NURBN2012: Nursing Practice- Pathophysiology & Pharmacology Applied to Nursing- Robert Case Study- Report Writing Assignment
You are required to write a 2000 word report which addresses the main issuesassociated with providing nursing care for Robert and assisting him to manage both the physical andpsychological impacts of his diagnosis. You will need to explore the pathophysiology, pharmacology and nursing management of the scenario and demonstrate your understanding in the answers you provide. Youranswers should be informed by your reading of current research and literature.
Robert is a 51 year old man who lives with his wife in regional Victoria. He has been admitted to your wardfrom the Intensive Care Unit (ICU), where he had a 3 day stay for an acute exacerbation of COPD, causedby community acquired pneumonia. He required several days of non-invasive ventilation whilst in ICU.Robert tells you his wife (Jill) was very frightened when he was admitted to ICU, and he doesn’t want ‘to puther through that anymore’. He would like some help to understand and manage his COPD. Robert said hewas diagnosed with COPD about 18 months ago by his GP, but admits he was sick for ‘a while’ before that.
He is a current smoker, and has smoked for about 40 years. He has unsuccessfully attempted to quit onmore than 5 occasions. Robert worked for many years on his chicken farm, but now finds he becomes breathless very easily and Robert and Jill have had to hire a farm helper.
Robert’s medications include:
Salbutamol 2 – 4 puffs PRN
Budesonide/Efomoterol fumarate dehydrate 2 puffs daily
Metoprolol 25mg daily
Aspirin SR 100 mg daily
1.1 Describe the pathophysiology of COPD. Include in your answer the two disease processes contained in the umbrella term ‘COPD’ and how they develop.Robert has been diagnosed with a severe exacerbation of COPD, caused by Community Acquired Pneumonia.
1.2 Explain the term ‘acute exacerbation of COPD’. What factors put patients like Robert at high risk for exacerbations of COPD? What else may contribute to an exacerbation of COPD?
1.3 Describe the pathophysiology of pneumonia. Include in your answer the differences between Community Acquired, Hospital Acquired and Health Care Associated Pneumonia.
The Respiratory Physician who reviewed Robert in ICU suggested some changes to his current inhaler regime. The physician suggested that Robert cease his Budesonide/Efomoterol fumarate dehydrate, andcommence on Tiotropium 2 puffs daily