Introduction
COPD stands for achronic obstructive pulmonary disease that is an inflammatory lung condition of chronic nature. COPD is associated with the obstruction of airflow to and from the lungs. Some of the major symptoms of COPD include coughing, wheezing, sputum production, and breathing difficulty (GOLD, 2017) The main cause of COPD is long-term exposure of one’s airways to harmful substances, which can lead to irritation. One of the most common substances of this kind is cigarette smoke. People affected by this disease are also at risk of lung cancer and heart disease (GOLD, 2017).
COPD Diagnosis, Management, and Prevention Strategies
According to GOLD (2017), medical professionals should consider COPD as a diagnosis in all patients affected by such symptoms as sputum production, dyspnea, chronic cough as well as in those with a history of exposure to risk factors for this condition. Working with such patients or with patients who are known to have COPD, it is essential for health care providers to have their detailed medical history. Moreover, as specified by GOLD (2017), to make the diagnosis, it is necessary to have the patient undergo spirometry. Specifically, the existence of a post-bronchodilator FEV1/FVC < 0.70 is evidential of the presence of a significant limitation to the patient’s airflow (GOLD, 2017).
COPD management goals are based on the need to relieve symptoms, stop the progression of the disease, and prevent potential complications thus reducing mortality (WHO, 2018). Management and prevention strategies for patients with COPD include smoking cessation (if the patient is a smoker), pharmacologic therapy, pulmonary rehabilitation, inhaler technique, pneumococcal and influenza vaccination; in advanced COPD cases, palliative approaches can be considered (GOLD, 2017). In severe cases, non-invasive long-term ventilation can be one of the most suitable options (GOLD, 2017).In clinical settings, vaccinations can be enabled by involving respective professionals. Pulmonary rehabilitation can be carried out under the supervision of nurses who also can deliver patient education regarding the condition. Pharmacologic therapy involves timely administration of prescribed medications, which can be practiced in clinical settings. Smoking cessation is the most challenging strategy because it mostly depends on the patient’s readiness to give up the habit. However, nursing professionals can help motivate the patient and engage therapists specialized in smoking cessation.
Case Study Diagnosis
The selected case study was presented as an example in the article about the use of spirometry as a Pulmonary Function Test that helps determine the level of airway obstruction. Spirometry is usually viewed as one of the essential and necessary tests that are quick, objective, non-invasive, and do not require much preparation (GOLD, 2017). The patient described in the case study is a 67-year old smoker who also displays such symptoms as coughing and wheezing (Sewa& Ong, 2014).The patient’s spirometry indicated FEV1/FVC 44% predicted with FEV1 as low as 24%. According to the guidelines, the spirometry results of this patient indicate the likeliness of very severe airflow restriction (GOLD, 2017). Moreover, knowing that the patient displayed additional COPD signs such as wheezing and coughing and is exposed to a regular influence of noxious gases or particles, it is possible to diagnose them with COPD.
Treatment and Management Options
Several treatment options are available for this patient. First of all, GOLD (2017) guidance states that COPD patients aged 65 and older can benefit from pneumococcal vaccination because it reduces comorbidities preventing community-acquired pneumonia. Further, in order to reduce COPD symptoms, pharmacologic therapy needs to be implemented. In particular, the patient can benefit from bronchodilators that help increase FEV1. Beta2-agonists represent another suitable pharmacological option as they relax airways letting through more air. Anti-inflammatory agents such as PDE4 inhibitors could provide another series of advantages and are suitable for the level of severity of the patient’s condition. Finally, pulmonary rehabilitation is another management option available to the patient that could help address their rate of dyspnea. Additionally, the therapy could include patient education and self-management strategies for the improvement of their overall quality of life.
References
GOLD. (2017). Pocket guide to COPD diagnosis, management, and prevention. Web.
Sewa, D. W., & Ong, T. H. (2014). Pulmonary function test: Spirometry. Proceedings of Singapore Healthcare, 23(1), 57-64.
WHO. (2018). COPD management. Web.