Whether you are caring for patients in a hospital or nursing facility, you may encounter people in varying stages of chronic obstructive pulmonary disease. Three very important issues to be concerned with are dyspnea, hypercapnia and proper use of patient monitors. Here is additional information to help you provide a higher degree of care.
Defining COPD
What exactly is COPD? Some medical professionals believe COPD is basically emphysema. However, this is not always the case. Although a large percentage of COPD patients do have emphysema, there are other factors to consider. In general, COPD refers to chronic cases of bronchitis and also emphysema. Chronic bronchitis means the patient has some kind of disease affecting the airway.
The Importance of O2 Monitoring
If your patient has received surgery or a procedure involving general anesthesia, it is very important to keep track of O2 levels. In fact, patient monitors should be checked frequently to ensure the alarms for low oxygen levels are working properly.
Oxygen Therapy
O2 therapy can cause increased levels of CO2 in the blood (hypercapnia) and this can be dangerous. Be aware of the signs of high CO2, such as:
- Headaches
- Excess sleepiness or drowsiness
- Decreased respiration rate
You may need to decrease oxygen therapy but if this does not help, it may be necessary to contact the attending physician. Proper treatment of hypercapnia depends on the cause.
To avoid high CO2 concentration one should frequently check patient monitors to ensure O2 levels are between 88 and 92. Some COPD patients may actually do better with less oxygen, as it can encourage the lungs to breathe more efficiently.
Identifying Dyspnea
Dyspnea (difficulty breathing) can suddenly occur in COPD patients. If your patient complains he or she cannot breathe and is struggling this can be a life threatening situation. The first thing to do is assure the patient he or she is in the right place and getting the best possible care. This will help to reduce anxiety or panic which can make dyspnea much worse. It’s important to contact the physician on call for assistance. The doctor may recommend:
- Steroids
- Bronchodilators
- Pain medication
- Benzodiazepine drugs
Managing Dyspnea
You can work with your COPD patient and provide tools like breathing exercises and relaxation techniques which can lessen the symptoms of dyspnea. In some cases, the patient may need to reduce activity levels or sleep in an inclined position (perhaps in a reclining chair). You may also need to talk to the doctor about bringing in a respiratory therapist for assistance.
Remember to check patient monitors frequently for any signs of irregularities and try to keep the patient calm. With proper care, most COPD patients can live productive lives for years.
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