I.

INTRODUCTION

Our client XXX is 88 years old, farmer and a resident of ________ Island. He is a
cigarette smoker and consumed 1 pack of 20-30 sticks per day. He was admitted on December 2,
2012. That day was the second time he get at the hospital. He was diagnosed of having COPD to
consider in exacerbation.

Chronic obstructive pulmonary disease (COPD) is a condition in which there is limited

airflow in the lungs. The disease develops and worsens over time. COPD is not reversible, but
therapy can slow its progress.

Although patients can breathe in normally, changes in the small airways cause the walls
to narrow during expiration, making it hard to breathe out. In many patients with COPD, the
small sacs where oxygen and carbon dioxide are exchanged are destroyed, gradually starving the
body of oxygen.

COPD is associated with a set of breathing-related symptoms:

 Being out of breath, at first when doing physical activities, but as lung function
deteriorates, also at rest
 Chronic cough
 Spitting or coughing mucus (phlegm)

The ability to exhale (breathe out) gets worse over time.

The lungs are located in the chest cavity and are responsible for breathing. The alveoli are
small sacs where oxygen is exchanged in the lungs.

The two major diseases in this category are emphysema and chronic bronchitis, both
covered in this report. The third, less common disease, is obstructive bronchiolitis, an
inflammatory condition of the small airways. Asthma shares some of the same symptoms, but is
a very different disease. People can have asthma and COPD at the same time.

Because smoking is a common cause of both emphysema and chronic bronchitis, these
conditions often develop together and frequently require similar treatments and approaches.
When chronic bronchitis occurs together with emphysema, it is often difficult for a physician to
distinguish between the two diseases.

Acute exacerbations occur sporadically during the course of COPD and are heralded by
increased symptom severity. The specific cause of any exacerbation is almost always impossible
to determine, but exacerbations are often attributed to viral URIs or acute bacterial bronchitis. As
COPD progresses, acute exacerbations tend to become more frequent, averaging about 3
episodes/yr.

This case study aims to learn more and gain knowledge about this disease so we will be
able to develop and improve clients’ condition through the use of nursing process, nursing
management and different nursing intervention.
II. BIOGRAPHIC DATA

Name of Patient: Patient XXX

Address: Island X
Gender: Male Age:88 yrs.old Civil Status :Married
Date of Birth: April 15,1924 Place of Birth:
Educational Attainment : Elementary Graduate Occupation :Farming
Religion : Catholic
Chief Complaint: DOB, Abdominal & Back Pain
Primary Medical Diagnosis: COPD
T/C Exacerbation COPD
Physician:
Date of Admission: December 2, 2012

III. HEALTH HISTORY

A. History of Present Illness

It was Sunday night when the client experienced DOB, abdominal & back pain. He was
brought at Hospital on December 2, 2012 at exactly 9pm. He was pale, weak and irritable. His
respiration ranges from 27-30 cpm. He was also dyspneic with productive cough.

B. Past Health History

According to him, this was the second time that he was brought to the hospital.

C. Family History
There is no history of COPD, but his mother had hypertension.

IV. PSYCHOLOGICAL HEALTH

A. Coping Pattern
With regard to any problem or conflict he encountered. His family supported him all the
ways.

Analysis: Coping may be described as dealing with changes successfully or unsuccessfully. It is

cognitive and behavioral effort to manage external or internal demands that are approved as
exceeding resources of the person.(Fundamentals of Nursing Kozier& Erb pg. 1068)

Interpretation:
Our client has a good relationship to his family.

B. Interaction Patterns
Our client expresses his feelings and thoughts to his wife and friends. For him it is
essential and increase trust and bonding and for them to know his feelings. He is a kind of person
who does not blame others for whatever happens.

Analysis: This includes the ways of exposing affection of love, sorrow, anger, to note significant
family members in person’s life and openness of communication within a family member.
(Fundamentals of Nursing Kozier pg. 193)

Interpretation:
Our client is open and very close to his family and friends. This is essential to improve
social life.

C. Emotional Pattern
 If our client gets angry, he tells it frankly to his family and relatives in a good manner in
order to maintain good relationship to them.

Analysis: Emotional pattern includes thoughts and actions that relieve emotional distress. It does
not improve the situation, but the person often feels better. (Fundamentals of Nursing Kozier pg.
147)

Interpretation:
Good relationship to his family is very important to him. He believed that doing good
communication is the best way to have good relationship to them.

D. Family Copping Pattern

When he encountered problems he tells it to his wife.

Analysis: The families have functions that are important in how individual family members meet
their needs and maintain their health. The family provides the individual with the necessary
environment for development and social interactions. (Lippincott Williams and Wilkins of
Nursing page 30)

Interpretation:
Being open to his wife is a good quality to solve any problem.

E. Cognitive Pattern
Our client is elementary graduate. He can speak and understand Filipino and Ilocano.

Analysis: The families have functions that are important in how individual family members meet
their needs and maintain their health. The family provides the individual with the necessary
environment for development and social interactions. (Lippincott Williams and Wilkins of
Nursing page 30)

Interpretation:
Our client can read and understand Filipino and Ilocano.

F. Self Concept
He loves and accepts who he is physically.

Analysis: Self-concept involves all of the perception that is appearance, values, beliefs that
influence behavior and that are referred to when using the word I or me. It is over mental image
of oneself. (Fundamentals of Nursing, kozier and Erb’s page 957)

Interpretation:
Our client knows the qualities and characteristics that she possesses.

G. Sexuality
He is contended of being a male and accepts responsibility of being a father.

Analysis: Sexuality is an individually expressed and highly personal phenomenon whose

meaning evolves from life experiences. Satisfying or normal sexual expression can generally be
described as whatever behaviors give pleasure and satisfaction to the adults involved, without
treat of coercion or injury to self or others (Kozier & Erb’s Fundamentals of Nursing page 1029)

Interpretation:
He is satisfied with what he had now.
V. Socio-cultural Health

A. Cultural Pattern
Our client instructed his siblings to obey or respect elders and everyone. They have
family reunion yearly. They love eating Filipino foods.

Analysis: Cultural Pattern refers to cultural beliefs that we are practicing. Culture is a non
physical trait such as beliefs, attitudes and customs that is shared by a group. (Kozier and Erb’s
Fundamentals of Nursing page206)

Interpretation:
Their family believes that respecting others is a good quality that Filipinos must have.
They also love Filipino dishes.

Significant Relationship
Our client’s significant others give their best to support and give him strength to face his
problem.

Analysis: Significant relationship is the client’s support systems in times of stress what affects
the client illness has on the family and whether family problems are affecting the client. (Kozier
and Erb’s Fundamentals of Nursing page 268)

Interpretation:
His significant others serve as his backbone in every moment of his life especially his
family.

C. Recreation
Our client loves to go everywhere and he spends most of his times by smoking at least
20-30 sticks of cigarettes per day. Doing these made him more relaxed and it became his hobby.
He also loves drinking liquors occasionally.

Analysis: Recreation or hobbies are an exercise activity and tolerance hobbies and other interest
and vocations. (Kozier and Erb’s Fundamentals of Nursing page 263)

Interpretation:
Client’s recreation and hobbies are not good for his health even though it decreases
stress. Those hobbies are risk factors for developing much kind of disease.

D. Environment:
Our client lives in a simple but a clean house together with his beloved family. They have
dogs. They can move freely and comfortably in their house.

Analysis: Environment is all of the conditions, circumstances and influences surrounding and
affecting the development of a person. Physical environment consider the natural boundaries,
sizes and population density, types of dwells and incidence of crime and vandalism. (Kozier and
Erb’s Fundamentals of Nursing page 201)

Interpretation:
He is living in a healthy place. They love pets.

E. Economic
He is a farmer and has limited money to spend.
Analysis: Economic status identifies the client’s ability to pay or afford medical care or health
care in order to ensure his or her own health stability.

Interpretation:
They have slightly enough money to buy and support their basic needs.

VI. SPIRITUAL HEALTH

A. Religious Beliefs & Practices

His religion is Crusado. They attend mass occasionally and he prays every night.

Analysis: Spiritual and religious belief can signifies that affect health behavior. It also refers to
that part of being human that seeks meaningfulness through intra, inter, and transpersonal
connection. Spirituality generally involves a belief in a relationship with some higher power,
creative, divine being or infinite source of energy. (Kozier and Erb’s Fundamentals of Nursing
page 1042)

Interpretation:
Our client has a strong relationship and faith in God and it is good for him that he never
loses hope and to trust God especially in this kind of situation.

B. Value & Valuing

He valued most and keeps treasured all the things he received from others. He also valued
of taking care of his family.

Analysis: Values are freely chosen enduring belief or attitude about the worth of a person, object
idea or health. It is important because it influences decision and actions including nurse’s ethical
decision making. (Kozier and Erb’s Fundamentals of Nursing page 69)

Interpretation:
He appreciates all the things that he receives from his family and friends.