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NUR 221 Smoking & COPD

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Annie Powell

on 18 November 2014

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Transcript of NUR 221 Smoking & COPD


Chronic Obstructive Pulmonary Disease kills over 100,000 Americans each year, making it the 4th leading cause of death in The United States (Brunner, 2010).
So what exactly is COPD?
COPD refers to two different diseases of the lungs Emphysema and Chronic bronchitis.
Emphysema and Chronic bronchitis are each usually caused by years of cigarette smoking, afflicted individuals are most always diagnosed with both at once, hence the umbrella term COPD (Kaufman, 2013).



Causes
Prolonged exposure to air pollution.
Even recurring childhood lung infections can lead to COPD.
Exposure to second hand smoke.
Emphysema
Nursing Diagnoses

Chronic bronchitis
Since chronic bronchitis and Emphysema affect two different parts of the lungs, lets take a look at each individually.
Nursing Interventions
COPD
First, let's understand how the lungs should normally function!
References
Patent airway
Breath sounds
Height of bed, keep it high
Low-flow oxygen, if necessary
ENCOURAGE:
Deep breathing
Coughing
Fluids
Enhancement of nutritional intake
Cessation of smoking
ADMINISTER:
Antibiotics
Bronchodilators
Corticosteroids
Diuretics
Nebulizer
Low flow O2, if necessary
Years of cigarette smoking.
Can also be caused by inhaling a variety of industrial toxins, fumes, and chemicals.
Monitor:
Patient
Teaching

Kaufman, G. (2013). Chronic obstructive pulmonary disease: diagnosis and management.
Nursing Standard
, 27(21), 53-62.
Brunner, L. S. (2010). Management of patients with Chronic Obstructive Pulmonary Disease. In
Brunner & Suddarth’s textbook of medical-surgical nursing
(12th ed., p. 602-619). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
Ineffective Breathing Pattern

Ineffective Airway Clearance

Impaired Gas Exchange

Nutrition: imbalanced, less than body requirements

Risk for Infection

Knowledge Deficit
Review the harmful effects of smoking and advise cessation of smoking by patient.
Provide information about activity limitations and alternating activities with rest periods to prevent fatigue and conserve energy during activities.
Review oxygen requirements/dosage for patient who is discharged on supplemental oxygen for safe use.
Provide information/encourage participation in support groups.
Discuss respiratory medications, side effects, adverse reactions and how to use a metered-dose inhaler (MDI).
Discuss importance of medical follow-up care, periodic chest x-rays, sputum cultures.
Explain/reinforce explanations of individual disease process.
Instruct/reinforce rationale for breathing exercises (pursed lip), coughing effectively, and general conditioning exercises.
Stress importance of oral care/dental hygiene.
Discuss importance of avoiding people with active respiratory infections.
Stress need for routine influenza/pneumococcal vaccinations.
Discuss individual factors that may trigger or aggravate condition and encourage patient to explore ways to control these factors in and around the home and work setting.
Medical-surgical nursing made incredibly easy!
(3rd ed., pp. 385-387, 397-403). (2012). Respiratory System. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
ParrMr. (2012, October 2). Respiratory system song.
YouTube.
Retrieved March 6, 2014, from www.youtube.com
Buono, S., Quezada, D., & Urias, B. (2014, March 16). COPD INC. prezi.com. Retrieved March 17, 2014, from http://prezi.com/bcyvyetnm8qs/copy-of-copy-of-copd-inc/

COPD YouTube Video
Chronic bronchitis is characterized by inflammation of the bronchial tubes, which are passage ways that branch off from the trachea or windpipe and allow air to enter the lungs.

This inflammation causes thick mucous to build up in the tubes preventing sufficient air from reaching the lungs.
Emphysema occurs when the walls between the air sacs in the lungs, known as alveoli, lose their elasticity.

This in turn causes the air sacs to become fragile and over inflated leading to an unnatural retention of air within the lungs.
S&S
The symptoms of COPD tend to depend on which disease is more predominant in an inflected individual.
If Emphysema is the predominant disease, the first noticeable symptom will be SOB during physical exertion this will soon be followed by a phlegmatic cough and pursued lip breathing.
If Chronic bronchitis is predominant, than a persistent mucous filled cough will often be the first symptom to appear, this may be accompanied by wheezing, SOB, fatigue, respiratory or lung infections.
COPD is usually diagnosed based on the individuals medical history and examination of his or her lungs. This lung examination can be done with CXR, CAT Scan, and any number of pulmonary function tests like spirometry.
A spirometry measures inhalation and exhalation of the lungs and the efficiency of their ability to transfer oxygen to the blood.
Diagnostic Testing
There is NO CURE for COPD, however its destructive presence can be controlled and slowed with close medical attention allowing those afflicted to live longer and healthier lives.
QUIZ TIME!
1. What is the difference between Chronic Bronchitis and Emphysema?


2. What is the the number one risk factor of COPD?
Answer!
Chronic bronchitis refers to the constriction of the bronchioles.

Emphysema deals with the air sacs called alveoli.
Answer!
Smoking is the #1 risk factor and cause!

Smoking & COPD
By: Annie Powell
Tobacco use remains the single largest preventable cause of death and disease in the United States.

Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke.

In addition, smoking-related illness in the United States costs more than $289 billion a year, including at least $133 billion in direct medical care for adults and $156 billion in lost productivity.
American Indian/Alaska Natives - 21.8%
Asians - 10.7%
Blacks 18.1%
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