Most patients or loved ones with mild COPD do not present symptoms yet, but this does not mean no intervention is needed. It is important for care giving families to identify situations that can still be considered as normal or if medical attention is needed. This is done by having knowledge of vital signs and being able to perform vital signs monitoring. Shortness of breath is the most prominent symptom of COPD. Thus, the vital sign needed to be checked is respiration rate which measures the number of breaths per minute. The normal value is 15-20.

Monitor other vital signs like temperature (using oral thermometer, normal temperature is 98.6 F, auxiliary thermometer- 97.6 F and rectal thermometer- 99.6F), pulse rate (normal is 60-100 beats per minute) and blood pressure (normal is 100-140 systolic and 60-90 diastolic). This is to develop a baseline of observations to allow comparisons of symptoms, giving you an idea if the condition is worsening. However, bear in mind that monitoring of vital signs should not be replaced with a diagnosis performed by a healthcare provider.

Stage 2 COPD has several effects on the lifestyle of patients, especially on their diet and activities they are able to perform. Breathing problems becoming more frequent is very uncomfortable to them, thus a more structured care is needed. As a caregiver, make sure that patients or your loved ones with COPD are always resting comfortably. Find a chair; let them sit with their back against the chair while allowing the head and shoulders to drop slightly forward. Rest their arms on their thighs with palms facing upwards. Their feet should be rested on the floor or on a stool. Maintain this until breathing normalizes. If no chair is available, allow them to stand with their back against a pole or a flat wall. Also, engage them to do the following breathing techniques:

1. Pursed-Lip Breathing. Instruct patients and loved ones with COPD to take in slow, deep breaths through the nose and exhale with lips a bit pursed, like a whistle. Repeat until breathing normalizes. Let them practice this technique at least 3-4 times daily.

2. Diaphragmatic Breathing. This technique strengthens the muscles used for breathing, namely the diaphragm and rib muscles. Let the patient lie down with his knee bent. Place his hands on the abdomen and inhale deeply through the nose while pushing out the abdomen. Check that the abdomen is extended outward. Then allow the patient to exhale using the pursed-lip technique while he gently pushes the lungs upward with his hands. Check that the neck and shoulder of the patient does not move while doing this technique.

Stage 3 COPD has severe lifestyle effects on patients. They experience the challenge of coping up with breathing difficulties even at the slightest activity, and the constant fear of lung failure. This results to depression and anxiety. During anxiety attacks, instruct patients and loved ones with COPD to breathe deeply or do diaphragmatic breathing. A behavior therapy may be needed. Consult with a behavioral therapist on the right behavior modification program as cases vary from patient to patient.

Lastly, participate in a pulmonary rehabilitation program. It is a multidisciplinary approach that covers all areas of COPD management. Patients, caregivers and loved ones involved in caring will benefit from the education provided by this program. Everybody will gain not only vital information on nutrition, breathing techniques and the right exercise, but also an access to counseling services to help cope with the challenges of COPD.

References

About.com: COPD http://copd.about.com/od/copdbasics

Vital Signs. 2008. http://www.healthsystem.virginia.edu/UVAHealth/adult_cardiac/vital.cfm