🫁 Medical-Surgical Nursing Care Plan on COPD

Medical-Surgical Nursing | NANDA Nursing Care Plan Format

COPD Nursing | Practical File Ready

⚠️ Educational Purpose Only: This nursing care plan is for academic practical file preparation. Not for actual patient care or clinical decision-making.

📋 Student Information

Student Name	[Your Name]
Course	BSc Nursing / GNM / ANM
Subject	Medical-Surgical Nursing
Topic	COPD — Medical-Surgical Nursing Care Plan
Format	NANDA-I Nursing Care Plan Format
Date of Submission	[Enter Date]
Clinical Instructor	[Instructor Name]

📄 Page 1 — Patient Identification Data

Name	Mr. Mohan Lal Sharma
Age	65 Years
Sex	Male
Address	Jodhpur, Rajasthan
Occupation	Retired Factory Worker
Marital Status	Married
Religion/Category	Hindu / General
Annual Income	₹3,60,000/-
Medical Diagnosis	Chronic Obstructive Pulmonary Disease with Acute Exacerbation
Type of Family	Joint Family
Family Size	6 Members
Ward Name	Medical Ward / Respiratory Unit
Bed Number	12
Doctor Incharge	Dr. R. K. Mehta, MD Medicine
Date of Admission	10/03/2026
Hospital Name	Government Medical College Hospital, Jodhpur

📄 Page 2 — Chief Complaints & Clinical History

CHIEF COMPLAINTS

Progressive shortness of breath for 5 days
Productive cough with thick yellowish sputum for 4 days
Wheezing and chest tightness for 3 days
Fever with body ache for 2 days
Difficulty in sleeping due to breathlessness
Fatigue and inability to perform routine activities

HISTORY OF PRESENT ILLNESS

Mr. Mohan Lal Sharma, a 65-year-old male, was admitted to the medical ward with complaints of progressive breathlessness, productive cough, wheezing, and chest tightness. The patient was apparently stable until 5 days before admission, when he developed increased shortness of breath while walking and climbing stairs. Gradually, breathlessness increased even during rest and routine activities.

The cough was productive, associated with thick yellowish sputum, especially in the morning. The patient also complained of wheezing, chest tightness, disturbed sleep, and fatigue. He had a low-grade fever for 2 days before admission. He used his prescribed inhaler at home, but symptoms were not relieved adequately. Therefore, he was brought to the hospital by his son.

On admission, the patient was conscious and oriented but appeared anxious and dyspneic. Respiratory rate was increased, accessory muscles of respiration were used, and oxygen saturation was reduced on room air. The patient was diagnosed as a case of COPD with acute exacerbation and started on oxygen therapy, nebulization, antibiotics, corticosteroids, bronchodilators, and supportive nursing care.

PAST MEDICAL HISTORY

Known case of COPD for 8 years
History of recurrent respiratory infections
History of chronic cough and sputum production for several years
History of hypertension for 6 years; on regular medication
No history of diabetes mellitus
No history of tuberculosis
No known drug or food allergy

PAST SURGICAL HISTORY

No history of major surgery
No history of blood transfusion
No history of previous ICU admission

📄 Page 3 — Family History & Composition

FAMILY HISTORY

The patient belongs to a joint family.
There are 6 members in the family.
Father had history of chronic smoking and respiratory illness.
Mother had age-related illness.
Patient has long-term history of smoking and occupational dust exposure.
Son is an occasional smoker.
No family history of tuberculosis, asthma, or hereditary disease reported.

FAMILY COMPOSITION

Name	Age/Sex	Education	Occupation	Marital Status	Relationship	Health Status
Mr. Mohan Lal Sharma	65/M	Secondary	Retired Factory Worker	Married	Self / Patient	COPD with Acute Exacerbation
Mrs. Kamla Devi	60/F	Primary	Housewife	Married	Wife	Healthy
Mr. Suresh Sharma	36/M	Graduate	Shopkeeper	Married	Son	Occasional smoker
Mrs. Neha Sharma	32/F	Graduate	Housewife	Married	Daughter-in-law	Healthy
Master Rohan Sharma	10/M	Class 5	Student	Unmarried	Grandson	Healthy
Miss Kavya Sharma	7/F	Class 2	Student	Unmarried	Granddaughter	Healthy

FAMILY TREE

👴

Mr. Mohan Lal Sharma

Self / Patient

COPD with Acute Exacerbation

♡

👵

Mrs. Kamla Devi

Wife

Healthy

👨

Mr. Suresh Sharma

Son

Occasional smoker

👩

Mrs. Neha Sharma

Daughter-in-law

Healthy

👦

Master Rohan Sharma

Grandson

Healthy

👧

Miss Kavya Sharma

Granddaughter

Healthy

📄 Page 4 — Dietary, Personal, Socio-Economic & Environmental History

DIETARY HISTORY

The patient takes a mixed diet.
Diet is low in fresh fruits and green leafy vegetables.
Patient consumes tea 4–5 times daily.
Fluid intake is approximately 1.5–2 liters/day.
Appetite is reduced during acute exacerbation.
No known food allergy reported.

PERSONAL HISTORY

Sleep: Disturbed due to cough and breathlessness.
Appetite: Reduced during illness.
Bowel: Regular.
Bladder: Normal frequency.
Habits: History of smoking for 35 years; currently reduced but not completely stopped.
Activity level: Limited due to dyspnea and fatigue.
Allergy: No known drug or food allergy.

SOCIO-ECONOMIC HISTORY

The patient belongs to a middle-class family.
Family income is approximately ₹3,60,000 per year.
Patient lives with wife, son, daughter-in-law, and grandchildren.
Son is the primary earning member.
Patient has access to nearby government hospital facilities.

ENVIRONMENTAL HISTORY

The patient lives in a pucca house with adequate ventilation.
Past occupational exposure to dust and smoke due to factory work.
Uses LPG for cooking.
No biomass fuel exposure currently.
Safe drinking water and sanitation facilities are available.
Patient is advised to avoid dust, smoke, cold air, and respiratory irritants.

📄 Page 5 & 6 — Physical Examination

GENERAL CONDITION

Patient is conscious, oriented to time, place, and person. Patient appears anxious, dyspneic, and fatigued. He is sitting in semi-Fowler’s position and using accessory muscles of respiration. Cough with sputum is present.

VITAL SIGNS

Temperature: 99.4°F
Pulse: 104 beats/min
Respiration: 30 breaths/min
Blood Pressure: 146/88 mmHg
SpO₂: 88% on room air
Pain Score: 2/10 due to chest tightness

GENERAL APPEARANCE

Built: Moderately nourished
Posture: Sitting upright/semi-Fowler’s position
Activity: Dyspnea on minimal exertion
Speech: Speaks in short sentences due to breathlessness
Signs of distress: Tachypnea, wheezing, use of accessory muscles, mild cyanosis of lips

SYSTEMIC EXAMINATION

Respiratory System	Respiratory rate 30/min, prolonged expiration, bilateral wheeze present, coarse crepitations heard, use of accessory muscles present, SpO₂ 88% on room air.
Cardiovascular System	Pulse 104/min, regular rhythm, BP 146/88 mmHg, S1 and S2 audible, no murmur heard, peripheral pulses palpable.
Neurological System	Patient is conscious and oriented. GCS 15/15. Pupils equal and reacting to light. No focal neurological deficit observed.
Skin	Skin warm, mild cyanosis of lips noted, no edema, no rashes, skin turgor normal.
Head & Face	Face appears anxious and tired. No facial asymmetry. No swelling noted.
Eyes	Conjunctiva pink, sclera white, pupils equal and reactive to light, vision apparently normal.
Ear	External ear normal, no discharge, hearing normal.
Nose	Nostrils patent, no nasal discharge, nasal flaring present during dyspnea.
Mouth & Pharynx	Oral mucosa slightly dry, lips mildly cyanosed, throat congestion absent, oral hygiene satisfactory.
Neck	No lymph node enlargement, trachea central, no thyroid enlargement, accessory neck muscles used during respiration.
Chest	Barrel-shaped chest present, chest expansion reduced bilaterally, prolonged expiratory phase, wheeze and crepitations heard on auscultation.
Abdomen	Abdomen soft and non-tender, no organomegaly, bowel sounds present.
Extremities	No pedal edema, mild clubbing present, peripheral pulses palpable, capillary refill less than 3 seconds.

📄 Page 7 — Vital Signs Monitoring Record

DATE/TIME	TEMP (°F)	PULSE (/min)	RESP (/min)	BP (mmHg)	SpO₂ (%)	REMARKS
10/03/2026 — 9:00 AM	99.4°F	104/min	30/min	146/88	88% RA	Dyspnea, wheezing present
10/03/2026 — 1:00 PM	99.2°F	98/min	26/min	140/86	93% with O₂	After nebulization and oxygen therapy
11/03/2026 — 8:00 AM	98.8°F	92/min	24/min	136/84	94% with O₂	Breathlessness reduced
12/03/2026 — 8:00 AM	98.6°F	86/min	22/min	132/82	95% with O₂	Cough reduced, sputum decreasing
13/03/2026 — 8:00 AM	98.4°F	82/min	20/min	128/80	96% room air	Stable condition

📈 Nursing Trend: Patient improved gradually with oxygen therapy, nebulization, medication, breathing exercises, and nursing care. Respiratory rate decreased from 30/min to 20/min and SpO₂ improved from 88% to 96%.

📄 Page 8 — Diagnostic Investigations

SR. NO.	NAME OF INVESTIGATION	NORMAL VALUE	PATIENT'S VALUE	INTERPRETATION
1	Hemoglobin	13–17 g/dL	14.1 g/dL	Normal
2	Total WBC Count	4,000–11,000/mm³	13,200/mm³	Elevated due to infection/exacerbation
3	Neutrophils	40–70%	78%	Elevated
4	Platelet Count	1.5–4 lakh/mm³	2.6 lakh/mm³	Normal
5	ESR	0–20 mm/hr	32 mm/hr	Raised
6	Random Blood Sugar	80–140 mg/dL	118 mg/dL	Normal
7	Serum Creatinine	0.7–1.3 mg/dL	1.0 mg/dL	Normal
8	Blood Urea	15–40 mg/dL	34 mg/dL	Normal
9	Serum Sodium	135–145 mEq/L	138 mEq/L	Normal
10	Serum Potassium	3.5–5.0 mEq/L	4.1 mEq/L	Normal
11	Arterial Blood Gas — pH	7.35–7.45	7.32	Mild respiratory acidosis
12	PaCO₂	35–45 mmHg	54 mmHg	Raised — CO₂ retention
13	PaO₂	80–100 mmHg	62 mmHg	Low oxygen level
14	Chest X-ray	Normal lung fields	Hyperinflated lungs, flattened diaphragm	Suggestive of COPD
15	Sputum Examination	No pathogenic organism	Purulent sputum, bacterial growth suspected	Respiratory infection
16	Spirometry	FEV₁/FVC >70%	FEV₁/FVC 55%	Obstructive airway disease

📄 Page 9 — Medical Management (Drug Chart)

SR. NO.	MEDICATION	DOSE	FREQUENCY	ROUTE	ACTION / PURPOSE
1	Oxygen Therapy	2–4 L/min	As prescribed	Nasal cannula	Improves oxygen saturation and reduces hypoxia.
2	Nebulization with Salbutamol	2.5 mg	Every 6 hourly	Inhalation	Bronchodilator; relaxes bronchial smooth muscles and relieves bronchospasm.
3	Nebulization with Ipratropium Bromide	500 mcg	Every 8 hourly	Inhalation	Anticholinergic bronchodilator; decreases airway resistance.
4	Inj. Hydrocortisone	100 mg	Every 8 hourly	IV	Corticosteroid; reduces airway inflammation during acute exacerbation.
5	Tab. Prednisolone	40 mg	OD	Oral	Anti-inflammatory steroid used after stabilization.
6	Inj. Ceftriaxone	1 g	BD	IV	Antibiotic; treats suspected bacterial respiratory infection.
7	Tab. Azithromycin	500 mg	OD	Oral	Antibiotic; useful in respiratory tract infection and COPD exacerbation.
8	Tab. Ambroxol	30 mg	TDS	Oral	Mucolytic; helps loosen thick sputum and promotes expectoration.
9	Tab. Montelukast + Levocetirizine	10 mg + 5 mg	HS	Oral	Reduces allergic airway symptoms and improves breathing comfort.
10	Tab. Pantoprazole	40 mg	OD	Oral	Prevents gastric irritation due to steroids and stress.
11	Steam Inhalation	As tolerated	2–3 times/day	Inhalation	Helps loosen secretions and provides airway comfort.
12	Chest Physiotherapy	As advised	BD	Physical therapy	Promotes sputum clearance and improves ventilation.

📄 Page 10 — NANDA Nursing Diagnoses

Ineffective airway clearance related to increased mucus production and bronchospasm as evidenced by productive cough, wheezing, coarse breath sounds, and difficulty in expectoration.
Impaired gas exchange related to alveolar hypoventilation and ventilation-perfusion imbalance as evidenced by SpO₂ 88% on room air, dyspnea, cyanosis, and abnormal ABG values.
Ineffective breathing pattern related to airway obstruction and increased work of breathing as evidenced by respiratory rate 30/min, use of accessory muscles, prolonged expiration, and shortness of breath.
Activity intolerance related to imbalance between oxygen supply and demand as evidenced by dyspnea on minimal exertion, fatigue, and inability to perform routine activities.
Anxiety related to breathlessness, hospitalization, and fear of worsening respiratory condition as evidenced by restlessness, repeated questioning, and anxious facial expression.
Deficient knowledge regarding COPD management, breathing exercises, medication use, smoking cessation, and prevention of exacerbation as evidenced by lack of awareness about disease control and inhaler/nebulizer use.
Risk for infection related to retained respiratory secretions, chronic lung disease, and reduced immunity.
Imbalanced nutrition: less than body requirements related to increased energy expenditure during breathing and reduced appetite as evidenced by fatigue, weakness, and decreased oral intake.

📄 Page 11-13 — Nursing Care Plans (NANDA Format)

Nursing Care Plan — 1: Ineffective Airway Clearance

ASSESSMENT	NURSING DIAGNOSIS	GOAL/EXPECTED OUTCOME	PLANNING	IMPLEMENTATION	EVALUATION
Subjective: Patient complains of cough with thick sputum and difficulty in bringing out secretions. Patient says, “Mujhe balgam nikalne mein dikkat ho rahi hai.” Objective: Productive cough, wheezing, coarse breath sounds, respiratory rate 30/min, SpO₂ 88% on room air, use of accessory muscles.	Ineffective airway clearance related to increased mucus production and bronchospasm as evidenced by productive cough, wheezing, coarse breath sounds, and difficulty in expectoration.	Short-term goal: Patient will demonstrate improved airway clearance within 24 hours. Long-term goal: Patient will maintain clear airway with reduced cough, decreased sputum, and improved breath sounds before discharge.	Assess respiratory rate, rhythm, depth, and breath sounds regularly. Monitor amount, color, consistency, and odor of sputum. Maintain adequate hydration if not contraindicated. Teach effective coughing and deep breathing exercises. Administer prescribed bronchodilators and mucolytics.	Placed patient in semi-Fowler’s position to promote lung expansion. Encouraged deep breathing and controlled coughing every 2 hours. Provided warm fluids as tolerated to loosen secretions. Administered nebulization with Salbutamol and Ipratropium as prescribed. Administered Ambroxol as ordered to help sputum expectoration. Provided chest physiotherapy and steam inhalation as advised.	Patient was able to expectorate sputum effectively. Wheezing reduced, breath sounds improved, respiratory rate decreased from 30/min to 24/min, and SpO₂ improved to 94% with oxygen therapy.

Nursing Care Plan — 2: Impaired Gas Exchange

ASSESSMENT	NURSING DIAGNOSIS	GOAL/EXPECTED OUTCOME	PLANNING	IMPLEMENTATION	EVALUATION
Subjective: Patient complains of severe breathlessness and chest tightness. Patient says, “Mujhe saans lene mein bahut takleef ho rahi hai.” Objective: SpO₂ 88% on room air, respiratory rate 30/min, mild cyanosis of lips, PaO₂ 62 mmHg, PaCO₂ 54 mmHg, pH 7.32.	Impaired gas exchange related to alveolar hypoventilation and ventilation-perfusion imbalance as evidenced by low SpO₂, dyspnea, cyanosis, and abnormal ABG values.	Short-term goal: Patient will maintain SpO₂ above 92% with oxygen therapy within 1 hour. Long-term goal: Patient will maintain adequate gas exchange with reduced dyspnea and stable ABG values before discharge.	Monitor SpO₂ continuously or as prescribed. Assess signs of hypoxia such as cyanosis, restlessness, confusion, and tachycardia. Monitor ABG reports as advised. Administer oxygen therapy as prescribed. Position patient to improve ventilation.	Placed patient in high Fowler’s/semi-Fowler’s position. Administered oxygen therapy 2–4 L/min via nasal cannula as prescribed. Monitored SpO₂ and respiratory status frequently. Encouraged pursed-lip breathing to improve expiration and reduce air trapping. Administered bronchodilators and steroids as ordered. Observed for signs of respiratory fatigue and reported abnormalities.	Patient’s SpO₂ improved from 88% to 94% with oxygen therapy. Dyspnea reduced, cyanosis decreased, respiratory rate improved, and patient reported better breathing comfort.

Nursing Care Plan — 3: Ineffective Breathing Pattern

ASSESSMENT	NURSING DIAGNOSIS	GOAL/EXPECTED OUTCOME	PLANNING	IMPLEMENTATION	EVALUATION
Subjective: Patient complains of difficulty in breathing, especially during coughing and movement. Patient says, “Thoda chalne par bhi saans phool jati hai.” Objective: Respiratory rate 30/min, prolonged expiration, use of accessory muscles, wheezing, dyspnea on minimal activity.	Ineffective breathing pattern related to airway obstruction and increased work of breathing as evidenced by tachypnea, prolonged expiration, use of accessory muscles, and dyspnea.	Short-term goal: Patient will demonstrate improved breathing pattern within 24 hours. Long-term goal: Patient will maintain respiratory rate within normal range and use breathing techniques effectively before discharge.	Assess respiratory pattern, rate, depth, and use of accessory muscles. Maintain comfortable position to reduce work of breathing. Teach pursed-lip breathing and diaphragmatic breathing. Provide rest periods between activities. Administer medications as prescribed.	Kept patient in semi-Fowler’s position. Taught and demonstrated pursed-lip breathing technique. Encouraged slow deep breathing exercises. Reduced unnecessary activity and provided rest periods. Administered nebulization and steroid therapy as prescribed. Monitored respiratory rate and effort regularly.	Patient demonstrated pursed-lip breathing correctly. Respiratory rate decreased from 30/min to 22/min, use of accessory muscles reduced, and patient reported less breathlessness.

📄 Page 14 — Discharge Summary

Mr. Mohan Lal Sharma, a 65-year-old male, was admitted to the medical ward with complaints of severe breathlessness, productive cough with thick sputum, wheezing, chest tightness, and fatigue. On admission, the patient had tachypnea, SpO₂ 88% on room air, bilateral wheezing, prolonged expiration, and use of accessory muscles of respiration. Based on clinical features, physical examination, chest X-ray, ABG analysis, sputum examination, and spirometry findings, the patient was diagnosed with COPD with acute exacerbation.

During hospitalization, the patient received oxygen therapy, nebulization with bronchodilators, corticosteroids, antibiotics, mucolytics, steam inhalation, chest physiotherapy, breathing exercises, and supportive nursing care. The patient’s condition improved gradually. Breathlessness reduced, cough and sputum decreased, wheezing improved, respiratory rate came down from 30/min to 20/min, and SpO₂ improved from 88% on room air to 96% on room air.

The patient and family members were educated regarding COPD disease process, correct use of inhaler/nebulizer, pursed-lip breathing, diaphragmatic breathing, smoking cessation, medication compliance, nutrition, prevention of respiratory infection, and importance of regular follow-up. Patient was discharged in stable condition with advice for home care and follow-up.

At discharge, the patient is advised to:

Take all prescribed medicines regularly and do not stop inhalers or tablets without medical advice.
Use inhaler/nebulizer correctly as taught by the nurse/doctor.
Practice pursed-lip breathing and diaphragmatic breathing daily.
Avoid smoking completely and stay away from secondhand smoke.
Avoid dust, smoke, strong smell, cold air, and air pollution.
Drink adequate warm fluids unless restricted by the doctor.
Take small frequent meals and avoid heavy meals that increase breathlessness.
Maintain good oral hygiene and hand hygiene to prevent infection.
Take adequate rest and avoid overexertion.
Do light walking as tolerated and increase activity gradually.
Use mask in dusty or polluted environment.
Take influenza and pneumococcal vaccination as advised by the physician.
Report immediately to hospital if severe breathlessness, bluish lips, high fever, confusion, chest pain, or inability to speak occurs.
Attend follow-up visit after 1 week or as advised.

📄 Page 15 — Health Education

Medication Compliance —
The patient was educated to take all medicines exactly as prescribed by the physician. Bronchodilators help to open the airways and reduce breathlessness. Steroids reduce airway inflammation during exacerbation. Antibiotics should be completed as prescribed even if symptoms improve. The patient was advised not to stop inhalers, nebulization, or oral medicines without medical advice. The patient was also instructed to keep rescue inhaler available and use it as advised during sudden breathlessness.

Inhaler and Nebulizer Technique —
The patient was taught the correct method of using inhaler and nebulizer. Before using inhaler, the patient should shake it well, breathe out fully, place mouthpiece properly, press the inhaler while taking a slow deep breath, hold breath for 5–10 seconds, and then breathe out slowly. If a spacer is available, it should be used for better drug delivery. Nebulizer mask should fit properly, and the patient should breathe normally during nebulization. Equipment should be cleaned and dried after use to prevent infection.

Breathing Exercises —
The patient was taught pursed-lip breathing and diaphragmatic breathing. In pursed-lip breathing, the patient should inhale slowly through the nose and exhale slowly through pursed lips as if blowing out a candle. This helps to keep airways open longer and reduces air trapping. Diaphragmatic breathing helps improve ventilation and reduces the work of breathing. These exercises should be practiced several times daily, especially during breathlessness.

Smoking Cessation —
The patient was strongly advised to stop smoking completely. Smoking is the main cause of COPD progression and repeated exacerbations. Even one cigarette can irritate the airways and worsen breathing. The patient was advised to avoid passive smoking also. Family members were advised not to smoke near the patient. Counseling, nicotine replacement therapy, and medical support can be taken if the patient finds difficulty quitting smoking.

Prevention of Infection —
The patient was educated that respiratory infections can worsen COPD and cause acute exacerbation. He should wash hands frequently, avoid close contact with people having cough, cold, or fever, use mask in crowded places, maintain oral hygiene, and avoid exposure to dust and pollution. Annual influenza vaccination and pneumococcal vaccination should be taken as advised by the doctor.

Dietary Advice —
The patient was advised to take a balanced diet rich in protein, vitamins, and minerals. Small frequent meals are better than large heavy meals because a full stomach can increase breathlessness. Include dal, pulses, eggs if allowed, milk, curd, green leafy vegetables, fruits, and whole grains. Avoid oily, fried, very spicy, and gas-forming foods if they increase discomfort. Drink warm fluids to help loosen sputum unless fluid restriction is advised.

Activity and Rest —
The patient was advised to balance activity with rest. Light walking and simple daily activities should be done as tolerated. Activities should be performed slowly, with rest periods in between. The patient should avoid heavy lifting, sudden exertion, and climbing stairs rapidly. If breathlessness increases, the patient should stop activity, sit upright, and practice pursed-lip breathing.

Environmental Control —
The patient should avoid dust, smoke, strong perfumes, incense sticks, mosquito coils, cold air, and air pollution. The house should be well ventilated and clean. Wet mopping is preferred instead of dry sweeping to reduce dust. Patient should use a mask while going outside in polluted or dusty areas.

Warning Signs —
The patient and family were educated to seek immediate medical help if there is severe breathlessness not relieved by medicines, bluish discoloration of lips or fingers, high fever, increased amount or change in color of sputum, chest pain, confusion, drowsiness, inability to speak full sentences, or SpO₂ falling below advised level.

Follow-up Care —
The patient was advised to attend regular follow-up visits as advised by the physician. Lung function tests, medication review, inhaler technique checking, vaccination status, and symptom control should be assessed during follow-up. Patient was advised to keep all medical records and bring them during each hospital visit.

📄 Page 16 — Bibliography

Brunner, L.S. & Suddarth, D.S. (2022). Textbook of Medical-Surgical Nursing (15th ed.). Wolters Kluwer. Unit: Respiratory Disorders and Nursing Management.
NANDA International. (2024). Nursing Diagnoses: Definitions and Classification 2024–2026 (13th ed.). Thieme Medical Publishers.
Lewis, S.L., Bucher, L., Heitkemper, M.M., Harding, M.M., Kwong, J., & Roberts, D. (2023). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (12th ed.). Elsevier.
Doenges, M.E., Moorhouse, M.F., & Murr, A.C. (2024). Nursing Care Plans: Guidelines for Individualizing Client Care Across the Life Span (11th ed.). F.A. Davis Company.
GOLD. (2025). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Global Initiative for Chronic Obstructive Lung Disease.
World Health Organization. (2025). Chronic Obstructive Pulmonary Disease (COPD) — Fact Sheet. WHO, Geneva.
Park, K. (2023). Park’s Textbook of Preventive and Social Medicine (27th ed.). Banarsidas Bhanot Publishers.

⚕️ Medical Disclaimer: This nursing care plan is prepared for educational and academic purposes only as part of nursing practical file work (ANM, GNM, BSc Nursing). It is not intended for actual patient care, clinical decision-making, or medical diagnosis. Always refer to your institution's guidelines and standard textbooks.