Chronic Obstructive Pulmonary Disease (COPD) Flashcards
Describes conditions characterized by chronic obstruction to expiratory airflow - chronic bronchitis and emphysema.
Chronic Obstructive Pulmonary Disease (COPD)
What is COPD?
a preventable and treatable slowly progressive disease of airflow obstruction involving the airways, pulmonary parenchyma or both
What is parenchyma?
includes the bronchioles, bronchi, blood vessels, intersittium and alveoli
Obstruction from mucus
Bronchitis
destruction of alveoli
Emphysema
What are some risk factors for COPD?
Smoking second hand smoke genetic factors increased age environmental factors
What does smoking do?
impairs cilia activity of bronchi, bronchospasm, increases goblets, hypertrophy of serous and mucous glands, increased mucus production
What are some genetic factors of COPD?
deficiency of alpha 1 antitrypsin.
Aralast (alpha-proteinase inhibitor) made from human plasma. Given IV once week to pts w/ deficiency. Must monitor pts VS during infusion
EBN: benefits of aralast not yet proven
Also genetically susceptible people who are sensitive to environmental factors
What is Alpha 1 antitypsin?
an enzyme inhibitor. Without this certain enzymes will destroy lung tissue
What are some environmental factors of COPD?
chronic exposure to chemical fumes
Indoor and outdoor air pollution: farmers/crop dusters/dust, car exhaust fumes, living close to an interstate. Heating in poorly ventilated homes
Nursing management of risk factors
Teach about smoking Genetic counseling Give aralast wear air mask reduce respiratory infections Flu/ pneumonia vaccine
Patients produce excessive mucus. Have productive cough that lasts three months in two consecutive years where there is no other reason for cough
Chronic Bronchitis
What is patho for Chronic bronchitis?
Hypertrophy of mucus glands hypersecretion of mucus Loss ciliated epithelium Alveoli damaged which alters macrophages that destroy foreign bodies including bacteria Higher risk of pneumonia
What is the patho for Right sided heart failure
O2 can’t pass into alveoli and CO2 can’t escape
leads to depression of PO2 and incresed PCO2
Low PO2 causes pulmonary vasoconstriction which results in increased pulmonary blood pressure (pulmonary hypertension)
Pressure in R ventricle increases to eject blood into narrow pulmonary vessels.
This increased pressure leads to right sided heart failure (cor pumonale)
What is the patho for Bronchiectasis?
Chronic irreversible dilation of bronchi and bronchioles
may be caused from pulmonary infections, obstructions
Aspiration of foreign body
Pressure from tumors, enlarged lymph nodes etc
