Assessment: Chronic Obstructive Pulmonary Disease (COPD) using home oxygen

Assessment: Chronic Obstructive Pulmonary Disease (COPD) using home oxygen

Assessment: Chronic Obstructive Pulmonary Disease (COPD) using home oxygen

Assessment: Chronic Obstructive Pulmonary Disease (COPD) using home oxygen Guidelines

This is a 2,500 word assignment:

Chronic Obstructive Pulmonary Disease (COPD) using home oxygen

Patient : Mrs Parmar (COPD)

History

Sangita Parmar is a 65 year old female; she is widowed and has no children. She was diagnosed with COPD 8 years ago, initially she thought her recurrent cough was a smoker’s cough; she suffers from recurrent acute chest infections in the winter months. She currently smokes 20 cigarettes a day and has done for 30 years, she has however quit on several occasions but struggles to maintain this. She lives alone and until last year worked in a local café but her health has now forced her to stop working due to frequent periods of recurrent chest infections and breathlessness. Her BMI is 17. She has been getting increasingly breathless and her GP has evaluated her due to her failing respiratory function (respiratory rate of 28 and oxygen saturation of only 88% on air) and has now decided that she requires emergency hospital admission for further assessment (arterial blood gases, chest x-ray, ECG) and medical management (oxygen, bronchodilators, oral corticosteroids) and physiotherapy to improve respiratory function.

Mrs Parmar was stabilised in ED and transferred to the Respiratory ward for 12 days following her admission where she was given low dose oxygen, nebulisers (Salbutamol) oral steroids and antibiotics for her chest infection. Once stabilised and her course of antibiotics were completed Mrs Khan was discharged home, her discharge was slightly delayed due to the organisation of the package of care she now required to support her at home due to her recent hospital admission, with referrals to social services, occupational therapy, dietitian, physio and her local community COPD nurse specialist and palliative care input. Mrs Khans COPD has advanced and she now requires more support and monitoring out in the community to live at home.

A – E assessment on admission to ED

Some points to consider in your assignment however you do not have to cover all of them in your written summative piece of work

• COPD may be mild moderate or severe, how can you differentiate between these?
• What factors influence whether a person with COPD should be treated in hospital or at home?
• Whilst in hospital, Mrs Parmar is prescribed bronchodilator therapy and commenced on oral corticosteroids. Explore the action and side effects of these commonly used drugs.
• Advancing disease may require patients to be managed with LTOT (Long Term Oxygen therapy) for at least 15 hours a day. What home assessment would be required in order for this to be commenced ? What would be a contraindication for LTOT ?
• What priorities and lifestyle advice are identified in relation to priorities for implementation of care?
• Due to Mrs Parmars frequent infections and breathlessness she is finding it increasingly difficult to shop and cook adequate meals, as she lives alone, she finds it easier just to snack. A nutritional assessment tool shows she is at risk of malnutrition and she explains she feels she has lost weight recently as her clothes are feeling loose.
• Her BMI is 17. Malnutrition is a common concern with COPD; whilst in hospital what should the nurse do, to maintain nutrition?
• Smoking cessation is identified as a key area for management of COPD, what resources are available in the community to support this aspect of care?
• Home assessment, in preparation for discharge identifies several problems in relation to Activities of Daily Living, she has no toilet on the ground floor so is reluctant to drink adequate fluids, and how may this impact on her COPD?
• What support and self-help measures are recommended by the British Lung Foundation?
• What other members of the Multidisciplinary team may be involved in the care of Mrs Parmar ?
• What preventative immunization should be offered to this vulnerable individual to reduce the risks caused by seasonal community infections?

Explore TWO therapeutic interventions which can be employed to manage the patient’s problems in the acute or recovery (rehabilitation or end of life) phases. You should choose ONE pharmacological (oral or subcutaneous injection/s) AND ONE non-pharmacological intervention.

You could discuss both briefly, note key differences and justify their use and focus on an actual drug that fits into this category. The focus should be on ONE drug. You can compare and contrast the different groups. I would suggest a reference to explain why salbutamol (if that is your chosen drug) is used for this patient (NICE guidance). Ensure that it applies specifically to your fictional patient rather than a general description of the drug.

You could discuss both briefly, note key differences and justify their use and focus on an actual drug that fits into this category. The focus should be on ONE drug. You can compare and contrast the different groups. I would suggest a reference to explain why salbutamol (if that is your chosen drug) is used for this patient (NICE guidance).

Critically evaluate the evidence surrounding the interventions and the application to your chosen patient journey. Determine what the nurses’ role is in applying the interventions you have chosen and how you might encourage the patient to adhere to the proposed plan. Apply evidence to evaluate the role of the nurse.

You can use the same citation. If it is 2 different NICE guidance from the same year you would use (for example), NICE (2019a), NICE (2019b), in text and in your reference list.

• Make sure that they are recent (ideally from the last 5 years).
• Ensure that the source is credible (do not use newspapers, editorials).
• Follow APA format.
• Use a mixture of journal articles, books and grey literature

Guidance for Coursework

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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