Similarities: In both reports, the etiology of COPD which is an irritant is mentioned.  Irritants may include smoke from cigarettes or any other irritating chemical. Also, both reports show a complete pathophysiological process that results to COPD, starting from inflammation of the airway due to exposure to the irritant to the development of key symptoms of COPD which include chronic bronchitis and emphysema.

Differences: In my report, I mentioned smoking as the primary irritant that causes COPD unlike in the expert’s report which generalizes all irritants. Also, the expertise describes the whole inflammatory process which occurs due to exposure to irritants, including listing the major inflammatory mediators such as cytokines, histamine, and leukotriene. While defining chronic bronchitis, the expert describes that it is the presence of mucus, sputum, and a cough lasting for more than two months. On the other side, my definition of chronic bronchitis does not include major parameters such as time and signs.

Possible explanations for differences &/or omissions (if required): As shown above, the expert did not mention smoking as the primary irritant that causes COPD like I did. One reason for doing that is because of there several irritants that can cause COPD. On my side, I mentioned smoking as a major irritant because studies indicate that it is the primary cause. Besides, the expert mentioned the inflammatory mediators released during the inflammatory process since they are important in determine medications to use in managing the patient with COPD.

Similarities: Assessment of ABC and for signs of respiratory failure is described in both reports. Also, the importance of a MET call has been emphasized in both reports. Monitoring of SpO₂ has as well been discussed in the two reports. Lastly, patient education including self-medication and nutritional management has been discussed in both reports.

Differences: In the expert’s report, nursing management is based more on preventing hypoxia by administering oxygen. On the other side, my report includes sleeping and breathing techniques as ways of necessitating breathing to prevent hypoxia. The expert emphasizes on focused respiratory assessment while I focused on implementing the possible intervention to prevent the deterioration of COPD. Lastly, the expert described the importance of managing anxiety and involving the patient’s social worker in the management process while in my report I emphasized on educating the patient about all the roles that she is supposed to play for a better recovery.

Possible explanations for differences &/or omissions (if required): The expert emphasized on focused respiratory assessment and oxygen therapy as they are urgent interventions for a patient at risk of hypoxia. Also, the expert emphasized on managing the patient’s anxiety since it can cause a person to have difficulty breathing. Lastly, the expert involves the social worker in planning the patient’s patient management since she cannot recall all the instructions given.

Learning Outcome 3: Pharmacological Management

Similarities: Salbutamol has been used as a bronchodilator in both reports. Seretide used as a maintenance treatment in both reports. Regular medications administered in both cases. Lastly, adverse effects for the use of salbutamol are outlined.

Differences: In the expert’s report, confirmation of the right medicine by checking their generic names is emphasized whereby in my report no emphasis is put on confirming if the medications to be administered are the right ones.

Possible explanations for differences &/or omissions (if required): Confirming generic names enables nurses to avoid administering wrong medications.

·                     The expert’s response on nursing management of the patient with COPD involved focussed respiratory assessment and managing anxiety which I did not include in my report. Thus, it added to my knowledge regarding the assessment of COPD patients

Challenged:

·                     In my report, I ignored some important nursing management parameters such as confirming medications before administration, focused respiratory assessment, and management. All these parameters were present in the expert’s report. Therefore, I should take note of all important parameters in managing patients in my future nursing practice.

Main take home idea:

·                     I should perform comprehensive patient assessment and management such as performing a focused respiratory assessment and managing anxiety in COPD patients

The knowledge I have learnt from the expert’s response will help me to perform comprehensive patient assessment and prioritized patient interventions. For example, I will ensure that I apply the DRSABC mnemonic while assessing patients, perform a focused respiratory assessment, and manage anxiety in COPD patients.