COPD

Question 0

Risk factors for developing COPD

Answer 0

Cigarette smoke, occupational chemicals, air pollution severe recurrent respiratory infections, and alpha-1 antitrypsin deficiency

Question 1

Define COPD

Answer 1

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

Question 2

Types of COPD

Answer 2

Chronic Bronchitis and emphysema

Question 3

Chronic bronchitis

Answer 3

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

Question 4

Define emphysema

Answer 4

Abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of the walls and without obvious fibrosis

Question 5

Common manifestations of COPD

Answer 5

Chronic inflammation found in airways, lung parenchyma of respiratory bronchioles and alveoli, and pulmonary blood vessels

Question 6

PathoGenesis of COPD

Answer 6

Complex and involves many mechanisms, with an inflammatory process different from that of asthma. Systemic manifestations

Question 7

Defining feature of COPD

Answer 7

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

Question 8

Diagnosis of COPD should be considered when?

Answer 8

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

Question 9

Symptoms of COPD

Answer 9

Chronic intermittent cough is the earliest symptoms; sputum mayor may not be present, symptoms are progressive

Question 10

Classifications of COPD

Answer 10

Mild, moderate, severe, and very severe; depends on severity of obstruction

Question 11

Complications of COPD

Answer 11

Cor pulmonale, exacerbations, respiratory failure; anxiety and depression often occur in the picture

Question 12

Cor pulmonale with COPD

Answer 12

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

Question 13

Exacerbations of COPD

Answer 13

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

Question 14

Confirmation of COPD

Answer 14

Done through pulmonary function test. Is made when FEV1/FVC ratio is less than 70% and related symptoms are present

Question 15

Diagnostic workup for COPD

Answer 15

Confirm the diagnosis of COPD via spirometry on and determine the impact of the disease on the patient’s quality of life

Question 16

Primary goals of care for COPD

Answer 16

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

Question 17

Basic therapy for COPD

Answer 17

Cessation of smoking and bronchodilator therapy to reduce dyspnea and increase FEV1

Question 18

Monotherapy for COPD

Answer 18

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

Question 19

Surgical Procedures for COPD

Answer 19

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

Question 20

Techniques used to improve COPD

Answer 20

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

Question 21

Effective coughing for COPD

Answer 21

Conserves energy, reduces the team, and facilitates removal of secretions. Huff coughing is an effective technique

Question 22

Chest physiotherapy for COPD

Answer 22

Percussion, vibration, and postural drainage

Question 23

Airway clearance for COPD

Answer 23

Use positive airway pressure, such as flutter, a cappella, or therapep. High-frequency chest wall oscillation, such a smart vest, helps to clear airways

Question 24

Common symptoms of emphysetamous COPD

Answer 24

Weight loss and malnutrition; the patient with weight loss needs extra protein and calories and tips on energy conservation while eating

Question 25

Nursing management with COPD

Answer 25

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

Question 26

O2 therapy for COPD

Answer 26

Improve survival, exercise capacity, cognitive performance, and sleep in hypoxemic patient

Question 27

Goals of O2 therapy for COPD

Answer 27

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

Question 28

Administering O2 for COPD

Answer 28

Low or high flow system; most methods are low flow devices that deliver O2 in concentrations that vary with the respiratory pattern

Question 29

Dry 02 and COPD

Answer 29

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

Question 30

Medical complications associated with O2 therapy and COPD

Answer 30

CO2 narcosis, oxygen toxicity, infection, and absorption atelectasis. The risk of combustion related injury is also a possibility