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Application of theory & Lifestyle modification of patient with COPD and Asthma

Asma, Hind, Nawal, Oksha, Sarah Course coordinator Nazih Abu Tabar RN, MSc College of Nursing Riyadh KSAU-HS

Objectives:
At the end of this seminar the student will be able to: -

Define the COPD and Asthma. Understand the chronicity of the disease and the risk factors related to it and the goal of managing the disease. Recognize the statistical of COPD and Asthma in KSA and worldwide. Describe the lifestyle modification in COPD and Asthm. Apply models on case scenario about Astma.

COPD
Chronic obstructive pulmonary disease (COPD) is a condition that makes breathing difficult. Is a chronic airflow limitation that is not reversible. A broad term that covers several lung conditions, including chronic bronchitis and emphysema. ?

Asthma
Asthma is a multifactorial disease that is characterized by airway hyperresponsiveness, inflammation. Inflammation leads to cough, chest tightness, wheezing and dyspnea. Is often reversible spontaneously or under treatment.

Chronicity of disease
COPD
It is a major cause of morbidity and mortality. Worldwide, COPD causes about 3 million deaths each year

(Bourke, 2003). In the UK in 1999, the number of deaths from COPD had risen to 32 155 (British Thoracic Society, 2002b), which relates to one in 20 of all deaths, making it the fifth leading cause of death.
Complications of COPD include: Respiratory infections.. High

blood pressure.. Heart problems.. Depression.

Chronicity of disease
Asthma
Asthma is a common chronic disease worldwide and affects

approximately 24 million persons in the United States.


It is the most common chronic disease in childhood, affecting an

estimated 7 million children.


it is a common cause of hospitalization for children in the United States. Complications of Asthma include: Death.. Decreased ability to exercise

and take part in other activities.. Lack of sleep due to nighttime symptoms .. Permanent changes in the function of the lungs.. Persistent cough ..Trouble breathing that requires breathing assistance (ventilator)

Major risk factor related to these diseases


COPD

environmental exposures and host factors. cigarette smoking. passive smoking.

Asthma
Common allergens can be seasonal (eg, grass, tree, and weed pollens) or perennial (eg, mold, dust, roaches, or animal dander). airway irritants (eg, air pollutants, cold, heat, weather changes, strong odors or perfumes, smoke). exercise, stress or emotional upsets, sinusitis with postnasal drip, medications, viral respiratory tract infections, and gastroesophageal reflux.

prolonged and intense exposure to occupational dusts and chemicals, indoor air pollution, and outdoor air pollution. deficiency of alpha1 antitrypsin.

The goal of managing the disease


The goals of effective COPD and Asthma management are

to: Prevent disease progression. Relieve symptoms. Improve exercise tolerance. Improve health status. Prevent and treat complications. Prevent and treat exacerbations. Reduce mortality.

Statistics

Statistics (Con..)

According to the latest WHO estimates (2004), currently 64 million people have COPD and 3 million people died of COPD. WHO predicts that COPD will become the third leading cause of death worldwide by 2030.

Statistics (Con..)
In United states

Statistics (Con..)

Affect of lifestyle modification:


smoking cessation, good nutrition, good hand hygiene, obtaining vaccinations, physical exercise, social and emotional support, Learning breathing techniques, avoid stimulating environment. How all this will affect positively on patient with COPD and Asthma?

Case scenario:

Mr.S 6 years old came through ER with his mother complaining of shortness of breath, persistent cough, loud wheeze, tired, diagnosed with asthmatic attack because he exposed to cigarette smokes at home. He admitted to ward 8 and the mother ask the nurse to give oxygen because he needs it and she always use O2 at home when he gets attack. During the assessment the nurse found his father is smoker, and he always smokes cigarettes at home. Also, his grandfather is asthmatic. His mother does not give him the medication when he is stable, but in attack she does. She said that the medications do not give any benefits when he is stable. She asked if there is any alternative treatment instead of medications. Temp: 37 SPO2:89 RR: 56, HR:111 Weight:18,height:123cm

Risk Factors:
Modifiable Non- modifiable

life style

family history

medication administration

Age

Mr. S needs:

Maintain airway clear and intact. Medication adherence. Identify potential triggers. correct misconception. Psychological support.

chronic care model

self management support

health system

Increase awareness how to attack in children Have precautions to avoid causes of asthma attack Emotional support and strategy asthmatic child Increase coping for child with asthma

Primary health care centers catering the needs of patients with asthma. Access for care and follow up Free treatment Special department for asthmatic children Educational session after each follow order to increase the awareness toward asthmatic signs and symptoms,Inhaler medication use.

Apply process of discovery for children


Identify child needs regarding condition

Community resources and policies

delivery system design

Asthma day on 5 may ,during the world asthma day , the Saudi national asthma committee (SNAC) ,it is health education activities directed to physicians ,nurse and allied health services. SNAC is also distributing leaflets and flyers on asthma education Raise the awareness of public on asthma and relief the suffer of asthmatic patient.

Multidisciplinary team availability (nurse specialists ,consultants ,educators, dietitians, social works, respiratory therapist access to have holistic care regarding the condition

Clinical information system

decision support

Provide incidence and prevalence of asthma attack in order to figure out the severity of disease and mortality and morbidity rate of childhood asthma In national guard hospital the use Quadra med system which facilitate sufficient information for asthmatic children hospital Message reminder for patient appointments

Provide child with qualified treatment and support him/her and the family as well to decide and accept what is suitable for them.

Behavior change model


Precontemplation.
His mother dose not give him the medication when he is stable, but in attack she dose. She said that the medications do not give any benefits when he is stable.

Educational objectives and instructions to prevent noncompliance behavior


Assess child and identify potential triggers. Prevention of attack. Medication administration. Motivation toward medication adherence. Correct misconception regarding the medication. Motivation to change life style. Maintain healthy diet. Increase awareness of some techniques to enhance the airway and improve coping. Improve patient and his mother knowledge.

Patient Educational model or tool


These tools can help your patients to identify their problems and avoid the risk factors which can modifiable.

Summary:

Asthma and COPD are serious condition which lead to difficulties breathing. COPD is a major cause of morbidity and mortality. WHO predicts that COPD will become the third leading cause of death worldwide by 2030. Asthma is the most common chronic disease in childhood, affecting an estimated 7 million children. It lead to many serious complication if it doesnt treat well.

Conclusions
at the end, a respiratory system is the major important system we have to take care of it and prevent any damage that affect its function.

References:

http://www.cdc.gov/copd/pdfs/Framework_for_COPD_Prevention.pdf. Global surveillance, prevention and control of chronic respiratory diseases : a comprehensive approach / Jean Bousquet and Nikolai Khaltaev editors. World Health Organization 2007 http://www.who.int/respiratory/copd/management/en/index.html Patient Education. A practical Approach book. Richard D. Muma, Barbara Ann Lyons. http://science.kennesaw.edu/~bodavis/LECT10.PDF.