Introduction
It is needed to prepare a comprehensive nursing plan for R.W., a seventy-year-old female with a past medical history of chronic obstructive pulmonary disease (COPD). To do this, it is imperative to collect subjective complaints from R.W., objective findings, and laboratory results, including comprehension of the pathology involved in COPD and Osteoarthritis. The overall aim is to develop a holistic plan of care that addresses her immediate health concerns, supports disease management, and enhances overall well-being.
Subjective and Objective Assessment
Subjective complaints reported by the patient are difficulty eating hard foods due to mouth pain, poor quality sleep despite propping herself up on pillows, and significant pain in her hands and knees attributed to osteoarthritis. On inspection, accessory muscle use during breathing led to a productive cough with thick yellow sputum and decreased oxygen saturation, which are the primary symptoms of COPD (Ritchie & Wedzicha, 2020). In addition, she was found to have evidence of malnutrition, low hemoglobin and albumin levels, dry, flaky skin, plus a non-healing wound. Multiple caries and missing teeth were evident upon dental examination, worsening the nutritional status and general health.
Nursing Diagnosis and Interventions
The nursing care plan for R.W. is based on primary, secondary, or tertiary interventions that can be used depending on how severe her condition is. Direct interventions focus on managing COPD, including nutritional support and oral hygiene. This includes the administration of bronchodilators together with corticosteroids for managing acute exacerbation of COPD and counseling regarding smoking cessation strategies (Karasu & Birimoğlu Okuyan, 2021). Secondary interventions include managing her pain associated with arthritis, thus providing wound care to her non-healing wound. For example, physicians may prescribe NSAIDs or acetaminophen for pain relief, explore non-pharmacological pain management techniques, and provide wound care and infection monitoring.
Conclusion
The plan provides comprehensive nursing care for R.W., addressing not only her current health problems but also long-term illnesses and promoting general well-being. As a blend of primary, secondary, and tertiary levels of prevention, it will offer comprehensive care that addresses the complex nature of R.W.’s health complications. To this end, the primary, secondary, and tertiary interventions are integrated. Tertiary interventions emphasize chronic disease management education and financial assistance.
References
Karasu, F., & Birimoğlu Okuyan, C. (2021). The effect of nursing care applied to patients with chronic obstructive pulmonary disease on their sexual experiences and quality of life. Sexuality and Disability, 39(3), 529-542.
Ritchie, A. I., & Wedzicha, J. A. (2020). Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clinics in Chest Medicine, 41(3), 421-438.