In order to design a patient-centred approach for treatment, it is imperative that a nurse note for all of the details of the patient for focusing in areas of concern. There are multiple factors related to non-Management to medication in individuals. Although multiple medical treatments are in place to correct for chronic diseases, non-Management to medication in patients is the most common barrier faced by the medical professionals in medical management. The patients are either seen overusing, underusing or improperly using the medications prescribed to them. Some of these factors commonly include patient’s own perception about their diseases, having a feeling of incompetency about various medical management therapies and self-experiences and behaviours of individuals (Jarab, 2019).
There are two main area of concern in the case study of Haden. Firstly, the patient is having trouble keeping up with his medication routine and secondly, the patient is not ready to leave habits like smoking and drinking that are major attributing factors to enhance the clinical manifestations in the patient. The regimen for treatment of Chronic Obstructive Pulmonary diseases is usually for a longer duration. This contributes to lengthier treatment as compared to other comorbidities and can thus, be reflected as one of the attributing factors for non-Management in such patients. The patient in the given study is also unaware of his current medical status and has very little knowledge about the medication he is taking.
It is the role of the nursing staff to contributes to the patient’s knowledge and perception about his disease. Studies have shown, that where physicians work closely with their patients in imparting knowledge to them about their medical conditions, there have been higher medication-Management rates. It is also important for the nursing staff to have a good communication channel with the patient at all times, so that specific information can be provided to the patient (Garvey, 2018). This has also been proven helpful in enhancing secondary medication-Management in individuals related to their misunderstandings about their disease. Positive reinforcement of the importance of following the regimen strictly has also shown positive results in individuals that lacked Management to their medication routine (Effing, 2016). It can be helpful in our case study as well, as the patient is embarrassed to carry out his supplement oxygen apparatus.
The patient in the case study is doing overall well, as per the noted vitals, although, he is having green coloured sputum on coughing. Sputum culture of the patient should be done as it is an indicator of bronchitis (Hewitt, 2016). The chest X-ray can also be done to note for the congestion in the lungs. The patient is on supplement oxygen and is currently a smoker as well, review of pulmonary functions tests should be done to check for the current status of lungs. This will also be helpful in defining the oxygen therapy, in terms of dosage for the patient to be prescribed for home use (Lareau, 2019). The patient should also be screened for cardiac monitoring, as the patient is having a severe smoking history. Smoking causes arties to reduce and thin over the due course of time, which will allow less blood, flow and causing constriction leading up to patient developing myocardial infarction (Busch, 2017).
There are multiple therapies and methods in place to target the issue of Management to medication in COPD patients, but behavioural therapy of all has been found to be beneficial for the patients largely. As the patient in the given case study is on multiple drugs, it is crucial that synchronisation of the multiple drugs dosages should be done. The intake duration for medications, for the patient can be reduced down to two to three times a day, rather than prescribing drug taking up the routine of whole day, on hourly basis. The medication time can also be synced to routines like breakfast, dinner, lunch etc. so that the patient can remember to take his medication on time.
The understating of the medical condition, should be provided to the patient along with proper rationale and improved communication, so that the patient is able to recognize for the repercussions of the disease. The disease should also be targeted including various aspects related to the problem such as inclusion of physical activity, smoking cessation etc. The patient in our case study has a history of smoking and current is a smoker as well. As smoking is a potential risk factor for the patient, it is important to treat the same. This can be done by educating the patient about the same and helping him enrol in smoking cessation program as well.
As the patient himself might have a very little knowledge about the warning signs, it is imperative that detailed information regarding the same, both written and verbal should be provided to the patient to manage the same (Hesso, 2016). As the patient in the case study feels the medications are making him no good, he can be counselled about the same and can be listened to closely, in order to express his perceptions regarding the same. These concerns can then me considered as main area of focus and can be worked upon, with collaborative approach from the patient.
The patient in the case study is a 63-year-old man, having a history of Chronic Obstructive Pulmonary Disease. He is a current smoker and has a history of 40 packs years of smoking. The patient gets admitted to the hospital on/off due to his current medical status. The recent admission was 3 weeks before, when he developed, left lower lung pneumonia. He developed a viral infection, due to which he had acute exacerbation of COPD and was thus, admitted for further medical management. Post-discharge the patient is experiencing breathlessness with minimal exertion which is hampering his activities of daily living. Patient has also been on in inhaler and is prescribed home oxygen as well, to compensate for the respiratory loss.
Patient is also having green coloured sputum, with dry cough. Patients with COPD usually present with persistent dyspnoea. In cases of acute exacerbations, the symptoms of the patient can get worse, such as increased feeling of breathlessness and sputum with cough. The main area of concern in the patient is shortness of breath and medication non-Management. The patient in the case study can be taught about correct technique to use his inhaler. He can be imparted education about the importance of the same and home use of oxygen therapy. It is also imperative to teach the patient for cessation of smoking as it can bring about a severe progression in the symptoms. There is an important role of communication in the holistic management of the patient.
It is also important as the patient might be at a risk of developing cardiac diseases as well, due to smoking history. Dietary interventions also play a major role in management of the disease. As the immunity of the patient loosens over the due course of time, intake of healthy food is important to help in fast recovery of the patient. It is also important to manage the regular follow-ups of the patient, in order to keep a close vigil on the patient recovery process and identify for the required modifications in the intervention plan.
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Garvey, C., & Kaplan, A. G. (2018). Optimizing Management to Improve Clinical Outcomes in Patients with Chronic Obstructive Pulmonary Disease. Journal of Family Practice, 67(10), 40-42.
Hesso, I., Gebara, S. N., & Kayyali, R. (2016). Impact of community pharmacists in COPD management: inhalation technique and medication Management. Respiratory Medicine, 118, 22-30.
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Jarab, A. S., & Mukattash, T. L. (2019). Exploring variables associated with medication non-Management in patients with COPD. International Journal of Clinical Pharmacy, 41(5), 1202-1209.
Lareau, S. C., Fahy, B., Meek, P., & Wang, A. (2019). Chronic Obstructive Pulmonary Disease (COPD). American Journal of Respiratory And Critical Care Medicine, 199(1), 11-12.
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Toback, M., & Clark, N. (2017). Strategies to improve self-management in heart failure patients. Contemporary Journal of Nurse, 53(1), 105-120.
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