INTRODUCTION:

Good morning everybody,I hope you people are well known me,but still I will introduce myself to you.I am T.Immanuvel studying post B.Sc.Nursing II-Year.

When I was posted in the ward I met a patient with the complaints of tightness,cough,sputum(mucous) production,wheezing. So ,if these symptoms are found to the patient what will be the diagnosis it is COPD. Let me discuss in detail about Chronic obstructive pulmonary disease.

shortness of breath,chest

SUBJECT TOPIC GROUP OF STUDENT NO.OF.STUDENTS PLACE DATE TIME AND DURATION METHOD OF TEACHING AUDIO VISUAL AIDS

: Medical and Surgical Nursing : Chronic Obstructive Pulmonary Disease : B.Sc.Nursing : :Sri Manakula Vinayagar Nursing College : :45 minutes :Lecture Cum Discussion :Chart,OHP,Black board,Pamphlets

NAME OF THE STUDENT TEACHER EVALUATOR

:T.Immanuvel[P.B.B.Sc NSG II Yr] : :Mrs.Sathiyakala Msc.Nursing[Lecturer in Nursing]

CENTRAL OBJECTIVES:
Student will be able to gain knowledge regarding chronic obstructive pulmonary disease and develop desirable attitude towards care of the patients with this condition.

SPECIFIC OBJECTIVES:
The student will be able to, Define chronic obstructive pulmonary disease List out the risk factors for chronic obstructive pulmonary disease

Enlist the diseases including in chronic obstructive pulmonary disease Describe the pathophysiology of chronic obstructive pulmonary disease

 Enumerate the clinical manifestations of chronic obstructive pulmonary disease Explain the diagnostics findings of chronic obstructive pulmonary disease

Enumerate the management of chronic obstructive pulmonary disease General management Medical (Pharmacological) management Surgical management Nursing management

Discuss the complications of chronic obstructive pulmonary disease

S.NO SPECIFIC OBJECTIVES 1. Introduction

TIME CONTENT

TEACHER/ LEARNER ACTIVITIES

A.V AIDS

EVALUATION

1min

Introduction: Chronic obstructive pulmonary disease(COPD) is a term referring to a combination of two lung diseases, Chronic bronchitis and Emphysema. COPD is characterized by obstruction to airflow that interferes with normal breathing. Teacher explain Roller Definition: in lecture board Chronic obstructive pulmonary disease is a method. disease state characterized by airflow limitation that is not fully reversible; Student are sometimes refered to as chronic airway actively obstruction or chronic obstructive lung participate and disease. taking notes. Teacher explain Hand out Causes: about the causes Exposure to tobacco smoke in lecture accounts for an estimated 80% to method. 90% of COPD cases. Passive smoking Student are Occupational exposure, actively dust,chemicals. participate and Ambient air pollution taking notes. Genetic abnormalities .

2.

Define chronic 1min obstructive pulmonary disease

What is chronic pulmonary disease?

obstructive

3.

List out causes chronic obstructive pulmonary disease

the 5min for

What are tha causes of chronic obstructive pulmonary disease?

S.NO SPECIFIC OBJECTIVES Enlist diseases including chronic obstructive pulmonary disease

TIME CONTENT

the 5min in

4.

TEACHER/ A.V LEARNER AIDS ACTIVITIES Teacher discuss Chart COPD may include disease: about the diseases Chronic bronchitis: including in Bronchitis is a disease of the airways COPD defined as the presence of cough and sputum production for atleast a combined total of 3 months in each of 2 consecutive Student are years. actively participate and taking notes. Emphysema:

EVALUATION

What are the diseases including in COPD?

Emphysema is a disease of the airways characterized by destruction of the walls of overdistended alveoli. Bronchiectasis: Bronchiectasis is a chronic dilation of a bronchus or bronchi,the dilated airways become Saccular and are a medium for chronic infection. Asthma: Asthma is a disease with multiple precipitating mechanisms resulting in a common clinical outcome of reversible airflow obstruction.

S.NO SPECIFIC OBJECTIVES 5. Describe the pathophysiology of chronic obstructive pulmonary disease

TIME CONTENT Pathophysiology:

TEACHER/ LEARNER ACTIVITIES

A.V AIDS

EVALUATION

Due to any abnormal inflammatory response of the lings to noxius particles or Teacher OHP gases. explains about the pathophysiology by lecture method. The inflammatory response occurs throughout the proximal and peripheral Student are airways. actively participate and taking notes Changes and narrowing occurs in the airways.

What are the pathophysiology?

steps

in

In the proximal airways changes include increased numbers of goblet cells and enlarged submucosal glands.

Leads to hyper secretion of mucus in the peripheral airways.

Obstruction of the airway

S.NO SPECIFIC OBJECTIVES 6.

TIME CONTENT

Enumerate the 5min clinical manifestations of chronic obstructive pulmonary disease

Clinical manifestations: Chronic cough Shortness of breath Chest tightness Dysphea Sputum production Pulmonary infection Wheezing Weight loss Chronic repository infection Hyper inflation[Loss of lung elasticity] Diagnostic Test Findings: History collection Physical examination Pulmonary function test Spirometry Chest X-Ray Arterial blood gas analysis Blood Chemistry: Eosinophilia

TEACHER/ A.V LEARNER AIDS ACTIVITIES Teacher eplain Chart about the clinical manifestation by lecture method. Student are actively participate and taking notes. Teacher explain Chart about the diagnostic findings of lecture method. Student are actively participate and taking notes.

EVALUATION

What are the clinical manifestation for COPD?

7.

Explain about 5min the diagnostic findings of chronic obstructive pulmonary disease

What are the diagnostic findings for COPD?

S.NO SPECIFIC OBJECTIVES 8.

TIME CONTENT

Enumerate the 15min management of chronic obstructive pulmonary disease

Management: i. General Management:

Risk Reduction: Smoking cessation is the single most cost effective interrention to reduce the risk of Student are developing COPD. actively participate and Patient education. taking notes. Physical condition Self-Care activities ii. iii. Medical Management: Oxygen physiotheraphy Chest physiotheraphy Breathing exercises Nutritional theraphy Pharmacological management: Bronchodilators Corticosteroids Antimicrobial theraphy iv. Surgical management: Bullectomy Lung valve reduction surgery Lung transplantation

TEACHER/ A.V LEARNER AIDS ACTIVITIES Teacher explain OHP about the management by lecture method..

EVALUATION

What are the management for chronic obstructive pulmonary disease?

S.NO SPECIFIC OBJECTIVES

TIME CONTENT

TEACHER/ LEARNER ACTIVITIES

A.V AIDS

EVALUATION

v.

Nursing Management: Accessing the patient Achieving airway clearance Improving breathing patients Improving activity tolerance Monitoring and managing potential ccomplications Promoting home and community-based care.

S.NO SPECIFIC OBJECTIVES 9

TIME CONTENT

Discuss the 2min complication of chronic obstructive pulmonary disease

Complications: Respiratory failure Pneumonia Atelectosis Airway obstruction Acute asthmatic episodes Hypoxemia

TEACHER/ A.V LEARNER AIDS ACTIVITIES Teacher Hand out explains about complication by lecture method. Student are actively participate and taking notes.

EVALUATION

What are the complications of COPD?

Nursing Diagnosis: I. Impaired gas exchange and airway clearance due to chronic inhalation of toxins. Impaired gas exchange related to ventilation perfusion in equality. Ineffective airway related in constriction,increased production. clearance broncho mucus

II.

III.

IV.

In effective breathing patient related to shortness of breath and airway irritants. Self-care deficits related to fatigue secondary to increased work of breathing and insufficient ventilation and oxygenation.

V.

S.NO SPECIFIC OBJECTIVES

TIME CONTENT

TEACHER/ LEARNER ACTIVITIES

A.V AIDS

EVALUATION

VI.

Activity intolerance due to fatigue,hypoxemia and ineffective breathing patients. Inefective coping related to reduced socialization,anxiety,deppression, and the inability to work.

VII.

VII Deficient knowledge about selfmanagement to be performed at home.

ASSESSMENT

Subjective Data:

NURSING DIAGNOSI S Impaired Gas exchange and airway clearance due to chronic inhabilation of toxins.

GOAL

INTERVENTIO N

RATIONAL

IMPLEMENTATION

EXPECTED OUTCOME

Improv 1. Evaluate ement current in gas smoking exchan habits ge patient family.

a) To provide baaseline dara.

Objecitive Data:

of and b) Smoking causes permanent Educated 2. Educate damage to regarding hazards regarding the lung. of smoking and hazards of relationship in smoking and COPD. relationship in c) Improve COPD. knowledge Provided level. Educational materials. 3. Provide d) Chronic Educational inhalation of materials. both indoor Evaluated current and outdoor exposure to 4. Evaluate toxins causes occupational current damage to the toxins,indoor and exposure to airways and outdoor air occupational impairs gas pollution. toxins,indoor exchange. and outdoor Educated regarding air pollution. types of indoor and 5. Educate outdoor air regarding pollution. types of indoor and outdoor air pollution.

Evaluated current smoking habits of patient and family.

a) Identifies the hazards of cigarette smoking. b) Identifies resources smoking cessation. for

ASSESSMENT Subjective Data:

NURSING DIAGNOSIS Impaired gas exchange related to ventilation perfusion inequality.

GOAL

INTERVENTION

RATIONAL

IMPLEMENTATION

Improv 1. Assess the a) Provide ement general condition baseline in gas of the patient. dara. exchan ge 2. Provide b) Maintain comfortable bed comfort to and position. the patient. 3. Encourage c) Gas patient in exchange is diaphragmatic improved breathing and and fatigue effective is coughing. minimized 4. Evaluate d) Improve effectiveness of gas nebulizer or MDI exchange. treatments. e) Maintain 5. Administer breathing oxygen therapy. pattern. 6. Administer f) Improve bronchodilators gas as per exchange physiciansorder. level.

EXPECTED OUTCOME 1. Assessed the i) Evidences minimal side general condition effects,heart rate hear of the patient. normal,absence of dysrhythmics,normal 2. Provided mentation. comfortable bed and position. ii) Reports a decrease in dysphea. 3. Encouraged patient in diaphragmatic breathing and effective coughing. 4. Evaluated effectiveness of nebulizer or MDI treatments. 5. Administered oxygen therapy. 6. Administered bronchodilators as per physicians order.

Objective Data:

ASSESSMENT Subjective Data:

NURSING DIAGNOSIS Ineffective airway clearance related to broncho constitution increased mucus production,ineffect ive cough,broncho pulmonary infection.

GOAL Achiev ement of airway clearan ce

INTERVENTION

RATIONAL

IMPLEMENTATION I.

EXPECTED OUTCOME Verbalizes need drink fluids. to

1. Assess the general condition a. Provide of the patient. baseline dara. 2. Encourage the use of b. Improve diaphragmatic ventilation breathing and and coughing mobilize techniques. secretions. 3. Instruct the c. Bronchial patient to avoid irritants bronchial cause irritants such as broncho cigarette constriction smoking. . 4. Teach early signs d. Early of infection that recognition are to be reported is crucial. to the clinician immediately. e. Adequate delivery of 5. Assist in medication administering to the nebulizer or airways. MDI. f. Improve 6. Administer airway medications as clearance. per physicians order.

II.

Assessed the general condition of the patient. Encouraged the use of diaphragmatic breathing and coughing techniques. Instructed the patient to avoid bronchial irritants such as cigarette smoking. Taught early signs of infection that are to be reported to the clinician immediately. Assisted in administering nebulizer or MDI. Administered medications as per physicians order.

Demonstrate diaphragmatic breathing and coughing.

Coughing is minimized.

III.

Objective Data:

IV.

V.

VI.

SUMMARY:
Thus we people learned about chronic obstructive pulmonary disease and causes , clinical features, and management for curing this disease.

CONCLUSION:
Thus from todays session we people had some knowledge on causing nature of chronic obstructive pulmonary disease and its management.As a whole I thank my principal mam and all staff and everyone for your patience given to me while I am taking my session.I thank you for this opportunity to share my knowledge to all.

BIBLIOGRAPHY:
BRUNNER & SUDDHARTHS,Textbook of Medical-Surgical Nursing,Published by Lippincott Williams & Wilkins,12th Edition,Volume-1,Page no:- 601-630 BT.BASAVANTHAPPA,Textbook of Medical Surging and Nursing,!st Edition,Jaypee Medical (P) Ltd, Page no:-528-540

PHILIPS,Textbook of Medical surging and Nursing,1st Edition, Page no:- 820-828