|Type of paper:||Essay|
|Categories:||Teaching Medicine Healthcare Substance abuse|
Chronic Obstructive Pulmonary Disease (COPD) is a common lung disease that causes difficulty in breathing for its patients. The leading risk factor that causes COPD is smoking, and other people can get the disease after being exposed to air pollution, dust, and chemical fumes for a long time. The teaching plan provides insight into COPD through a patient who has the disease and provides the expected outcomes when handling the disease. From the teaching plan, the patient can learn to do basic tests by themselves without the assistance of a medical practitioner so that they can monitor their progress and stay vigilant in improving their health.
The patient, J.M., is a 68-year-old male who was brought to the hospital by his daughter when he could not any longer put his shoes on because of increased weakness, fatigue, and swelling in his ankle. Patient J.M. weighs 189 lb. and is 62 inches in height. He has a heart rate of 95, and his blood pressure is at 154/90. From an oral examination, patient J.M. recorded 99 degrees F but did not mention any pains in his body resulting from his condition. The patient also does not have any known drug allergies. In his past medical history record, patient J.M. has had Alzheimer's, Rheumatics arthritis (R.A.), macular degeneration, congestive heart failure, and COPD. COPD is a cause of disability and interferes with the ability of the patient to do routine activities like walking, as seen in patient J.M.
Patient Learning Need
COPD is a progressive disease, that is, it develops slowly in patients, becoming worse with time. It is pertinent that the patient learns how they can manage the disease once they are diagnosed. COPD can manifest itself as emphysema where the walls in the air sacs are damaged, or chronic bronchitis where the lining of the airways are inflamed and thick mucus is formed in the lining hindering breathing (Postma & Rabe, 2015). Hillas et al. (2015) identify that the challenge of managing COPD is brought about by the comorbidities that come along with COPD since they increase the severity of the disease. The common COPD comorbidities include lung cancer, atrial fibrillation, pancreatic cancer, breast cancer (in women), ulcers, diabetes, liver cirrhosis, and anxiety (Hillas et al., 2015). The patient needs to learn more about the COPD so that he can avoid the risk factors and consciously work towards making his condition better. Many people do not like burdening others into continually caring for them or doing things for them. The patient, J.M., can, therefore, be taught some essential breathing diagnosing skills so that he can do the tests regularly while at home and monitor the progression of the illness without having to go to a medical facility.
To handle COPD and its comorbidities, patient J.M. should embark on the following objectives religiously. First, he should make lifestyle changes to slow the progression of COPD. As indicated earlier, there is no cure to the disease, and it becomes worse with time. However, with the right way of living, the fatalities of the disease can be significantly reduced. The most important lifestyle change is listing and avoiding the causative factors of the disease, that is, lung irritants. Patient J.M. should avoid smoking at all costs as well as avoid areas that have high levels of air pollution. The eating patterns should also be adjusted to accommodate smaller meals eaten frequently and taking supplements for the foods. The patient can make a timetable of his feeding times and what is to get consumed at that time. The patient should do physical activities to strengthen his muscles, but he should not take on actions that will be dangerous to his health because of his condition. It is, therefore, advisable that he runs the operations he wishes to do with the medical practitioner first before embarking on them.
The second objective is to manage the disease and its symptoms. Management of COPD can get done through treatment and therapy options. Patient J.M. should schedule regular check-ups with the doctors and consume the medications provided as they should. The patient can ask his family members and friends to assist him with some activities, but for others, he can adjust himself to do. For instance, he could put all the items he needs in one place, which he can access quickly and wear loose clothes and shoes that are easy to get into and remove. Also, the patient should learn how to do his activities slowly so that they will need less oxygen in performing those activities.
Thirdly, the patient should be able to prepare for emergencies. Patients may experience severe symptoms when they least expect them. Such symptoms may be difficulties in breathing, lips, and fingernails turning blue/grey, rapid heartbeat, and mental disorientation (NIH, 2020). The patient should make a list of the doctor's contact, who should be alerted as soon as the emergencies occur. The patient and his loved ones should also have numbers to a nearby hospital and a list of the medication that the patient is taking in handy. Financially, COPD is draining to the patient and his caregivers. Hospitalization for COPD patients accounts for about 87% of the total costs of managing the disease (Price et al., 2014). Patient J.M. and his caregivers should, therefore, have some emergency money put in place to support the patient when emergencies occur.
Patient J.M. has had several medical conditions in the past that may have affected his overall immune system. Despite that, he has been reluctant to quit smoking, and this is the greatest contributor to his failing health condition. Using spirometry, the patient's breathing can be assessed to determine the progress of the illness and whether the treatment provided is effective. The patient reported that he has significantly reduced the number of cigarettes in a day but needs to do more for the sake of his health. The patient needs to understand that the effects of his COPD do not only affect him, but they also impact his family members who take care of him daily. The patient also needs to believe in himself and commit to a support group that can assist him in quitting smoking. Finally, the patient may consider options like surgery if the medications do not combat the severity of the disease. In operation, the patient can have a lung transplant, bullectomy, or have a lung volume reduction surgery (NIH, 2020). The patient should be well informed of risks that may occur when such surgeries are performed and the benefits of each.
Short and Long Term Goals
The first short term goal for the patient is to create a workout schedule. The workout schedule will help the patient to remain physically active and, at the same time, keep fit. The physical activities should be limited by the doctor so that the patient cannot do anything that will harm their body during the exercises. Another short term goal is to improve the breathing of the patient through oxygen therapy. A patient with COPD experiences shortness of breath, and this can limit their energy to do many things. Therefore, using oxygen masks or nasal prongs, a patient can do more tasks and have improved alertness. Oxygen therapy can also help the patients to sleep better and live longer. As a long term goal, the patient can receive emotional support from the caregivers, family, and friends to help them cope with the psychological challenges that result from having COPD. The patient may have anxiety, stress, or depression resulting from having the disease and constant communication, and, in extreme cases, the medication can help the patient to learn how to cope with the disease and its impacts (NIH, 2020).
Teaching Intervention and Rationale
The patient required a lot of care and attention owing to the severity of the illness. After going through the medical records, the patient shared his experience and what he had been doing that could have encouraged or discouraged the severity of the disease. The patient was taken through the causes of the disease so that he could understand what he was supposed to avoid and the actions he was supposed to take to slow the progression of the disease. For better understanding, pictures and charts were used to create a vivid impression on the patient.
Evaluation of Learning
To ascertain that the patient had understood his lessons, he was asked to state the causative factors, signs and symptoms, and treatment options of the disease. He was also requested to show how he would check his pulse and how he would monitor his breathing to detect any notable changes that would warrant a doctor's visit. The patient was supposed to send results of his physical activities, eating records, and his pulse rate every other day of the week to the medical practitioner for supervision. The results of the records would help the doctor ensure that the objectives and the goals of the teaching plans are achieved, and the patient can manage his COPD without any complications.
As indicated earlier, there is no cure to the disease, and it becomes worse with time. However, with the right way of living, the fatalities of the disease can be significantly reduced. Many people do not like burdening others into constantly caring for them or doing things for them. The patient, J.M., can, therefore, be taught some essential breathing diagnosing skills so that he can do the tests regularly while at home and monitor the progression of the illness without having to go to a medical facility.
Hillas, G., Perlikos, F., Tsiligianni, I., & Tzanakis, N. (2015). Managing comorbidities in COPD. International journal of chronic obstructive pulmonary disease, 10, 95. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293292/
NIH (2020). COPD. U.S. Department of Health and Human Services. https://www.nhlbi.nih.gov/health-topics/copd
Postma, D. S., & Rabe, K. F. (2015). Asthma-COPD overlap syndrome. New England Journal of Medicine, 373(13), 1241-1249. https://www.nejm.org/doi/full/10.1056/NEJMra1411863
Price, D., West, D., Brusselle, G., Gruffydd-Jones, K., Jones, R., Miravitlles, M., & Bichel, K. (2014). Management of COPD in the U.K. primary-care setting: an analysis of real-life prescribing patterns. International journal of chronic obstructive pulmonary disease, 9, 889. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154894/
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