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After 8 hours of Nurse-PatientSignificant others interaction. The patient-significant others will be able to acquire nowledge, skills and attitude in the care of patient with : Chronic Obstructive Pulmonary Disease Specific Objectives After 2 hour of nursepatient-significant others interaction, the patient-significant others will be able to: 1. Define : Chronic Obstructive Pulmonary Disease

After 1 hour of nurse-patientsignificant others interaction, the patient-significant others will be able to: Also known as, chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD), chronic airflow limitation (CAL) and chronic obstructive respiratory disease (CORD), is the occurrence of chronic bronchitis or emphysema, a pair Definition of COPD is very important as to not misconcept COPD with other diseases Informal discussion Cooperative learning Visual aids Manila paper Starting an informal discussion will help build rapport. 10 mins At PICU Manila Paper Pentel Pen

Define Chronic Obstructive Pulmonary Disease

of commonly co-existing diseases of the lungs in which the airways become narrowed

2. Identify the risk factors of Chronic Obstructive Pulmonary Disease

Exposure to tobacco smoke Occupational exposure to dusts and chemicals Age. Genetics Oxidative stress Environment Nutrition Socio-economic status

It is an important part of the lecture to be able to identify what caused COPD in the client.

Lecture Visual aids Images

For easy understanding of the subject.

15 mins At PICU Pictures

Identify the risk factorrs of Chronic Obstructive Pulmonary Disease

3. Enumerate the signs and symptoms of Chronic Obstructive Pulmonary Disease

tachypnea, a rapid breathing rate wheezing sounds or crackles in the lungs heard through a stethoscope breathing out taking a longer time than breathing in enlargement of the chest, particularly the front-toback distance (hyperaeration) active use of muscles in the neck to help with breathing breathing through pursed

For supplemental knowledge.

Formal discussion In this phase of Powerpoint teaching we will need a more serious interaction. To gain full attention of the patient and the SO

20 mins. AT PICU Manila Paper Images

Enumerate the signs and symptoms of Chronic Obstructive Pulmonary Disease

lips increased anteroposterior to lateral ratio of the chest (i.e. barrel chest). 4. Show awareness of the disease condition Management Bronchodilators Bronchodilators are medicines that relax smooth muscle around the airways, increasing the calibre of the airways and improving air flow. They can reduce the symptoms of shortness of breath, wheeze and exercise limitation, resulting in an improved quality of life for people with COPD.[49] They do not slow down the rate of progression of the underlying disease.[4] Bronchodilators are usually administered with an inhaler or via a nebulizer. Anticholinergics Anticholinergic drugs cause airway smooth muscles to relax by blocking stimulation from cholinergic nerves. Ipratrop ium provides short-acting rapid relief of COPD symptoms. Tiotropium is a longacting anticholinergic whose regular use is associated with Since the patient already acquired COPD. We prioritize management than prevention. Formal Discussions Powerpoint Quiz Pharmacological : Health Teaching Management of COPD is a very important knowledge. For it will be done wrong, the patient might die. 30 mins. At PICU Laptop Yellow Paper Ballpen Shows awareness of the disease condition

improvements in airflow, exercise capacity, and quality of life. Ipratropium is associated with increased cardiovascularmorbidity.[52] While tiotropium in pill form reduces the risk of all cause mortality, cardiovascular mortality and cardiovascular events[53] that in mist form increases mortality.[54 Corticosteroids Corticosteroids are used in tablet or inhaled form to treat and prevent acute exacerbations of COPD. Well-inhaled corticosteroids (ICS) have not been shown to be of benefit for people with mild COPD, however, they have been shown to decrease acute exacerbations in those with either moderate or severe COPD.[55] They however have no effect on overall oneyear mortality and are associated with increased rates of pneumonia.[43] Other medication Antibiotics (specifically macrolid es such as azithromycin reduce

the number of exacerbations in those who have two or more a year.[56] Supplemental oxygen Supplemental oxygen or oxygen therapy can improve oxygen saturation levels, allowing patients with COPD or low oxygen levels to maintain their mobility and increase their ability to complete activities of daily living (ADL), such as exercise, household chores, shopping, etc. Long-term oxygen therapy for at least 16 hours a day can improve the quality of life and survival for people with COPD and arterial hypoxemia or with complications of hypoxemia such as pulmonary hypertension, cor pulmonale, or secondary erythrocytosis.[57] Hig h concentrations of supplemental oxygen can lead to the accumulation of carbon dioxide andrespiratory acidosis for some people with severe COPD; lower oxygen flow rates are generally safer for these individuals. Another safety issue concerning the use of oxygen for patients with COPD is smoking, because oxygen can act as an oxidizing

agent. Other measures Pulmonary rehabilitation is a program of exercise, disease management and counselling coordinated to benefit the individual.[58] Pulmonary rehabilitation has been shown to improve shortness of breath and exercise capacity. It has also been shown to improve the sense of control a patient has over their disease as well as their emotions Prevention Annual influenza vaccinations and pneumococcal vaccinations. Smoking cessation Occupational Health Air pollution 5. Express his feeling for the plan of care Help the patient and SO to This will express their feelings towards the help us plan of care evaluate if the patient and SO will cooperate in the plan of care and if Informal Discussion For the patient and SO, to be able to express their feelings more. 10 mins. At PICU Express his feelings for the plan of care?

there would be some modification s needed.

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