Fill in the concept map linked below with the information from the COPD case study. Then look at opportunities, real or imagined, for collaborative and/or interdisciplinary care. What could you do to make everything and everyone work together for the good of the patient?
Evaluation may be real or imagined as well. Think “outside” the realm of the clinical picture you’re presented. If you believe the suggested improvements to care will benefit the patient, say so! If you are not convinced that the prescribed collaboration will be effective, say that as well.
| Patient’s Medical Diagnosis |
| Clinical Manifestations:
Subjective:
Objective:
|
| Nursing Diagnosis:
Short Term Goal:
Long Term Goal:
|
| Patient’s Past Medical History and Significant Findings: |
| Nursing Interventions (at least 4): |
| Collaboration: With whom will the nurse be working and why? |
| Patient’s Laboratory & Test Results:
|
| Evaluation of Plan or Anticipated Evaluation of Plan:
|
Patient’s Medical Diagnosis:
- Clinical Manifestations:
- Subjective: Patient reports shortness of breath, chronic cough, and wheezing.
- Objective: Decreased lung function, increased respiratory rate, use of accessory muscles for breathing, and oxygen saturation below normal.
Nursing Diagnosis:
- Impaired Gas Exchange related to COPD.
Short Term Goal:
- Improve oxygenation and relieve respiratory distress.
Long Term Goal:
- Enhance the patient’s ability to manage COPD, reduce exacerbations, and improve overall quality of life.
Patient’s Past Medical History and Significant Findings:
- History of smoking, exposure to environmental pollutants.
- Frequent hospital admissions due to COPD exacerbations.
Nursing Interventions (at least 4):
- Administer prescribed bronchodilator medications and oxygen therapy to relieve bronchoconstriction and improve oxygen saturation.
- Provide education on smoking cessation, emphasizing its importance in managing COPD.
- Teach the patient breathing exercises and relaxation techniques to manage dyspnea.
- Collaborate with a respiratory therapist for pulmonary rehabilitation and home oxygen therapy evaluation.
Collaboration:
- Collaboration is essential in managing COPD. The nurse may collaborate with:
- Respiratory therapist for pulmonary function tests, inhaler technique training, and oxygen therapy assessment.
- Pulmonologist for medication management and treatment plan adjustments.
- Dietitian for nutritional assessment and dietary counseling.
- Physical therapist for exercise and mobility support.
Patient’s Laboratory & Test Results:
- Pulmonary function tests (spirometry) showing decreased FEV1/FVC ratio.
- Arterial blood gases (ABG) indicating hypoxemia and hypercapnia.
- Chest X-ray revealing hyperinflated lungs.
Evaluation of Plan or Anticipated Evaluation of Plan:
- Anticipated Evaluation: Regular assessment of the patient’s respiratory status, symptom management, and compliance with medications and lifestyle changes.
- Regular monitoring of oxygen saturation levels and arterial blood gases to ensure adequate oxygenation.
- Periodic spirometry to evaluate lung function improvement.
- Frequent follow-up appointments to assess progress toward short-term and long-term goals.
Opportunities for Collaborative and Interdisciplinary Care:
- Interdisciplinary COPD Clinic: Establish an interdisciplinary COPD clinic where patients can receive comprehensive care from a team of healthcare professionals, including nurses, pulmonologists, respiratory therapists, dietitians, and physical therapists.
- Telehealth Services: Utilize telehealth to facilitate regular follow-up appointments, education, and remote monitoring for COPD patients, enhancing access to care.
- Community-Based Support: Collaborate with community organizations to provide support groups and resources for COPD patients and their families, promoting self-management and social support.
- Research Collaboration: Engage in research collaborations with academic institutions to explore new treatment modalities and interventions for COPD patients.
- Medication Management: Implement collaborative medication management programs with pharmacists to optimize medication adherence and reduce adverse effects.
These collaborative efforts can enhance the overall care and support for COPD patients, improving their quality of life and reducing hospital admissions. However, the effectiveness of these collaborations will depend on communication, coordination, and patient engagement in the care plan.