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Chronic Obstructive Pulmonary Disease (COPD) - 10 Nursing Diagnosis

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Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition characterized by persistent airflow limitation and impaired gas exchange. It includes chronic bronchitis and emphysema, with symptoms such as chronic cough, sputum production, wheezing, and shortness of breath. COPD significantly affects quality of life, exercise capacity, and oxygenation.

Chronic Obstructive Pulmonary Disease (COPD) - 10 Nursing Diagnosis

Nurses play a vital role in monitoring respiratory function, improving airway clearance, preventing complications, promoting smoking cessation, and educating patients on how to manage symptoms. Below are ten evidence-based nursing diagnoses for COPD, complete with goals, interventions, and rationales to support clinical practice and documentation.

1. Ineffective Airway Clearance related to mucus hypersecretion and impaired ciliary function

Goal: Patient maintains a patent airway and effectively expectorates sputum.

Interventions:
  • Encourage controlled coughing and deep breathing exercises.
  • Increase fluid intake if not contraindicated.
  • Perform chest physiotherapy and postural drainage as indicated.
  • Administer bronchodilators as prescribed.

These interventions help mobilize secretions and improve ventilation, reducing airway obstruction.

2. Impaired Gas Exchange related to alveolar damage and ventilation-perfusion imbalance

Goal: Patient demonstrates stable oxygen saturation levels within target range.

Interventions:
  • Monitor ABG and SpO₂ regularly.
  • Administer oxygen therapy at the lowest effective rate.
  • Position patient in high Fowler’s or tripod position.

Optimizing positioning and monitoring oxygenation ensures adequate gas exchange and reduces respiratory stress.

3. Activity Intolerance related to imbalance between oxygen supply and demand

Goal: Patient performs daily activities within tolerance level without dyspnea. Interventions:
  • Encourage rest periods between activities.
  • Use pursed-lip breathing during exertion.
  • Collaborate with physical therapy for exercise training.

Energy conservation and breathing control techniques increase endurance and reduce dyspnea.

4. Risk for Infection related to retained secretions and impaired lung defense

Goal: Patient remains free from signs of infection such as fever, increased sputum, or leukocytosis.

Interventions:
  • Encourage vaccination (influenza, pneumococcal).
  • Maintain hydration and airway clearance techniques.
  • Monitor temperature and sputum color changes.

Prevention and early detection minimize the risk of respiratory infections that exacerbate COPD.

5. Imbalanced Nutrition: Less Than Body Requirements related to fatigue and dyspnea

Goal: Patient maintains stable weight and adequate calorie intake.

Interventions:
  • Provide small, frequent, high-calorie meals.
  • Encourage meals during periods of low respiratory effort.
  • Consult dietitian for nutritional planning.

Adequate nutrition supports muscle function, including respiratory muscles.

6. Anxiety related to breathlessness and fear of suffocation

Goal: Patient verbalizes reduced anxiety and improved coping. Interventions:
  • Teach relaxation and breathing control techniques.
  • Provide reassurance and clear explanations.
  • Encourage family involvement and emotional support.

Anxiety increases oxygen demand and worsens dyspnea; reducing anxiety improves breathing efficiency.

7. Fatigue related to increased work of breathing and chronic illness

Goal: Patient identifies strategies to conserve energy and reduce fatigue. Interventions:
  • Schedule frequent rest periods.
  • Optimize oxygen therapy during exertion.
  • Encourage sleep hygiene practices.

Energy conservation reduces workload on respiratory muscles and prevents exhaustion.

8. Ineffective Breathing Pattern related to respiratory muscle fatigue

Goal: Patient demonstrates effective breathing technique. Interventions:
  • Teach diaphragmatic and pursed-lip breathing.
  • Observe respiratory rate, depth, and chest movement regularly.

Breathing exercises improve ventilation and reduce the work of breathing.

9. Disturbed Sleep Pattern related to cough and orthopnea

Goal: Patient reports improved sleep quality. Interventions:
  • Elevate head of bed during sleep.
  • Administer medications to reduce cough before bedtime.
  • Encourage sleep routine and limit caffeine.

Better sleep improves immune function, energy levels, and respiratory control.

10. Knowledge Deficit related to lack of understanding of COPD management

Goal: Patient verbalizes knowledge of disease, medication use, and lifestyle modifications. Interventions:
  • Teach inhaler technique and medication purpose.
  • Educate on smoking cessation and environmental triggers.
  • Encourage enrollment in pulmonary rehabilitation programs.

Education improves treatment adherence and reduces the frequency of exacerbations.


Related Articles : 10 Nursing Diagnosis for COPD

References

  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). COPD Guidelines. https://goldcopd.org
  2. World Health Organization. Chronic Obstructive Pulmonary Disease (COPD). https://www.who.int
  3. Centers for Disease Control and Prevention (CDC). COPD Information and Prevention. https://www.cdc.gov/copd
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Chronic Obstructive Pulmonary Disease Nursing Diagnosis