Mr. Tom has chronic obstructive pulmonary disease (COPD), which is a lung disease that prevents normal breathing. Most of the time, he has no trouble doing any activities.
The nursing assistants at the care center encourage him to breathe slowly and deeply to keep his chest wall flexible. On days when he does not have physical therapy, they help him do the exercises his therapist has instructed him to do. They encourage him to cough to clear his air passages and provide access to tissues and trash containers to help Mr. Tom maintain his dignity.
In the past two months, Mr. Tom has been having more trouble with his breathing. He often gets short of breath when eating, so nursing assistants give him small meals several times a day rather than full meals less frequently. To help him breathe when resting, they make sure the head of his bed is raised.
Recent measurements of his oxygen levels show his oxygen levels are low, so he is now receiving oxygen therapy through a nasal cannula (a two-pronged tube inserted into his nostrils). As part of their care for Mr. Tom now, the nursing assistants regularly check that the tubes are in place, and they check for skin breakdown near the cannula. They also check that the flow rate matches what the doctor prescribed. In addition, they take precautions against fire and make sure “Oxygen in Use” signs are placed outside his door.