Running head: REFLECTION ON ATI COPD ATI COPD Reflection: Clinical Prioritation Lauren Kim Samuel Merritt University 1 REFLECTION ON ATI COPD 2 Clinical Prioritization Identify the Highest Priority of Care Within the ATI Real Life COPD simulation, it became very clear that managing patent airways for the patient with a low O2 saturation was the most important priority. The patient presented with symptoms of dyspnea, wheezing, diminished lung sounds, and confusion. With the listed symptoms, it is important to maintain a high oxygen saturation because the patient could further go into hypercapnia in which excessive carbon dioxide would enter the bloodstream further resulting in respiratory acidosis. Best Practice of Management and Prioritizing COPD Patients When administering care for COPD patients, there is a wide range of available procedures that can be administered such as decreasing exposure to risk factors, implementing behavioral changes, medication therapy, and education regarding the disease. Regarding prioritizing care of COPD patients, I think drug therapy should be prioritized in order to provide bronchodilators to aid in the management of airway patency. Furthermore, because drug therapy is individualized, it is important to correctly evaluate the effectiveness of the progression of disease. As “The individualization of treatment is essential and should be based on the availability of existing drugs, disease severity, patient preferences, drug interactions, and comorbidities. The goal should always be to meet the disease control objectives effectively” (Fernandes, 2017). Medications often implemented within drug therapy for COPD patients include short-acting B2 agonists such as Fenoterol and Albuterol and Long-acting B2 agonists such as Formoterol, Salmeterol, Olodaterol, and Indacaterol. Reflection/ Complications to Consider REFLECTION ON ATI COPD 3 When completing the online simulation, I realized that I should spend some time reviewing previous lecture materials on management of COPD. When presented with the vital signs and after observing that the patient’s SpO2 was 88%, my initial reaction was to administer 2L O2, NC in order to increase the SpO2. However, it is important to understand that for COPD patients, a lower SpO2 is expected due to the chronic inflammation and obstruction of the lungs. Furthermore, when taking care of COPD patients, it would be important to consider the positioning of the patient. Upon initial assessment, the patient appeared to be in tripod position due to having difficulty breathing. If the patient’s head of the bead was more elevated, he would be able to sit up without having to utilze energy to get into a comfortable position. REFLECTION ON ATI COPD 4 References Fernandes, F., Cukier, A., Camelier, A. A., Fritscher, C. C., Costa, C., Pereira, E., Godoy, I., Cançado, J., Romaldini, J. G., Chatkin, J. M., Jardim, J. R., Rabahi, M. F., Nucci, M., Sales, M., Castellano, M., Aidé, M. A., Teixeira, P., Maciel, R., Corrêa, R. A., Stirbulov, R., … Lundgren, F. (2017). Recommendations for the pharmacological treatment of COPD: questions and answers. Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 43(4), 290–301. https://doi.org/10.1590/S1806-37562017000000153
