Julie is a 52-year-old female who has come to a local walk-in clinic to discuss her COPD and specifically the problem she is having with exacerbations and time ‘off sick’. She is a heavy smoker, and her progressively deteriorating lung function suggests that she has moderate COPD, although she also has a history of childhood asthma, and had allergic rhinitis as a teenager. She has a sedentary office job and, although she is breathless on exertion, this generally does not interfere with her lifestyle. The relatively frequent exacerbations are more troublesome. They are usually triggered by an upper respiratory infection and can take a couple of weeks to recover. She has had three exacerbations this winter, and as a result her employer is not happy with her sickness absence record and has asked her to seek advice from her general practitioner. Julie is on a short-acting 2-agonist, although she rarely uses it except during exacerbations. In the past, she has used an inhaled steroid, but stopped that some time ago as she was not convinced it was helping. While auscultating Julie’s lungs, the nurse hears expiratory wheezes throughout. Her vital signs are as follows: blood pressure 110/82; pulse 116; respiratory rate 39; oxygen saturation on room air is 88%. Recent spirometry showed a typical COPD flow-volume loop, although she had some reversibility (250ml and 20%) with a post-bronchodilator FEV1 of 60% predicted. Question:6 1. Explain some of the emotional and psychological issues Julie may experience. How can you as a nurse support Julie to help her cope with this situation? Support your answer with explanation, and references.References within 5 years. Solution Julie has been experiencing the relatively frequent exacerbations & these are more troublesome because they are triggered by an upper respiratory infection and can take a couple of weeks to recover due to chronic obstructive pulmonary syndrome (COPD). These effects have induced variable physiological effect sin Julie with change in breathing rate & heart rate as a result she may experience \"COPD associated with psychiatric depression\" & feelings of hopelessness and fatigue and sleeplessness. Finally, she is going to experience emotional issues such as \"stress & anxiety\" with feeling of weakness and lower consciousness to engage in enjoyable activities As a nurse, it is crucial to support Julie to help her cope with this situation by advising her to learn breathing techniques from a psychologist & respiratory specialist so that she can cope with emergency situation using pulmonary rehabilitation setting. The psychological issues can be rectified by advising her to take medication and treatment plan. The emotional issues can be stopped by advising her to participate in exercises along patients of COPD & asthma References: Farrokh Sohrabi, MD 2012. Coping With the Emotional Challenges of COPD. Everyday Health.

1. Julie is a 52-year-old female who has come to a local walk-in clinic to discuss her COPD and
specifically the problem she is having with exacerbations and time ‘off sick’. She is a heavy
smoker, and her progressively deteriorating lung function suggests that she has moderate COPD,
although she also has a history of childhood asthma, and had allergic rhinitis as a teenager.
She has a sedentary office job and, although she is breathless on exertion, this generally does not
interfere with her lifestyle. The relatively frequent exacerbations are more troublesome. They are
usually triggered by an upper respiratory infection and can take a couple of weeks to recover.
She has had three exacerbations this winter, and as a result her employer is not happy with her
sickness absence record and has asked her to seek advice from her general practitioner.
Julie is on a short-acting 2-agonist, although she rarely uses it except during exacerbations. In the
past, she has used an inhaled steroid, but stopped that some time ago as she was not convinced it
was helping.
While auscultating Julie’s lungs, the nurse hears expiratory wheezes throughout. Her vital signs
are as follows: blood pressure 110/82; pulse 116; respiratory rate 39; oxygen saturation on room
air is 88%. Recent spirometry showed a typical COPD flow-volume loop, although she had some
reversibility (250ml and 20%) with a post-bronchodilator FEV1 of 60% predicted.
Question:6
1. Explain some of the emotional and psychological issues Julie may experience. How can
you as a nurse support Julie to help her cope with this situation? Support your answer with
explanation, and references.References within 5 years.
Solution
Julie has been experiencing the relatively frequent exacerbations & these are more troublesome
because they are triggered by an upper respiratory infection and can take a couple of weeks to
recover due to chronic obstructive pulmonary syndrome (COPD). These effects have induced
variable physiological effect sin Julie with change in breathing rate & heart rate as a result she
may experience "COPD associated with psychiatric depression" & feelings of hopelessness and
fatigue and sleeplessness. Finally, she is going to experience emotional issues such as "stress &
anxiety" with feeling of weakness and lower consciousness to engage in enjoyable activities
As a nurse, it is crucial to support Julie to help her cope with this situation by advising her to
learn breathing techniques from a psychologist & respiratory specialist so that she can cope with
emergency situation using pulmonary rehabilitation setting. The psychological issues can be
rectified by advising her to take medication and treatment plan. The emotional issues can be
stopped by advising her to participate in exercises along patients of COPD & asthma

2. References:
Farrokh Sohrabi, MD 2012. Coping With the Emotional Challenges of COPD. Everyday Health