Responding to Altered Health Care Needs: Adult FOP Case Scenario

Define and discuss the condition the patient is presenting with, including the relevant related pathophysiology.

Mr. Doyle is experiencing Chronic obstructive pulmonary disease (COPD) based on the symptoms he is experiencing. Thus, COPD refers to a chronic pulmonary inflammatory illness that produces blocked pulmonary airflow. Symptoms include respiratory trouble, cough, production of mucus (sputum), and wheezing. This is often caused by long-term gas or particle substances exposure, usually through smoking cigarettes (Arrigo et al., 2019 pp. 140). Persons with COPD are more at risk for heart disease, lung cancer, and several other diseases. In this scenario, Mr. Doyle is a persistent active cigarette smoke for decades which makes him experience extreme conditions of COPD.

Consequently, the most prevalent diseases contributing to COPD are emphysema and chronic bronchitis. These two diseases are often expected and can differ in severity among people with COPD. The inflammation of the lining of the bronchial pipes conveys the air from and to the air sacs (alveoli) of the lungs called chronic bronchitis. It is distinguished by cough and daily mucous production (Arrigo et al., 2019 pp. 140). In this regard, emphysema is a disorder in which alveoli are damaged by harmful exposure to cigarette smoke and other irritating gasses and particle matter at the end of the tiniest air passageways of the lungs (bronchioles). Therefore, while COPD is a gradual, longer-term illness, COPD is curable. Most COPD individuals can achieve reasonable symptom control and quality of life with appropriate treatment as well as reduced risk of other related diseases.

Nevertheless, the development of unfavorable functional changes related to an illness is known as pathophysiology. Thus, the latter begins with airway impairment and little airbags in the lungs for patients with COPD. For patients with such conditions, symptoms develop from cough with mucous to breathing difficulties. The COPD damage cannot be remedied. However, the affected individuals may take specific preventive actions to reduce their COPD risk. The combined processes of peripheral inflammation and airway reduction culminate in COPD. The latter leads to airflow constraints and alveoli, and terminal ultimately affects and capillary vessels and tissues deterioration and loss that further limit airflow and diminish transferring capability. Airflow restriction is measured by the quantity and intensity of inflammation, fibrotic development inside the airway, and the presence of secretions and exudates. Reduced exhalation airflow leads to an air trap that might result in less respiration and less activity (Arrigo et al., 2019 pp. 140). In addition, gas transfer abnormalities are associated with decreased airflow and alveolar and pulmonary vascular bed structure loss. Low levels of blood oxygen (hypoxemia) and increased blood carbon dioxide levels (hypercapnia) are caused by the impeded transport of gas.

Using a systematic approach, discuss the assessment and the priorities of nursing care related to the scenario demonstrate an understanding of the biopsychosocial factors that may influence the patient’s care.

Nurses play a critical role in improving the well-being of the patient. In this regard, these healthcare professionals ensure the quality of healthcare services are appropriate by incorporating substantial assessment of the patient to encompass priorities while treating the latter based on the biopsychosocial factors that may alter their care. Therefore, this section will include nursing assessment and preferences for treatment of Mr. Doyle whose has been diagnosed with chronic obstructive pulmonary disease.

According to Toney-Butler, T.J. and Unison-Pace, 2018, the first nursing assessment comprise systematic and ongoing data gathering, the first step in five stages of the nursing process and the sorting, analyzing, and organization of data, as well as recording and communication of data collection. Critical thinking skills within the nursing process offer a policy foundation for developing and guiding a patient care plan with evidence-based practices. This notion of precision training for customized treatment based on the particular cultural, spiritual, and physical demands of the individual, instead of a one-size-fits-all approach trail, leads to an advantageous conclusion. Thus, based on Mr. Doyle’s case, practitioner nurses need to incorporate appropriate health assessment of the patient by gathering information based on his medical history, physiological, sociological, and physiological needs.

Moreover, patient assessment is the initial stage in a patient’s practical medical, personal, and patient’s family history evaluation. An essential element of this procedure involves the collecting of subjective and objective data. Part of the evaluation comprises data collection, using the appropriate age or condition pain scale, by acquiring vital indicators such as temperature, burning rate, heart rate, blood pressure, and pain levels. The evaluation determines Doyle’s present and future treatment requirements through diagnosis. In this regard, the caregiver detects the normal and abnormal physiology of the patient and supports priority actions. Consequently, to determine the appropriate treatment of Mr. Doyle, the caregiver needs to consider encompassing various nursing processes such as assessment, analysis which is also equivalent to diagnosis, planning which involves developing a comprehensive care plan which contains nurse objectives, possible results, including interventions, implementation, and evaluation to determine whether the intervention was successful or not.

While assessing the patient to determine the appropriate priorities, the professional nurse should be able to understand that the initial nurse evaluation aims to define the parameters and responsibilities for evaluating and providing adequate individual patient care. In this regard, it involves documenting the successful level of care to ensure the patient’s need is met in a culturally competent as well as linguistically appropriate manner. Secondly, it should confirm information regarding community support and a safe plan of patient discharge. Therefore, it is essential for healthcare professionals, especially nurses, to strive to complete on a nursing admission assessment board, such that the data collected should be entered and may vary a little according to facilities, including, the admission history and physical examination will be changed to a hospital after the patient has reached the unit or condition (Arrigo et al., 2019 pp. 140).

Pain assessment is also crucial for evaluating the patient to offer an appropriate treatment plan for the latter. Thus, according to MacNee (2006 pp. 1202-1204), pain evaluation can be subjective and hard to evaluate. The patient or the customer says anything based on their pain. The numerous elements that impact the patient’s pain should be understood as informers. Thus, systemic pain evaluation, measurement, and re-evaluation increase the comforting abilities of the patient. Age-sensitive pain levels help to quantify and communicate pain in a concise manner between suppliers. Improving pain assessment communication and reassessing during admission and release procedures facilitates pain management, improving the overall function and quality of life. In addition, in 2017, opportunities for improved pain reassessment policies and processes were identified in the clinic according to one outpatient project performance and improvement. The study indicated that the pain reassessment conformity rates for the 30 minutes described in the clinical policy were low. The poor pain reassessment was due to the high loads of patients, staff recollection rather than documentation, and the absence of established processes in the electro-medical record (EHR). Hindrances to pain assessment and re-evaluation are significant benchmarks for efforts to enhance quality (MacNee, 2006 pp. 1202-1204). Therefore, primary pain management indicators, matched to an opioid epidemic and oversedation danger, all play a part in future research and quality research initiatives, aiming to enhance the pain management goals and overall patient satisfaction. Recognition of pain signs and complete knowledge in evaluating pain will lead to the procedures for treatment and pain.

Additionally, professional nurses need to perform a psychosocial assessment of Doyle to determine his health needs. In this regard, the health and emotional requirements of the patient are the primary focus. The mental or emotional health screening consists of assessing cognitive function, hallucination, and illusion checks, evaluating attention levels, and investigating interest and activity levels. The question of how the client feels and responds to them is part of a psychological evaluation. For instance, is the patient upset, vocal, angry demanding, suicidal or sad, flat-touching, unable to speak, sobbing, stunned, or any indication of drug abuse?

Nevertheless, the psychological review may comprise opinions on the patient’s side depending on whether they are valid or Invalid (Kusnanto, Agustian, and Hilmanto, 2018 pp 497). Therefore, cultural and religious convictions should be taken into account. In this regard, healthcare nurses need to perform delirium screening. Thus, the latter is crucial, as symptoms are frequently mild and easily ignored or dismissed as weariness or sadness.

Another professional approach nurses should incorporate is a biopsychosocial assessment. Thus, the latter allows counselors, social workers, and other conduct professionals in multilevel learning about their clients and understanding their subjective point of view. This allows biopsychosocial evaluations to diagnose and treat their clients successfully. In this regard, biopsychosocial assessment entails examining the patient’s biological, social and psychological conditions of the patient. Thus, Drs. George Engel and John Romano established the biopsychosocial concept at Rochester years ago (Kusnanto, Agustian, and Hilmanto, 2018 pp 497). The biopsychosocial analysis is an essential part of human health and disease in the broader context of our education programs. In contrast, pathophysiology and other biological approaches to illness focus on traditional biomedical models of clinical practice. Therefore, the process includes the study of health, sickness, and health services that comprehensively address biological, psychological, and social aspects as well as their complex interactions.

Nonetheless, systematic assessment of psychological and social variables needs appropriate social sciences, just as the help of relevant sciences, which requires consideration of biological elements. The natural sciences and social sciences are therefore fundamental for medical practice. In other words, psychological and social variables are not only epiphenomena: both at their level and concerning their biological correlates, they may be comprehended by scientific means (MacNee, 2006 pp. 1202-1204). Therefore, the physician should be aware that relationships are essential to the provision of health services in order to use the biological-psychosocial approach to clinical practice. Thus, they should apply it in;

• Achieving a history of the patient in the context of life conditions
• Decide what factors are most essential in the biological, psychological, and social fields
• Multidimensional therapy.

Furthermore, a patient’s physical assessment is also essential. They include body assessments like habitus, hygiene, stature, skin condition like signs and symptoms, chronic wounds or breakdown, and the patient’s inclusive mood and psychological state. Additionally, determining of initial vital signs involves temperature recorded in most institutions of Celsius, respiratory speed, rate of the pulse; blood pressures with appropriate size cuff; reading the pulse of oximetry and noting whether room oxygen is measured accurately in kilograms and height measurement, so the body mass index (BMI) is calculable for weights and guidelines for nutrition (MacNee, 2006 pp. 1202-1204).

Conclusively, primary history and physical examination can lead to the detection of situations of life or limb threats that may be stabilized immediately, guaranteeing better results for the patient. The more probable the disease is to be detected, nursing diagnosis established, suitable procedure or therapy undertaken, and regular care provided, the sooner the patient is assessed correctly. Physiological anomalies caused by changes in signs of life or awareness frequently warn against the deteriorating state of the patient; hence, it is necessary to intervene quickly to avoid adverse events, decrease morbidity and mortality risk. That being said, safe practice is based on the significance of a boss-to-toe evaluation, research-driven critical thinking skills, and therapeutic dialogue. Therefore, the patient’s health assessment plays a crucial role in helping the caregivers provide the appropriate diagnosis and treatment to the patient. For this scenario, Mr. Doyle should be assessed to determine the proper treatment he deserves.

Moreover, the healthcare provider is informed of evaluations that contain current essential signs, laboratory values, changes such as reduced urinary performance, heart rhythm, pain, and mental state, and relevant historical records with treatment suggestions. Thus, communicating in quickly changing scenarios and deteriorating patient conditions clearly and compellingly can speedy answers in challenging circumstances. Health providers communicate and participate in decision-making (Guidet et al., 2018 pp. 1-15). Therefore, incorporating SBAR-model is essential. This is because it enables the communication between health team members and bridges the difference between a descriptive approach, narrative, and a detailed one.

Critically discuss the impact of COPD illness on the patient and family.

Acute illnesses such as COPD harm the patients, including their family members. Thus, this illness affects both the former and the latter based on emotional functioning, psychological, financial resources, and interpersonal relationships. Therefore, this section will focus on the impact of COPD illness on patients and family members based on the following;

Financial Resources

The family’s financial expense is one of the enormous stresses on sufferers’ families. It may include the payment of therapy, transportation to appointments, and the cost of hiring a caregiver. In Canadian research, around forty-five families spent an average of C$624 per month for intellectually handicapped patients’ care and assistance, with many describing no funds left at the end of the month. In comparison to the United States of America research, depending on the severity of the COPD patient, the financial impacts of families taking care of COPD patients varied between US$3,630 and US$17,700 (Golics et al., 2013 pp.399-407). Additionally, Family members of patients sometimes experience financial constraints leading to stress and concern. Family members of dermatologists increase their working hours to support their families financially, and many need state subsidies to pay the additional expenditures that might result in sacrifices for others. Even supplying basic requirements imposed a financial burden on the parents while caring about a kid with a cerebral paralysis. Access to finance was also challenging, which further raised stress and emotional consequences. Therefore, in low-income families that frequently have little assistance and suffer significant challenges of social functioning and relationships, the problems associated are more challenging to get financing.

Psychological Effects

Family members are highly affected by the psychological repercussions of living with and caring for a relative with an illness. Every member of the family feels the impact of some disorders. The most prevalent implication of the findings was the emotional impact. Family members frequently experience the psychological pain caused by their emotions of impotence and loss of control (Golics et al., 2013 pp.399-407). Family members report various emotions such as guilt, anxiety, wrath, distress, humiliation, frustration, desperation, relief, and loss. Consequently, every emotion has a varied and diverse effect on the family members, frequently depending on the severity of the patient’s condition and the time since.

In most cases, the psychological distress of women cancer spouses was more significant than that of men. However, when assessing relatives’ overall quality of life, no significant difference was found between gender (Golics et al., 2013 pp.399-407). There may be sex variations in care responses, but the well-being of spouses in patients with rheumatoid arthritis was different depending on the patient’s gender. Not only the parents and partners are emotionally impacted by the illness of a relative. For instance, children with omnipresent developmental abnormality had “severe difficulty with adjustment” in contrast to control groups.

Effects on Family Relationships

Patients’ family members are negatively affected, as well as between the relative and the patient and other family members as a result of the disease. Thus, low-income family connections do not bode well to manage chronic diseases irrespective of condition, and often family members have difficulty in having relationships since they cannot support one another emotionally. Family members of patients with multiple sclerosis experienced detrimental impacts on their relationships, leading to conflicts, tension, and a lack of mutual understanding. In this regard, most patient’s relatives are struggling with patients whose ideas, perspectives, and behavior resulting from their condition have changed. Relations between other family members have limited time. For instance, Golics et al. reported that 38% of dermatologically afflicted teenagers believed their state influences their family ties.

Additionally, in most incidences, patient partners suffer due to the disease as a consequence of a person’s partner, frequently owing to symptoms or not having time together as a couple because of the condition of another family member. It can lead to conflict between couples, sometimes resulting in a collapse in partnerships or partners who look outside the relationship for sexual encounters. However, connections in some families can become stronger as the members of the family work together, helping one other. The majority took the initiative to sustain excellent family ties with families with an intellectually disabled kid.

Social Effects

A profound effect on the social lives of family members while caring for a person with an illness. Moms who cared for children with impairments thought that their lives were so different from their friends and believed that only sad conversations could contribute to them and lost friends. Other families told acquaintances that they were driving away because they did not understand the family situation (Guidet et al., 2018 pp. 1-15). In this regard, most individuals have complained about social dysfunction with related skin illnesses. For fear of outsiders’ reactions to their vision, such as basal cell carcinoma on the face or persistently obstructive lung illness requiring oxygen therapy, such disorders may have a more considerable influence on the social life of patients and families. Adolescent moms with chronic severe pain reported more significant social constraints than children with chronic lower pain, which the authors said may be linked with the condition directly.

Conclusively, the effect of the disease on the family members of patients has a wide variety of information. If the findings from disease-specific research are relevant to a broader population or whether families are similarly affected in all medical specialties is unknown. For instance, an investigation involving family members of disabled children results in the familial quality of life areas identified by Poston and others. Guidet et al., 2018 pp. 1-15 highlights the absence of accurate and valid family outcome action and harmful impacts on a disease or clinical field of family outcome research, including lack of communication between medical and concealing similarities among diseases. However, the lack of general measures to assess the effects of a range of conditions on family members of patients indicates that a familial-centered strategy to care and more education for professionals is needed.

References

Arrigo, M., Huber, L.C., Winnik, S., Mikulicic, F., Guidetti, F., Frank, M., Flammer, A.J. and Ruschitzka, F., 2019. Right ventricular failure: pathophysiology, diagnosis, and treatment. Cardiac failure review, 5(3), p.140.

Logics, C.J., Basra, M.K.A., Finlay, A.Y. and Salek, S., 2013. The impact of disease on family members: a critical aspect of medical care. Journal of the Royal Society of Medicine, 106(10), pp.399-407.

Guidet, B., Vallet, H., Boddaert, J., de Lange, D.W., Morandi, A., Leblanc, G., Artigas, A. and Flaatten, H., 2018. Caring for the critically ill patients over 80: a narrative review. Annals of intensive care, 8(1), pp.1-15.

Kusnanto, H., Agustian, D. and Hilmanto, D., 2018. The biopsychosocial model of illnesses in primary care: A hermeneutic literature review. Journal of family medicine and primary care, 7(3), p.497.

MacNee, W., 2006. Pathology, pathogenesis, and pathophysiology. BMJ, 332(7551), pp.1202-1204.

Toney-Butler, T.J., and Unison-Pace, W.J., 2018. Nursing admission assessment and examination.

White, J.V., Guenter, P., Jensen, G., Malone, A., Schofield, M., Group, A.M.W., Force, A.M.T. and Directors, A.B., 2012. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for identifying and documenting adult malnutrition (undernutrition). Journal of the Academy of Nutrition and Dietetics, 112(5), pp.730-738.