COPD Flashcards
Risk factors for developing COPD
Cigarette smoke, occupational chemicals, air pollution severe recurrent respiratory infections, and alpha-1 antitrypsin deficiency
Define COPD
Preventable and treatable disease state characterized by airflow limitation that is not fully reversible. Usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles and gases, primarily caused by cigarette smoking
Types of COPD
Chronic Bronchitis and emphysema
Chronic bronchitis
Presence of chronic productive cough for three months and each of two consecutive years in a patient that other causes of chronic cough have been eliminated
Define emphysema
Abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of the walls and without obvious fibrosis
Common manifestations of COPD
Chronic inflammation found in airways, lung parenchyma of respiratory bronchioles and alveoli, and pulmonary blood vessels
PathoGenesis of COPD
Complex and involves many mechanisms, with an inflammatory process different from that of asthma. Systemic manifestations
Defining feature of COPD
Not fully reversible airflow limitation during forced exhalation that is caused by loss of elastic recoil and airflow obstruction secondary to mucus hypersecretion, mucosal edema, and bronchospasm. Gas exchange abnormalities result in hypoxemia and hypercapnia
Diagnosis of COPD should be considered when?
Patient over the age of 40 with symptoms of cough, sputum production, or dyspnea, and/or a history of exposure to risk factors for the disease
Symptoms of COPD
Chronic intermittent cough is the earliest symptoms; sputum mayor may not be present, symptoms are progressive
Classifications of COPD
Mild, moderate, severe, and very severe; depends on severity of obstruction
Complications of COPD
Cor pulmonale, exacerbations, respiratory failure; anxiety and depression often occur in the picture
Cor pulmonale with COPD
Hypertrophy of the right side of the heart, with or without heart failure, resulting from pulmonary hypertension and is a late manifestation of chronic pulmonary heart disease
Exacerbations of COPD
Signal by a change in the patient’s usual dyspnea, cough, and/or sputum that is different from the usual daily patterns. These patients require changes in management and can have significant Mortality if it’s not appropriately treated
Confirmation of COPD
Done through pulmonary function test. Is made when FEV1/FVC ratio is less than 70% and related symptoms are present
Diagnostic workup for COPD
Confirm the diagnosis of COPD via spirometry on and determine the impact of the disease on the patient’s quality of life
Primary goals of care for COPD
Prevent disease progression, relieve symptoms and improve exercise tolerance, prevent entry complications, promote patient participation care, prevent and treat exacerbations, and improve quality-of-life and reduce mortality
Basic therapy for COPD
Cessation of smoking and bronchodilator therapy to reduce dyspnea and increase FEV1
Monotherapy for COPD
With inhaled anti-cholinergics are long acting beta two agonist maybe use or combined with inhaled corticosteroid; all these medications decrease exacerbations of COPD with no one better than the other
Surgical Procedures for COPD
Lung volume reduction surgery to reduce the size of the lungs, a bullectomy to improve lung function, lung transplantation to improve function capacity and enhance quality of life
Techniques used to improve COPD
Pursed Lip breathing used for prolonged exhalation and thereby prevent bronchiolar collapse and air trapping; airway clearance techniques such as effective coffee techniques, chest physiotherapy, and airway clearance devices
Effective coughing for COPD
Conserves energy, reduces the team, and facilitates removal of secretions. Huff coughing is an effective technique
Chest physiotherapy for COPD
Percussion, vibration, and postural drainage
Airway clearance for COPD
Use positive airway pressure, such as flutter, a cappella, or therapep. High-frequency chest wall oscillation, such a smart vest, helps to clear airways
Common symptoms of emphysetamous COPD
Weight loss and malnutrition; the patient with weight loss needs extra protein and calories and tips on energy conservation while eating
Nursing management with COPD
Pulmonary rehabilitation with the overall goal to increase quality of life and improve exercise capacity; walking; adequate sleep; interventions for complications such as exacerbations, pneumonia, cor pulmonale, and acute respiratory failure
O2 therapy for COPD
Improve survival, exercise capacity, cognitive performance, and sleep in hypoxemic patient
Goals of O2 therapy for COPD
Reduce the work of breathing, maintain the PaO2, and/or reduce the workload on the heart, keeping the SaO2 more than 90% three rest, sleep, and exertion, or PaO2 more than 60
Administering O2 for COPD
Low or high flow system; most methods are low flow devices that deliver O2 in concentrations that vary with the respiratory pattern
Dry 02 and COPD
Dry 02 has an irritating effect of membranes and dry secretions, therefore it is important that O2 be humidified when administered either by humidification or nebulization
Medical complications associated with O2 therapy and COPD
CO2 narcosis, oxygen toxicity, infection, and absorption atelectasis. The risk of combustion related injury is also a possibility
