Nursing care for patients with Chronic Obstructive Pulmonary disease at home : case study of two cases.

Abstract

     This study was case study aimed to study and compare nursing care for patients with chronic obstructive pulmonary disease from the beginning of admission to discharge planning and referral for continuous care at home and use it as a guideline for nursing care for patients with chronic obstructive pulmonary disease at home to develop the quality of nursing care to be more efficient. This case study is a comparison of 2 patients with chronic obstructive pulmonary disease. The study was conducted in case study 1 who came to receive services at Pho Chai Hospital on February 17, 2025 and in case study 2 on March 24, 2025. Data were collected using interviews, observations, and medical records. The assessment of patients' health status according to Gordon's 11 health models was used. Define nursing diagnosis and METHOD Model theory.

     Main findings: Case study patient 1, a 90-year-old Thai man, had chronic obstructive pulmonary disease 12 years ago, had hypertension, chronic kidney disease stage 4, gout. 1 hour before coming to the hospital, he had symptoms of shortness of breath, shortness of breath, coughing with sputum. The doctor diagnosed Acute Exacerbation COPD with Pneumonia. He received bronchodilators, oxygen and intravenous fluids to maintain water and electrolyte balance. He received antibiotics and was treated according to the 5 nursing plans. His symptoms improved and he was discharged home. Case study patient 2, an 80-year-old Thai man, had chronic obstructive pulmonary disease 5 years ago and was not treated continuously. 1 hour before coming to the hospital, he had a high fever, coughed, shortness of breath, was tired, could not lie down, and used an inhaler at home 3 times, but his symptoms did not improve. The doctor diagnosed Acute Exacerbation COPD with Pneumonia, Sepsis, Respiratory Failure, provided nursing care according to the 6 symptom treatment plans and transferred to Roi- Et Hospital. Both patients received nursing care according to the GOLD guideline 2017 for COPD Management and received continuous nursing care at home.