COPD Flashcards
What is COPD?
- Chronic Obstructive Pulmonary Disease
- COPD is not a single condition, but rather a group of diseases of the lungs.
- chronic complication that cannot be reversed
What are the 2 main TYPES of Chronic Obstructive Pulmonary Disease (COPD)
- emphysema
- chronic bronchitis
What 3 main symptoms do Asthma and COPD share?
- wheezing
- cough
- shortness of breath
Asthma is usually diagnosed in ___ and is often related to ___
- childhood
- allergies
COPD is usually diagnosed in ___ and its related to ___.
- OLDER patients
- long-term smoking
Asthma usually has a __ cough.
dry
COPD has a ___ cough.
productive
Asthma symptoms ____ between episodes
disappear
COPD symptoms progressively ___.
worsen
Q: What is the main characteristic of COPD?
inability to expire air effectively
A form of COPD characterized by:
* inflammation of the bronchial tubes (airways) that leads to excessive mucus production, causing cough and difficulty breathing
* Bronchial walls become thick
Chronic Bronchitis
Chronic Bronchitis patients become susceptible to recurrent ___.
respiratory infections
2nd type of COPD characterized by:
* Progressive damage to the alveoli (air sacs) in the lungs.
* alveoli wall is destroyed leading to air trap and making it difficult to exhale fully
Emphysema
What is a major cardiovascular complication of COPD?
Cor pulmonale (right-sided heart failure)
* due to long-term high blood pressure in the pulmonary arteries (aka pulmonary hypertension).
A patient with long-term COPD is diagnosed with cor pulmonale. Which of the following findings should the nurse expect?
A. Crackles in the lower lobes
B. Peripheral edema and jugular vein distention
C. Elevated blood pressure and bradycardia
D. Wheezing with inspiration and expiration
Answer: B. Peripheral edema and jugular vein distention
Rationale: Cor pulmonale is right-sided heart failure caused by pulmonary hypertension from chronic lung diseases like COPD. Peripheral edema and jugular vein distention are classic signs of right-sided heart failure.
A nurse is assessing a patient with COPD. Which complication should the nurse monitor for if the patient develops pulmonary hypertension?
A. Left-sided heart failure
B. Right-sided heart failure
C. Myocardial infarction
D. Pulmonary embolism
Answer: B. Right-sided heart failure
Rationale: Cor pulmonale, or right-sided heart failure, is a complication of COPD caused by increased pressure in the pulmonary arteries from long-term lung damage. This condition leads to hypertrophy and failure of the right ventricle.
COPD 4 Most Common Risk Factors
- Tobacco Smoke: Accounts for 80-90% of cases
- Passive Smoking: Includes second and third-hand smoke
- Increased age
- Asthma
- Occupational exposures
- Air pollution
- genetics abnormalities: Alpha-1 deficiency
Most COMMON S/S of PROGRESSED COPD
(not seen in Asthma)
List 9
- Chronic cough
- Sputum production
- Dyspnea @ rest
- Thin with Barrel Chest
- Accessory muscle use
- Polycythemia due to chronic hypoxia
- Cyanosis and clubbing of fingers
- Musculoskeletal wasting
- Depression
Which device would the nurse teach a patient with COPD to blow into to loosen pulmonary secretions?
A. Incentive spirometer
B. Peak flow meter
C. Flutter valve device
D. Holding chamber (spacer)
C. Flutter valve device
(blow air into device= causes vibrations to release secretions)
5 Diagnostic studies for COPD
- Pulmonary Function Tests
- Spirometry: assess lung function and diagnose COPD or asthma
- ABG’s: evaluate oxygen and carbon dioxide levels in the blood
- Chest XRay: rule out other issues
- Echocardiogram: evaluates function of ventricles/cor pulmonale
ABG lab results for COPD in the LATE stages?
- Low PaO2,
- elevated PaCO2
- low-normal pH
- increased HCO3: body’s way of compensating
If patient is NOT a smoker, what diagnostic tests will be anticipated?
Alpha-1 Antitrypsin Levels: To check for deficiency, especially if there are symptoms of lung disease.
2 RESPIRATORY complications of COPD
Respiratory insufficiency and respiratory failure
Define:
Atelectasis
partial or complete collapse of a lung or a section of a lung due to alveoli becoming deflated or filled with fluid.
Define:
Pneumothorax
condition where air leaks into the space between the lung and the chest wall, causing the lung to collapse partially or completely.
Which is a type of obstructive airway disease that causes gradual destruction of the alveoli, causing shortness of breath?
A. Chronic bronchitis
B. Cor pulmonale
C. Asthma
D. Emphysema
D. Emphysema
Which test might be ordered to diagnose COPD or to track the effectiveness of treatment?
A. Echocardiogram
B. Pulmonary Function Test
C. Arterial Blood Gas
D. Chest x-ray
B. Pulmonary Function Test
(all can be done but MOST used for lung funtion is B)
What is the most cost-effective intervention to reduce the risk of developing COPD?
Smoking Cessation:
Medical Management for COPD
List 7
- Vaccines – (flu, pneumonia, Covid)
-
Bronchodilators: SAMA/LAMA, SABA/LABA
-Often used in combination with corticosteroids - Alpha1-antitrypsin therapy
- Antibiotics
- Mucolytic agents
- Antitussive agents: suppress coughing
- Vasodilators
MED used for COPD Exacerbations ONLY
Roflumilast (Daliresp)- (PDE4 inhibitor) – reduces risks for exacerbations
Name 2 palliative surgical procedures for COPD
(do not cure)
1.Bullectomy
2.Lung Volume Reduction Surgery
What is done in bullectomy?
- Bullae are enlarded spaces that do not contribute to ventilation and take up space in thorax.
- These are surgically removed.
What is done in Lung Volume Reduction Surgery
- Surgically removes lung tissue allowing functional tissue to expand, resulting in improved elastic recoil, decreased dyspnea, and improved lung function
- option for patients with advanced or end-stage COPD
The ONLY cure for COPD
Lung Transplantation
* Costly & limited by shortage of donor organs
How does COPD lead to chronic HIGH levels of Carbon Dioxide (CO2)?
- In COPD patients, chronic high levels of CO2 cause the body to adapt to this abnormal condition.
- Over time, the brain becomes less sensitive to changes in CO2 levels.
- As a result, even when CO2 levels rise, the body does not respond as strongly or quickly as it normally would.
Should you withold oxygen from a hypoxic COPD patient?
You should NEVER withhold oxygen from a COPD patient if they are hypoxic, but use it cautiously
Why is oxygen therapy a concern for COPD patients?
COPD patients have a different drive to breathe than normal people.
* Oxygen binds to hemoglobin more easily than carbon dioxide.
* Administering excessive oxygen to COPD patients can lead hemoglobin to release carbon dioxide to pick up oxygen.
* This results in a spike in CO2 levels, potentially worsening the patient’s condition.
What is considered a normal O2 saturation range for COPD patients?
88-92% may be normal and acceptable for them
Define:
It measures the amount of oxygen dissolved in the blood and is an important indicator of how well oxygen is being transported from the lungs to the bloodstream
PaO2
CO2 normal levels
35-45 mmHg
(assess respiratory function and metabolic status- too much = Acid in body)
Pt education for COPD patients
List 5 (most important)
- Breathing and airway clearance exercises
- Activity pacing/energy conservation
- Oxygen therapy: no smoking
- Nutritional therapy: low carb, high calories, high protein- are needed bc they are thin, not so much fluids.
- Coping measures – psychosocial/emotional
REview:
4 COPD Complications
- COPD Exacerbations
- Cor Pulmonale: diuretics, O2, antbx, bronchodilators, meds
- Acute Respiratory Failure
