I.Introduction A.

Description of the disease Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. The more familiar terms chronic bronchitis and emphysema are no longer used! but are now included within the COPD diagnosis. COPD is not simply a "smo#er s cough" but an under$diagnosed! life$threatening lung disease may include diseases that cause airflow obstruction (e.g.! %mphysema! chronic bronchitis) or any combination of these disorders. Other diseases as cystic fibrosis! bronchiectasis! and asthma that were previously classified as types of chronic obstructive lung disease are now classified as chronic pulmonary disorders. &owever! asthma is now considered as a separate disorder and is classified as an abnormal airway condition characterized primarily by reversible inflammation. COPD can co$e'ist with asthma. (oth of these diseases have the same ma)or symptoms* however! symptoms are generally more variable in asthma than in COPD. B. Recent Trends, Innovations and/ Refinement in treatment +ew ,nhaler Drug -pproved (y .D- .or Chronic COPD! The /.0. .ood and Drug -dministration has )ust announced the approval of a form of new long$term treatment for patients suffering from chronic obstructive pulmonary disease (COPD). The new treatment is an inhaler drug called Breo Ellipta (fluticasone furoate and vilanterol inhalation powder). ,t is also approved for the treatment of e'acerbations in COPD patients. The new inhaler! developed by 1la'o0mith2line! wor#s by reducing inflammation in the lungs as well as rela'ing the muscles around the airways! which improves airflow and prevents wheezing and breathlessness. (reo %llipta is a combination of two different drugs3 fluticasone furoate! an inhaled corticosteroid! and vilanterol! a long$acting beta4$adrenergic agonist (5-(-). 6esearchers evaluated the effectiveness of the inhaler in 7!788 people who were diagnosed with COPD.The results of the study indicated that! compared to placebo! (reo %llipta was very effective at improving lung function and reducing e'acerbations. (reo %llipta is not approved for the treatment of asthma. ,n fact! as a 5-(-! the drug s bo' label will include a warning that it can increase the ris# of asthma$related death. ,n addition! the medication is not recommended for people under the age of 9: and should not be used as a rescue therapy to treat sudden breathing complications. 0ide effects lin#ed to (reo %llipta therapy include3 ,ncreased ris# of pneumonia (one fractures &eadache ,nflammation of the nasal passages Thrush /pper respiratory tract infection COPD has no cure yet. &owever! lifestyle changes and treatments can help you feel better! stay more

active! and slow the progress of the disease. The goals of COPD treatment include3 6elieving your symptoms 0lowing the progress of the disease ,mproving your e'ercise tolerance (your ability to stay active) Preventing and treating complications ,mproving your overall health This newest definition COPD! provided by the 1lobal ,nitiative for Chrnonic Obstructive 5ung Disease (1O5D)! is a broad description that better e'plains this disorder and its signs and symptoms (1O5D! ;orld &ealth Organization <;&O= > +ational &eart! 5ung and (lood ,nstitute <+&5(,=! 488?). -lthough previous definitions have include emphysema and chronic bronchitis under the umbrella classification of COPD! this was often confusing because most patient with COPD present with over lapping signs and symptoms of these two distinct disease processes. C.0tatistics (local and international) Chronic Obstructive Pulmonary Disease (COPD) and asthma are 4 of the leading causes of deaths in the Philippines and the world. -ccording to ;orld &ealth Organization! @88 million people worldwide suffer from COPD while 94A of Philippine population of B8 million have asthma. Currently! COPD is the fourth leading cause of mortality and the 94th leading cause of disability. &owever! by the year 4848 it is estimated that COPD will be the third leading cause of death and the firth leading cause of disability (0in! Cc-lister! Can. %t al.! 488D). People with COPDcommonly become symptomatic during the middle adult years! and the incidence of the disease increases with age. The prevalence of chronic obstructive pulmonary disease (COPD) in the /nited 0tates was stable from 9BB: through 488B and has remained higher in women than in men!COPD was more prevalent in older age groups. COPD was more prevalent among Puerto 6ican and non$&ispanic white adults than among non$ &ispanic blac# and Ce'ican$-merican adults! and among adults with family income below the poverty level (:.DA) than among adults with income at least 488A of the poverty level (?.DA). Prevalence of COPD was almost twice as high in the %ast 0outh Central /.0. Census division (7.EA) as in the Pacific division (D.BA). .rom 9BBB through 4887! COPD hospitalization rates declined for both men and women! but COPD death rates declined only for men. The prevalence of COPD rose with age for both men and women throughout most of the lifespan COPD prevalence was highest among women aged @EF7? (98.?A) and 7EF:? (B.7A) and among men aged 7EF:? (99.4A). COPD prevalence was greater among women than men in all age groups e'cept the two highest age groups (7EF:? and :E and over)! for which the difference was not statistically significant. D.O)ectives

O(G%CT,H%0 1eneral Ob)ective3 The main aim of the group is to be able to present the case presentation of our selected client that would present a comprehensive discussion of the pathological mechanism of the illness to yield significant information for the case study. 0pecific Ob)ectives3 ,n order to meet the general ob)ective! the group aims to3 Cognitive3 I ,nterpret the pertinent data gathered from the patient and his significant others I Define the complete diagnosis of the patient! I 6ationalize the doctorJs order obtained from the patientJs chart! I ,nterpret the laboratory test results of the patient! I Psychomotor3 I 0tate the past and present health history of the client! I Trace the family genogram! I Present the cephalocaudal assessment obtained from the patient! I Discuss the anatomy and physiology of the organ involved in the patientJs disease! I Present the etiology and symptomatology of the patientJs disease! I Trace the pathophysiology of the patientJs disease! I Present the medications given to the client! including their respective modes of action! indications! contraindications! side effects! adverse reactions! nursing responsibilities! and importance to the clientJs condition* I Discuss the surgical procedure performed to the patient and its important interventions in the pre! intra! and postoperative phase. I Present a specific! measurable! attainable! realistic and time$bounded nursing care plans for the client! -ffective3 I %stablish rapport to the patient and the patientJs significant others! I ,nform suitable recommendations to the client! his significant others and community! and the medical world! etc.

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Overall! COPD poses a common! growing! and significant clinical challenge for patients and clinicians ali#e. Clinicians e'pert #nowledge regarding diagnosis and management can enhance patients longevity and Suality of life. 6esults of emerging studies will li#ely lead to enhancements in current management and new paradigms in managing patients with COPD. COPD is an underrecognized and underdiagnosed disease with ma)or impact on patient health status and associated morbidity and mortality. %arly diagnosis is feasible with close attention to patient history and to the )udicious use of spirometry. %arly therapy is most li#ely to be of benefit if it alters disease progression or improves symptoms and functional status. These criteria have been conclusively proven with respect to aggressive! early approaches to smo#ing cessation. 0imilarly! diagnosis of asthma is crucial as early intervention with anti$inflammatory therapy has been demonstrated to alter disease progression and symptoms. Of note! symptomatic limitation is underreported by patients with mild COPD. -s such! close Suestioning of the patient with mild disease for symptoms of functional limitation or e'acerbations is necessary as therapeutic interventions in this setting can li#ely prove favorable. 6%COCC%+D-T,O+3 - first line recommendation for the management of COPD in many guidelines. Their Sualities beyond broncho dilatation! improvement of dyspnoea! e'ercise tolerance! decreasing COPD e'acerbations and improving health related Suality of life for patients is the focus of ongoing modern clinical research. These improvements were to some e'tent already seen with short$acting anticholinergics that are mar#eted for a longer time! but have become greater with the more recent development of long$acting anticholinergics. ,n addition to these important benefits the long$acting anticholinergic tiotropium also demonstrated its ability to reduce the ris# of death in the ?$year /P5,.TT trial. .urther analyses from this long$term trial have shown how the clinical course of the disease can be positively affected when maintenance treatment with tiotropium is initiated as early as recommended in the 1O5D 1uidelines (0tage ,,) and have also shown the importance of initiating this treatment in patients previously naUve of maintenance therapy. The most effective intervention in COPD remains giving up smo#ing. ConseSuently smo#ing cessation should be standard treatment for COPD! accompanied by the usage of bronchodilators.

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