RESPIRATORY
copd (chronic obstructive pulmonary disease)
made up of two diseases:
WHAT IS IT?
Emphysema
Group of chronic & progressive inflammatory lung
diseases that cause obstructed air flow in the lungs
Damage & rupture to inner
structure of alveoli
damage from copd is irreversible
He
li
thy Alveo
al
Chronic Bronchitis
Inflammation of the lining of
the bronchial tubes
lthy Airway
Hea
physema
em
onic bronch
chr
itis
Narrowed
airway
Patients usually have combination of symptoms from
Emphysema & Chronic Bronchitis leading to:
Air flow obstruction & inability to fully exhale
Excess mucous
production
Broken down alveolar
membranes
(Emphysema)
(Chronic Bronchitis)
&
RISK FACTORS
DIAGNOSTICS
Caused by irritant exposure to lungs
→ Chest x-ray
! co2
→ Arterial blood gas
" O2
→ Pulmonary Function Test: Spirometry
→ Smoking most common
Alpha1!Antitrypsin deficiency
(protects lining of lungs)
→ Genetics
→ Frequent respiratory infections as child
→ Age over 65 years old
→ Asthma
→ Frequent exposure to chemicals/ pollution
"pink puffer"
Experience air trapping due
to loss of lung elasticity
▶ Pink skin
▶ Pursed lip breathing
▶ Barrel chest
▶ Tachypnea & dyspnea
▶ Cachexia
▶ Minimal cough
★1st sign: Shortness of breath & fatigue
© nurse well versed
will tripod
to get air
exchange
NO CURE: focused on symptom management
medications
2→ Corticosteroids: " inflammation
!sone Ex: Prednisone & Hydrocortisone
fvc
Forced vital capacity
Amount of air patient can forcibly
exhale after taking deepest inhale
FEV1
Forced expiratory volume
Amount of air patient can forcibly
exhale from lungs in first second
chronic bronchitis
"blue bloater"
Leads to right
sided heart failure
causing edema
Experience cyanosis due to
airflow obstruction
▶ Cyanosis
▶ Peripheral edema
▶ Obese
▶ Chronic productive cough
▶ Crackles & wheezes
▶ Recurrent infections
★1st sign: Productive cough >3 months x 2 years
TREATMENT
1→ Bronchodilators: dilate airways
!terol Ex: Salmeterol & Albuterol
Patient breathes into tube connected to computer
to measure different volumes during breathing
fev1/ fvc ratio <70% indicates obstructive lung disease
SYMPTOMS
Emphysema
Thickened smooth
muscle
take in this
order!
Open airways first
so steroids can work
pulmonary rehab
→ Breathing techniques
→ Exercise training
→ Nutritional counseling
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NURSING INTERVENTIONS
close monitoring
→ Monitor O2 sat
→ ABG’s
→ Lung sounds
→ Secretions
give o2 with caution
Patient at risk for hypercapnia,
O2 is given in low amounts with
target SPO2 between 88-92%
education
→ Smoking cessation
→ Effective breathing & coughing
→ Stay up to date on vaccines
→ Avoid irritants to " exacerbations
(Smoke, very hot or very cold weather, sick people)
diet
▶ Small, frequent
meals
▶ ! calorie !protein
▶ Stay hydrated
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