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NURSING DIAGNOSIS: Nutrition: imbalanced, less than body requirements
May be related to
- Dyspnea; sputum production
- Medication side effects; anorexia, nausea/vomiting
- Fatigue
Possibly evidenced by
- Weight loss; loss of muscle mass, poor muscle tone
- Reported altered taste sensation; aversion to eating, lack of interest in food
Desired Outcomes
Nutritional Status (NOC)
- Display progressive weight gain toward goal as appropriate.
- Demonstrate behaviors/lifestyle changes to regain and/or maintain appropriate weight.
5 Chronic Obstructive Pulmonary Disease (COPD) Nursing Care Plan (NCP)
Nursing Interventions & Rationale
| Nursing Interventions | Rationale |
| Assess dietary habits, recent food intake. Note degree of difficulty with eating. Evaluate weight and body size (mass). | Patient in acute respiratory distress is often anorectic because of dyspnea, sputum production, and medications. In addition, many COPD patients habitually eat poorly, even though respiratory insufficiency creates a hypermetabolic state with increased caloric needs. As a result, patient often is admitted with some degree of malnutrition. People who have emphysema are often thin with wasted musculature. |
| Auscultate bowel sounds. | Diminished/hypoactive bowel sounds may reflect decreased gastric motility and constipation (common complication) related to limited fluid intake, poor food choices, decreased activity, and hypoxemia. |
| Give frequent oral care, remove expectorated secretions promptly, provide specific container for disposal of secretions and tissues. | Noxious tastes, smells, and sights are prime deterrents to appetite and can produce nausea and vomiting with increased respiratory difficulty. |
| Encourage a rest period of 1 hr before and after meals. Provide frequent small feedings. | Helps reduce fatigue during mealtime, and provides opportunity to increase total caloric intake. |
| Avoid gas-producing foods and carbonated beverages. | Can produce abdominal distension, which hampers abdominal breathing and diaphragmatic movement and can increase dyspnea. |
| Avoid very hot or very cold foods. | Extremes in temperature can precipitate/aggravate coughing spasms. |
| Weigh as indicated. | Useful in determining caloric needs, setting weight goal, and evaluating adequacy of nutritional plan. Note: Weight loss may continue initially, despite adequate intake, as edema is resolving. |
| Administer supplemental oxygen during meals as indicated. | Decreases dyspnea and increases energy for eating, enhancing intake. |
Found through:
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