This essay will give a critical account of a patient summary given below. It will incorporate the pathophysiology of COPD, linking the signs and symptoms that the patient presented on admission. It will also explore the detailed process of respiratory assessment of a patient experiencing exacerbation of COPD in hospital.

This essay will give a critical account of a patient summary given below. It will incorporate the pathophysiology of COPD, linking the signs and symptoms that the patient presented on admission. It will also explore the detailed process of respiratory assessment of a patient experiencing exacerbation of COPD in hospital.

Mrs Williams had been admitted to A & E following exacerbation of COPD. She is known type two diabetes, asthmatic and a heavy smoker. On admission she is alert and orientated. However she is unable to talk in full sentences and to take up her peak expiry flow rate due to an increased respiratory rate. She presented with BM of 2.4mmhg, RR of 32BPM, HR of 120BPM, and SPo2 levels of 80% on 60% O2. Her presenting symptoms included increased breathlessness, wheeziness, cough, increased sputum production and increased anxiety. She was using her accessory muscles while breathing and appeared distressed and tired. From the summary above it is clear that Mrs. William is acutely ill suffering from diagnosis given at the handover of exacerbation of COPD. It was evident from her old medical notes that she has been admitted with the same problems before several times.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease marked by an irreversible, damage to the smaller air sacs in the lungs called alveoli (www.patient.co.uk). COPD leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out of the lung. George-Gay & Chernecky (2002) claims that an excercabation of COPD is acute in onset and a constant deterioration of the patient’s symptoms.Comprehensive Assessment Of A Chosen Patient Nursing Essay

The main complaint of the presented complain on admission was increased breathlessness which is common worsening symptom of excercabation of COPD. The primary cause for breathless in COPD is due to the interference of gaseous exchange process in the alveoli. The interference is caused due to the loose of elasticity of the alveoli which results in the airways to become narrow (Hoggs and Senior 2002). Therefore the lungs hyper-inflates in order to get rid of trapped air in side the lungs which causes shortness of breath (Bersten & Soni (2009) and Price et al, 2005).

Another symptom of excercabation of COPD is breathlessness with wheeze. Mrs. Williams also presented with wheeziness as well as shortness of breath which could be heard without stethoscope. A wheeze is an unusual symptom of COPD however it is classic for Mrs. William as she has history of asthma and the fact that she is a heavy smoker. A wheeze is defined as a whistling sound while breathing. This occurs as a result of an air flow due to an obstructed airway in the lungs (www.patient.co.uk & Ali, Summer & Levitzky (2009).Comprehensive Assessment Of A Chosen Patient Nursing Essay

Cox (2001) states that the purpose of the respiratory assessment is to determine the respiratory status of the patient and to determine information related to other systems such as cardiovascular and neurological system. It is claimed the deterioration in patient condition often starts with respiratory function abnormalities. Hunter & Rawlings-Anderson (2008) also claims that a thorough assessment helps the nurses to diagnose, manage and evaluate therapeutic interventions for the patient at and early stage which is also agreed by Kennedy (2007).

The look, listen and feel approach is used throughout the assessment in the practice in order to carry out an effective assessment. The use of this approach is also emphasized by Hunter & Rawlings-Anderson (2008). Simpson (2006) suggests that a comprehensive respiratory assessment is carried out in different steps. These steps include initial assessment, history taking, physical examination and further examinations. Following these steps will ensure that no information is missed which can give a vital information on patient’s health status (Hunter & Rawlings-Anderson , 2008). This essay will now explore each stage in detail.Comprehensive Assessment Of A Chosen Patient Nursing Essay

Simpson (2006) identifies the first stage in respiratory assessment as preparing the patient for an assessment making sure that the patient is comfortable and patient has been explained with the procedure and consented verbally. It also involves making sure that patient is seated in an upright position to facilitate maximum lung expansion. According to Bickely (2003) and Moore (2007) an upright position also helps to access the anterior and posterior thorax. Moreover, it is responsibility of the nurse to make sure that a suitable environment is provided in order to ensure privacy. Cox (2001) agrees that this can help physical and psychological comfort for the patient. Simpson (2006) and Hunter & Rawlings-Anderson (2008) states that using the look listen and feel approach during an initial assessment stage is paramount as by observing a patient can give us lots of vital information about their condition. This involves observing the patient to determine the degree of breathlessness, distress, cyanosis and their speech pattern. Vital sings of the patient must be noted as an emergency interventi