Nursing care plan ( NCP ) - Essay Example

Nursing Care Plan for Patient with COPD This is the case of Carissa, a 70 year old patient with chronic obstructive pulmonary disease (COPD). She was first brought into the clinic due to a productive cough which has been persistent for two months. Her initial bout with coughing occurred with cough and fever; she was prescribed some antibiotics but the coughing was persistent. She was shifted to a stronger antibiotic which managed to reduce her coughing but did not completely stop it. She did not seek medical care despite her persistent cough and only when she was having difficulty breathing did she seek medical care.

She has been recently widowed and is living with her daughter’s family. She has hypertension and has been taking maintenance medications to manage her blood pressure. She also has gouty arthritis and is taking diuretics and pain relievers to manage it. The symptoms of her disease include the dyspnea. This dyspnea is causing a reduction in her exercise tolerance, thus also reducing her activities of daily living. Her cough is productive with increased production of sputum. She also has wheezing and chest congestion.

Based on her medical history with the disease, she remembers that she has had incidents of persistent coughing during her childhood years, including other common childhood diseases. She remembers that she has had childhood asthma during her school age years, as well as several incidents of bronchitis when she was in her teens and during her early adult life. Her husband was a smoker so she was exposed to second hand smoke for thirty years being married. Second-hand smoke often contributed to her persistent coughing in her adult and her late adult life.

In reviewing her environment, she has been a housewife most of her life, except for ten years when she worked as a clerk in a stock broker firm. Her family has lived in an area which is near an asbestos plant which often emits toxic fumes into the air, and which often dumps dust and other wastes in the outskirts of their neighborhood. This plant has been contributory to various respiratory health issues because from the time the plant was built, the incidents of COPD have increased in the area, and some incidents of lung cancer have registered at rates higher than the rest of the general population.

Her cough has persistently caused her difficulties in breathing; it has also caused her problems with sleeping as she would often have coughing bouts at night. Her cough is also productive, especially in the morning. Labored breathing is mostly apparent during exercise and during activities which require exertion. Factors which precipitate her coughing are mostly exposure to smoke, toxic fumes; eating sweets and cold drinks; and irritated throat. She seems to have developed antibiotic resistance because her cough is persistent despite her intake of antibiotics.