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COPD Management: Symptoms and Treatment

The patient is experiencing worsening symptoms of COPD, including leg edema and dyspnea, with a reported O2 saturation of 83%. Physical assessment reveals crackles in the lungs, bilateral pitting edema, and signs of respiratory acidosis. The care plan includes continuous monitoring of the airway, administration of oxygen, and urinary output monitoring.

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Benedict James Bermas
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4 views1 page

COPD Management: Symptoms and Treatment

The patient is experiencing worsening symptoms of COPD, including leg edema and dyspnea, with a reported O2 saturation of 83%. Physical assessment reveals crackles in the lungs, bilateral pitting edema, and signs of respiratory acidosis. The care plan includes continuous monitoring of the airway, administration of oxygen, and urinary output monitoring.

Uploaded by

Benedict James Bermas
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Goal – To mitigate symptoms of COPD

CC - leg edema and dyspnea

S:

- Patient verbalized “ang hirap huminga ng maayos tapos hinihingal agad ako”
- Patient also verbalized “simula last month pahira ng pahirap ako huminga at parang kailangan
ko ng oxygen ko”
- Patient verbalized of pain in the chest stating that she feels a pinching pain.
O:
- Patient VS:
o Bp: 100/60
o HR: 92
o RR:29
o PR: 79
o O2sat: 83%
- Patient appears awake and alert
- Patient also appears anxious
- Patient is sweating profusely
- Patient is showing facial grimace

A:

- Patient continues to present with crackles in mid – lower LF with cough, during physical
assessment patient showed positive grade 2 bilateral pitting edema, she was also alert
tachypneic in mild distress.
- In the laboratory test showed that the patient has a right axis deviation and a right atrial
enlargement with old septal wall MI, with a Poor R wave progression in ECG
- ABG showed patient has respiratory acidosis with secondary severe hypoxemia
- Patient has a low o2 sat with 83%

P:

- Continuous monitoring of airway of patient, inspect cough for any signs of abnormalities.
- Make sure patient is getting adequate o2 by continuous administration of nasal cannula
- Suction patient if necessary
- Monitor urine output after urinary catheter is inserted.

Common questions

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The patient's anxiety and profuse sweating could be stress responses induced by hypoxemia and respiratory distress. Anxiety may also stem from the struggle to breathe and fear of suffocation. Profuse sweating can occur due to the body responding to hypoxic stress, signaling further sympathetic activation and cardiovascular demand .

Continuous monitoring and oxygen administration are critical because the patient exhibits severe hypoxemia (O2 saturation at 83%) along with signs of respiratory distress. Maintaining adequate oxygen levels is essential to prevent respiratory failure and to manage the secondary effects of COPD exacerbations, including cardiovascular strain .

A low oxygen saturation level of 83% alongside respiratory acidosis indicates compromised gas exchange and inadequate respiratory function. It reflects the lungs' reduced ability to efficiently oxygenate blood and eliminate carbon dioxide, common in advanced COPD, leading to altered blood gas levels .

Grade 2 bilateral pitting edema suggests fluid retention, often a sign of right-sided heart failure, a common comorbidity in COPD. It reflects systemic venous congestion due to chronic pulmonary hypertension, indicating advanced cardiovascular complications associated with the patient's COPD .

The patient's dysregulated vital signs—such as rapid respiratory rate, low blood pressure, and abnormal ECG readings—along with laboratory results showing respiratory acidosis and severe hypoxemia, could lead to potential complications like respiratory failure, acute cardiac events, or further deterioration in cardiac function, risking mortality if not managed promptly .

Right atrial enlargement indicates pressure overload, often associated with chronic lung disease like COPD, which places a strain on the heart resulting from pulmonary hypertension. The presence of an old septal MI suggests past cardiac injury, potentially exacerbated by the chronic hypoxic environment. This highlights the need for integrated cardiac and pulmonary management to address the complexities of COPD .

The primary physiological symptoms exhibited by the patient include leg edema, dyspnea, chest pain, and an oxygen saturation level of 83%, which indicates severe hypoxemia. In COPD, dyspnea and hypoxemia occur due to impaired airflow and gas exchange. Edema can result from right-sided heart failure, a common comorbidity in COPD patients, while the chest pain may suggest strain from breathing difficulties or heart-related issues .

The diagnostic findings include crackles in the lungs, grade 2 bilateral pitting edema, right axis deviation, right atrial enlargement, old septal wall myocardial infarction (MI), and poor R wave progression on the ECG, as well as respiratory acidosis with severe hypoxemia on the ABG. These imply significant underlying cardiovascular strain, likely due to COPD progression, resulting in impaired heart function and compromised respiratory efficiency .

The patient's verbalization of increasing difficulty to breathe and feeling an urgent need for oxygen suggests a worsening of her COPD symptoms, indicating reduced lung function and increased physical demand on respiration. This aligns with her subjective feeling of breathlessness and may help guide therapeutic interventions .

The patient's verbalized need for oxygen likely indicates an acute awareness of her deteriorating respiratory function and the real-time challenges in maintaining adequate airflow. This awareness can be a critical factor in her engagement with treatment plans and adherence to medical guidance .

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