Comprehensive Nursing Care Plan for Chronic Obstructive Pulmonary Disease (COPD)

 **Comprehensive Nursing Care Plan for Chronic Obstructive Pulmonary Disease (COPD)**

**Patient Information:**

- **Name:** [Insert Name]

- **Age:** [Insert Age]

- **Gender:** [Insert Gender]

- **Date:** [Insert Date]

- **Nurse:** [Insert Name]

### **Assessment**

#### **Subjective Data:**

- Patient reports shortness of breath (dyspnea), especially with exertion.

- Complains of persistent cough with sputum production.

- States increased fatigue and difficulty performing daily activities.

#### **Objective Data:**

- Respiratory rate: [Insert Value] breaths/min

- Oxygen saturation: [Insert Value]% on room air

- Lung auscultation reveals wheezing and diminished breath sounds.

- Barrel chest observed on inspection.

- Use of accessory muscles for breathing.

- Arterial blood gases (if available): [Insert Results]

- Chest X-ray: [Insert Findings, e.g., hyperinflation, flattened diaphragm]

### **Nursing Diagnoses**

1. **Ineffective Airway Clearance** related to excessive mucus production and bronchial constriction as evidenced by wheezing and productive cough.

2. **Impaired Gas Exchange** related to alveolar-capillary membrane changes as evidenced by hypoxemia and dyspnea.

3. **Activity Intolerance** related to imbalance between oxygen supply and demand as evidenced by fatigue and shortness of breath during activities.

4. **Anxiety** related to difficulty breathing and fear of suffocation as evidenced by restlessness and patient statements.

### **Goals and Outcomes**

#### **Short-Term Goals:**

- Patient will demonstrate effective airway clearance as evidenced by improved breath sounds and decreased sputum production within 24 hours.

- Patient’s oxygen saturation will remain above 90% with supplemental oxygen as needed during hospitalization.

#### **Long-Term Goals:**

- Patient will verbalize understanding of COPD management strategies, including medication adherence and breathing exercises, by discharge.

- Patient will engage in light activities of daily living (ADLs) with minimal fatigue within one week.

### **Interventions and Rationales**

#### **1. Ineffective Airway Clearance:**

- **Intervention:** Encourage fluid intake of 2-3 liters/day if not contraindicated.

  - **Rationale:** Hydration helps thin mucus, making it easier to expectorate.

- **Intervention:** Perform chest physiotherapy and postural drainage as prescribed.

  - **Rationale:** Helps mobilize secretions and improve airway clearance.

- **Intervention:** Administer prescribed bronchodilators and mucolytic agents.

  - **Rationale:** Relaxes bronchial muscles and reduces mucus viscosity.

#### **2. Impaired Gas Exchange:**

- **Intervention:** Monitor oxygen saturation and arterial blood gases regularly.

  - **Rationale:** Provides data on the effectiveness of oxygen therapy and ventilation.

- **Intervention:** Position the patient in high-Fowler’s or tripod position.

  - **Rationale:** Optimizes lung expansion and reduces work of breathing.

- **Intervention:** Administer low-flow oxygen therapy as prescribed.

  - **Rationale:** Prevents hypoxemia without suppressing the respiratory drive.

#### **3. Activity Intolerance:**

- **Intervention:** Encourage the patient to perform activities in short intervals with rest periods.

  - **Rationale:** Conserves energy and prevents overexertion.

- **Intervention:** Collaborate with physical therapy to develop a pulmonary rehabilitation plan.

  - **Rationale:** Gradual activity improvement enhances endurance and functional capacity.

- **Intervention:** Teach the patient to use pursed-lip breathing during exertion.

  - **Rationale:** Promotes effective ventilation and reduces dyspnea.

#### **4. Anxiety:**

- **Intervention:** Provide reassurance and educate the patient about the condition and treatment plan.

  - **Rationale:** Reduces fear and enhances coping.

- **Intervention:** Encourage relaxation techniques such as deep breathing exercises.

  - **Rationale:** Helps reduce anxiety and improves respiratory function.

- **Intervention:** Maintain a calm environment with minimal noise and interruptions.

  - **Rationale:** Promotes relaxation and reduces stress.

### **Evaluation**

- Patient demonstrates effective airway clearance with decreased wheezing and productive cough.

- Oxygen saturation levels are maintained within the target range.

- Patient reports reduced dyspnea during light activities and exhibits improved tolerance to ADLs.

- Patient verbalizes reduced anxiety and demonstrates proper breathing techniques.

### **Education and Discharge Planning:**

- Teach the patient the importance of smoking cessation if applicable.

- Provide instructions on the correct use of inhalers and nebulizers.

- Educate on recognizing early signs of infection or exacerbation and when to seek medical attention.

- Encourage adherence to a prescribed exercise program and dietary

 recommendations.

- Provide resources for support groups or pulmonary rehabilitation programs.