Emphysema can be defined as types

of lung disease

characterized by shortness of breath. It destroyed the alveoli. Alveoli are tiny

air sac in the lung

(Better Health Channel, 2007a).

1 2

Figure 1 normal alveoli figure 2 damaged alveoli

The most common cause of emphysema is smoking; smoking is the inhalation and
the exhalation of the

fumes from burning tobacco in cigarette (Better Health Channel, 2007b). Mr.
Hans Vandenberg has

smoked 20 cigarettes a day for 40 years, he is short of breath and get very
agitated when told

what to do. Mr. Hans Vandenberg condition is quite complex as he is non

compliant with his

nursing care. This essay will discuss, give and predict some ways of how to
support Mr. Hans

Vandenberg through communication to understand the importance of

nursing intervention in

order to involve him in his own care.

During his admission Mr. Hans Vandenberg gets very agitated. An agitation
is a mental state of

extreme emotional disturbance (Australian Institutes of Health and Welfare,

2003). It is

important not to intervene alone, using other nurses and care stuffs and
avoiding getting too

closed is important as safety first is your first priority. Also avoid

overreaction as you are trying

to build trust first with Mr. Hans Vandenberg. Keeping eye contact while
asking him his

preferred name and using that name to call Mr. Hans Vandenberg will enable
him to feel save.

Also finding out his preferred language and using this language will give Mr.
Hans Vandenberg a

good understanding of what is being said to him (Crisp and Taylors, (2009a).
Actively being

attentive to the cause of his agitation and attempting behavioral intervention

aiming at those

causes may calm Mr. Hans Vandenberg’s situation down.

According to the Australian Institutes of Health and Welfare (2006b) a calmer

environment

needs to be created for Mr. Hans Vandenberg in an attempt to deal with his
agitation.
Removing out the possible stressors, triggers or danger, moving Mr. Hans
Vandenberg to a

safer or quieter place, offering rest and privacy will eventually avoid
environmental triggers

such as noise, insecure space and fear. A quiet environment is important for
many reasons; it is

a good place where you as a caregiver can introduce your self to Mr. Hans
Vandenberg and let

him know that you will stay with him to help him through his problem. It also
enables you to

effectively explain clearly to Mr. Hans Vandenberg what is going on around

his new

environment, ask Mr. Hans Vandenberg questions and try to engage him in
a conversation

(Crisp and Taylors, (2009b p380). Avoiding social conversation with Mr. Hans
Vandenberg is

paramount, as these may trigger some other unsettled issues with his past
(Better Health

In addition to his agitation, Mr. Hans Vandenberg is also non compliant with
his nursing care. A

non compliant patient is a patient’s failure to adhere or comply with any

therapeutic suggestion

(Better Health Channel, 2007c). Creating an environment where Mr. Hans

Vandenberg can feel

save and say whatever he want to say whether is right or wrong is important.
This enables you

to find out Mr. Hans Vandenberg’s goals and what is motivating him. Humor
can also help a
caregiver stay motivated (Crisp and Taylors, 2009c). You have to be able to
laugh about

situation. Patients pick upon on if a caregiver is being humorous with them

(Better Health

Channel, 2006a). Being humorous to Mr. Hans Vandenberg may inspire him
and provide an

uplifting spirit or feeling. In addition Mr. Hans Vandenberg needs to see if you
are willing,

personate and can demonstrate perseverance in every situation in his care,

reminding Mr.

Hans Vandenberg that you are there to help him in whatever situation he
may have can inform

Mr. Hans Vandenberg that you care about him.

Another problem is smoking. As Mr. Hans Vandenberg continue to smoke 20
cigarettes a day,

it’s important to let Mr. Hans Vandenberg know that his emphysema was due
to smoking.

Since Mr. Hans Vandenberg already an addict working out a slow process in
trying to convince

him to stop his smoking may be a good way, (Lippmann and Natoli, 2001).
This can be achieved

by demonstrating commitment to Mr. Hans Vandenberg e.g. showing quality

care and services

such as remembering appointment, keeping whatever request made and

assuring him of any

progress. In addition involve Mr. Hans Vandenberg in a discussion, do not

discuss issues that

are controversial with Mr. Hans Vandenberg and avoid question that can be
answered with a

simple yes or no. while communicating make sure you listen to view that you
don’t agree with

before giving your own. Further more avoid negative behaviors such as
wanting to

communicating with some one else and rolling your eyes while
communicating with Mr. Hans

Vandenberg. Slowly try and involve Mr. Hans Vandenberg in other successful
program to help

quit for example taking him in a private place and calling quit line (137848) if
he is ok with to

get more information.

Giving Mr. Hans Vandenberg bronchodilators as prescribed by the doctor is
important, this is

to relieve coughing, shortness of breath and trouble breathing by opening

constricted air

ways (Chandler 1998, P151). Before any action, telling Mr. Hans Vandenberg
what you are

going to do and your reason for doing it can show respect for him and allow
him to feel

comfortable and build hope in the caregiver, further use of appropriate

language and medical

terminologies is also vital, breaking or changing these terms into clear and
simple layman’s

term can make it easier to Mr. Hans Vandenberg to understand his

medication for example

saying “the doctor need you to take this tablet 2 time a day” instead of your
medication is

prescribed 2 times a day by the doctor.

Mr. Hans Vandenberg live alone, he is at risk of loneliness. Loneliness is a
feeling where people

experience a powerful atmosphere of emptiness, normally without any body

valuable available

in life (AIHW, 2007). Involving Mr. Hans Vandenberg in a discussion here can
help; as he is

lonely it is very important to choose appropriate time and topic to chat on.
Ask questions that

are clear and precise share concern and advice where necessary. In addition,
Mr. Hans

Vandenberg does not want to be in a hospital and says that he just want to
die. He is at risk of a

serious trauma. We can not change circumstances but we can change our
own brain chemistry

and be freed from the emotional slavery of negative reaction (Hawton,

2002). Clear

communication to Mr. Hans Vandenberg is important, give Mr. Hans

Vandenberg courage by

telling him not to think that way because you don’t want him to die say to
him that he is loved

and would be badly missed. If you are unable to say it out find other ways or
leave him a letter

expressing your feeling and concern for him. Plead to Mr. Hans Vandenberg
and reinforce

emotional ties. Spending time with Mr. Hans Vandenberg also can rest his
emotional trauma,

asking him how he would like to be helped may lighten his mine. It is
important to be patient if

Mr. Hans Vandenberg can not respond immediately. Your patience,

perseverance and strength
may change something. A time use reasons then let him alone and watch. If
any positive

behavior is displayed, appreciate him for it, and gives him cuddle if ok with
then advice and give

hope.
Although Researchers continue to investigate the factors that may make
some people more

susceptible to emphysema than others, there are some clear causes of

emphysema such as

smoking. It is also important to know that individual’s lifestyle choices have a

significant impact

on health. A 63 years old person can be healthier than a 25 year old person
from emphysema, it

all take our social, emotional and behavioral role. Bad luck but say the truth
emphysema can

not be cured, however by providing good communication in relation to these

individual’s

lifestyle choices, emphysema can be modified to improve health status.

Bibliography

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