COPD Flashcards
It is caused by chronic bronchitis and emphysema.
→ is a term used to describe a group of progressive lung diseases that lead to airflow obstruction.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
PATHOPHYSIOLOGY COPD
→ Exposure to irritants such as smoking, dust, pollen, etc., irritates the goblet cells and these cells respond by increasing sputum production thereby causing an obstruction on the bronchi causing a productive cough and if this last for more than 3 months for 2 consecutive years this is now known as chronic bronchitis. This inflammation can reach the alveoli, wherein it causes alveolar wall destruction called as emphysema. These two conditions obstruct the airway and contribute to Chronic Obstructive Pulmonary Disease
➢ presence of cough and sputum production for at least 3 months in each of 2 consecutive years
→ It is characterized by a productive cough lasting 3 or more months in 2 consecutive years.
CHRONIC BRONCHITIS (CB)
is a major factor implicated in the development of CB.
Cigarette smoke
the initial symptom of CB
Productive cough due to increased sputum production
In COPD remember there are 2 things to remember, Chronic Bronchitis and Emphysema
*In chronic bronchitis - bronchi is affected
**If bronchi affected in COPD,
**Goblet cell - seen in bronchi
manifestation? sputum production
that will have PRODUCTIVE COUGH
———————-
emphysema - alveoli affected
*150 million alveoli each lungs and surfactant - seen in alveoli
1. decrease surface tension - decrease attractiveness of water
2. so alveoli will not collapsed
**alveoli collapsed - manifestation? DYSPNEA
TO KNOW
In COPD remember there are 2 things to remember, Chronic Bronchitis and Emphysema
(EXPLAIN NA)
*In chronic bronchitis - bronchi is affected
**If bronchi affected in COPD,
**Goblet cell - seen in bronchi
manifestation? sputum production
that will have PRODUCTIVE COUGH
———————-
emphysema - alveoli affected
*150 million alveoli each lungs and surfactant - seen in alveoli
1. decrease surface tension - decrease attractiveness of water
2. so alveoli will not collapsed
**alveoli collapsed - manifestation? DYSPNEA
CHRONIC BRONCHITIS
→ 3 Laboratory Studies
▪ Arterial Blood Gases
▪ Pulse Oximetry
▪ Sputum Culture & Sensitivity
CHRONIC BRONCHITIS
→ Laboratory Studies
Sputum Culture and Sensitivity
(Define and Nursing Intervention)
– for rapid identification and treatment of pulmonary infection.
✓ Give the patient a sterile sputum container.
✓ Best done in the morning, before eating or drinking.
✓ Chest Physiotherapy combined with Nebulization help loosen secretions for expectoration.
✓ Difficult in producing sputum, give nebulizer with saline for 15-30mins to soften and loosen sputum to help expectorate
✓ Collect at least 1tsp of sputum.
✓ Brushing the teeth and rinsing the mouth is recommended, to reduce contamination of the sputum.
✓ Let the patient cough after taking several deep breaths.
→ It is characterized by destruction of the wall of the alveoli with resulting enlargement of abnormal air spaces.
EMPHYSEMA
→ _____ is strongly implicated as a
causative factor of Emphysema
Cigarette smoking
→ Two Major Changes that occur with
emphysema:
▪ Loss of lung elasticity
▪ Hyperinflation of the lung
→ _______ is the initial symptom of Emphysema
Dyspnea
Emphysema - Explain:
Hyperinflation
Barrel Chest
✓ Hyperinflation is an excessive expansion of the alveoli due to loss of lung elasticity. This results in larger but less efficient air sacs. As the bronchi are obstructed, patients have difficulty exhaling CO2, which results in elevated levels of CO2 in the bloodstream.
▪ Barrel chest is primarily caused by the loss of lung elasticity and hyperinflation of the alveoli, which results in the chest taking on a more expanded shape
EMPHYSEMA - EXPLAIN
E-cigarettes or vaping are devices used to inhale an aerosol, which typically contains nicotine (though not always).
▪ It inactivates the cilia, which are responsible for removing microorganisms. With the cilia not working effectively, it becomes easier for microorganisms to enter the trachea, potentially causing lung infections.
▪ It produces carbon monoxide, wherein hemoglobin is more attracted to this type of gas therefore decreasing the carrier for oxygen.
▪ It causes vasoconstriction which increases blood pressure and delays wound healing.
➢ Surfactant is being produced by the type 2 alveolar cells.
(Surfactant is needed to ______________)
prevent the attraction of water molecules to each other thus preventing the collapse of the alveoli
❖ RISK FACTORS OF EMPHYSEMA
→ Cigarette Smoking (most common)
→ Environmental Pollutants
→ Genetic because there is a deficiency of alpha antitrypsin, an enzyme that is produce by the lungs, so that if viruses enters, this enzyme will protect the lining of the alveoli.
→ Age – the lungs weakens as we age
→ Exposure to secondhand smoke - there will be irritating lungs and air sacs -> they lose their elasticity -> diminish antitrypsin -> Protein destroying enzymes will destroy collagen and elastin -> dilated and accumulation of Carbon dioxide in the Alveoli)
PHYSICAL ASSESSMENT OF EMPHYSEMA
㾎 Inspection
㾎 Percussion
㾎 Palpation
㾎 Auscultation
PHYSICAL ASSESSMENT OF EMPHYSEMA
㾎 Inspection
→ Barrel Chest
→ Prominent Sternocleidomastoid Muscle
→ Decreased appetite
→ Lose Weight
→ Mouth Breather
→ Tripod Position
→ Barrel Chest
*because of accumulated co2 in the alveoli
**(AP Diameter > Lateral Diameter)
**results of loss of lung elasticity
**chronic air trapping.
***chest wall expansion with chest rigidity
Accessory muscles of respiration are used for
breathing
→ Prominent Sternocleidomastoid Muscle
→ Decreased appetite
→ Lose Weight
→ Mouth Breather – They breathe through their mouth because they are having a hard time exhaling the excess CO2 that has accumulated.
→ Tripod Position – upper extremity is supported by a table; they do this because the lungs is occupied with CO2 and they are having dyspnea; this position pulls the shoulder up allowing more space for the lungs to expand.
PHYSICAL ASSESSMENT OF EMPHYSEMA
㾎 Percussion
Hyper resonant
– signifies that there is increased lung inflation from air tapping
PHYSICAL ASSESSMENT OF EMPHYSEMA
㾎 Palpation
Decreased Fremitus
done by vibration through asking the patient to say tres,tres or 99
transmission of vibration is obstructed
PHYSICAL ASSESSMENT OF EMPHYSEMA
㾎 Auscultation
Breath Sounds
Breath Sounds are reduced
Crackles and wheezes can be heard as air passes through the fluid.
Clubbing of Nails
▪ It results from chronic oxygen deprivation in the tissue beds.
▪ It will take years for clubbing to develop.
▪ Normal: diamond shape is present
▪ Commonly seen in association with: Hypoxemia and Polycythemia
to know