This guideline addresses the nursing assessment and management of stable, unstable and acute dyspnea associated with COPD.
This guideline addresses the nursing assessment and management of stable, unstable and acute dyspnea associated with COPD.
As an introduction, we’ve provided summaries of the practice recommendations from the BPG document — but we strongly encourage downloading RNAO’s official PDF.
Nurses will acknowledge and accept the patients’ self-report of dyspnea.
All individuals identified as having dyspnea related to COPD will be assessed appropriately (See Figure 1 – COPD Decision Tree). Respiratory assessment should include:
Nurses will be able to identify stable and unstable dyspnea, and acute respiratory failure.
Every adult with dyspnea who has a history of smoking and is over the age of 40 should be screened to identify those most likely to be affected by COPD. As part of the basic dyspnea assessment, nurses should ask every patient:
For patients who have a history of smoking and are over the age of 40, nurses should advocate for spirometric testing to establish early diagnosis in at risk individuals.
Nurses will be able to implement appropriate nursing interventions for all levels of dyspnea including acute episodes of respiratory distress:
Nurses must remain with patients during episodes of acute respiratory distress.
Smoking cessation strategies should be instituted for patients who smoke:
Nurses should provide appropriate administration of the following pharmacological agents as prescribed: (See Appendix L – COPD Medications)
Nurses will assess patients’ inhaler device technique to ensure accurate use. Nurses will coach patients with sub-optimal technique in proper inhaler device technique.
Nurses will be able to discuss the main categories of medications with their patients including:
Annual influenza vaccination should be recommended for individuals who do not have a contraindication.
COPD patients should receive a pneumococcal vaccine at least once in their lives (high risk patients every 5 to 10 years).
Nurses will assess for hypoxemia/hypoxia and administer appropriate oxygen therapy for individuals for all levels of dyspnea.
Nurses should support disease self-management strategies including:
Nurses should promote exercise training.
Nurses should promote pulmonary rehabilitation.
This website was developed by a team of researchers at the Daphne Cockwell School of Nursing at Toronto Metropolitan University (Formerly Ryerson University). The purpose of the site is to provide supplementary resources for implementing RNAO’s Best Practice Guidelines. Some information about the best practice guidelines has been collected directly from the RNAO BPG website. We have done our best to ensure accuracy, however some discrepancies may occur. For official, up-to-date information about the best practice guidelines, please refer to the RNAO website.