Nursing in therapy with a course in primary care. Problem: Dry Cough Patient Education Plan for Cough Technique

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How to cough correctly

Cough is an increased exhalation through the mouth, which occurs when the airways try to free themselves from an extraneous irritant. Cough is caused by contraction of the muscles of the respiratory tract due to irritation of special receptors. Dust, dry air, pieces of food, mucus, pus can act as an irritant.

Cough is a protective reflex of the body, which ensures the patency of the airways.

The cough mechanism is as follows:

• Foreign agent enters the respiratory tract
• Decreased respiratory clearance
• The cough receptor is irritated
• There is a cough

Cough is usually an involuntary reaction of the body, but it can also be forced.

The most common cause of a cough is a cold or a viral infection.

Cough with a cold can be divided into three stages:

• 2-3 days - dry, non-productive cough without expectoration
• up to 14 days - acute bronchitis, cough with sputum and mucus
• up to 8 weeks - mild cough, coughing

What is a cough

Cough is productive and unproductive.

Productive This is a wet cough, in which the secreted mucus is easily coughed up. Together with the secreted mucus, pathogens are excreted from the body. Therefore, a productive cough cannot be suppressed.

Unproductive is a dry cough. With such a cough, you feel a strong irritation in the throat, a dry urge to cough, but no coughing occurs. Such a cough must be converted into a productive one.

It is important to know that any kind of cough is a cause for concern, as coughing is not a disease itself, but a symptom of a disease. If you cough, you need to see a doctor for a diagnosis and proper treatment.

How to Cough the Right Way if You Have a Productive Wet Cough

How to help the body with a cough

A productive cough is characterized by coughing up sputum and mucus. It cannot be suppressed with antitussive drugs, which block the cough reflex and thus prevent coughing. The mucus should flow freely from the respiratory system, thus cleansing it.

For a productive cough:

When you feel the mucus rising high in your throat, take a short deep breath for 2-3 seconds. This will lead to a contraction of the muscles of the larynx and an increase in the tone of the bronchial muscles. Then the abdominal muscles reflexively contract and forced exhalation occurs. Together with it, mucus is separated and comes out.
Do not press your lips tightly - this prevents mucus from escaping.

In order to alleviate a productive cough, it is recommended to perform the coachman exercise:

1. Sit on a chair
2. Put your feet shoulder width apart
3. Lean forward slightly
4. Keep your back straight
5. Rest your elbows on your knees
6. Hands pointing forward
7. Neck relaxed

How to cough properly if you have a non-productive dry cough

A non-productive dry cough often causes excruciating contractions of the diaphragm without coughing. It may be accompanied by a tickling in the throat and severe tickling. This is due to inflammation of the mucous membrane of the respiratory tract.

To relieve dry cough, follow these recommendations:

1. Drink plenty of water.
2. Breathe often, shallowly. Deep breaths stimulate the cough reflex.
3. Swallow saliva while holding your breath, in several doses.

In order to alleviate an unproductive cough, it is recommended to perform the Wall exercise:

1. Approach the wall at a distance of about 30 cm.
2. Move one leg forward, slightly bend at the knee
3. Raise your arms up, bend at the elbows
4. Lean your hands on the wall
5. Put your head in your hands
6. Keep your back straight
7. Take 10 deep breaths through your nose

Also, with a dry cough, you can try the Rider exercise:

1. Sit facing the back of a chair
2. Bend your arms at the elbows, put them on the back of a chair
3. Lean forward slightly, keep your back straight
4. Lay your head in your hands
5. Take 10 deep breaths through your nose

How to treat a cough

Natural cough remedy Prospan, plant-based

With a dry cough, remedies are also recommended that contribute to the separation of sputum. Such funds translate an unproductive cough into a productive one and contribute to a speedy recovery. The use of cough suppressants may be indicated for dry frequent cough, leading to vomiting, sleep disturbance and appetite.

Most patients in our country prefer herbal cough preparations. These drugs are generally well tolerated.

Among phyto cough preparations, Prospan can be distinguished - a herbal preparation based on a standardized ivy extract E.A. 575®. Prospan dissolves mucus, reduces its viscosity and promotes coughing, and also relieves spasm of the muscles of the bronchi and inflammation, which makes it easier to breathe during a cough. Prospan is available in five forms for all ages.

NEED FOR NORMAL BREATHING

1. Initial assessment

Risk factors for impaired respiratory function are chronic obstructive pulmonary disease, tracheostomy, nasogastric tube, vomiting, trauma or surgery on the neck, face, mouth, etc.

To assess the satisfaction of the need for normal breathing (providing sufficient oxygen), the nurse must be able to conduct both subjective (questioning) and objective (examination) examination of the patient.

The most common signs indicating insufficient supply of oxygen to the human body are shortness of breath, cough, hemoptysis, chest pain, tachycardia.

Dyspnea- subjective feeling of difficulty in breathing. The patient, as a rule, says that he does not have enough air, there is nothing to breathe. Signs of shortness of breath are increased breathing, a change in its depth (superficial or, conversely, deeper) and rhythm. It is necessary to clarify under what circumstances shortness of breath appears. Shortness of breath can be physiological if it appears after exercise or in a stressful situation, and pathological (with diseases of the respiratory system, blood circulation, brain, blood, etc.).

In some cases, a nurse can detect a pathological violation of the rhythm and depth of breathing, which is observed in diseases of the brain and its membranes (brain hemorrhage, tumor and brain injury, meningitis, etc.), as well as in severe intoxications (uremic, diabetic coma and etc.).

Depending on the change in the depth of breathing, the tidal volume of the lungs may increase or decrease, breathing may be shallow or deep. Shallow breathing is often combined with an abnormal increase in breathing, in which inhalation and exhalation become shorter. Deep breathing, on the contrary, in most cases is associated with a pathological decrease in breathing.

Sometimes deep breathing with large respiratory movements is accompanied by a loud noise - big breath Kussmaul characteristic of a deep coma (prolonged loss of consciousness).

With certain types of shortness of breath, the rhythm of respiratory movements may be disturbed. Violation of the function of the respiratory center causes a type of shortness of breath, in which, after a certain number of respiratory movements, a noticeable (from several seconds to a minute) lengthening of the respiratory pause or short-term breath holding (apnea) occurs. Such breathing is called periodic. There are two types of shortness of breath with periodic breathing.

Breath of Biot characterized by rhythmic movements that alternate at regular intervals with long (up to 30 s) respiratory pauses.

Cheyne-Stokes breathing differs in that after a long respiratory pause (apnea), silent shallow breathing first appears, which quickly increases in depth, becomes noisy and reaches a maximum at the 5-7th breath, and then decreases in the same sequence until the next short-term pause. Patients during a pause are sometimes poorly oriented in the environment or completely lose consciousness, which is restored when the respiratory movements are resumed.

Cough - a protective reflex act aimed at removing sputum and foreign bodies from the bronchi and upper respiratory tract. Cough push - a fixed sonorous exhalation.

The cough can be dry (no sputum production) or wet (sputum production). Sputum may vary in consistency(thick, liquid, frothy), bloom(transparent, yellow-green, with blood) and smell(odorless, fetid, putrid).

It should be known that the effectiveness of a cough depends on several factors: the viscosity of the sputum, the closure of the glottis, the patient's ability to take a deep breath and tighten the accessory respiratory muscles to obtain high pressure in the airways.

With damage to the nerve centers, muscle weakness, intestinal paresis, pain syndrome, the presence of an endotracheal tube or tracheostomy, as well as non-closure of the vocal cords, clearing the lungs with a cough is not possible.

Hemoptysis - coughing up blood or bloody sputum.

Pain in the chest usually occurs when the pleura is involved in the pathological process.

Check with the patient:

• localization of pain;
• intensity and nature of pain;
• the reason for the increase or decrease (for example, he lies on the sore side or presses the sore side with his hand) of pain.

Signs of any (according to localization) pain can be:

Facial expression (grimace of pain, clenched teeth, wrinkled forehead, tightly closed or wide-open eyes, clenched teeth or wide-open mouth, biting lips, etc.);

Body movements (restlessness, immobility, muscle tension, continuous rocking back and forth, scratching, movements to protect the painful part of the body, etc.);

Decrease in social interactions (avoidance of conversations and social contacts, the implementation of only those forms of activity that relieve pain, narrowing the range of interests).

Smoking, especially for a long time and a lot of cigarettes, causes chronic obstructive pulmonary disease and lung cancer. These diseases lead to a violation of the supply of oxygen to the body, i.e. disturb the satisfaction of the need for normal breathing. Such an effect can be exerted by an unfavorable environment (gas contamination, dustiness, tobacco smoke, etc.).

Assessing the patient's condition, it is necessary to pay attention to his position (for example, forced sitting orthopnea, forced position on the sore side, Fowler's high position), the color of the skin and mucous membranes (cyanosis, pallor).

Assessing the need for normal breathing, it is necessary to determine the frequency, depth and rhythm of respiratory movements, as well as to examine the pulse. Normal breathing movements are rhythmic.

The frequency of respiratory movements in an adult at rest is 16-20 per 1 minute, and in women it is 2-4 more than in men. In the supine position, the number of respiratory movements usually decreases (up to 14-16 per 1 minute), and in the upright position it increases (18-20 per 1 minute). Shallow breathing is usually observed at rest, and when the physical or emotional mood is deeper. It should be remembered that in cases where the need for breathing is not satisfied due to any acute illness and acute respiratory failure (ARF), a number of characteristic signs can be identified when assessing the patient's condition. ODJ:II1 of them is tachypnea(acceleration of breathing) up to 24 in 1 minute or more. Human behavior changes: there is anxiety, sometimes euphoria, verbosity, excitement. Verbosity caused by the fear of death.

It is always very difficult to speak against the background of rapid breathing. At a high degree, one person gradually loses consciousness and falls into a coma.

The color of the skin also changes. Most often, cyanosis develops, but even more dangerous is gray pallor, the so-called earthy color of cold, clammy skin covered with sweat. ARF is accompanied by increased heart rate (tachycardia), sometimes the pulse becomes frequent and non-arrhythmic (takhiarucumin) or rare (bradycardia). Blood pressure rises first hypertension), then decreases ( hypotension).

A patient with ARF needs emergency care from all members of the medical team

2. Patient problems

Based on the data obtained during the assessment of the patient's condition, certain problems of the patient are formulated, associated with the dissatisfaction of the need for normal breathing.

Patient problems may be due to reasons such as:

ignorance, inability, unwillingness or inability to take a position that reduces shortness of breath and pain;

unwillingness to regularly perform breathing exercises;

inability to use a spittoon;

inability to use an inhaler;

risk of respiratory tract infection due to inadequate care of the oral cavity, respiratory equipment, etc.;

decreased physical activity (due to shortness of breath or pain);

fear of death from suffocation;

The need to quit smoking

Decreased appetite due to foul-smelling sputum.

Lack of understanding of the importance of regular intake of medicines prescribed by a doctor, etc.

the patient will be able to take measures to reduce the discomfort associated with coughing up sputum;

the patient will follow the entire treatment program;

The patient will carry out the prevention of respiratory tract infections, etc.

3. Goals of nursing care

Discussing the future care plan with the patient (if the need for normal breathing is not met), it should be envisaged that the patient achieves one or more goals:

the patient will know and be able to take a position that facilitates breathing;

The patient will recover (maintain) the physical activity necessary for self-care;

The patient will be able to independently use the inhaler (spittoon);

the patient will take medicines in accordance with the doctor's prescriptions;

The patient will quit smoking (reduce the number of cigarettes smoked per day);

The patient will know self-help techniques for an asthma attack.

4. Nursing care

Positioning the patient in bed with the head of the bed elevated or using two or three pillows will greatly improve breathing.

Various types of drainage position improve sputum production, which means they contribute to recovery. Postural drainage will be effective (stimulating the natural discharge of sputum) only if the patient stays in a given position for a long time. Such drainage is prescribed by a doctor, and is performed under the supervision and with the help of a nurse.

Teaching the patient the technique of coughing will enable him to expel sputum most effectively. One of the methods:

Take a slow deep breath;

Hold your breath for 2 s;

Open your mouth and cough while exhaling.

Teaching certain breathing techniques also aims

leno to improve the satisfaction of the patient's needs in the normal

linen breath.

One of these techniques is that the patient exhales

through pursed lips, while the exhalation lengthens. At

With this breathing technique, patients cough up sputum more easily, i.e.

cough becomes more productive.

5. Assessing nursing outcomes

During the implementation of the care plan, the nurse carries out the current

general and final assessment of the effectiveness of nursing intervention

If empowerment interventions

patient to satisfy the need for normal breathing, "

turned out to be insufficient and ineffective, it is necessary to change the nature of

interventions in consultation with the attending physician.

Patient education can only be effective when he knows and understands the significance of each stage of training. The learning process, like the nursing process, has five stages.

Stages of patient education:

1. Collection of information about the patient (examination) and assessment of the initial level of knowledge and skills of the patient or his relatives. At each contact with the patient, starting with the primary one, the nurse receives some information about him. Thus, the collection of information about the patient is continuous. All this information is analyzed and evaluated by the nurse.
It determines whether the patient has knowledge and skills regarding his condition, whether he or his relatives want to acquire the appropriate knowledge and skills, whether the patient is capable of learning, whether he is able to learn, etc.

2. Identifying the patient's problems. After collecting and evaluating information, the nurse identifies a nursing problem. After that, she must determine how to solve this problem, which will be the content of the next stages of patient education.

3. Determining the goals of patient education, planning its content. Before developing a patient education plan, the nurse should set certain goals for herself. The formulation of learning objectives should focus on three areas: cognitive, emotional and psychological. Goals reflect what the patient needs to do in order to achieve the result. A well-set goal should contain three components (aspects):
1) what the patient needs to do (what he should be able to do, understand, etc.), i.e. learning outcome;
2) time frame - a time interval (or a specific date) during which the learning goal will be achieved (by the 3rd day, in a week, by the end of the month);
3) with the help of whom or what the goal will be achieved (on their own, with the help of relatives, with the help of crutches).
The formulation of goals in the given situation can be as follows: in the cognitive sphere,
psychological sphere, emotional sphere.
In any case, goals should be specific, realistic and achievable.

After determining the goals of patient education, the nurse plans the content and methods of education. The plan includes the time and duration of training.

The content of patient education can be different: maintaining health, maintaining a certain level of health, maintaining a certain level of the patient's quality of life.
The nurse should involve the patient in the preparation of an individual training plan, taking into account his personal characteristics, social conditions, interest in the issues studied and physical condition.

4. Implementation of the patient education plan. To implement the planned plan, the nurse, together with the patient and / or his relatives, create an environment favorable for learning, choose the time for it. If the microclimate of the room is unfavorable
(poor lighting, low temperature, the presence of strangers) or the patient's condition leaves much to be desired (the patient is upset, his pain has increased, shortness of breath), then training
better to postpone.
The following methods can be used to successfully educate the patient:
demonstration - the nurse demonstrates skills of self-care or mutual care (brushing teeth, determining respiratory rate, using crutches, injections, measuring blood pressure, etc.); a clear, repetitive demonstration of each stage of a skill is an important means of achieving learning objectives;
counseling - a nurse observes from the outside how the patient performs a specific skill and, in case of difficulty or at difficult stages, provides him with advisory assistance;
role-playing is a very effective method of teaching, especially social skills; with this method, the patient’s capabilities and the difficulties of self-care in the household are better understood.
environment, new skills are developed (the ability to start a conversation, behave confidently in a particular environment), the level of self-awareness increases, new solutions to the problem are found.
The training scheme consists of five stages:
1) presentation of the necessary information;
2) repetition by the patient of everything that he remembered;
3) showing (demonstrating) what the patient must master;
4) repetition by the patient independently or together with the nurse of the skill;
5) independent explanation and demonstration by the patient of the skill from beginning to end.
Each step of this scheme can be repeated several times until the patient learns the planned material. The nurse should strive to move from the transfer of knowledge to the development of skills, and then to a sustainable skill.
In the process of teaching the patient, it is necessary to constantly maintain the interest of the trainees, ask them leading questions or build a conversation according to the “question-answer” principle, emphasize information important to the patient. At the end of the conversation, it is important to briefly repeat all the basic information.

The nurse needs to make sure that the trainees correctly understand the information being conveyed. To do this, she systematically checks and evaluates their knowledge and skills.

5. Evaluation of patient learning outcomes. After the implementation of the training plan, the nurse evaluates the result, i.e. relates it to the goals.

The nurse's understanding of the goals, objectives and principles of patient education, the ability to use a variety of methods, methods and means of training will contribute to the effective education of patients and their loved ones and, consequently, improve their quality of life.

How to quickly cure bronchitis and get rid of an annoying cough - these questions concern many, especially in the spring and autumn, when the body is weakened and needs vitamins. Many do not try to look for quick ways to get rid of a cough, but use various techniques to feel at least some relief, even if not for long.

Everyone knows that drugs sometimes do not have a special effect. Severe coughs are difficult to treat with pills and syrups, and the sputum seems to have developed a strong immunity to the drugs. If you still hope to find a drug that can quickly relieve you of a cough, then we have to disappoint you, today there are no effective medicines that can quickly eliminate this problem.

Even leading experts in the field of medicine have repeatedly voiced that absolutely all pharmaceutical preparations act on the placebo principle. But this is not a reason to give up, yet there are some techniques that can alleviate a person's condition during the period of illness. It is quite possible to cure bronchitis and get rid of an annoying cough if you perform some breathing exercises.

Effective ways to eliminate cough

During a cough, our body loses a lot of carbon dioxide, which is essential to maintain a normal airway. An insufficient amount of CO2 causes irritation of nerve cells and their receptors, which provokes coughing, at the same time, oxygen levels decrease not only in the brain, but throughout the body as a whole. A persistent strong cough can cause pathological effects, the accumulation and intensification of which, in turn, provokes even more attacks. How to break this chain, cure bronchitis or any other respiratory diseases?

Effective exercises for severe or chronic cough

Initially, you need to learn how to cough through your nose, do not be surprised, but this is true, your mouth should be closed at this time. You also need to learn to cough with your mouth, while holding your nose with your fingers. These two simple exercises allow you to normalize the concentration of carbon dioxide in the body and calm the irritated receptors.

It is also necessary to learn how to inhale less air in order to increase the level of CO2 in the respiratory tract and enrich the cells of the body with oxygen. Such manipulations can cause some discomfort, but, nevertheless, this is a reliable way to quickly eliminate a cough.

Note! The use of these techniques requires prior consultation with your doctor!

As soon as you get the feeling that an attack is coming, you need to find a comfortable place, sit down, relax and straighten your back, and then do some simple exercises that will help normalize breathing. Take a good breath, close your mouth and pinch your nose with your fingers, briefly holding your breath. The first short breath must be taken through the nose, connecting the abdominal muscles and the diaphragm, after which you need to exhale smoothly. Then repeat the exercise until you feel relief. The main task of this technique is to support moderate oxygen starvation, that is, throughout the whole time you should feel the desire to inhale more air. A short breath hold will enrich the cells of the body with oxygen and increase the level of carbon dioxide in the respiratory tract.

To stop a cough, it is enough to perform such exercises for only two minutes, this is really the most effective way to alleviate your condition. These techniques allow you to suppress even nighttime attacks, and to feel maximum relief, you need to monitor the position of your body when you go to bed. To suppress the urge to cough at night, you need to lie on your left side or on your stomach, but not on your back.

The above exercises are included in the Buteyko system, which has been known to everyone since the days of the Soviet Union. Such breathing techniques are effective not only for the treatment of prolonged, but also chronic cough, and this has been confirmed by many patients who have experienced serious diseases (bronchitis, asthma, fibrosis, tuberculosis, lung cancer, acquired immunodeficiency syndrome). Almost all patients who regularly suffer from coughing confirmed that such exercises really helped them. Despite this, the Buteyko system has been criticized more than once, so it’s your right to believe in the effectiveness of this technique or not, but it’s better to do the exercises yourself and feel the result.

Of course, even a person who does not have a higher medical education may have a question - how is sputum removed from the body if the coughing process is hindered? It must be understood that the Buteyko technique allows you to normalize the oxygen balance in the body, thereby eliminating the cause of coughing and, accordingly, reducing the amount of sputum produced by the body. And you can speed up recovery with the help of additional exercises.

An effective method of getting rid of bronchitis. Asthma Control Exercises

This complex will strengthen not only the body, but also restore health. It is better not to start practicing during the period of colds or more serious illnesses. But you can still perform several exercises that will help relax the spine, as well as the chest, thereby speeding up the process of sputum discharge.

The simplest exercise and, perhaps, the most enjoyable one is “rollers” (rolls lying on your back in different directions and back and forth), you need to move slowly and at the same time make sure that your back is as round as possible. But this exercise is recommended only for those who do not have any problems with the spine. With the help of this massage, it will be possible not only to reduce cough, but also to completely heal the entire body, since in the process of rolling there is pressure on the nerve roots of the spinal cord, which are responsible for the normal functioning of all organs and systems. "Rollers" allow you to improve your well-being and help you wake up in the morning in a good mood.

Just a few exercises will help your body get rid of serious ailments:

• deflections. Performing back bends of the body, the chest opens, and there is an improvement in the functioning of the lungs and heart. By bending the upper spine during an asthma attack, the process of exhalation is facilitated. On the contrary, if it is difficult to inhale, then it is necessary to lean forward and bend in the lumbar region (if such movements are not contraindicated);
• inverted poses. To ensure a good outflow of mucus from the lungs, you need to stand on your head or shoulders, and in the latter case, you can also improve blood circulation and activate the immune system;
• "camel". This posture allows you to free the nasal passage, clear the pharynx and lungs, and also activate the facial tissues;
• "a lion". With the help of this exercise, it is possible to activate the tissues of the larynx, bronchioles and trachea, get rid of tonsillitis, reduce inflammation in the throat, and also strengthen the cartilage of the thyroid gland;
• "fish". This posture helps to restore breathing, as well as improve the functioning of all respiratory organs (pharynx, larynx, nasal passage).

To achieve the maximum effect, the exercises must be done comprehensively, while not forgetting about relaxing techniques, for example, the “corpse” pose. If you are seriously concerned about your health, we advise you to take a closer look at the exercises, sometimes this is the only way to solve the problem, when no medication or any other means can help get rid of the disease.

The main role in the primary prevention of COPD belongs to anti-tobacco propaganda: it is necessary to ensure that as few people as possible start smoking. In patients with COPD, smoking cessation leads to a decrease in the rate of decline in lung function.

The use of protective masks, as well as the proper organization of the workplace, are important when working with industrial hazards.

Specific occupational risk must be carefully managed.

Dispensary observation:

Examination by a therapist 2-3 times a year.

· Inspection of specialists once a year.

laboratory and instrumental studies once a year.

Typical patient problems:

cough, as the disease progresses with sputum production,

shortness of breath

· weakness,

· fast fatiguability,

a bad dream

· loss of appetite,

Lack of knowledge about illness, inhaler use, adherence and medication.

Purpose and scope of nursing interventions:

· oxygen therapy

· functional position in bed

· productive cough training

· adherence to treatment regimen

· preparation for research (radiography, bronchoscopy, blood analysis, sputum)

· ensuring infectious safety.

The role of the nurse in caring for patients with respiratory diseases:

Sputum- needs to be defined daily amount , which can range from 10-15 ml (with chronic bronchitis) to 1 liter or more (with bronchiectasis).

The patient should spit sputum into an individual spittoon, on the bottom of which a small amount of 5% chloramine solution is poured.

· The spittoons are emptied daily, washed thoroughly and disinfected.

The daily amount is noted on the temperature sheet every day.

It is very important to achieve free discharge of sputum, since its delay (for example, with bronchiectasis, lung abscess) increases the intoxication of the body.

The patient is helped to find a position (the so-called drainage position, on one side or another, on the back), in which sputum is most completely removed, i.e. efficient drainage of the bronchial tree. The patient should take this position once a day for 20-30 minutes.

Teach the patient how to properly collect sputum for analysis. Therefore, before collecting sputum, the patient must brush his teeth and rinse his mouth. Sputum in the amount of 4-5 ml is collected in the morning, when it is richest in microflora.

Pulse rate, BP, PSV, NPV- monitoring the patient's condition, be able to correctly carry out these manipulations and enter the results of the calculation daily into the temperature sheet. The respiratory rate is entered daily and the graphic curve is marked with a blue pencil, the pulse rate is red.

Dyspnea- the patient is given an elevated (semi-sitting) position, freeing him from restrictive clothing, providing fresh air through regular ventilation.

Severe degree of respiratory failure- carry out oxygen therapy.

Example:

Problems- unproductive cough, lack of understanding of the need for a drainage position, etc.;

Violated needs breathing needs.

Definition nursing care goals :

The patient will know and be able to take a position that facilitates breathing;

The patient retains the physical activity necessary for self-care, etc.;

The patient will be able to independently use the spittoon (inhaler, spacer, spinhaler, etc.).

The patient takes medicines in accordance with the doctor's prescription;

The patient will quit smoking (reduce the number of cigarettes smoked per day);

The patient (relatives) knows the techniques of self-defense during an asthma attack;

The patient knows the measures to reduce the discomfort associated with expectoration of sputum and the like.

Nursing Interventions:

Positioning the patient in bed with the head of the bed raised or using two or three pillows can significantly improve breathing.

Postural drainage (positional, draining position). Positions used to empty the various segments of the lungs.

Teaching the patient the "coughing technique". Combination of postural drainage with other methods of stimulation of natural sputum discharge.

Teaching the patient breathing techniques to improve the satisfaction of the patient's need for normal breathing.

Oxygen therapy, methods of inhalation through a nasal fork-shaped cannula, mask, catheter.

Evaluation of nursing care: ongoing and final evaluation of the effectiveness of nursing intervention.

Ensuring the infectious safety of the patient and the nurse.

Factors Associated with Decreased Survival in COPD(by Burrows)