COPD Mary Flashcards
What is COPD
- Chronic inflammatory lung disease that causes obstructed airflow from lungs
Mary Risk factors for COPD
- Smoking
-exposure to chemicals - Possibly genetics
What genetic condition leads to COPD
- Alpha-1 anti-trypsin deficiency (AAT)
General S+S COPD
- Barrel chest
- chronic cough
- Blue tinged lips
- Finger clubbing
- Pursing lips when breathing
- shortness of breath
- accessory muscle use when breathing
- labored breathing
Mary S+S COPD
- pursed lip breathing
- shortness of breath
- barrel chest
- labored breathing
accessory muscle use - purple tinged lips
Emphysema patho
- Exposure to irritants
= inflammation in alveoli
= increase proteases and decrease anti-proteases
= oxidative stress
= alveolar tissue destruction + decrease tissue healing
= decrease alveolar walls
= decrease capillaries
= decrease elastin
= decrease alveolar surface area for gas exchange + enlarged air spaces + lose recoil
= bronchiole expiratory collapse
= decrease gas exchange
= air trapping and hyperventilation
Chronic bronchitis path
- Bronchial inflammation and oedema
- increase mucous production
- decrease cilia action
= increase airway resistance
= decrease gas exchange
Medication COPD management
- Beta-agonists
- bind to beta2 adrenergic receptors on bronchiole smooth muscle, stimulating bronchodilation - Anticholinergics
- blocks muscarinic acetylcholine receptors on bronchiole smooth muscle
- preventing bronchoconstriction
= bronchodilation - corticosteroids
- anti-inflammatory agents used to decrease the inflammatory response - Oxygen
- low-level oxygen therapy may be used to maintain oxygen saturation
Mary management before hospital COPD
- inhaler
- oxygen
Mary COPD medications after hospital
- Salbutamol
- short acting beta-agonist bronchodilator - seretide
- long acting beta-agonist bronchodilator and corticosteroid - Spiriva
- anticholinergic for bronchodilation - oxygen therapy
General COPD complications
- Respiratory acidosis
- metabolic acidosis
Tissue wasting - pulmonary hypertension
- respiratory failure
- cyanosis (purple tinged lips )
Mary COPD complications
- purple tinged lips (cyanosis)
- weight loss
- occasional ankle oedema (sign of right heart failure)
- acute respiratory failure
COPD patho
- hyperinflation flattens diaphragm, expands chest and increase thoracic volume
= respiratory muscles work harder and accessory muscles facilitate ventilation
= expanded rib cage
= difficult to reduce intrathoracic pressure during inspiration and increase airway resistance
= energy expenditure increases and fatigue occurs
Physical evaluation of Mary COPD
- weight loss
- dusky colour
- lips blue tinge
- breathing quiet but labored
- barrel chest
- RR 20 breaths/min
- accessory inspiratory muscles
- coarse crackles
other evaluation of COPD
- blood tests
- spirometry
Mary COPD spirometry results
- pulmonary function test
- indicates she has progressive COPD
- increased residual volume
- increased functional residul capacity
- reduced forced vital capacity
= lung volume increased and air flow decreased
= more air trapped in lunges
= harder to move air in and out of lungs
Lab tests for COPD
- Blood gases and PH
- sputum sample
investigations for COPD
- chest x-ray
- pulmonary function tests
- ECG
Mary chronic bronchitis element of COPD
causes mucus secretion, narrowing and obstruction of airway
= mary airway resistance increase and reduce airflow and lengthening her expiration time
- mary unable to expire air
= air trapped
= increase residual volume and increased functional residual capacity
Mary emphysema element of COPD
- Associated with loss of lung elasticity
- without elastic recoil
= harder for mary to generate pressure required to drive expiration - airway prone to collapse during expiration
- results in trapped air increase residual volume
= decrease vital capacity
what is emphysema
- Type of COPD in which the alveoli are damaged
Compare Chronic Bronchitis and Emphysema
Chronic bronchitis
- inflammation occurs in bronchioles leading to branchial oedema
- increasing mucous production
- decrease Hilary action
- increase airway resistance
- decrease gas exchange
Emphysema
- inflammatory destruction of alveoli and capillaries.
- decrease alveolar surface area for gas exchange
- decrease airflow
- air trapping
