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Chronic Obstructive Pulmonary Disease

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by

Amanda Fudge

on 18 March 2015

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Transcript of Chronic Obstructive Pulmonary Disease

Progressive
Lung Disease
characterized by
small airway
obstruction and
reduction in
expiratory flow
rate
What is COPD?
Chronic Obstructive Pulmonary Disease
History
Smoking
Childhood Respiratory Disease
Family Hx
Other Medical Conditions
Physical
Heart and Lung
Cough
Dyspnea
Activity intolerance
Cyanosis
Clubbing
Barrel Chest
Assessment
Thickened bronchial walls
Excessive production of mucus in bronchi w/ recurrent cough >3 months consecutive 2 years
Inflammation in the bronchial walls
Hyperplasia of mucous-secreting glands
Chronic Bronchitis
Permanent destruction alveolar walls
Loss of lung elasticity
Airway walls thicken
Bronchioles are narrowed
Smaller, narrowed airway
Decreased O2 in blood
Compensates by increasing resp rate
Emphysema
History & Pysical
Lab
CBC
ABG's
Chest X-ray
Spirometry
Indicators
Chronic cough
Progressive Dyspnea
Hx of Exposure
Stage 0
- At Risk (Normal Spriometry with symptoms)
Stage I
- Mild COPD ( abnormal Spriometry with chronic cough w/out sputum)
Stage II
- Moderate COPD (Abnormal spriometry with dyspnea, chronic cough, sputum production)
Stage III
- Severe COPD (Respitory failure or signs of right sided heart failure)
Classification of COPD
Smoking
Work-related hazards
Family History
Frequent Respiratory Illness
Chronic Cough
Childhood Respiratory Illness
Risk Factors
Spirometry
Objectives
What is COPD?
Assessment for COPD
Diagnosis for COPD
Therapy for COPD
Nursing Interventions
Nursing Diagnoses
Therapy for COPD
Surgery
Lung Volume Reduction Surgery (LVRS)
Lung Transplant
Breathing Exercises
Abdominal Breathing
Pursed-lip breathing
Medications
Bronchodilators (open airways)
Anticholenergics (Reduce hypersensitivity)
Steroids (Reduce inflammation)
Antibiotics (Tx infections)
Nursing Interventions
Monitor
Oxygenation
Low Dose O2
Skin Color
SpO2
Breath Sounds
Provide soft mechanical diet
Oral Care
After Resp Tx's
Candidiasis (oral steriods)
Effective coughing (TCDB)
Nursing Dx
Ineffective airway clearance r/t increased production of secretions AEB consistent cough with sputum production
Imbalanced nutrition: less than body requirements r/t fatigue AEB Pt stating I am too tired to eat lunch today
Self Care deficit r/t activity intolerance AEB Pt states he does not want to shower because he can't catch his breath.
Clinical Manifestation
Emphysema
Progressive Dyspnea
Thin build
Increased diameter of chest (barrel chest)
Quiet/diminished breath sounds
Later stages chronic bronchitis may develop
Chronic Bronchitis
Frequent productive cough
Frequent respiratory infection
Bluish-red color of skin
Scattered crackles, rhonchi, and wheezing breath sounds
Cor Pulmonale (hypertrophy of Right side of heart)
Diagnostics
NCLEX Questions
1. The client says, "I hate this stupid COPD!" What is the best response by the nurse?
A. "Then you need to stop smoking."
B. "What is bothering you?"
C. "Why do you feel this way?"
D. "You will get used to it"
NCLEX Questions
2. Which statement by the client with chronic obstructive pulmonary disease (COPD) indicates the need for additional follow-up instruction?
A. "I don't need to use my oxygen all the time"
B. "I don't need to get the flu shot"
C. "I need to eat more protein"
D. "It is normal to feel more tired than I use to"
Blue Bloater vs. Pink Puffer
Full transcript