COPD Flashcards
What does COPD mean?
Chronic obstructive pulmonary disease
Who has the most death/COPD causes ?
White people
Who has the least amount of COPD cases?
Hispanics
Over how many people have COPD?
16 million
COPD is the what leading cause of death?
Third
Gender differences of COPD
More men have it
More woman die from it
What is exacerbation mean?
Worsen of a condition
What’s the number reason of getting COPD?
Smoking
COPD is what? (3)
Characizteried by?
Preventable, treatable, often progressive diseases
Characterized by persistent airflow limitation
Chronic inflammatory response in airways and lungs primarily caused by what?
Cigarettes smoking & other noxious particles/gases
Noxious particles - toxins
Someone can have COPD for years
But if they come to the hospital with respiratory distress what do they have?
Acute exacerbations
What does dyspnea mean?
Trouble breathing
Is there a cure for COPD?
No
What other things contribute to severity of the disease (2)? Examples too
Exacerbations ( good days & bad days )
Other illnesses, asthma, pneumonia
COPD puts you at risk of developing what
Developing other respiratory illness
What is the primary function of the lung? & function
Alveoli
Gas exchange
What does COPD Alveoli sacs look like? (3)
Sacs become in enlarged, saggy & lose elastic recoil
COPD does not include what? (2)
Chronic bronchitis & emphysema
What does chronic bronchitis mean?
( BLUER )
The presence of cough & sputum production for at least 3 months in each of 2 consecutive years
B - big and blue skin
L - long term chronic cough
U - Unsual lung sounds
E - edema peripherally ( heart failure )
( pulmonary hypertension & big feet )
R - right side heart failure
Cor pulmonae
What does emphysema mean?
( PINK )
Destruction of alveoli without fibrosis
P - pink & pursed lip breathing ( hugging and puffing )
I - increase chest ( barrel chest )
N - no chronic cough
K - keep on tripoding
What’s are risk factors of COPD? (11)
Infection
Severe respiratory Infections in childhood
HIV
TB
Cigarette smoking
Asthma
Air pollution
Occupation
Aging
Genetics
AATD
Smoking is the number one cause of COPD
Develops ___ of smokers
Anyone over __
With a smoking history of ____ more pack years
20%
40
10 pack years
What is pack years mean?
1 pack a day for 30 years how many pack years?
30 pack years
2 packs a day for 15 years ??
30 pack years
What is examples of occupational dust and chemicals? (4)
Dusts
Vapors
Irritants
Fumes
When you have asthma, how does that effect you for COPD?
They overlap each other from pathologic & functional
What does ATTD mean?
Antitrypsin deficiency
COPD pathophysiology is characterized by?
(3 ex)
Chronic inflammation of airways, lung parenchyma, pulmonary blood vessels
What’s the defining feature of COPD?
Airflow limitation not fully reversible during forced exhalation
Airflow limitation not fully reversible during forced exhalation are due to what (2?)
Loss of elastic recoil
Airflow obstruction due to mucosal hypersecretion, mucosal edema, and bronchospams
COPD pathophysiology
Disease progression marked by worsening due to ? (3) (AAG)
Abnormliaties in airflow limitation
Air trapping
Gas exchange
COPD pathophysiology
Severe disease (2)
Pulmonary hypertension
Systemic manifestations
COPD pathophysiology
Primary process is inflammation
What is inhaled that causes inflammation and result to what?
Inhale noxious particles and gases results inflammation
Results in Damage to lung tissue
What are the inflammatory cells of COPD? (3)
Neutrophils
Macrophages
Lymphocytes
What’s the main characteristic of COPD?
Inability to expire air
Peripheral airways are obstructed and trap air during expirations and results in what?
Increase residual volume which results in barrel shape chest
What’s the biggest characteristic of COPD, inflammation of what?
Inflammation of the small alveoli sacs
Barrel chest happens when the lungs become what?
Overfilled with air
Whats the diameter of barrel chest ?
1:1
What’s the reason for a barrel chest?
In order to expand the lungs to get more air but it doesn’t help at all
But since it doesn’t have the alveoli sac
So air exchange doesn’t happen
As air trapping increases, alveolar walls are destroyed resulting in formation of what? (2?
Bullae and blebs
What is Bullae and blebs?
No surrounding capillary bed resulting in VQ perfusion mis match
What is VQ perfusion mix match? (2)
Low oxygen in blood (hypoxemia)
High CO2 In blood ( hypercapnia )
What’s the driving force of breathing?
CO2
Excess mucus production and cough
(4) causes what?
Increase mucus goblet cells
Enlarged submucosal gland
Dysfunction of cilia
( hair doesn’t push chemicals out )
Inflammatory mediators
COPD is a systemic disease as result of ?
What does systemic mean
Systemic - blood stream & all parts of body
Chronic inflammation
What are other diseases common for COPD? (4)
Cardiovascular
Osteoporosis
Diabetes
Metabolic syndrome
Your heart and lungs are right next to each other, so that means?
If you have heart problems
You’ll have lung problems
Vice versus
Pulmonary vascular change means for COPD? (2)
Vasoconstriction of small pulmonary arteries due to hypoxia
Hypertrophy
Pulmonary arteries Thicken
Results in pulmonary hypertension resulting in _____ & ______?
Right ventricular hypertrophy
Right heart failure
Left side of the heart means ?
Right side if the heart failure mean?
Cardiovascular problems
Respiratory problems
What does pulmonary hypertension mean?
Can’t breathe even though your blood pressure is fine
When you have right heart failure, what is happening and results what?
Not enough blood pumping
Backing into your lungs
Resulting in pulmonary edema
What’s the diagnosis of COPD?
FEV1/FEV < 70%
How do you test FEV1/FEV?
And what’s the normal range for those who have have COPD?
Forced expiratory volume in a machine in the first one second to the forced vital capacity of the lungs
0.75-85
What’s an abnormal FEV1/FEV ratio, or to see who has COPD?
Below 70
Since COPD is a progressive disease there are what to categorize it?
Stages
What are the 4 stages of COPD?
Gold 1 - mild
Gold 2 - moderate
Gold 3 - severe
Gold 4 - very severe
What are clinical manifestations of COPD? (20)
Chad spits dying rice chowder chips why?
Chunky fat weed ants put badly triad
Purge right hypo sex cap increases CYAN
Chronic cough
Sputum production
Dyspnea
Risk factors exposure
Chest heaviness
Chest breather
Wheezing
Chest tightness
Fatigue
Weight loss
Anorexia
Prolonged expiratory phase
Barrel chest
Tripod position
Pursed lip breathing
Peripheral edema ( ankles ) right heart failure
Hypoxemia - < 60
Sa < 88
Hypercapnia > 45
Increase RBC
( polycythemia/erythrocytosis)
Cyanosis
Not all COPD will produce sputum? True or false
True
What does chest heaviness mean for COPD? (4)
Can’t take a deep breath
Gasping
Increased effort to breathe
Air hungry
What’s a chest breather mean?
Use Accessory and intercostal muscle
Inefficient breathing
What is the tripod position?
2 hands on knees bend down
What does polycythemia/erythrocytosis mean?
Increase RBC
What are the complications of COPD?
_____examples?
Common cause ? (2)
You’ll also have increase what?
Acute exacerbations
Increased dyspnea
Increased sputum volume
Increased sputum purulent ( infection)
Malaise - tiredness
Fatigue
Insomnia
Confusion
Bacterial or viral infections
Frequency with disease progression
Complications COPD
they will have increase what
Decrease what
And how do we test for this? Or measure it
Increase CO2
Decrease OXYGEN
ABG ( aertial blood gas )
What are some treatments for COPD?
Short term?
Examples (3) 1 ex of eah
Saba - albuterol, anticholinergic, antibiotics, diuretics
Oral corticosteroids
- premidosone
Oxygen - nasal cannula
As a nurse you want to education a patient on acute exacerbations why?
In order for a patient to understand and prepare/avoid it
Inter professional care
COPD patients live where?
Outside the hospitals
Though when COPD patients come into the hospital they are there for what (2?)
Acute exacerbations
Acute respiratory failure
How is do we stage COPD? Like how do we put them in the 1-4 category?
How many times they come into the hospital for acute exacerbations & acute respiratory failure
If you have COPD, you want avoid what?
Occupational or environmental triggers
We want to make sure COPD patients have what two vaccines?
And how many times?
Flu and pneumococcal vaccine
Yearly
Number 1 goal for COPD patients is to do what?
Stop smoking !!!
Smoking cessation
What’s the first nursing intervention of COPD?
Stop smoking
Educating on smoking
What are asthma medication ?? (5)
Saba
LABA
Anticholinergic drug
corticosteroids
LTMA
What are 4 COPD medication?
Bronchodilators
LABA
ICS
Anticholinergic drug
What’s anticholinergic drugs mean?
COPD
Promote bronchodilation by preventing muscles around bronchi from tightening
What’s example of corticosteroids for COPD? (2)
Beclomethasone
Budesonide
If you are giving a patient a inhaled corticosteroids, you want to make sure a patient what?
Why?
Gargles and spits it out
To avoid oral thrush & organisms
You will never LTMA for emegereny? True or false?
True
What does MDI stand for and mean?
Metered dose inhaler
Small hand held pressure devices
You always want to start what with a brand new inhaler?
1 or 2 puffs
Inhalers Can be used with a spacer or holding chamber to what (3)?
Reduce oropharyngeal medication
Increase delivery to lungs
Reduce problems with hand breath coordination
For an inhaler you always want to teach what?
Correct technique
If bronchodilator use of great than 2 canisters/month should prompt what?
Visit to HCP
Some inhalers can come as what?
DPI
Dry power inhaler
What are some advantages of DPI? (2)
Less manual dexterity
No spacer needed
What are some disadvantages of DPI? (3)
Low FEV1 - inadequate inspiration
Not all common meds
Power may clump
What’s a nebulizer?
Machine converts drug solutions into fine mist for inhalation via mask or mouthpiece
: easy to use
Neblukizer needs what? (2)
O2 generator
Air compressor
Patient education
What’s the best way to teach a patient an inhaler? What method?
Teach back
