GUAGUA NATIONAL COLLEGES

Guagua, Pampanga
College of Allied Medical Programs

Unveiling Chronic Obstructive Pulmonary Disease:

An Informative Guide

In Partial Fulfillment of the

Requirements in Health Education
for the Degree Bachelor of Science in
Nursing

SUBMITTED BY:

Angeles, Micaella N.
Baluyut, Ginger C.
Candelario, Shaina Kaye M.
Correa, Ayesha Froan B.
Dela Pena, Dexter John M.
Del Rosario, Ma. Jenine Bianca P.
Dizon, Franchesca Jennina S.
Guevarra, Aneche Y.
Landagan, Cherlyn F.
Larioza, Rochelle S.
Mangalindan, Francine Mae
Quinto, Mariella Jelaine T.
Sangil, Jhon Carl B.
Tuazon, Alexia Megalie O.

2024
CHAPTER 1

I. INTRODUCTION

Health is a dynamic state influence by various factors, including genetics, lifestyle

choices, environmental exposures, and access to healthcare (Dorothy Johnson, 1980). Amidst
this intricate tapestry of health lies a prominent concern: Chronic Obstructive Pulmonary
Disease (COPD), a continuing respiratory condition that takes heavy toll on affected
individuals and health care systems alike. This study aims to understand the complexities of
COPD, including its pathophysiology, risk factors, and management, is crucial for improving
patient outcomes and reducing the impact of the disease.

A. Definition
Chronic obstructive pulmonary disease (COPD) is a common lung disease causing
restricted airflow and breathing problems. The respiratory system is significantly impacted
by Chronic Obstructive Pulmonary Disease (COPD) in a numerous way, it starts a chain
reaction that alters the structure, functionality, and general health of the respiratory system.
COPD is sometimes called emphysema or chronic bronchitis. (WHO, 2023).
Emphysema leads to the deterioration of the delicate alveolar walls and elastic fibers
within the lungs, causing the collapse of small airways during exhalation and impeding the
outward flow of air. Conversely, chronic bronchitis involves inflammation and constriction
of the bronchial tubes, accompanied by increased mucus production. This excess mucus
further obstructs the already narrowed airways, resulting in persistent coughing as the body
attempts to clear the air passages.
COPD ranks as the third highest contributor to global mortality, with 3.23 million
deaths recorded in 2019. Over 70% of COPD cases in high-income nations are attributable
to tobacco smoking, while in low- and middle-income countries (LMIC), this figure drops to
30–40%. Notably, almost 90% of COPD-related deaths among individuals under 70 years
old occur in LMIC. Additionally, COPD stands as the seventh most significant cause of
global disability, as measured by disability-adjusted life years, highlighting its widespread
impact on health worldwide.

B. Signs and Symptoms

Chronic obstructive pulmonary disease (COPD) stands as a progressive and chronic

inflammatory lung ailment typified by persistent coughing and shortness of breath. The
 indications of COPD can vary greatly and have a substantial effect on a person's respiratory
health and general well-being. Early detection of COPD plays a pivotal role in impeding its
advancement and preventing grave complications. Physicians rely on the Global Initiative for
Chronic Obstructive Lung Disease (GOLD) Criteria system to gauge the severity of COPD,
which comprises four delineated stages: mild, moderate, severe, and very severe. The
determination of an individual's stage is based on outcomes from a pulmonary function test
known as spirometry, which evaluates lung function by assessing the volume of air one can
inhale and exhale and the rate at which it is expelled. Additionally, the severity of symptoms
and the frequency of exacerbations are taken into account by healthcare providers in
discerning the appropriate stage of COPD for a patient.

In the initial stage of COPD, characterized as mild, symptoms are often subtle, including
occasional shortness of breath particularly during physical activity, on and a persistent
cough, sometimes accompanied by mucus. Despite their understated nature, these symptoms
may evade detection by affected individuals. However, even in this early phase, lung damage
can occur. In the moderate stage of COPD, symptoms that were present in the earlier
stage intensify as airflow limitations progress. Shortness of breath becomes more pronounced
during physical activities, accompanied by increased coughing and mucus production.
Individuals may also experience wheezing, fatigue, and difficulty sleeping.

C. Causes and Effects

The pathogenesis of COPD is emphysema and chronic bronchitis these two are the
primary contributors to COPD. Emphysema leads to the deterioration of the delicate alveolar
walls and elastic fibers within the lungs, causing the collapse of small airways during
exhalation and impeding the outward flow of air.

Conversely, chronic bronchitis involves inflammation and constriction of the

bronchial tubes, accompanied by increased mucus production. This excess mucus further
obstructs the already narrowed airways, resulting in persistent coughing as the body attempts
to clear the air passages.

Respiratory efficiency is hampered by alveolar damage, which is evident in

emphysema and decreases the surface area available for the intake of oxygen and the
emission of carbon dioxide. Breathing mechanics are further compromised by COPD's
reduction of lung elasticity, which causes hyperinflation and weakening of the respiratory
muscles.
 COPD is primarily caused by long-term exposure to irritants that damage the lungs
and airways. The main risk factor for COPD is cigarette smoking among individuals.
Furthermore, exposure to tobacco products like cigars and pipes, particularly when inhaling
the smoke, can also precipitate the condition.

Additionally, even non-smokers are at risk of developing COPD through exposure to

secondhand smoke, especially in residential settings where smokers reside. However,
additional factors that can also contribute to the development of the disease this includes
pollution and fumes, exposure to environmental pollutants and inhaling chemical fumes,
dust, or harmful substances in the workplace can be significant contributors. Furthermore,
individuals may develop COPD due to exposure to biomass fuel smoke in inadequately
ventilated indoor spaces.

Occasionally, genetics can also play a role in COPD onset. This is particularly
evident in cases of "alpha-1 antitrypsin deficiency," or AAT deficiency, a rare genetic
condition. Individuals with this disorder have a genetic defect that hampers the production of
a vital lung-protecting protein. Consequently, their lungs are more susceptible to damage,
potentially leading to severe COPD.

D. Treatment and Medications

The primary treatments for COPD encompass a multifaceted approach aimed at
managing symptoms and improving quality of life. Foremost among these strategies is
smoking cessation, recognized as the most impactful measure for halting disease progression.
Even in advanced stages, quitting smoking can prevent further deterioration, with support
readily available from healthcare providers and cessation programs. Additionally, cognitive
behavioral therapy plays a vital role in COPD management, offering techniques to address
anxiety, depression, and stress, thereby enhancing coping mechanisms and overall well-
being.

Inhalers play a pivotal role in COPD management, providing rapid relief and
targeted therapy directly to the lungs. Categorized into short-acting and long-acting
bronchodilators, these devices address specific symptoms and treatment needs. Steroid
tablets may complement inhaler therapy, particularly in cases of persistent breathlessness or
frequent exacerbations, by reducing airway inflammation and enhancing symptom control.
 Additional modalities, such as pulmonary rehabilitation and electrical muscle
stimulation, offer holistic support to enhance exercise tolerance and alleviate symptoms. In
severe cases or exacerbations, nebulized medications and roflumilast may be necessary to
control symptoms and inflammation. Long-term oxygen therapy can help maintain adequate
blood oxygen levels, especially in individuals with compromised oxygen levels.

In certain instances, COPD patients may require tube thoracostomy to address

complications like pneumothorax or pleural effusion. While this procedure may pose
challenges due to underlying respiratory conditions, it can effectively alleviate symptoms and
improve lung function when performed with careful monitoring and management.

For patients unresponsive to conventional treatments, surgical interventions such as

lung volume reduction surgery or lung transplantation may be considered. Although these
options carry risks, they offer potential benefits in enhancing lung function and overall
quality of life. The decision to pursue surgical options should be based on thorough patient
assessment and consideration of individualized risk-benefit profiles. Additionally, non-
invasive interventions like tube thoracostomy can aid in managing acute exacerbations of
COPD, helping to remove trapped air, and allowing the lung to re-expand, thereby improving
respiratory function.

To add more, nutrition plays a crucial role in managing chronic obstructive

pulmonary disease (COPD), while it can't cure COPD, a healthy diet can reduce
complications like chest infections. Guidelines include reducing carbs to lower carbon
dioxide, favoring whole foods and healthy fats, and including protein-rich sources like tofu
and lean poultry. Potassium-rich foods support lung function, while hydration is crucial for
thinning mucus. Weight management is key, as excess weight strains the heart and lungs,
while being underweight can lead to fatigue and infections. Practical mealtime strategies, like
small, frequent meals and easy-to-prepare foods, can ease strain on the lungs and encourage
adequate calorie intake.

In summary, by integrating these approaches, individuals with COPD can effectively

manage their condition and enhance their overall well-being.
E. Definition of Terms

Asthma: Defined by a proliferation of activated T helper lymphocytes, mast cells, and

eosinophils leading to a persistent inflammation of the respiratory tract (Hamid & Tulid,
2008).

Chronic Bronchitis: A prevalent but erratic symptom of chronic obstructive pulmonary

disease (COPD). It has many clinical ramifications, such as a faster deterioration of lung
function, increased risk of airflow obstruction in smokers, a tendency to lower respiratory
tract infection, more frequent exacerbations, and a worse overall mortality rate (Kim &
Criner, 2012).

Chronic Obstructive Pulmonary Disease (COPD): COPD may be a progressive lung

illness characterized by wind stream restriction that's not completely reversible, driving to
side effects such as shortness of breath, hack, and sputum generation (Worldwide Activity
for Incessant Obstructive Lung Malady, 2021). In this ponder, COPD alludes to the umbrella
term including constant bronchitis and emphysema.

Comorbidity: Comorbidity alludes to the nearness of one or more extra constant conditions
nearby COPD, such as cardiovascular infection, diabetes, or sadness. Overseeing
comorbidities is fundamental for comprehensive COPD care and improving patient outcomes
(Vanfleteren et al., 2016).

Dyspnea: Dyspnea, too known as shortness of breath, is a common side effect experienced
by people with COPD. It can essentially affect day by day exercises and quality of life,
requiring compelling administration procedures as portion of COPD care (Parshall et al.,
2012).

Emphysema: Characterized as airspace enlargement of the adult lung in contrast to

developmentally defective alveolarization of the newborn lung, which is a common
definition of progressive destructive lung disorders (Stewart & Voekel, 2008).
Health: A dynamic state influenced by various factors, including genetics, lifestyle choices,
environmental exposures, and access to healthcare (Dorothy Johnson, 1980).

Inhaler Strategy: Inhaler method alludes to the proper strategy of utilizing inhaler gadgets
to provide medicine to the lungs viably. Appropriate inhaler method is significant for
optimizing the helpful benefits of COPD medications (Lavorini & Fontana, 2014).

Management: Administration within the setting of COPD alludes to the comprehensive care
and treatment procedures aimed at controlling side effects, making strides lung function, and
improving the quality of life for people with COPD (Worldwide Activity for Incessant
Obstructive Lung Illness, 2021).

Oxygen Therapy: Oxygen treatment involves the organization of supplemental oxygen to

people with COPD who have low blood oxygen levels. It makes a difference ease side effect,
make strides work out resistance, and enhance quality of life in COPD patients (Hardinge &
Annandale, 2011).

Pathophysiology: Pathophysiology refers to the ponder of the utilitarian changes that happen
within the body as a result of infection or damage (Huether & McCance, 2017).
Understanding the pathophysiological instruments of COPD is basic for creating focused on
treatment techniques and mediations.

Pulmonary Function Tests: Pulmonary function tests are demonstrative tests that assess
lung function, including spirometry, lung volumes, and dissemination capacity. These tests
offer assistance to evaluate the seriousness of COPD, screen infection movement, and direct
treatment choices (Pellegrino et al., 2005).

Pulmonary Rehabilitation: Pneumonic rehabilitation could be a multidisciplinary program

that incorporates work out preparing, instruction, and behavioral intercessions to progress the
physical and enthusiastic well-being of people with incessant respiratory conditions like
COPD (Spruit et al., 2013).

Risk Factors: Hazard components are factors or conditions that increment the probability of
creating a specific illness or wellbeing condition (Rothman & Greenland, 1998).
Distinguishing and tending to the chance factors associated with COPD is basic for
anticipation and early mediation.

Smoking Cessation: Smoking cessation alludes to the method of quitting tobacco use. It
may be a vital component of COPD administration, as smoking is the essential chance
calculate for creating COPD and stopping smoking can moderate malady movement and
make strides results in individuals with COPD (Anthonisen et al., 2005).

Spirometry: Spirometry may be a common pneumonic work test that measures the volume
of discuss breathed out and breathed in by the lungs. It may be a crucial device for
diagnosing and observing respiratory conditions like COPD (Pellegrino et al., 2005).

Worsening: A compounding in COPD alludes to a sudden compounding of indications,

regularly activated by contaminations, discuss contamination, or other variables.
Exacerbations can lead to expanded horribleness and mortality in people with COPD
(Wedzicha & Seemungal, 2013).

F. Case Study

Case Study 1:

Reason for Consultation: Sudden onset dyspnea and respiratory distress

History of Presenting Condition: A 65-year-old male, was seen in the ER today with a
complaint of sudden onset dyspnea and some respiratory distress. Denies any nausea,
vomiting, chest pain, hemoptysis, cough, fever, and chills.

History: Patient is positive for asthma and COPD as patient is lifelong smoker at 1+ packs
per day.

Assessment: CHEST has good air entry bilaterally. No wheezing. Bilateral basal crackles
are noted. Some dullness to percussion on the left. CT scan was ordered and shows a left
pleural effusion and acute pneumothorax due infectious process. Probable comprehensive
atelectasis

Plan

1. Admit patient to the unit for treatment and possible left thoracotomy by lack of
improvement on standard therapy.

2. Treat with a course of antibiotics for URI.

3. oxygen therapy if indicated by 02 sats.

 4. Repeat CT scan in 48 hours. Up

Case Study 2:

Reason for Consultation: Shortness of breath

History of Presenting Condition: The patient is a 60-year-old white female presenting to

the emergency department with acute onset shortness of breath. Symptoms began
approximately 2 days before and had progressively worsened with no associated,
aggravating, or relieving factors noted.

History: Patient is positive for COPD a year ago and has been using BiPAP ventilatory
support at night when sleeping.

History: Similar symptoms approximately 1 year ago with an acute, chronic obstructive
pulmonary disease (COPD) exacerbation requiring hospitalization.

Assessment: Patient has requested to use BiPAP ventilation in the emergency department
due to shortness of breath and wanting to sleep. Initial physical exam reveals temperature
97.3 F, heart rate 74 bpm, respiratory rate 24, BP 104/54, HT 160 cm, WT 100 kg, BMI 39.1,
and O2 saturation 90% on room air, tachypnea present, (+) wheezing noted, bilateral rhonchi,
decreased air movement bilaterally. The patient was barely able to finish a full sentence due
to shortness of breath.

Plan

1. Administer supplemental oxygen to improve oxygen saturation.

2. Start bronchodilator therapy with medications like albuterol and ipratropium bromide
to relieve bronchospasm.
3. Consider systemic corticosteroids to reduce airway inflammation.
4. Continuously monitor vital signs and respiratory status.
5. Assess the need for non-invasive ventilation if the patient's condition worsens.
6. Evaluate for underlying pulmonary pathology with chest imaging if necessary.
7. Consider admission to the hospital based on the patient's response to treatment and
clinical condition.
8. Arrange for follow-up with a healthcare provider for long-term management.

II. STATEMENT OF THE PROBLEM

 The research undertaking is to explore and assess the Chronic Obstructive Pulmonary
Disease with the aim provide informative guide. Specifically, this would attempt to find an
answer to following questions:

1. What is Chronic Obstructive Pulmonary Disease?

2. What are the symptoms, cause and effect, medication, and treatment of Chronic
Obstructive Pulmonary Disease?
3. What are the primary risk factors for developing COPD?
4. How can COPD exacerbations be prevented or minimized?

III. OBJECTIVE OF THE STUDY

This study aimed to delve deeper into Chronic Obstructive Pulmonary Disease
(COPD) and discuss its etiology, risk factors, effects on health, clinical manifestations,
diagnostic methods, treatment options, and medication options.

Through a descriptive research approach, our study aims to contribute to a deeper

understanding of COPD among nursing students, patients with COPD and their families,
future researchers, and the general population. By providing comprehensive knowledge about
COPD, raising awareness about its impact, promoting strategies for maintaining health, and
exploring avenues for illness prevention, we aspire to empower individuals and improve
COPD management.

IV. SIGNIFICANCE OF THE STUDY

An in-depth look at Chronic Obstructive Pulmonary Disease (COPD) will be

beneficial in understanding the disease much further. By examining different aspects of
COPD, it aims to improve patient care and inspire further research in this critical area.

The following are individuals that would likely benefit from the study:

 Nursing Students
The study offers a comprehensive understanding of COPD essential for providing competent
and compassionate care. By elucidating the complexities of COPD, the researchers equip
future nurses with the knowledge and skills necessary for early detection, accurate diagnosis,
and effective management of this prevalent respiratory condition. At the end of this study,
Nursing students will be deeply aware and learn to foster a supportive environment for
individuals living with COPD, contributing to improved patient outcomes, and advancing the
field of respiratory care.
 Patients with same conditions
The main beneficiaries of this study, which may help them gain a deeper insight into their
condition. It helps them to have a better understanding of the risk factors and mechanisms
underlying COPD. It can be utilized as an educational resource to empower them about the
causes, symptoms, self-management, existing treatments, and some therapy or exercises that
can improve their health management. They will be a knowledgeable person who is aware of
the underlying facts when it comes to managing their condition. Therefore, this study can
help COPD patients by enhancing their well-being, promoting health equity, and improving
outcomes.

 Family of patients with COPD

Families of patients with COPD will benefit from this study by gaining a deeper
understanding of the disease and its implications. It helps them provide better support and
care to their loved ones dealing with COPD, fostering a supportive environment conducive to
the patient's wellbeing.
 Future Researchers
The findings presented in the study will serve as a useful reference material about COPD
who would plan to conduct their research relative to this study. Furthermore, this study
provides a solid starting point for delving deeper into COPD. They can use the insights
gained here to explore new ideas, fill in knowledge gaps, and develop better ways to manage
and treat the condition. By building on what we've learned, they can make strides toward
improving the lives of COPD patients and their families.

V. SCOPE AND LIMITATION

The scope of this summary encompasses an in-depth exploration of Chronic

Obstructive Pulmonary Disease (COPD), including its pathophysiology, symptoms, risk
factors, and management strategies. It highlights the significant impact of COPD on
individuals' health and well-being globally and emphasizes the importance of understanding
the complexities of this respiratory condition. Additionally, the summary discusses the
nursing care plan framework (ADPIE) for COPD patients, focusing on comprehensive care
measures such as airway management, gas exchange facilitation, nutrition enhancement,
complication prevention, patient education, and outcome assessment. Furthermore, it
addresses the significance of drug studies in evaluating the effectiveness and safety of
commonly used medications for COPD treatment, aiming to improve treatment choices and
patient care outcomes.

CHAPTER II

I. REVIEW OF RELATED LITERATURE

Local Literature

Caldoza-De Leon (2020) states that individuals all over the globe are losing their
loved ones to lung disease at a rapid rate This advanced and untreatable illness significantly
impairs the breathing of 210 million individuals worldwide. Only 10% of Filipinos aged 40
and above may suffer from COPD, with only 2% receiving a clinical diagnosis. 10 Filipinos
succumb to smoke-related illnesses every hour, with COPD being the 7th leading cause of
death. Cigarette smoking causes 9 out of 10 cases of COPD. The Philippines has the second
highest smoking prevalence among ASEAN members with 13 million adult Filipino
smokers. Other factors associated with COPD include exposure to specific gases or fumes,
large quantities of secondhand smoke and pollution, and constant use of a cooking fire
without adequate ventilation. A rare occurrence is when non-smokers develop emphysema
because they have a deficiency in alpha-1 antitrypsin protein.

According to Blake et al. (2024), in the Philippines, COPD is a significant public

health concern, with a high prevalence among adults, particularly in urban areas. The
prevalence of COPD among Filipino adults aged 40 years and older is estimated to be around
14.6%. The study also highlights the impact of smoking, biomass fuel exposure, and air
pollution on the prevalence of COPD in the Philippines. Tobacco smoking is the primary risk
factor for COPD in the Philippines, with a high prevalence of smoking among adults,
especially males. Additionally, exposure to biomass fuel smoke from traditional cooking
methods is a significant risk factor, particularly in rural areas where access to clean cooking
technologies is limited. The management of COPD in the Philippines is often hindered by
limited access to healthcare services, particularly in rural and remote areas. Challenges faced
by healthcare providers in diagnosing and managing COPD include limited access to
spirometry and essential medications. The importance of integrated care and community-
based interventions in improving COPD management in the Philippines is emphasized.
Cultural factors also play a significant role in the prevention and management of COPD in
the Philippines. Traditional beliefs and practices may influence health-seeking behaviors and
adherence to treatment among patients with COPD, providing insights into potential barriers
and facilitators to COPD care in the Philippines.

Protease imbalance and oxidative stress are hallmarks of COPD, an inflammatory

disease that affects the lung parenchyma, pulmonary vasculature, and airways. The lungs'
gas-exchanging surfaces, or alveolar air sacs, are destroyed in emphysema, a type of COPD
that results in obstructive physiology. Smoking and other irritants cause an inflammatory
response in emphysema patients, drawing neutrophils and macrophages that release a variety
of inflammatory mediators. Alveolar sacs are harmed by oxidants and overabundance
proteases in this process. The breakdown of elastin by proteases results in a loss of elastic
recoil, which collapses the airway during exhalation (Ang & Fernandez, 2024).

The signs and symptoms of chronic obstructive pulmonary disease (COPD) are
similar throughout the world in the Philippines. People frequently have a chronic cough that
frequently produces mucus and ongoing dyspnea, especially when they are physically active.
Chest tightness and wheezing, which is characterized by a high-pitched whistling sound
during breathing, are other common symptoms. As a result of heightened vulnerability to
colds, the flu, and other respiratory illnesses, frequent respiratory infections are prevalent.
The increased effort needed to breathe is the reason why many patients report chronic
fatigue. In more extreme situations, low blood oxygen levels can result in cyanosis, which is
a bluish tint to the lips or nail beds. As advanced stages increase energy expenditure and can
decrease appetite due to labored breathing, unintentional weight loss can also be a symptom.
These symptoms can vary in intensity and usually get worse over time, especially if
irritations like tobacco smoke are continuously inhaled. In the Philippines, environmental
factors and medical care accessibility have a major impact on COPD management and
progression (Seposo et al., 2021).

Chronic obstructive pulmonary disease (COPD), a preventable but frequently

misdiagnosed and potentially fatal respiratory condition, is one of the illnesses linked to poor
air quality. Chronic airflow restriction and a chronic inflammatory response in the airways to
harmful particles or gases are characteristics of COPD. The main signs of COPD are
persistent, progressive dyspnea, coughing, and mucus or sputum production. These
symptoms usually appear after the age of 40 to 50. It is still tobacco smoke exposure that is
the main cause of COPD. Nonetheless, recent studies have demonstrated how important fine
particulate matter (PM2.5) is in aggravating COPD. Obesity and occupational exposure to
chemicals, fumes, dusts, and irritants—both organic and inorganic—are additional
modifiable risk factors. According to Lanueva, Espiritu, and Anlacan (2023), non-modifiable
 factors that lead to COPD include advancing age, male gender, deficiencies in lung
development, bronchial hyperreactivity, long-term asthma, respiratory tract infections in
growing up, and a family past with respiratory disorders.

Foreign Literature

Chronic obstructive pulmonary disease (COPD) is a major global health concern

characterized by progressive airflow restriction and respiratory symptoms, which negatively
impact patients' quality of life. Emotional distress is prevalent among COPD patients, with
higher rates of anxiety and depression compared to the general population. Factors contributing
to distress include the high symptom burden and various stressors like hospitalization and fear
of the future. Illness-related emotional distress significantly affects self-management and
outcomes in COPD, yet there is currently no standardized instrument to measure it (Zanolari,
2020).

According to Macleod (2021), exacerbations (ECOPD) are critical events in COPD

progression, with significant socioeconomic burden. They are triggered by acute respiratory
symptoms, but other factors like comorbidities contribute as well (Macleod et al., 2021).
Defining ECOPD accurately is crucial for personalized management strategies, including acute
interventions, prevention of recurrence, and long-term preventative measures.

The risk factors for poor health among Central Appalachian employees with COPD
are not well understood. As predictors of mental and physical discomfort, health risks
included: (1) comorbidities; (2) substance use/abuse; and (3) restricted healthcare access.
Race and income were added as covariates. Compared to respondents without comorbidities,
individuals who reported multiple comorbidities were more likely to experience both
physical and mental suffering. Employees who occasionally smoked electronic cigarettes
were more likely to experience physical discomfort. Individuals who reported financial
hurdles impeding their ability to receive medical care were more likely to experience both
psychological and physical suffering. Employees with lower incomes were more likely to
experience distress than those with higher incomes. Comorbidities, e-cigarettes, and high
medical costs are potential causes of occupation-related disability among employees with
COPD working in Central Appalachian U.S. States. Translation to Health Education
Practice: Worksite interventions should address risks negatively associated with health
outcomes among workers with COPD from Central Appalachia. (M. Stellefson.et.al. 2020)
 Effective management of COPD involves pharmacological therapies and non-
pharmacological interventions, but compliance remains a challenge, emphasizing the need
for personalized approaches (GOLD, 2021).

Furthermore, a thorough framework for the management of COPD is provided by the

Athe Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines (GOLD,
2021). The goals of pharmacological therapies, such as inhaled corticosteroids and
bronchodilators, are to lessen the likelihood of an exacerbation and to relieve symptoms. An
essential part of managing COPD is also non-pharmacological interventions like respiratory
infection vaccinations, smoking cessation programs, and pulmonary rehabilitation. But
compliance with these tactics is still not ideal, underscoring the necessity of customized
methods to address the needs of each patient
 CHAPTER III
I. METHODOLOGY
A. Nursing Care Plan
The care plan we selected follows the ADPIE (Assessment, Diagnosis, Planning, Implementation, and Evaluation) framework to
ensure comprehensive and effective nursing care for patients with COPD.
ASSESSMENT DIAGNOSIS PLANNING IMPLEMENTATION EVELUATION
Assess for the following: After a detailed Goals and expected Therapeutic interventions and Evaluation entails a detailed
 Dyspnea assessment, a nursing outcomes may include: nursing actions for patients with assessment of whether the specified
 Exercise intolerance diagnosis is developed COPD may include: outcomes have been achieved or not.
 Bronchospasm to tackle COPD- Examples are:
 Respiratory changes
related challenges,
 Auscultation findings 1. The patient will maintain
 Increased secretions drawing from the clear and patent airways, 1. Maintaining Patent Airway
 Abnormal breath nurse's clinical insight demonstrating effective Clearance 1. The patient has maintained
sounds and the patient's breath sounds and the clear and patent airways,
 Subcostal retractions individual health ability to effectively 2. Promoting Effective Gas exhibiting effective breath
 Bronchial hyperplasia status. Although cough and clear Exchange & Oxygen Therapy sounds and the ability to
 Persistent cough secretions. effectively cough and clear
nursing diagnoses
 Nasal flaring 3. Improving Breathing Pattern secretions.
provide a structure for 2. The patient will achieve
 Fatigue Through Breathing Exercises
 Confusion care, their improved ventilation and 2. The patient has achieved
 Tachypnea applicability may optimal tissue 4. Administering Medications improved ventilation and
 Airway obstruction differ across clinical oxygenation, as and Pharmacological Support optimal tissue oxygenation, as
 Secretion retention scenarios. In practice, evidenced by ABG values demonstrated by ABG values
 Exertional dyspnea specific nursing within the normal range 5. Promoting Infection Control within the normal range and
 Alveolar damage and the absence of & Preventing Complications the absence of respiratory
diagnostic terms may
 ABG abnormalities respiratory distress distress symptoms.
not always take symptoms.
 Shortness of breath 6. Promoting Optimal Nutrition
 Vital sign changes precedence in care Balance 3. The patient has shown
 Altered respiratory plans. Instead, nurses 3. The patient will improved breathing patterns,
rate. rely on their expertise demonstrate improved 7. Promoting Rest and maintaining a normal
 Ineffective breathing to tailor care plans to breathing patterns, Tolerance to Activity respiratory rate, and is free
address each patient's maintaining a normal from cyanosis and other signs
respiratory rate, and be 8. Providing Patient Education of hypoxia.
distinct needs and
free from cyanosis and & Health Teaching
concerns, prioritizing other signs of hypoxia.
their health objectives.
 B. Summary of the Study

Health, influenced by various factors, encompasses overall well-being and the

utilization of one's capacities in life. Chronic Obstructive Pulmonary Disease (COPD), a
prevalent respiratory condition, poses significant challenges to affected individuals and
healthcare systems worldwide. Understanding COPD's complexities, including its
pathophysiology, symptoms, risk factors, and management, is essential for enhancing patient
outcomes and mitigating its impact.

COPD, characterized by restricted airflow and breathing difficulties, ranks among

the leading causes of global mortality and disability. It encompasses conditions like
emphysema and chronic bronchitis, affecting the respiratory system's structure and function.
Major contributors to COPD include long-term exposure to tobacco smoke, environmental
pollutants, and genetic factors.

Signs and symptoms of COPD vary but commonly include shortness of breath,
chronic cough, wheezing, and chest tightness. As the disease progresses, symptoms worsen,
impacting daily activities and quality of life. Causes of COPD involve the interplay of
emphysema and chronic bronchitis, leading to airway obstruction and inflammation.

Treatment strategies for COPD aim to manage symptoms, improve lung function,
and enhance quality of life. Smoking cessation, inhaler therapy, pulmonary rehabilitation,
and medication options like bronchodilators and corticosteroids play key roles. In severe
cases, surgical interventions or oxygen therapy may be necessary.
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D. Curriculum Vitae