This assignment will examine the care of a patient with one particular acute care problem. The acute care problem is breathlessness and this will be explored using the nursing process of assessment, planning, implementation and evaluation. Additionally it will discuss the care provided to the patient giving a rationale using current research and evidence. Furthermore it will consider how this knowledge of this acute problem can enhance future practice.
In accordance with the Nursing and Midwifery Council, (NMC) Code of Professional Conduct (NMC, 2004) on safeguarding patient information, no names or places will be disclosed. Therefore throughout the following assignment the patient will be referred to as Richard.
Richard is a 62 year old gentleman who presented to the department with a complaint of acute breathlessness (dyspnea). He appeared distressed and reported he was finding it increasingly difficult to breath. He informed the staff that he had been producing excessive, abnormal sputum for a few days, however it was only the last few hours that his breathing had become unmanageable.
He explained that he was diagnosed with chronic obstructive pulmonary disease (COPD), which the doctor stated was emphysema, the year previous, and although he occasionally become breathless he felt this was different. Richard was diagnosed with an exacerbation of his COPD and this is defined by Vestbo (2004) as a sustained worsening of the patient's condition, from the stable state and beyond normal day-to-day variations that is acute in onset.
Emphysema decreases the efficiency of the gas exchange process (Shaw, 2005) which is the reason for Richards's dyspnea. It affects the alveoli, specifically their sensitive membranes through which the gas exchange process occurs. Emphysema produces alveolar membranes to lose normal elastic recoil, therefore trapping and stagnation of alveolar air, (National Emphysema Foundation, 2006) these then become brittle, and then...