Nursing Care Plan for COPD: Diagnoses, Interventions & Outcomes

Patient Scenario

J.M., a 68-year-old male with a 40 pack-year smoking history, presents with worsening dyspnea, productive cough with yellowish sputum, and SpO2 88% on room air. Currently on albuterol inhaler PRN and tiotropium daily.

Priority Nursing Diagnoses

1. Impaired Gas Exchange

Related to: Alveolar-capillary membrane changes secondary to COPD

As Evidenced By: SpO2 88%, dyspnea on exertion, use of accessory muscles, prolonged expiratory phase

Goals:

• Short-term: SpO2 ≥90% within 2 hours with supplemental O2
• Long-term: Maintain SpO2 ≥90% on ≤2L NC at discharge

Interventions:

• Apply O2 via nasal cannula at 1-2 L/min (COPD patients: low-flow O2)
• Monitor SpO2 continuously and ABGs as ordered
• Position in high Fowler's or tripod position
• Administer bronchodilators as ordered
• Encourage pursed-lip breathing

Rationale: Low-flow O2 prevents suppression of hypoxic drive. Positioning optimizes diaphragmatic excursion.

2. Ineffective Airway Clearance

Related to: Excessive mucus production and bronchospasm

As Evidenced By: Productive cough, yellowish sputum, adventitious breath sounds (rhonchi)

Goals:

• Short-term: Clear breath sounds in all fields within 24 hours
• Long-term: Demonstrate effective coughing technique by discharge

Interventions:

• Assess breath sounds every 4 hours
• Encourage fluids (2-3L/day unless contraindicated)
• Teach controlled coughing and huffing technique
• Administer mucolytics as ordered
• Perform chest physiotherapy if ordered
• Suction PRN if patient unable to clear secretions

3. Activity Intolerance

Related to: Imbalance between oxygen supply and demand

As Evidenced By: Verbal report of fatigue, dyspnea with ADLs, SpO2 drops with activity

Goals:

• Short-term: Perform ADLs with assistance without desaturation within 48 hours
• Long-term: Independently perform basic ADLs with energy conservation techniques

Interventions:

• Assess activity tolerance using Borg scale
• Schedule activities with rest periods
• Teach energy conservation techniques
• Encourage use of incentive spirometry
• Provide supplemental O2 during activity as needed
• Gradual increase in activity level as tolerated

4. Deficient Knowledge

Related to: Disease process and self-management

As Evidenced By: Questions about medications, continued smoking

Goals:

• Patient will verbalize understanding of COPD management by discharge
• Patient will demonstrate correct inhaler technique

Interventions:

• Teach disease process in understandable terms
• Demonstrate and return-demonstrate inhaler technique
• Discuss smoking cessation resources
• Provide written discharge instructions
• Teach signs of exacerbation requiring medical attention
• Referral to pulmonary rehabilitation

Evaluation

Reassess all outcomes at specified timeframes. Modify care plan based on patient progress. Document ongoing evaluation.

Get Care Plan Help →

Where to go next

If you are building on this topic, our nursing care plan examples shows the full worked structure, and the NANDA-I nursing diagnosis list covers the reference detail most rubrics expect. When the deadline is tight, our MSN and PhD-prepared nurses provide care plans and clinical documentation support and nursing assignment help so you can study the model, then write with confidence.

Need a tutor on this today? Get instant help or message us on WhatsApp.