References

Goals for Patient Teaching

Teaching Plan for
Lewis, S. L., Bucher, L., Heitkemper, M. M., &
Harding, M. M. (2017). Medical-surgical
Patient and caregiver will work together to
nursing: assessment and management of
clinical problems (10th ed.). St. Louis, Chronic create a plan that will help the patient to
avoid environments in daily life that can
MO: Elsevier, Inc.
Obstructive lead to COPD exacerbations .

Pulmonary Disease
Mayo Clinic Staff Print. (2016, July 12). COPD.
Retrieved February 23, 2017, from http:// Patient and caregiver will create a plan to
www.mayoclinic.org/diseases- assist patient in the goal to quit smoking in
conditions/copd/symptoms-causes/dxc- order to prevent disease progression
20204886
Patient will understand which medications
are used for short term, acute
exacerbations and will demonstrate use of
rescue inhaler.

Teach patient about prescribed

medications as well as treatment options
and assist patient in finding accurate
information about the disease and
treatment online. Assess for patient
understanding of treatment plan.

Purpose: to empower Ms. Bloomfield

with understanding of condition and
treatment options.
 Your Condition
What causes COPD?
Chronic Obstructive Pulmonary disease is a lung
disease in which inflammation makes it difficult for inhaled air
to escape the lungs. Inflammation can occur in the airways,
bronchioles and alveoli, and pulmonary blood vessels (med
surg p.559). The products of inflammation, such as mucus
hypersecretion, mucosal edema, and bronchospasm, cause the
lungs to lose their elasticity so that they cannot recoil or push
air back out of the lungs (p.559).
Why should we care?
In the book Medical Surgical Nursing: Assessment
and management of clinical problems by Lewis, Bucher,
Heitkemper ,and Harding it says that it is estimated that there
are around 12.7 million people above age 18 that are
diagnosed with COPD in the US but that number is largely
underestimated due to the fact that the disease goes
undiagnosed until it is advanced. The book also goes on to say
that COPD is the third leading cause of death in the US with
over 133,000 deaths each year (2017, p.557). Due to these
many incidences, we see that this is a very serious condition
that must be taken seriously. The good news is that this
disease is preventable and can be treated.
What are the risk factors?
There are several things that can put patients at
risk for developing COPD. Some of these risk factors include:
Cigarette smoking, exposure to occupational chemicals and
dust, air pollution, genetics, and recurring respiratory tract
infections. (Lewis, Bucher, Heitkemper, & Harding, 2017,
p.558)
Impact of COPD
COPD can cause serious complications in the
patient and strain on caregivers and loved ones. Some of these
complications include: respiratory infections, heart problems,
lung cancer, high blood pressure in lung arteries, and
depression due to inability to enjoy activities that require
exertion (Mayo Clinic Staff, 2016)
Your Ambulatory/Home Care Environment
The major environmental concern that has already been
addressed as a major contributing factor for you, Ms.
Bloomfield, is the habit of smoking. This is a major
contribution and by limiting the amount of time spent
smoking as well as the packs per day smoked, the risks
for serious effects of COPD can be dramatically
decreased.
Another possible contributing factor to the progressing
disease is the environment in which you, Ms. Bloomfield,
spend time taking astrophotos. One of the risk factors we
previously mentioned is occupational chemicals and dust
(including wildfire smoke). When you travel to the
country, you are exposed to smoke from nearby
wildfires. As you previously stated, these wildfires have
been exacerbating your cough which is good evidence to
the fact that it is contributing to the inflammation which
is causing your COPD. The risk for COPD increases if a
person has both occupational exposure and a habit of
smoking (Lewis, Bucher, Heitkemper, & Harding, 2017,
p.558).
Interventions
The first thing that would be useful for you to do, Ms.
Bloomfield would be to quit smoking. You have already
begun to work on this goal and have decreased your
amount of smoking to only 10 cigarettes per day. If you
continues to decrease the amount you smoke until you
can eventually quit altogether, the rapid decline in
pulmonary function you are experiencing will slow.
The sooner you are able to stop, the less damage will
be done to your lungs and your cough and sputum
production will decrease (Lewis, Bucher, Heitkemper,
& Harding, 2017, p. 562).
Along with smoking cessation, another thing that can
be done is to try to avoid taking astrophotos in areas
where there is a high amount of pollution or smoke or
check the news for areas that have experienced
wildfires and avoid these areas.
A third intervention that can be done to help with
your condition is to adhere to the recommended
drug therapy prescribed by the doctor. The
medications that have been prescribed for you can
reduce symptoms, increase exercise capacity,
improve overall health, and reduce the number and
severity of exacerbations (Lewis, Bucher,
Heitkemper, & Harding, 2017, p. 562).
A final possible intervention would be to use proper
breathing and coughing techniques to assist with
airway clearance and decrease strain on accessory
muscles. (Lewis, Bucher, Heitkemper, & Harding,
2017, p..568)