Management of Patients with Chronic Pulmonary Disease

Management of Patients with Chronic Pulmonary Disease

Case study 1

How should the nurse explain to the patient and family the pathophysiology of bronchiectasis as it is related to the symptoms the patient is experiencing?

This is a persistent sickness that manifests itself in phases. The bronchial walls thicken and become irritated. Frequent bronchial illnesses are observed in the individual, indicating bronchiectasis. Infections will appear and disappear on a regular basis. He has recently discovered clubbing of fingers as a result of this persistent sickness.

How should the nurse explain to the patient and family the goals of medical management that may be used to treat bronchiectasis?

Medications will be administered if the illness is bacterial. Piroxicam is a kind of medication that can also be used to alleviate inflammation. To address bronchospasm and ease the breathing process, the physician may prescribe an atomizer or hand-held equipment.

What does the nursing management for bronchiectasis entail?

Maintaining proper dental cleanliness, oxygen treatment, and a healthy balance of relaxation and exercise. Administer medications exactly as indicated. Allow ample time for the sufferer to complete meals, or serve small, regular foods to ensure appropriate nourishment.

Case study 2

Explain the medications to the patient and practice filling in the asthma action plan.

The green zone section- The optimum maximal stream is 400 liters per second., while the optimum stream at 80 percent is 320 liters per second. The physician evaluates with the patient that when the patient’s maximum flow metre reading before taking medicines every day is in this zone and the individual has zero asthmatic complaints, then the patient’s asthma is in management.

Salmeterol (Serevent)- 50 mcg per Twelve hrs., at 8 a.m. and 8 p.m. The physician adds that this drug is a long-term beta 2-adrenergic activator that works for 12 hrs. to calm the bronchi’s flexible tissues. It may not be administered in the event of an asthma exacerbation. The physician could double-check that the atomizer is appropriately marked, with a green label for medications in the green region.

Fluticasone (Flovent)- 2 breaths per Twelve hrs, at 8 a.m. and 8 p.m. The physician adds that this drug is an administered corticosteroid which is intended to reduce bronchial irritation. To avoid a candidiasis, you should constantly wash your mouths with water and rinse at the rear of your throats before spitting it out.

Cromolyn sodium (Nasal Crom)- 1 spritz to every nostril once a day and prior exposure to recognized asthma causes. You can apply the spritz every four hours. Nasal Crom helps to keep mast cells stable. When an individual is exposed to an allergy, the mast cells get activated, causing inflammatory and tightness or stiffening of the airways. The nurse goes over the next section of the activity program with the patient, which contains several possible causes for asthma crises in order to evaluate for recognized causes. The physician advises the patient to administer the Nasal Crom up to every four hours in a 24-h cycle prior to being subjected to a recognized cause.

The yellow zone section- The maximum flowing limit for the 50-79 percent of the optimum maximal stream is 200 to 319 liters per second. The practitioner directs the patient that if the maximal stream quantification is in this spectrum or the patient has the signs mentioned on the asthma activity scheme; the patient must administer albuterol, a fast-acting beta-2 agonist that speedily thickens the seamless musculature of the airways, in addition to the long-run control medication. Because albuterol is an emergency nebulizer, the physician may apply a red and yellow label to notify the patient in which region of the activity program to utilize this nebulizer. 

 If the difficulties persist or the maximal stream gauge reading does not revert to the green region within two days, the patient should consult a practitioner.

The red zone section- The maximal stream limit is lower than 50 percent, or 200 litres per second. The physician goes over the patient’s signs if they were in this region or if their peak stream gauge was lower than 200 litres per second.

 The patient would instantly take four breaths of albuterol, and if little progress to the yellow or green region is detected after 15 mins, the patient should contact the practitioner.

Explain ways to evaluate the patient’s mastery of the content?

• Have the patient describe the asthma management program in her personal terms to the physician.

• Ask the patient to illustrate how to utilize the spacer with an atomizer.

• Have the patient illustrate how to use the peak flow gauge and analyze the results.