Chronic obstructive
pulmonary disease
(COPD)
Dr. Walaa Nasr
Lecturer of Adult Nursing
Second year
COPD
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lines
What is the COPD?
Overview
Causes of COPD
Symptoms of COPD
What's the difference between COPD and
asthma?
Diagnostic tests needed for COPD
Medical management of COPD
Preventive measures
Nursing intervention
Outlook and Prognosis
COPD
Definition
COPD, or chronic obstructive
pulmonary disease, is a
progressive disease that
makes it hard to breathe.
"Progressive" means the
disease gets worse over
time.
COPD
Overview
COPD
Overview
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In COPD, less air flows in and out of the
airways because of one or more of the
following:
The airways and air sacs lose their
elastic quality.
The walls between many of the air sacs
are destroyed.
The walls of the airways become thick
and inflamed.
The airways make more mucus than
usual, which tends to clog them.
COPD
Causes
Smoking
Air
pollution
genetic (hereditary) risk
COPD
Symptoms
 Productive
cough
 Breathlessness
 Chest infection
 Other symptoms of COPD can be
more
vague,
weight
loss,
tiredness and ankle swelling.
Difference between COPD and
Asthma
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In COPD there is permanent damage to the airways.
The narrowed airways are fixed, and so symptoms are
chronic (persistent). Treatment to open up the
airways, is therefore limited.
In asthma there is inflammation in the airways which
makes the muscles in the airways constrict. This
causes the airways to narrow. The symptoms tend to
come and go, and vary in severity from time to time.
Treatment to reduce inflammation and to open up the
airways usually works well.
COPD is more likely than asthma to cause a chronic
(ongoing) cough with sputum.
Difference between COPD and asthma
(cont…)
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Night time waking with breathlessness
or wheeze is common in asthma and
uncommon in COPD.
COPD is rare before the age of 35 whilst
asthma is common in under-35.
COPD
Diagnostic tests
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Symptoms
Physical examination
Sample of sputum
Chest x-ray
High-resolution CT (HRCT scan)
Pulmonary function test (spirometery)
Arterial blood gases test
Pulse oximeter
COPD
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Medical management
Give antibiotics to treat infection
Give bronchodilators to relieve bronchospasm, reduce
airway obstruction, mucosal edema and liquefy
secretions.
Chest physiotherapy and postural drainage to improve
pulmonary ventilation.
Proper hydration helps to cough up secretions or
tracheal suctioning when the patient is unable to
cough.
Steroid therapy if the patient fails to respond to more
conservative treatment.
COPD
Medical management (cont…)
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Stop smoking
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Oxygenation with low concentration during the acute episodes
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In asthma adrenaline ( epinephrine) SC if the bronchospasm not
relieved.
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Aminophylins IV if the above treatment does not help.
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IV corticosteroids for patients with chronic asthma or frequent
attack.
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Sedative or tranquilizers to calm the patient.
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Increase fluids intake to correct loss of diaphoresis and
inaccessible loss of hyperventilation.
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Intubations and mechanical ventilation if there is respiratory
failure.
COPD
Preventive measures
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To prevent irritation and infection of the
airways, instruct the patient to:
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Avoid exposure to cigarette, pipe, and cigar
smoke as well as to dusts and powders.
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Avoid use of aerosol sprays.
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Stay indoors when the pollen count is high.
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Stay indoors when temperature and humidity
are both high
COPD
Preventive measures (cont…)
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Use air conditioning to help
pollutants and control temperature
decrease
Avoid exposure to persons known to have
colds or other respiratory tract infection
Avoid enclosed, crowded areas during cold and
flu season.
Obtain immunization against influenza and
streptococcal pneumonia.
COPD
Preventive measures (cont…)
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To ensure prompt, effective treatment of
a developing respiratory infection,
instruct the patient to do the following:Report any change in sputum color
character, increased tightness of the
chest, increased dyspnea, or fatigue.
Call the physician if ordered antibiotics
do not relieve symptoms within 24
hours.
COPD
Nursing intervention
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Assessment
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History
Patient's environment
 Work history, exercise pattern,
smoking habits
 The onset & development of
symptoms
 Sleeping positions
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COPD
Nursing intervention (cont…)
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Physical examination
Signs of heavy smokers
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Observe for clubbing
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Distended neck vein on expiration
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The presence of barrel chest
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Observe for abdominal breathing
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The use of pursed lips breathing and
chest movement
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Auscultate the chest& listen for
musical wheezes characteristics of
chronic bronchitis
COPD
Nursing intervention (cont…)
review the results of diagnostic procedure:
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Arterial blood gases
Pulmonary function tests
X-ray films
Nursing diagnosis
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Ineffective breathing pattern related to increase
need of O2
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Ineffective airway clearance related to excessive
accumulation of secretions
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Impaired gas exchange
expiration &co2 retention
related
to
impaired
COPD
Nursing intervention (cont…)
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Activity intolerance related to inadequate
oxygenation
High risk for ineffective individual coping
related to chronic disease, its effects& its
treatment
High risk for altered health maintenance
related
to
insufficient
knowledge
of
prevention, identification and treatment of
respiratory complication of COPD