Page 12 - Altered Obstructive Nursing Care
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Nursing Interventions Rationale
Discuss individual factors that may trigger or
aggravate condition (excessively dry air, wind, These environmental factors can induce or
environmental temperature extremes, pollen, aggravate bronchial irritation, leading to
tobacco smoke, aerosol sprays, air pollution). increased secretion production and airway
Encourage patient and SO to explore ways to blockage.
control these factors in and around the home
and work setting.
Cessation of smoking may slow or halt the
progression of COPD. Even when the patient
Review the harmful effects of smoking, and wants to stop smoking, support groups and
advise cessation of smoking by the patient medical monitoring may be
and SO. needed. Note: Research studies suggest that
“side-stream” or “second-hand” smoke can be
as detrimental as actually smoking.
Provide information about activity limitations
and alternating activities with rest periods to
prevent fatigue; ways to conserve energy Having this knowledge can enable patients to
during activities (pulling instead of pushing, make informed choices or decisions to reduce
sitting instead of standing while performing dyspnea, maximize activity level, perform most
tasks); use of pursed-lip breathing, side-lying desired activities, and prevent complications.
position, and the possible need for
supplemental oxygen during sexual activity.
Peak flow level can drop before the patient
exhibits any signs and symptoms of asthma
Instruct asthmatic patient in use of peak flow during the “first time” after exposure to a
meter, as appropriate. trigger. Regular use of the peak flow meter may
reduce the severity of the attack because of
earlier intervention.
Frequently these patients are simultaneously on
several respiratory drugs that have similar side
effects and potential drug interactions. It is
Discuss respiratory medications, side effects, important that patient understand the
adverse reactions. difference between nuisance side effects
(medication continued) and untoward or
adverse side effects (medication possibly
discontinued or dosage changed).
Demonstrate technique for using a metered-
dose inhaler (MDI), such as how to hold it, Proper administration of drug enhances
taking 2–5 min between puffs, cleaning the delivery and effectiveness.
inhaler.
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