The Chronic Care Model. In an estimated 5. Most of these patients would prefer to die at home, not only because of comfort concerns, but due to the higher quality of care that tends to be provided by informal and paid caregivers in this setting reviewed…… [Read More] Eloniemi-Sulkava and colleagues evaluated patients at baseline using the Barthel Index and Neuropsychiatric Inventory NPI see Appendix.
COPD is not a disease, but rather, a collection of more specifically diagnosed medical conditions such as bronchitis and emphysema. Patients diagnosed with COPD tend to be older because it takes time for symptoms to evolve; average age of first diagnosis is 40 Cherney, The patient in question is 64 years old, a white male living at home in the end stages of COPD.
His personal hygiene and ability to cope with daily life have both decreased significantly, and he is in need of almost continual care.
Patient needs including total smoking cessation, medical interventions, doctor-supervised exercise, and psychological treatments.
The patient needs to take care to avoid loneliness and isolation, and social networks will be important. The nurse practitioner in charge of the patient's case can ensure the patient is aware of all the resources available in the community.
Cultural issues in this case include the fragmentation of the family, poor communication between family members, and lack of support.
Barriers to care include patient resistance to lifestyle change, patient resistance to smoking cessation, and lack of social support. Clinical Evaluation General considerations include providing effective palliative care for the patient.
Being at home ensures that the patient is comfortable and has access to some social support including neighbors who can alleviate some of the isolation and loneliness that might occur if the patient were in a facility.
The goals of care should be to maximize patient comfort and well-being, particularly paying attention to physical and psychological needs as well as any spiritual needs.
The patient can be regularly encouraged to take fresh air and mild to moderate exercise like walking, and to take advantage of smoking cessation methods that might prolong life or enhance its quality.
The inability to breathe properly is the primary cause of concern, which is why all efforts must be made to provide the patient with medical tools and medications such as bronchial dilators.
Assessment tools that can be used include pulse oximetry, diffusing capacity for carbon monoxide DLCOspirometry and other pulmonary function tests, and measuring arterial blood gas Han, et al. Physical findings will depend on the outcome of these assessment tests, and psychological findings will depend on the medical team that should include psychologists.
The medical team may also need to determine whether there are other conditions or diseases present, which may impact the treatment plan. Management The plan of care for the patient will include ongoing assessments of patient lung functions, but also assessments of air quality inside the patient's house.
Pharmacological interventions may eventually include the use of opioids to reduce dyspnea, and which in turn will impact patient sense of well-being.
However, side effects may be a concern. Oxygen therapies, including both short burst oxygen therapy and long-term oxygen therapy, may or may not benefit the patient.
Non-pharmacological interventions may be especially important for improving quality of life for the patient. Exercise programs should be designed by specialists, requiring the use of a referral to a physical therapist specializing in respiratory problems.
The nurse practitioner may monitor patient responses. Breathing exercises are known to be helpful for some patients, as are humidifiers or air purifiers in the home Nall, Depending on the climate where the patient lives, outdoor time may or may not need to be regulated. If the patient becomes open to quitting smoking, then a variety of psychological tools may be useful and the patient's quality of life may improve.
Other referrals may include the use of psychologists for patients who are experiencing depression and family therapy to include end-of-life issues. The interdisciplinary team will include the primary care physician and related pulmonary specialists, nurse practitioners, psychologists, and physical therapists, as well as persons trained in the use of oxygen therapies.
As leader, the APRN takes charge of the interdisciplinary team, coordinating meetings and ensuring timely interventions and responses to patient and family concerns.
The APRN also acts as informer and educator for patient and family. Emerging literature may reveal new treatments, and the APRN can inform the patient of those new treatments. The APRN is also a clinician who performs direct activities like assessments, diagnoses, monitoring, and provision of treatments.
As case manager, the APRN monitors patient progress and organizes future assessments and referrals. The first is a classic case study of a year-old African-American female.
The case study is significant not only because of her young age but because of her having received a lung transplant, something that has not yet been recommended for our patient but might if the medical team determined that his prognosis would improve and if he would quit smoking.Chronic obstructive pulmonary disease (COPD) is a condition in which the airways in the lungs become damaged, making it difficult for air to flow in and out.
Symptoms of the disease include shortness of breath, low oxygen in the blood, cough, pain, weight loss and risk of lung infections. Jan 31, · As the National Organizatoin of Nurse Practitioner Faculty (NONPF, ) competencies indicate, full spectrum of health care services should include health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, palliative care and end of life care.
Aspects Of Discharge Planning Nursing Essay. FOR MR SMITH’S SEVERE COPD. This assignment looks at the communication strategies to support and empower the patient living with COPD, a Long Term Condition (LTC) and their Significant Others when Planning their Discharge from Hospital.
|Palliative Care Essays: Examples, Topics, Titles, & Outlines||Advance care planning Management of dyspnea In majority of patients with end-stage COPD, the dyspnea becomes refractory to medications.|
|NICE | The National Institute for Health and Care Excellence||Just how much of the human experience is determined before we are already born, by our genes, and how much is dependent upon external environmental factors?|
These include chronic obstructive pulmonary disease (COPD), Alzheimer’s disease,and acute massive cerebrovascular accident, to name a few. Palliative Care is a team effort THREE FORMS OF PALLIATIVE CARE. Healthcare, an international, peer-reviewed Open Access journal.
Case history: Mr. Russell Halbert was a year-old male with a one hundred pack year history of smoking, Chronic Obstructive Pulmonary Disease (COPD).