Realistic nursing care plan - Essay Example

He is peripherally cyanosed and very anxious. To be able to provide a realistic nursing care plan on the above-mentioned case, it is first necessary to add a little more information that may help us focus on the type of chronic obstructive pulmonary disease (COPD) that Mr. Percy Jones might be suffering. Before moving on, it is imperative at this point to define what CODP is. CODP is generally defined by the Manual of Nursing Practice (2001, p. 294) as "a term that refers to a group of conditions characterized by continued increased resistance to expiratory airflow.

" Marieb (2002, p. 403) further gives us features that are common among CODP patients, and these are as follows: patients almost always have a history of smoking; dyspnea occurs and becomes progressively more severe; coughing and frequent pulmonary infections are common; and most CODP victims are hypoxic, retain carbon dioxide and have respiratory acidosis, and ultimately develop respiratory failure. Generally, CODP may either be chronic bronchitis or emphysema. Chronic bronchitis is characterized by severe inflammation of the mucosa of the lower respiratory passages, coupled with the excessive production of mucus (Marieb, 2002, p. 403) which results in the presence of "cough and sputum production for at least a combined total of three months in each of two consecutive years" (Smeltzer and Bare 2004, p. 569). Emphysema, on the other hand, is a disease that "affects the airways characterized by the destruction of the walls of overdistended alveoli" (Smeltzer and Bare 2004, p. 569). We shall elaborate on emphysema in a short while.

The case clearly alludes to a type of CODP that stems directly from too much exposure to mining dusts. Though most CODP cases are due to cigarette smoking or passing smoking, Mr. Jones' illness differs from the majority as to the main cause and probable coincidence of the different types of CODP. Though complications and the occurrence of two types of CODP is a possibility, allow me to narrow down Mr. Jones' CODP type based on the facts that are given. According to a study by Cogon and Taylor (1998, p. 406), miners, due to dust exposure, are prone to centrilobular emphysema, especially in the presence of pneumoconiosis.

Emphysema, as must be recalled, is a progressive COPD condition where the walls of the alveoli are destroyed due to recurrent infection. Such results in the enlargement of dead space in the lungs which leads to hypoxemia, and in worse cases, hypercapnia (which, in turn, may lead to other complications) (Smeltzer and Bare, 2004, p. 570). Emphysema, in turn, may either be panlobular or centrilobular. Again, both types of emphysema may exist in one patient, the main difference between the two are as follows: panlobular emphysema, there is the destruction of the bronchiole, alveolar duct, and alveoli such that all air spaces within the lobule are essentially enlarged, but there is little inflammatory disease (Smeltzer and Bare 2004, p. 570); in centrilobular emphysema, what is affected are the proximal aspects of the lung acinus, primarily the area of the respiratory bronchioles (RadioWiki 2005), though, alveolar ducts in the proximal and middle portion of the pulmonary module may be destroyed in gross cases, resulting in holes or emphysematous spaces (Daroca