Nutrition Care Plan for COPD - Essay Sample

Introduction

Chronic obstructive pulmonary disease (COPD) is a chronic illness characterized by inflammation of the lungs, obstructing the flow of air. The symptoms of the disease include wheezing, production of mucus, cough and breathing difficulty (Barker, 2007). The main cause of COPD is long-term exposure to particulate matter or irritating gases, especially from smoking. The most common conditions that lead to COPD are chronic bronchitis and emphysema.

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According to Barker (2007), the leading risk factor of COPD is exposure to tobacco smoke for a long time. The risk is even higher for asthmatic individuals who smoke. The other risk factor is professions that expose people to chemicals, dust, and vapor for a long time. Prolonged exposure to smoke from burning fuels is also a risk factor for COPD. Age is also a risk factor for COPD. Since the symptoms of the illness develop slowly, they mostly begin to manifest beyond the age of 40. Also, the genetic disorder alpha-1-antitrypsin deficiency is often associated with COPD (Ucgun et al., 2006).

The first step in treating COPD is smoking cessation (Barker, 2007). There are medicines and products that can help patients replace nicotine and overcome relapses. For the symptoms of the disease, the common treatments include bronchodilators, inhaled steroids, combination inhalers, oral steroids, phosphodiesterase-4 inhibitors, theophylline, antibiotics. In severe cases of COPD, doctors may use oxygen therapy or enroll patients to pulmonary rehabilitation program.

Mr C is currently experiencing acute exacerbation of COPD. He has shortness of breath because his airway is blocked. Therefore, he is intubated to improve oxygenation. According to Ucgun et al. (2006), vent support can improve the condition of a patient who was otherwise unable to breathe adequately. However, it can also affect a patient's respiratory and cardiac systems negatively. Vent support forces air into the lungs, leading to positive pressure which makes it affects blood circulation and may result in heart failure (Barker, 2007).

The main nutrition therapy goal for a patient with COPD receiving vent support is to avoid malnutrition which is associated with increased mortality and poor immune function (Romieu, 2006) . Nutrition therapy thus reduces the risk of complications. Nutritional therapy is supposed to ensure that the patient is weaned from the ventilator.

For Mr C's nutrition therapy, I recommend early enteral feeding to preserve muscles responsible for controlling lung function. However, the patient should not overfeed as this may lead to other complications. About 50% of colories given to the patient should be carbohydrates, 30% should be fat, and 20% should be protein (Romieu, 2006) . Protein should be administered at 2 grams per kilogram body weight. Since the patient receives IV fluids, the caloric density may be kept below 1.5 cal/mL (Ireton-Jones, Borman, & Turner, 1993) .

Upon discharge from hospital, I recommend that Mr. C resumes oral (by mouth) feeding. However, he must begin with small servings of 4 or 5 meals daily to allow his diaphragm and lung muscles to move easily (Ireton-Jones, et al., 1993) . Each of the meals should be balanced with larger portions of nutrient-rich and low-calorie foods and little portions of sodium-rich as well as high-calorie foods. Specifically, Mr. C should take complex carbohydrates such as whole grains, fruits and vegetables. Whole grains are sources of fibre useful in regulating hearth health and blood pressure. At the same time, he should take cholesterol-free and unsaturated fats. He also needs to go for low-fat proteins. In addition, Mr. C should cut down his sodium and salt intake and drink plenty of water to keep him hydrated and thin his mucus (Romieu, 2006). Also, to strengthen his immunity and reduce risk of infection as he continues to recover from COPD, Mr. C's diet should include nutrients such as fish oil, dietary nucleotides, glutamine, and arginine.

References

Barker, J. (2007). Predictors of hospital outcome and intubation in COPD patients admitted to the respiratory ICU for acute hypercapnic respiratory failure. Yearbook of Pulmonary Disease, 2007, 318-319. doi:10.1016/s8756-3452(08)70491-2

Ireton-Jones, C. S., Borman, K. R., & Turner, W. W. (1993). Nutrition Considerations in the Management of Ventilator-Dependent Patients. Nutrition in Clinical Practice, 8(2), 60-64. doi:10.1177/011542659300800260

Romieu, I. (2006). Nutrition In Respiratory Disease. Encyclopedia of Respiratory Medicine, 172-179. doi:10.1016/b0-12-370879-6/00267-2

Ucgun, I., Metintas, M., Moral, H., Alatas, F., Yildirim, H., & Erginel, S. (2006). Predictors of hospital outcome and intubation in COPD patients admitted to the respiratory ICU for acute hypercapnic respiratory failure. Respiratory Medicine, 100(1), 66-74. doi:10.1016/j.rmed.2005.04.005