NR 305 Week 5 Discussion Topic: Assessment of Respiratory
Status
Please review the video above as it will provide you with an opportunity to immerse yourself in
the role of a nurse addressing tobacco use during routine patient care. In doing so, reflect on
what you have learned about tobacco use & the role that nurses & other interdisciplinary team
members play in helping to assist tobacco users with quitting. While viewing, it is also important
to keep in mind that tobacco users move through stages of change in the process of quitting.
They move from pre-contemplation to contemplation, contemplation to preparation; preparation
to abstinence; abstinence to maintenance. Every stage requires a different strategy by a nurse.
After watching the video, & reflecting on the information presented, address each of the
following questions.
1. What are the common symptoms associated with an exacerbation of COPD?
2. What assessment techniques will you use to assess Mary?
3. Identify smoking strategies that would be appropriate for each of the encounters that
Mary had with the nurse throughout the video that could have been used to assist Mary in
quitting smoking. (NR 305 Week 5)
4. Find a resource in your community that could assist Mary. Start by searching the Internet
for your local health department’s website. What services are available to Mary? Briefly
describe the services that the state quit line provides. Does it meet the 4 As? Is it
accessible, acceptable, affordable, or available for Mary?
5. What will you do to follow-up on Mary’s smoking cessation process?
Hello professor & class
What are the common symptoms associated with an exacerbation of COPD?
One of the common causes of COPD is cigarette smoking. An exacerbation of COPD is a flare-up
or episode when ones breathing gets worse than usual often resulting from an infection
(Copdfoundation). With COPD patients, they inhale oxygen but fail to completely exhale carbon
dioxide. Some of the most common symptoms include; increased shallow rapid breathing, increased
wheezing, productive cough, chest tightness, & shortness of breath especially with activity.
What assessment techniques will you use to assess Mary?
, Assessing her breathing pattern by looking at her respiratory rate, the depth of her respirations,
how much effort is she putting in to breath? Is she using her accessory muscles to breath?
Auscultation of lung sounds will be my next step. The type of lung sounds heard during
auscultation sometimes determines the type of treatment or further testing needed for the patient.
When it comes to COPD patients, lungs sounds are always good means to determine the progress
of the patient’s treatment. A general skin assessment will be done to check for any edema to the
lower extremities, skin color & any other abnormalities with Mary’s skin. Color should be
consistent with person's genetic background, with allowance for sun-exposed areas on the chest
& the back. No cyanosis or pallor should be present (Jarvis 425). Checking Mary saturations w is
a great indicator how much oxygen Mary might need. I will also like to know if Mary has had
any fevers lately.
Identify smoking strategies that would be appropriate for each of the encounters that Mary had
with the nurse throughout the video that could have been used to assist Mary in quitting
smoking.
Per Mary: lately, she has been coughing so hard, having difficulty catching her breath, feeling
she might be having twinges in her chest & scared to death she might be having another heart
attack. She further expresses her willingness to learn more about her condition & how to prevent
a heart attack from happening again.
At this time, explaining the effects of cigarettes smoking to the body in general & giving Mary
some statistics about cigarette smoking will be beneficial. Mary has to know that cigarette
smoking causes COPD, lung cancer, other types of cancers & might have been the cause of her
DM type 2(CCN). The chemical in tobacco damages the blood vessels leading to plaque buildup
which might eventually lead to a heart attack (NIH). Letting Mary know that smoking is not
good for the heart & can more than likely lead to another heart attack might make her willing to
quit smoking cigarette. At this point in time, she is willing to learn & open to suggestions, I think
is a great time to be truthful with Mary.
Per Mary: cigarette smoking is her one remaining vice & is a learned habit that started about
the age of about 13. She smokes a pack a day & craves it if she doesn’t get one first thing in the
morning.
Mary expresses her addiction for cigarettes & her inability to function without smoking first
thing in the morning. Acknowledging to Mary that quitting cigarette smoking could be
challenging but not impossible will be necessary. Suggesting cutting down on how much she
smokes daily, maybe ¾ or ½ a pack a day for a start. Suggesting using a nicotine patch will be
another option. Referring Mary to community programs that can help quit cigarette will be
helpful. The addictive nature of nicotine makes it very challenging to quit. Most Copd patients
adhere to the no smoking rule during the exacerbation phase of Copd, once their breathing
improves, they fall back into smoking. Making sure Mary knows that quitting will be a very slow
process & she will have support could actually encourage her to take up the challenge.
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