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Pathophysiology, 4. Implementation. After the nurse and interdisplinary…

- - - - Objective Data that is observable and measurable by the nurse
        
        Diagnostic Studies
        
        Pulse Oximetry : Clients with COPD often suffer from low blood oxygen concentrations.The use of a pulse oximeter can help a nurse quickly determine if a client is displaying this warning sign by allowing them to measurie the client's peripheral blood oxygen saturation (Spo2)
        
        Chest X-ray or Computer Tomography (CT): These image tests are able to create a accurate image of the structures within a client's chest (heart, lungs, blood vessels, etc.) These can be used to rule of other diseases, and well as detect empheysyma due to their ability to capture enlarged arteries within the lungs
        
        Arterial blood gas test: This type of test measures the amount of oxygen and carbon dioxide in the blood, as well as the level of acidity. It offers a more detailed perspective into the client's respiratory status as opposed to pulse oximetry
        
        Spirometry: This is a type of pulmonary function test that measures lung function.This test works by having the client blow into a large tube that is connected to a spirometer, a device that can detect forced vital capacity (largest amount of air client can blow out after they take their biggest breath in), and forced expiratory volume
        (amount of air that client can blow out in their first second).
        
        Physical Examination
        
        Integumentary Assessment: Nurse should assess Cyanosis (for chronic bronchitis), pallor or ruddy colour, poor skin turgor, thin skin, easy bruising, peripheral edema
        
        Respiratory Assessment: While assessing the thorax and lungs, the nurse should look for signs of rapid, shallow breathing, accessory muscle use, inability to speak, prolonged expiratory phase, pursed lip breathing, wheezing, crackles, diminised breath sounds, and hyper-resonant or dull chest sounds when percussing
        
        Cardiovascular: Nurse should assess for tachycardia, dysrhythmias, jugular vein distension, right sided heart sound (cor-pumonale), and edema (primarily in the feet)
        
        Gastro-intestinal Assessment: Nurse should assess for Ascites and hepatomegaly
        
        Musculo-skeletal: Nurse should assess for signs of muscles atrophy, and an increased anteroposterior diameter (also known as barrel chest)
        
        General Assessment: Nurse should obtain client's height, weight, and BMI
      - Subjective Data that obtained by the nurse through the client's perspective
        
        Information retrieved from health interview
        
        Medications:
        The nurse should ask the client about their use and duration of any supplemental O2, bronchodilators, anticholinergics, corticosteroids, antibiotics, OTC drugs, and complementary therapists. Additionally, the nurse should also note the associated effectives, and any experiences of adverse affects from the client's point of view
        
        Current health: The nurse should assess the client's experience of dyspnea (with activity and at rest) and cough. If the client expresses that the cough is productive, the nurse should gather additonal data from the patient regarding colour, consistency, andquantity of secretions