7 Chronic Obstructive Pulmonary Disease (COPD) Nursing Care Plans

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In this nursing care plan guide are seven (7) nursing diagnosis for Chronic Obstructive Pulmonary Disease (COPD). Get to know the nursing interventions, goals and outcomes, assessment tips, and related factors for COPD.

What is Chronic Obstructive Pulmonary Disease (COPD)? 

Chronic Obstructive Pulmonary Disease (COPD) is defined as “a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.” (Global Initiative for Chronic Obstructive Lung Disease or GOLD)

Any respiratory disease that persistently obstructs bronchial airflow fall under the broad classification of COPD, also known as chronic airflow limitations (CAL). Chronic Obstructive Pulmonary Disease (COPD) is a condition of chronic dyspnea with expiratory airflow limitation that does not significantly fluctuate. Within that broad category, the primary cause of the obstruction may vary; examples include airway inflammation, mucous plugging, narrowed airway lumina, or airway destruction.

The term COPD mainly involves two related diseases — chronic bronchitis and emphysema. Although asthma also involves airway inflammation and periodic narrowing of the airway lumina (hyperreactivity), the condition is the result of an individual response to a wide variety of stimuli/triggers and is therefore episodic in nature with fluctuations/exacerbations of symptoms. COPD is also called chronic obstructive lung disease (COLD).

Asthma: Also known as chronic reactive airway disease, asthma is characterized by reversible inflammation and constriction of bronchial smooth muscle, hypersecretion of mucus, and edema. Precipitating factors include allergens, emotional upheaval, cold weather, exercise, chemicals, medications, and viral infections.

Chronic bronchitis: Widespread inflammation of airways with narrowing or blocking of airways, increased production of mucoid sputum and marked cyanosis.

Emphysema: Most severe form of COPD, characterized by recurrent inflammation that damages and eventually destroys alveolar walls to create large blebs or bullae (air spaces) and collapsed bronchioles on expiration (air-trapping).

Nursing Care Plans

Nursing care planning for patients with COPD involves the introduction of a treatment regimen to relieve symptoms and prevent complications. Most patients with COPD receive outpatient treatment, the nurse should develop a teaching plan to help them comply with the therapy and understand the nature of this chronic disease.

Here are seven (7) nursing care plans (NCP) and nursing diagnosis (NDx) for Chronic Obstructive Pulmonary Disease (COPD):

  1. Ineffective Airway Clearance
  2. Impaired Gas Exchange
  3. Ineffective Breathing Pattern
  4. Imbalanced Nutrition: Less Than Body Requirements
  5. Risk for Infection
  6. Deficient Knowledge
  7. Activity Intolerance
  8. Other Possible Nursing Diagnosis
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Risk for Infection

Respiratory infections that are minor in nature may be threatening to people with COPD. Bronchopulmonary infections must be controlled or prevented to diminish inflammatory edema.

Nursing Diagnosis

Risk factors may include

  • Inadequate primary defenses (decreased ciliary action, stasis of secretions)
  • Inadequate acquired immunity (tissue destruction, increased environmental exposure)
  • Chronic disease process
  • Malnutrition

Desired Outcomes

  • Verbalize understanding of individual causative/risk factors.
  • Identify interventions to prevent/reduce risk of infection.
  • Demonstrate techniques, lifestyle changes to promote safe environment.
Nursing Interventions Rationale
Nursing Assessment
Monitor temperature. Fever may be present because of infection or dehydration.
Review the importance of breathing exercises, effective cough, frequent position changes, and adequate fluid intake. These activities promote mobilization and expectoration of secretions to reduce the risk of developing a pulmonary infection.
Observe color, character, odor of sputum. Odorous, yellow, or greenish secretions suggest the presence of pulmonary infection.
Obtain sputum specimen by deep coughing or suctioning for Gram’s stain, culture, and sensitivity. Identifies the causative organism and susceptibility to various antimicrobials.
Therapeutic Interventions
Demonstrate and assist the patient in the disposal of tissues and sputum. Stress proper handwashing (nurse and patient), and use gloves when handling or disposing of tissues, sputum containers. Prevents spread of fluid-borne pathogens.
Limit visitors; provide masks as indicated. Reduces potential for exposure to infectious illnesses such as upper respiratory infection (URI).
Encourage a balance between activity and rest. Reduces oxygen consumption or demand imbalance, and improves patient’s resistance to infection, promoting healing.
Discuss the need for adequate nutritional intake. Malnutrition can affect general well-being and lower resistance to infection.
Recommend rinsing mouth with water and spitting, not swallowing, or use of a spacer on the mouthpiece of inhaled corticosteroids. Reduces the localized immunosuppressive effect of drug and risk of oral candidiasis.
Administer antimicrobials as indicated. May be given for specific organisms identified by culture and sensitivity, or be given prophylactically because of high risk.
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References and Sources

References and recommended sources for this care plan guide for Chronic Obstructive Pulmonary Disease (COPD):

  • Ackley, B. J. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. Elsevier Health Sciences.
  • Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
  • Brunner, L. S., & Suddarth, D. S. (2004). Medical surgical nursing (Vol. 2123). Philadelphia: Lippincott Williams & Wilkins. [Link]
  • Carlson, M. L., Ivnik, M. A., Dierkhising, R. A., O’Byrne, M. M., & Vickers, K. S. (2006). A learning needs assessment of patients with COPD. Medsurg Nursing15(4). [Link]
  • Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
  • Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]

See Also

You may also like the following posts and care plans:

Respiratory Care Plans

Care plans about respiratory system disorders:

Originally published on July 14, 2013. 

3 COMMENTS

  1. This is a fantastic site that enrich and enhance nurses knowledge across their area of discipline and practices.

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