BRIGHAM YOUNG MEDICAL CENTER

May 31, 2018

Healthcare Statement
Allison Bloomfield
Date of Birth: January 30, 1980

It was a pleasure to meet with you the other day. This letter summarizes what was discussed in
regards to your recent diagnosis of chronic obstruct pulmonary disease (COPD). COPD is
generally characterized as chronic airflow limitation to the lungs. This limitation occurs when
there is inflammation in the airways and pulmonary blood vessels, creating a constriction (Lewis,
Bucher, Heitkemper, & Harding, 2017). The constriction makes it difficult to breathe and
continue on with daily living. Lewis, Bucher, Heitkemper, and Harding identified several
different causes for COPD including: cigarette smoking, occupational chemicals and dusts, air
pollution, infection, genetics, gender, asthma, and aging (2017).

When left untreated, COPD can have affects that should be looked out for. COPD causes
discomfort and shortness of breath; this may lead you to finding yourself taking the elevator
instead of the stairs, walking shorter distances, and anything that involves decreasing activity due
to fatigue and possible anorexia (Lewis, Bucher, Heitkemper, & Harding, 2017). You may find
yourself constantly leaning forward with your arms braced against your knees, chair, or bed to
help ease the effort of breathing (Jarvis, 2016). Although COPD is treatable, there are factors that
make the disease difficult to control. Cigarette smoking plays a significant role in management
of the disease. In your case specifically, the amount of time you spend outside near wildfires will
play a major role in how your disease progresses. Outdoor pollutants, dusts, and fires will make
it difficult to control exacerbations (Lewis, Bucher, Heitkemper, & Harding, 2017). With
astronomy being an important aspect of your life, some difficult changes may lie ahead.

During our meeting we identified some goals we would like you to meet before your next visit in
3 weeks. As a reminder they are as follows (Gulanick & Myers, 2014):
1. Will report back a higher tolerance to physical activity and experience fewer acute
episodes as shown by stable vital signs.
2. Daily smoking will be reduced to 1 cigarette per day. Within 5 weeks, there will be no
smoking desire/actions. This can improve conditions and undesirable symptoms.
3. Will have proper understanding of management in case of acute episodes as shown by
proper knowledge and demonstration on how to use newly prescribed medications
(bronchodilators).
4. Will be able to properly demonstrate and teach pursed lip breathing, huff coughing, and
symptoms of a worsening condition. This will ensure adequate knowledge to keep your
condition controlled.
In order to help meet these goals, here are some tips on how to help achieve them as you
continue on with your life:
 Continue to work towards quitting smoking. Studies show that the sooner one is able to
quit smoking, the quicker they will see improvements related to COPD (Lewis, Bucher,
Heitkemper, & Harding, 2017). There are different programs that can aid you in quitting
and if needed, discuss your different options with your doctor.
 BRIGHAM YOUNG MEDICAL CENTER
 Properly follow the medication regimen that has been provided to you by your doctor.
Bronchodilators make it easier for your body to be able to breathe by causing proper
muscle relaxation in the lungs (Jarvis, 2016). Proper use of medications can improve
daily living and acute exacerbations.
 There are things that can be done within the comfort of your own home. We went over
proper technique for huff coughing and splinting. These techniques will help to move
secretions within your body and will eventually rid of them (Gulanick & Myers, 2014).
The movement and removal of secretions will improve breathing and help make it more
effortless.
 Pursed-lip breathing is another technique that can be done wherever you are. This
technique allows you to be able to more effectively exhale. Proper exhalation will
discourage carbon dioxide retention (Gulanick & Myers, 2014). This will be especially
useful during any physical activity.
 Exercise and movement will allow promote movement of secretions (Gulanick & Myers,
2014). The movement of secretions will help to improve breathing during activity and
rest. Ensuring safe amounts of activity will lead to a healthier lifestyle. The appropriate
amount of exercise for you should be discussed in greater detail with your primary health
care provider.
 Ensuring the proper amount of liquids is important in keeping the secretions loose in your
body. It will minimize thickness and make them easier to remove from the body. You
should be aiming to drink 2-3 liters of fluids a day (Lewis, Bucher, Heitkemper, &
Harding, 2017). While most liquids can do the job, water is the best source of liquid for
your body and will lead to the best results.

Please notify us if you have any questions. We look forward to meeting with you in 3 weeks.

Best regards,
Briana, RN

COPD trivia:
 An estimated 12.7 million adults in the United States over age 18 have COPD.
 An additional 24 million people have evidence of impaired lung function. The number of people
with COPD is greatly underestimated because the disease is usually not diagnosed until it is
moderately advanced.
 COPD is the third leading cause of death in the United States, resulting in more than 133,000
deaths in Americans each year
 COPD occurs more in men than in women, however, the number of women with COPD is rising
due to the increase in use of cigarettes.
(Leiws, Bucher, Heitkemper, & Harding, 2017)
 BRIGHAM YOUNG MEDICAL CENTER
References

Gulanick, M. & Myers, J.L. (2014). Nursing care plans. (8th ed.). Philadelphia, PA: Mosby.

Jarvis, C. (2016). Physical Examination & Health Assessment, 7th Edition. St. Louis, MO:

Elsevier

Lewis, S. L., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2017). Medical-Surgical

Nursing: Assessment and Management of Clinical Problems, 10th Edition. St. Louis,

MO: Elsevier.