COPD

Question 1

COPD Patho

Answer 1

chronic inflammation of airways. parenchyma and blood vessels. Loss of elastic recoil, mucus hypersecretion, air traps during exhalation

Question 2

COPD Risk Factors

Answer 2

Cigarette smoking, inhalation of noxious substances, aging, asthma, gender (mainly men)

Question 3

COPD S&S

Answer 3

• Dyspnea
• Chest breathing (vs abdominal)
• Wheezing
• Fatigue
• Tripod position
• Pursed-lip breathing
• Barrel Chest
• Weight loss/Anorexia
• Edema (right HF)
• Hypoxemia, Hypercapnia
• Cyanosis

Question 4

Complications of COPD

Answer 4

• Pulmonary Hypertension (vasoconstriction d/t alveolar hypoxia)
• Cor pulmonale (late, pulmonary HTN increases RV pressure)

Question 5

COPD Diagnosis

Answer 5

• FEV1/FVC Ratio < 70%!!!!
• CXR
• Increased Residual Volume
• CAT and CCQ questionnaires
• ABGs: low PaO2 and pH, increased PaCO2 and HCO3

Question 6

COPD Care

Answer 6

• Influenza and Pneumococcal vaccines!!
• Stop smoking
• Teach how to use inhalers

Question 7

COPD Meds

Answer 7

• Bronchodilators (SABA, LABA)
• Anticholinergics (MDI, DPI)
• Inhaled Corticosteroids
• Anti-inflammatories (roflumilast!!)
• Mucolytics (Mucinex/Guafenisin)
• Combo Drugs (DuoNeb or Advair)

Question 8

O2 Therapy for COPD

Answer 8

• No more than 2L bc hypoxic drive (unless emergency)
• Low-flow most common
• High-flow for fixed concentration (venturi mask)
• Keep O2 > 90%

Question 9

Teachings for COPD

Answer 9

• Pursed-lip breathing!!
• Focus on use of diaphragm (may be contraindicated for moderate to severe COPD bc increased workload)
• Effective coughing
• Eat 5-6 small meals (high calorie high protein)
• Rest 30 minutes before eating and avoid exercise 1hour before and after meals
• Supplement O2 before meals if necessary