EAC COPD

Question 1

two ways chest diseases cause hypoxia

Answer 1

Airway obstruction

Impaired perfusion of the alveoli

Question 2

two main COPD’s

Answer 2

Chronic bronchitis

Emphysema

Question 3

Define:

Chronic Bronchitis

Answer 3

an inflammatory condition affecting the airways.

Bronchial mucus glands secrete excess mucous which the patient coughs up but it obstructs the airways.

Question 4

Define:

Emphysema

Answer 4

characterised by distension of the alveoli and destructive changes in their membranes.

Question 5

signs and symptoms of:

Chronic Bronchitis

Answer 5

productive cough (if greeny yellow an infection may be present)

usually cyanotic (blue bloaters)

tachycardia

tachypnoea

dyspnoea

use of accessory muscles

pupils may be dilated or slow to react

if hypoxia is severe, GCS may be reduced

may be evidence of oedema

BP may be normal or slightly raised

slow capillary refill

if pulse oximetry is available a reduced O2 saturation will be indicated

auscultation usually reveals rhonchi and wheezes

use of domiciliary O2 therapy

Question 6

define:

Rhonchi

Answer 6

Rhonchi are coarse rattling respiratory sounds, usually caused by secretions in bronchial airways

Question 7

signs and symptoms of:

Emphysema

Answer 7

usually thin

usually maintain normal skin colour (pink puffer)

tachycardia

tachypnoea

dyspnoea

use of accessory muscles and difficulty exhaling

BP usually elevated

cyanosis may be evident in an acute attack

pursed lips on expiration

confusion and acute anxiety may be present because of hypoxia

wheezing and crackles may be heard on auscultation mainly on inspiration

patient will appear to have abnormally large chest

cardiac arrhythmia’s may develop

may be evidence of oedema

Question 8

Management of Chronic Bronchitis and Emphysema

Answer 8

ensuring open airway using suction if necessary

consider administration os salbutamol for acute exacerbation

administering oxygen to relieve hypoxia (consider loss of hypoxic stimulus) aim for SpO2 of 88-92%; be aware of risks

maintaining patient in their most comfortable position (usually upright)

being prepared to ventilate or carry out full CPR

monitoring the patients condition closely; be prepared to manually assist ventilation if necessary

documenting all treatments and measurements

providing a smooth journey to hospital

Specific to Chronic Bronchitis:
encouraging coughing, collect samples of sputum

Question 9

Features of exacerbation of COPD

Answer 9

More dyspnoea then usual

reduced SpO2 to normal level for patient

unable to talk

noisy breathing

Question 10

Conditions with similar features to an exacerbation of COPD

Answer 10

Asthma

Pneumonia

Tuberculosis

Pleurisy

Pulmonary embolism