Nursing Care for Patients with Chronic Obstructive Pulmonary Disease with Pneumothorax and Respiratory Failure: A Case Study

Abstract

This study aimed to present nursing care for patients with COPD with pneumothorax and respiratory failure, nurses must understand the pathophysiology of the disease and provide effective, accurate, and appropriate nursing care. This can reduce the occurrence of complications, enable patients to safely overcome the crisis, and reduce mortality in patients with COPD with pneumothorax and respiratory failure. This study utilized a case-control study. Data were collected through observation, interviews, and analysis of medical records. analysis during 1-19 November 2024, at the Emergency Department, Central Chest Institute.

A 81-year-old Thai male patient with chronic obstructive pulmonary disease and a pneumothorax. And this time presented to the hospital with symptoms of shortness of breath and difficulty breathing two hours prior to admission. He was experiencing shortness of breath, using abdominal muscles for ventilation, and was restless. A chest X-ray showed a pneumothorax in the left pleural space. He was treated with an O₂ mask with bag at 10 liters per minute and a chest tube was inserted for drainage. The patient had severe complications including respiratory failure. Nursing care was implemented according to 5 nursing diagnoses as follows: The patient has a risk of life-threatening complications due to a pneumothorax in the pleural space, Risk of tissues in the body receiving insufficient oxygen due to reduced gas exchange efficiency due to pathological conditions of the disease, The patient was uncomfortable due to pain in the area where the left chest drainage tube was inserted, Risk of infection due to the insertion of the device into their body, Patients and their relatives are concerned about their disease, treatment with chest drainage, and behavior to prevent recurrence, The results showed that the patient had good response to treatment, no severe.

The results of this study can be applied as practice guidelines for nursing care for patients with complex respiratory diseases, helping to improve the quality of nursing care in an efficient, accurate, appropriate, rapid, and safe manner. It can reduce the occurrence of complications, help patients overcome the crisis, and reduce the mortality rate. It helps improve the quality of nursing care and can be used as academic information for developing nursing personnel competence and planning effective patient care in collaboration with interdisciplinary professionals.