Smoker’s Lung Disease: Holistic Patient Assessment


Locating health issues at early stages is critical to the further successful management thereof. In the case under analysis, a holistic assessment of a patient with rapidly developing respiratory issues is considered. In order to reduce the probability of aggravation of the patient’s chronic obstructive pulmonary disease (COPD), changes in their lifestyle, specifically, abstaining from smoking and reconsideration of their dieting choices and physical activities will be required.

Part 1: Holistic Health Assessment

Health History

M. is a 28-year-old male Caucasian American with a comparatively small health record. He had flu at the age of 12 and received an appendectomy at 25. M. does not have any known allergies.

Physiological Assessment

PE: T 36.7, HR 119, RR 16, BP 127/85;

Gen: patient being responsive, quite active, having slight difficulty breathing

HEENT: no major issues observed, PERRL, no rubs or gallops observed.

Pul: significant pulmonary hypertension observed; wheezing in upper airways, chest tightness

Abdm: no bowel sounds heard, abdomen soft, tender, non-distended

GU: no major abnormalities observed.

Extr: no edema or tremor observed.

MSK: no abnormalities observed.

Skin: flushed, warm to the touch, slightly diaphoretic

Psychological Assessment

The patient does not have any mental health issues. There is no record of M. experiencing depression or similar psychological disorders.

Social Assessment

M. is very socially active and enjoys the company of his numerous friends. He has several social media accounts and communicates both online and offline. M. tends to be dependent on his friends’ opinions and judgments, which affects his lifestyle.

Cultural Assessment

M. has German ancestry, yet he describes himself as mostly American based on his culture and traditions. His native language is English, and his key values align with those of his community, being mostly centered on Christian ones.

Developmental Assessment

The patient has been developing properly, having acquired all of the required skills and gained the needed knowledge.

Spiritual Assessment

The patient is very religious, following essential Christian principles strictly. In addition, M. attends church regularly and focuses on his spiritual growth.

Part 2: Interpreting the Findings

The results of the holistic assessment performed above have provided the foundation for diagnosing an early onset of COPD. The evaluation outcomes point to the presence of ley signs and symptoms of COPD, including chest tightness and shortness of breath (Sama, Kriebel, Gore, DeVries, & Rosiello, 2017). In addition, the holistic examination of M. proves that the patient has little understanding of the effects that smoking and similar factors have on the development of respiratory issues. Currently, smoking seems to be the mechanism for M. to relieve his stress. Furthermore, the abnormality affects the patient’s social life, causing him to distance himself from the people who believe that smoking is harmful, and who are unwilling to become second-hand smokers.

The fact that the patient is quite social and easily influenced by his friends shows that the support of his community will be essential in changing M.’s current lifestyle toward a healthier one. By structuring an intervention that involves M.’s friends and family members, one will be able to reduce the development of COPD by altering his lifestyle (van Eerd et al., 2015). Moreover, using the patient’s spirituality to assist him in quitting smoking will be critical given the extent to which M.’s spiritual life plays in his emotional and psychological well-being.

The absence of higher education could be seen as an impediment toward altering the patient’s lifestyle. Indeed, without specific background knowledge, the patient may find it difficult to grasp the gravity and urgency of the issue, as well as gain the learning abilities to study the available health resources about COP. However, with the focus on the patient-nurse dialogue, one will build a framework for teaching M. the essential principles of self-care to reduce the threat of COPD aggravation (Gregersen et al., 2016). As a result, a gradual improvement in the patient’s respiratory system will be observed.

Part 3: Teaching Plan

Currently, it is imperative to introduce the patient to the idea that smoking affects his respiratory system, having caused the current abnormalities in his BP and pulmonary system, pointing to the early onset of COPD. For this reason, the use of a family-based intervention will be needed to dissuade the patient from smoking and convincing him to adopt a healthier lifestyle. Thus, the first stage will involve informing the patient, while the second one will imply using the support of his friends and family to encourage him to follow prescriptions.

The second step of the teaching plan will imply providing the patient with the steps that will allow him to minimize the probability of the further COPD aggravation. The key information will involve the methods of avoiding the irritants that may prompt the enhancement of COPD, as well as the health resources that M. can access in order to receive further support. Moreover, essential information about medications, such as aclidinium (Tudorza), and their dosage will be provided (Marsh et al., 2017).

Finally, it will be crucial to monitor changes in M.’s well-being, which will require regular checks. Thus, M. will have to be instructed concerning further hospital visits. The proposed steps are believed to lead to vast improvements, including a drop in the levels of COPD development and the successful management of the current abnormalities.


Identifying physiological abnormalities at their earliest stages is crucial for the effective prevention and management of health disorders. In the case under analysis, a holistic evaluation of the patient’s well-being has helped in locating the problem, its root cause, and the strategies for its mitigation. Therefore, the integration of a holistic assessment into the management of patients’ needs should become an essential step in administering healthcare services.


Gregersen, T. L., Green, A., Frausing, E., Ringbaek, T., Brøndum, E., & Ulrik, C. S. (2016). Do telemedical interventions improve quality of life in patients with COPD? A systematic review. International Journal of Chronic Obstructive Pulmonary Disease, 11, 809-822. Web.

Marsh, K., Zaiser, E., Orfanos, P., Salverda, S., Wilcox, T., Sun, S., & Dixit, S. (2017). Evaluation of COPD treatments: A multicriteria decision analysis of aclidinium and tiotropium in the United States. Value in Health, 20(1), 132-140. Web.

Sama, S. R., Kriebel, D., Gore, R. J., DeVries, R., & Rosiello, R. (2017). Environmental triggers of COPD symptoms: A case cross-over study. BMJ Open Respiratory Research, 4(1), 1-8. Web.

van Eerd, E. A., van Rossem, C. R., Spigt, M. G., Wesseling, G., van Schayck, O. C., & Kotz, D. (2015). Do we need tailored smoking cessation interventions for smokers with COPD? A comparative study of smokers with and without COPD regarding factors associated with tobacco smoking. Respiration, 90(3), 211-219. Web.

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