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COPD Concept Map

By Kyanna Johnson

Pathophysiology

Patho

  • Chronic inflammatory response occurs through the airway, lung parenchyma, and pulmonary vasculature. The inflammation narrrows the airways
  • An increase in goblet cells leads to enlarged submucosal glands causing excessive mucus secretion
  • Long term, this can cause scar formation, destroy the alveoli, thicken lining of blood vessels, and hypertrophy of smooth muscle tissue

Types

  • Chronic Bronchitis: obstruction of the small airways causing cough and excessive sputum production
  • also called blue bloaters
  • Emphysema: enlargement of the air space within the bronchioles and alveoli. Prone to alveolar collapse upon expiration and air trapping
  • also call pink puffers

Types of COPD

Risk Factors

  • History of smoking
  • Prolonged exposure to air pollutants (e.g., occupational dust and chemicals)
  • Genetics: alpha 1 - antitrypsin deficiency

Risk Factors

Diagonisis

Testing

  • Testing to confirm diagnosis:
  • spirometry: used to evaluate airway obstruction. FEV1/FVC < 0.7 is confirmation for airflow limitation
  • lung scan: perfusion/ventilation study used to differentiate between the types of COPD
  • Labs:
  • Arterial Blood Gas (ABGs): used to determine the severity of the disease
  • Complete Blood Count (CBC): used to monitor Hgb. Low oxygenated blood is a sign of worsening condition

Symptoms

Symptoms

  • Excessive sputum production
  • Monitor volume and frequency of sputum
  • Weight loss
  • Measured by taking daily or weekly weight
  • Use of accessory muscles for respiration
  • Assess respiratory pattern
  • Respiratory infections
  • Collect sputum for testing

Other signs and symptoms:

  • chronic cough
  • wheezing
  • dyspnea with exertion and/or at rest
  • barrel chest (emphysema)

Complications

Complications

  • Respiratory failure: related to comorbities, baseline respiratory function, oxygen saturation, and ABGS to determine if this has occurred
  • Chronic Bronchitis:
  • Cor pulmonale - right sided heart failure
  • Cyanosis
  • Emphysema:
  • cachexia (muscle wasting)

Medication

Treatment

  • Anticholinergics - ipratropium
  • Use: reduce mucus secretions
  • Nusring considerations: signs of increased intraocular pressure, dry mouth, urinary retenion, use with bronchodilators (e.g., albuterol)
  • Oxygen
  • Use: increase oxygen exchange
  • Nursing considerations: monitor pulse oximetry, flow rate, depending on route of administration, moisturizing nose; monitor
  • Methylxanthines - theophylline
  • Use: reduce inflammation; relax smooth muscles of the bronchi
  • Nursing considerations: no caffeine, seizures (sign of toxicity), use with anti-anxiety and nicotine, monitor for n/v/d

Strategy

Strategy

Objective

Objective

Targets

Targets

Design

Nursing Interventions

Strategy

Strategy

Posters

Posters

Packaging

Packaging

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