الفهرس 
Review of literatureOnly 14 pages are availabe for public view
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Abstract
150 Malnutrtion among COPD patients is often underestimated or completely ignored ,although it significantly affects outcomes . The study aimed to determine The effectiveness of Nutritional support on oxygenation for patient with COPD undergoing mechanical ventilation.Setting and subjects of the study : The study was conducted in ICU unit,Menoufia University hospital ,Menoufia Governerate,Egypt.The study was conducted on a convenient sample of sixty adult COPD within 24hour of admission. They will be divided and assigned into alternating two groups,thirty for each group.Study group (1) were received nutrtional support .Control group (II) were received ordinary hospital foods. Tools of the study: Four tools were utilized fore data collection : 1- Tools (I) : Nutrtional assesment tool :This tool was developed by the researcher based on relevant literature review except part two was developed by Nutrtional Research Group (1996) to asses nutrtional status of COPD .The tool was comprised of four parts ;Sociodemographic and clinical data ,nutrtional assesment,clinical and physical signs of nutrtional deficiency and biochemical measurements. 2- Tool ( II) : COPD ventilator parameter assesment tool : It was developed by the researcher & was used to assess the ventilator parameters which was obtained from the readings of the ventilator settings . 3- Tool (III):Respiratory assesment tool : It was developed by the researcher to assess respiratory status based on litrature review and it was comprised of two parts : - Part 1: Respiratory rate, breathing sound, sputum, use of accessory muscles chest expansion, cyanosis, cough. 151 Part 2: Dyspnea Analoug Scale : It was developed by (Borg, 1998 )and used by the researcher it include numerical scale to measure dyspnea ranged from zero to ten 4- Tool (IV):Laboratory studies : It was developed by the reasercher to assess progress of patient’s respiratory status and oxygenation & establish base line data about lung function as pulmonary function test (spirometry) & arterial blood gases measurement (ABGs) patients respiratory responses were identified against normal value where PH normal range : 7.35 -7.45,PaO2 normal range: 80-100 mmhg,PaCO2normal range :35-45 mmhg,HCO3normal range: 22-26meq/l,So2 normal range: 92-100%.Methods of the study : 1- Permission to carry out the study was taken from responsiple authorites and participants after explaining the aim of the study. 2- Tools developement : Tool Ι part 2 was developed by Nutrtional Research Group (1996), Tool Ι part 3 was developed by (Rosdable &Kowalski, 2003), while tool II and tool IV was developed by the researcher . Tool IIΙ part Ι was developed by the researcher after reviewing the the relevant literature,but Tool IIΙpart 2 was developed by (Borg ,1998).All tools were tested for content validity by five expert in the field of crtical care nursing and medical specialist in the field to ascertain relevance and completeness. 3- Protection of human rights:Consent was obtained from patients or his relatives for participation in the study after explaining the purpose and nature of the study. 4- Pilot study : A pilot study was carried out on (5) patients to test the feasibility and applicability of the developed tool accordingly, needed modification done. 5- Statistical analysis :The collected data were statistically analyzed by using IMPpersonal computer package spss. 6- Based on the finding of the current study,it can be concluded that: Nutrtional support had been proven to be an important aspect of patient care and - 152 improve oxygenation as there were more improvement in the study group than the control group.7- Based on the findings of the current study recommended that: A) Recommendations for the health staff : 1- Assesment of nutrtional status and nutrtion therapy should be part of the overall manegement of COPDand must be routinely entered in the patients medical record and nursing notes and regularly updated. 2- Encourging nurses for using glopal assesment tool to determine COPD patients who are at risk of malnutrtion or who are malnurnourshed . B) Recommendations for administration : 1- Nutrtional screening ,assesment and montoring should be included in the accreditation standerds for hospitals. 2- The hospital menue must be adapted according to patient need to provide suitable choices for patients requring modification of food consistences. C) Recommendations for future researches: 1- Replication of the study using alarger propbability sample of COPD patients and -different geographical areas to attain more generalized results .