COPD - Risk for infection and Impaired gas exchange

Chronic obstructive pulmonary disease (COPD) is a chronic condition associated with a history of emphysema, asthma, bronchiectasis, cigarette smoking, or exposure to air pollution, there is airway obstruction which progressively increased (Tucker, 1998: 237).

Important risk factors that cause of COPD
  • Cigarette smoking
  • Air pollution
  • Exposure in the workplace (coal, cotton, grains)
The process can take place in a span of more than 20 to 30 years (Smeltzer, 2002: 756).
Other factors, according to (Doenges, 1999: 152) allergens, emotional problems, cold weather, exercise, drugs, chemicals, and infection.

Nursing Diagnosis for COPD : Risk for Infection related to inadequate primary defenses (decreased cilia work, persistence secretions)

Goal: there are no signs and symptoms of infection with

  • Expressed understanding of the cause or individual risk factors.
  • Identify interventions to prevent or reduce the risk of the individual.
  • Demonstrate techniques, lifestyle changes to enhance the safe environment.

Interventions :
  1. Assess the patient's body temperature.
  2. Assess the importance of deep breathing, effective coughing, frequent position changes, and adequate fluid intake.
  3. Assess color, character, odor sputum.
  4. Teach proper hand washing.
  5. Keep an eye on visitors.
  6. Encourage a balance between activity and rest.
  7. Discuss the need for adequate nutritional intake.

Nursing Diagnosis for COPD : Impaired gas exchange related to impaired oxygen supply (airway obstruction by secretions, bronchospasm, air trap), damage to the alveoli.

Goal: Facilitate the exchange of gas with

  • The patient will demonstrate improved ventilation with adequate tissue oxygenation with blood gas analysis in the normal range and are free of symptoms of respiratory distress.
  • Patients will participate in a treatment program in the level of ability or situation.
  1. Assess frequency, depth of breathing, note the use of accessory muscles, breathing lips, inability to speak or speaking.
  2. Elevate head of bed, help patients choose a position that is easy to breathe and practice deep breathing.
  3. Assess the color of the skin and mucous membranes.
  4. Push spending sputum.
  5. Auscultation of breath sounds, note the decrease in air flow area and additional noise.
  6. Keep an eye on the level of consciousness or mental status.
  7. Keep an eye on vital signs and cardiac rhythm.

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