COPD is a long-term lung disease that traps air and makes breathing hard work. Exacerbations are often triggered by infections. Focus on breathing, safe oxygen use, and teaching breathing techniques.
A · AssessmentD · DiagnosisP · PlanningI · InterventionE · Evaluation
Each care plan below follows the nursing process (ADPIE).
CARE PLAN 1 · NURSING DIAGNOSIS
PLANNING · EXPECTED OUTCOMES
ASSESSMENT
Ineffective Breathing Pattern
Related to
- Air trapping and airway obstruction
- Respiratory muscle fatigue
As evidenced by
- Pursed-lip breathing
- Use of accessory muscles
- Prolonged exhalation
- Tachypnea
Short-term goals
- Respiratory rate returns toward baseline
- Client uses pursed-lip breathing correctly
Long-term goals
- Client manages daily activities with fewer episodes of shortness of breath
- Respiratory rate, pattern, and SpO2
- Accessory muscle use
- Lung sounds
| INTERVENTION | RATIONALE |
|---|---|
| Position upright or leaning forward (tripod) | This helps the diaphragm work and eases breathing. |
| Teach pursed-lip and diaphragmatic breathing | Slows breathing and helps empty trapped air. |
| Give bronchodilators as ordered | They open the airways quickly. |
| Titrate oxygen to the ordered SpO2 goal, often 88% to 92% | Avoids complications of too much oxygen in some clients with COPD. |
EVALUATION
- Breathing is slower and less labored
- Client demonstrates pursed-lip breathing
CARE PLAN 2 · NURSING DIAGNOSIS
PLANNING · EXPECTED OUTCOMES
ASSESSMENT
Activity Intolerance
Related to
- Imbalance between oxygen supply and demand
As evidenced by
- Shortness of breath with activity
- Fatigue
Short-term goals
- Client completes self-care with rest periods
Long-term goals
- Client takes part in pulmonary rehab or a home activity plan
- SpO2 and heart rate before and after activity
- Client's report of fatigue
| INTERVENTION | RATIONALE |
|---|---|
| Space activities with rest | Prevents oxygen demand from outpacing supply. |
| Encourage small, frequent meals | Large meals push on the diaphragm. |
| Refer to pulmonary rehab | Builds endurance and breathing skills. |
EVALUATION
- Client completes morning care with one rest break
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Hear report on a COPD exacerbation and choose your interventions.
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Why is oxygen titrated in COPD?
Some clients with COPD retain CO2. Following the ordered SpO2 goal, often 88% to 92%, keeps oxygen safe.
For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.