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Cognition refers the high order neural processes that determine the handling of information. Cognitive impairment has been demonstrated in 77% of patients with COPD (Dodd, 2010). In COPD, there is an accumulation of oxygen radicals, which is associated with neural damage and inhibition of production of the neurotransmitter. Cognitive impairment is a prognostic feature on the progression and disability of the disease. Symptoms of cognitive impairment are deduced from their behavior in terms of psychological, emotional and neurological factors.
The patient presents with impaired memory, inability to relate information, unconscious, disorientated and in severe cases reports of hallucination (Dodd, 2010). The patient may not understand their condition leading to neglect and noncompliance to treatment. They are anxious, unaware of their surrounding accompanied with coughing and difficulty in breathing.
Acute exacerbation of COPD is characterized by an increase in symptoms, deterioration of the lung function and health status. It is mainly results from bacterial and viral infection. Acute episodes are treated using oxygen, inhaled bronchodilators, antibiotics and systemic corticosteroids. Bronchodilators include beta₂ agonist, anticholinergics and methylxanthines (Nicholas, 2006).
In assessing the client’s cognitive function, a mini-mental state examination is performed. This test is made up of questions that test the arithmetic, reasoning and orientation functions. The patient is scored out of 30 points. A score of 25 and above indicates normal cognitive function. A patient who scores less than 9 points has severe cognitive dysfunction (Nicholas, 2006).
The diagnosis of COPD requires the demonstration of airway obstruction by spirometry. This is established when the post-bronchodilator Forced Expiratory Volume in one second (FEV₁) is less than 80% (Nicholas, 2006). Measurements ...Show more


Although there has been continuous public education about the relationship of COPD and smoking, about 20% of the American adult population has COPD (Dodd, 2010). A recent survey revealed…
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