COPD Flashcards
Obstructive pulmonary disease is an __ term
“umbrella”
Three disease processes covered in “obstructive pulmonary disease”
asthma, emphysema, chronic bronchitis
A patient with COPD has __ and/or __
emphysema and/or bronchitis
Alveoli are overinflated, they are stretched and damaged. There is impaired gas exchange
Emphysema
Excessive secretion production in the lungs
Chronic bronchitis
Is COPD preventable?
Yes
Is COPD treatable?
Yes
What causes a patient with COPD to be hospitalized?
A COPD exacerbation
What is the most common cause of a COPD exacerbation?
a respiratory infection
How is COPD diagnosed?
History, symptoms, and spirometry results (PFTs)
What is a barrel chest?
Increased anteroposterior diameter of chest due to hyperinflation (1:1)
Breath sounds of someone with COPD are usually __.
decreased
3 adventitious breath sounds you may hear in someone with COPD
Wheezing, rales, and/or rhonchi
Exhaling is normally a __ process
Passive
People with COPD have prolonged
expiration
__ __ breathing is a sign of advanced COPD
pursed lip
Prolonged expansion of the lungs will cause __ __
pulmonary hypertension
- Increased resistance: When expiration is prolonged, the airways remain narrowed for a longer period. This increases the resistance to airflow.
- Increased pressure: As the heart works harder to push air out against increased resistance, the pressure in the pulmonary arteries (the arteries that carry blood from the heart to the lungs) rises.
- Pulmonary hypertension: Over time, this chronic increase in pulmonary artery pressure can lead to pulmonary hypertension.
Pulmonary hypertension may cause __ __ __ and __ __.
neck vein distention and peripheral edema
Neck vein distention and peripheral edema are signs of __ __.
Advanced disease
Sign of advanced COPD, means excessively malnourished, extremely thin
Cachexia
What is pleural effusion?
Build up of excess fluid between the layers of the pleura outside the lungs
How is pleural effusion treated? (3)
Thoracentesis, antibiotics, diuretics
In addition to barrel chest, a patient may have a __ __ due to hyperinflation.
flattened diaphragm
Six potential nursing problems for a patient with COPD
1) Activity intolerance
2) Ineffective breathing pattern
3) Ineffective airway clearance
4) Impaired gas exchange
5) Anxiety
6) Poor nutritional status
What is an ineffective breathing pattern?
Too fast, too slow, too shallow, too deep
Patients with COPD typically breathe too __
fast (tachypnea)
Breathing pattern that is too fast and also too deep
hyperventilation
What does an ineffective airway clearance mean?
Congestion in the lungs that cannot be expectorated
What does impaired gas exchange mean?
Damage at the level of the alveoli
Why are patients with COPD anxious?
They are having such a hard time breathing
Single most effective and cost-effective intervention to reduce the risk for COPD and disease progression
Smoking cessation
2 teaching points for patients with COPD
____ and ___ vaccine
early detection of ___ ___
1) Teach pneumonia and influenza vaccine adherence
2) Teach early detection of respiratory illness
Mainstay of COPD self-management and adherence to this is critical
inhaler therapy
3 types of inhaler drugs
___ ___ ___ antagonist
___ ___ ___ antagonist
___ corticosteroids
Long acting beta antagonist, long acting muscarinic antagonist, inhaled corticosteroids
Steroids are potent __
anti-inflammatory
The typical o2 saturation goal for a patient with COPD?
88-92%
Why is the O2 saturation goal for patients with COPD lower than the healthy individual?
Because their body has adjusted to a lower oxygenation level due to the obstructive nature of the disease
What position and breathing method should you teach COPD patients?
Tripod position and pursed lip breathing
What is an intervention for the nursing problem ineffective airway clearance?
Cough techniques
What is an intervention for the nursing problem activity intolerance?
Teach energy conservation and relaxation exercises
Mainstay of treatment for patient admitted to hospital with hypoxemia
__ %
Oxygenation therapy above 90% (SpO2)
What stimulates a healthy person to inhale?
Increased levels of CO2
What stimulates a person with COPD to inhale?
Decreased oxygen
How is a “CO2 retainer” diagnosed?
arterial blood gasses
How does a patient with COPD develop CO2 narcosis?
When given high oxygenation, they lose their stimulus to breathe
If a patient with a COPD exacerbation is hypoxemic and develops CO2 narcosis due to high oxygenation, what should you never do?
Withhold oxygen therapy
What can happen if you withhold oxygen therapy for a COPD patient with hypoxemia?
They can die
If a patient with COPD exacerbation and hypoxemia stops breathing due to C02 narcosis, what are the next steps?
The patient will be intubated and moved to the ICU
A patient who is hypercapnic may be put on what type of ventilation?
Positive pressure ventilation (Bipap or venturi mask)
Hypercapnic means
increase in carbon dioxide
A patient with COPD exacerbation may be on bronchodilators such as…
metered dose inhalers (MDI) and wet nebulizers
Two types of chest physiotherapy a patient with a COPD exacerbation may do…
Percussion and postural drainage
A COPD patient experiencing an exacerbation in the hospital may be on __ if it is bacterial in nature
antibiotics
