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Linda Gerlach

on 28 March 2013

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Transcript of COPD

Chronic Obstructive Pulmonary
Disease (COPD) Di, Brenda & Linda What is it? - Progressive disease
- Caused by chronic bronchitis and/or emphysema
- Narrows airways, covers lungs in mucus and the alveoli remain inflated in grape-like clusters
- Reduces airflow
- Fewer & damaged air sacs create an ineffective exchange of gases (CO2 - O2) - Emphysema: scar tissue in alveoli reduces surface for exchange
- Chronic Bronchitis: damaged cilia cannot clear mucus causing it to accumulate
Hyperinflation: Air from previous breath remains in lung. Causes chest to over inflate and have high levels of carbon dioxide Did You Know? - COPD is the 4th leading cause of death in US
- There's no cure
- Kills one American every 4 minutes
- Around half of COPD patients are under 65yrs
- COPD is the second leading cause of disability that forces a person to stop working (Heart disease is first)
- Early diagnosis and treatment increases lifespan Etiology Caused by particles triggering an abnormal inflammatory response in lung, causing mucus and narrowing of airway

Some Causes:

- Smoking is the cause of 80% of cases
- Second-hand smoke
- Air pollution, dust and chemicals
- Repeated childhood lung infections
- A rare condition called Alpha 1 Antitrypsin deficiency (genetic) - COPD usually develops at 20-30yrs of age (smoking is picked up while young)
- Can occur in non-smokers who are working in air polluted areas

Examples: Bakers, hair dressers, auto body workers and industrial workers. Manifestations - Tachypnea
- Dyspnea
- Effort to breath
- Wheezing and crackles in lungs
- Brady intake
- Enlarged chest cavity
- In drawing at the neck
- Breathing through pursed lips
- Barrel chest
- Presence of sputum - Headaches
- Drowsiness
- Strained muscles
- Anxiety
- Persistent cough
- Sputum
- Chest tightness
- Stress
- Depression Signs Symptoms Flare-ups - Occurs for 48hrs or more
- Increases coughing, mucus, shortness of breath and changed mucus color.

Causes: Stress, infection, allergens, air pollution, weather changes etc.

- Avoid flare-ups by knowing your triggers
- If it occurs, follow doctor's action plan The 5 Dimensions of
Health & COPD Physical Social - Short of breath, consistent cough, chest tightness etc.
- Over time, body changes shape (into barrel chest)
- Minimal physical exertion is difficult and uncomfortable - Difficulty doing things they used to do, such as leaving home to visit friends
- Drowsiness, headaches and tiredness lessens desire to socialize
- Signs and symptoms restricts the patient as to what activities they can partake in Emotional - Life is stripped of things they cared about (hobbies, sports, socializing & daily activities)
- So much loss may lead to depression
- Depression may cause lack of motivation to control disease Cognitive - Drowsiness, tiredness, stress and anxiety contribute to poor cognitive health because it diminishes brains ability to function at its best.
- May find that problem-solving and coping abilities have weakened Spiritual - With all other dimensions in poor health, the patient may have a reduced feeling of self-worth
- Incapable of fulfilling one's potential due to reduced physical abilities
- Reduced emotional and cognitive health may result in a depression where they wont want to seek spiritual health.
- Pursuing spiritual health (for example going to church) is a seemingly impossible task. Interventions Although there is no cure, early diagnosis makes COPD easy to treat, assess, monitor and slow down the progression. Nursing Actions & Role of the HCA - Assist in giving medication (pills, puffers & oxygen)
- Practice special breathing techniques with patient
- Encourage and support patient to quit smoking
- Ensure living area is free of smoke and pollutants
- Encourage healthy lifestyle changes
- Provide smaller food portions
- Teach the importance of proper hygiene to avoid infections - Direct patient to Pulmonary Rehabilitation Programs for coping mechanisms and proper exercises
- Demonstrate ways in which a person uses less exertion for daily activities
- Provide proper nutrition via balanced meals and/or supplements
- Involve family in understanding and coping with the disease
- Help improve other dimensions of health for a better well-being Complications - Pneumonia
- Pulmonary Hypertension
- Cachexia
- Bone loss (Osteoporosis & Osteopenia)
- Fatigue
- Heart Failure (right side of lung called cor pulmonale
- Pneumothorax (collapsed lung)
- Depression & Anxiety
- Lung Cancer
- Malnutrition
- Vision problems (glaucoma & cataracts) Losses Physical - Independence
- Health impaired
- Adequate nutrition
- Physical changes (barrel shaped chest)
- Diminished ability to physically participate in usual activities Emotional - Control over one's life and body
- Alteration in roles: spouse, parent, co-worker, friend
- Self-esteem
- Self-confidence Social - Status in family (caregiver to receiving care)
- Loss of work due to disability
- Role in community
- Ability to see friends
- May lead to isolation Cognitive - Brain function diminished by decreased oxygen supply and poor nutrition
- Anxiety/depression
- Inability to think clearly Spiritual - Purpose
- Meaning
- Ability to participate in religion
- Reach self-actualization Community Resources Through Interior Health, a COPD patient can seek services in their community. Depending on the location, services may include:

- Spirometry screening
- Oxygen assessment
- Ventilator management
- Respiratory therapy
- Pulmonary Rehabilitation, etc These services are either brought to their home, found at health centers or at the doctors. Nearby community resources are found at:

- Invermere Hospital
- Golden General Hospital
- Creston Valley Hospital Calgary community resources:

- Community Accessible Pulmonary Rehabilitation (South Calgary Health Center)
- Pulmonary Rehabilitation Exercise Program (Rockyview General Hospital) Aside from physical community resources, there are helplines a person can call, such as:

- BreathWorks Helpline (part of the Lung Association) 1-866-717-COPD (2673)
- BC Smokers Helpline 1-877-513-5333
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