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COPD

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29 views18 pages

COPD

Uploaded by

mohamedhesham4152
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Chronic obstructive pulmonary diseases

Prepared by
Dr.Asmaa Said Ali
Assit.prof.of Mdical SurgicalNursing

Faculty of Nursing
AinShams University
2021-2022
Outlines
 Definition of COPD
 Causes and risk factors of COPD
 Pathophysiology of COPD
 Clinical manifestations
 Stages of COPD
 Complications of COPD
 Medical Management of COPD
 Nursing management of COPD
Chronic obstructive pulmonary disease
(COPD)
it is a disease state characterized by airflow
limitation that is not fully reversible. Chronic
Obstructive Lung Disease, chronic airflow
limitation
COPD may include diseases that cause airflow
obstruction (eg, emphysema, chronic bronchitis)
or a combination of these disorders.
Risk factors for COPD
 Cigarette smoke (Pipe, cigar, and other types of tobacco smoke)
accounts for an estimated 80% to 90% of COPD cases.

 Passive smoking

 Occupational exposure

 Air pollution

 Recurrent Infections.

 Genetic abnormalities, including a deficiency of alpha1-


antitrypsin, an enzyme inhibitor that normally counteracts
the destruction of lung tissue by certain other enzyme
Pathophysiology of COPD :
The inflammatory response occurs throughout
the airways, parenchyma, and pulmonary
vasculature
narrowing occurs in the small peripheral
airways.
Over time, this injury-and-repair process
causes scar tissue formation and narrowing of
the airway lumen.
Airflow obstruction may also be due to
parenchymal destruction as seen with
emphysema,
the inflammatory response
causes pulmonary vasculature changes that
are characterized by
thickening of the vessel wall.
These changes may occur as a result
of exposure to cigarette smoke or use of
tobacco products or as a
result of the release of inflammatory mediator
Clinical manifestations of COPD :
COPD is characterized by three primary symptoms:
 cough,
 sputum production,
 dyspnea on exertion
 Dyspnea may be severe and often interferes with the
patient’s activities.
 Weight loss is common because dyspnea interferes with
eating
 barrel chest”
Assessment and diagnostic findings
 Pulmonary function studies to confirm the diagnosis of
COPD, determine disease severity, and follow disease
progression.
 Spirometry is used to evaluate airflow obstruction, which is
determined by the ratio of FEV (volume of air that the patient
1

can forcibly exhale in 1 second) to forced vital capacity


(FVC)
 Arterial blood gas measurements may also be obtained to
assess baseline oxygenation and gas exchange.
 Chest x-ray may be obtained to exclude alternative
diagnoses.
Medical terminology:
 FEV(volume of air that the patient can
forcibly exhale in 1 second)
 FVC Forced vital capacity is the maximum
amount of air a person can expel from the
lungs after a maximum inhalation
 Obstructive lung disease is defined as a
FEV /FVC ratio of less than 70%.
1
Stages of COPD:
1. Normal spirometry
Chronic symptoms of cough, sputum production
2. mild COPD FEV1 /FVC < 70%
1

FEV1 80% predicted


May or may not have chronic symptoms
of cough, sputum production
3. moderate COPD FEV1FVC < 70%
FEV between 30% and 80% predicted
1

May or may not have chronic symptoms


of cough, sputum production
4. severe COPD FEV1/FVC < 70%
FEV < 30% predicted or FEV < 50%
1 1

predicted plus respiratory failure or clinical


signs of right heart failure
Complications of COPD
 Respiratory insufficiency
 Respiratory failure
 pneumonia,
 atelectasis,
 pneumothorax,
 and cor pulmonale
The acuity of the onset and the severity
of respiratory failure depend on:
the patient’s baseline pulmonary function,
pulse oximetry or arterial blood gas values,
comorbid conditions, the severity of other
complications of COPD.
Medical management for patient with COPD
 Smoking cessation (Quit smoking)
 Pharmacological therapy as Bronchodilators may
be used one type or more type according stage of
COPD
 corticosteroids may be used oral – intravenous
or inhaler – nebulizer
 Oxygen therapy can be administered as long-term
continuous therapy, during exercise to prevent
acute dyspnea
 pulmonary rehabilitation programs include
educational, psychosocial, behavioral, and physical
components. Breathing exercises and retraining
Nursing management for patient with COPD
The nurse play an important role in caring patient with
COPD through facilitating specific services for the
patient
 Respiratory therapy education,
 physical therapy for exercise
 breathing retraining,
 occupational therapy for conserving energy
during activities of daily living,
 nutritional counseling.
 The patient is taught to coordinate diaphragmatic
breathing with activities such as walking, bathing,
bending, or climbing stairs.
 The patient should bathe, dress, and take short walks,
resting as needed to avoid fatigue and excessive
dyspnea.
 Fluids should always be readily available,
 postural drainage exercises
 Breathing exercises
 Coping Measures
 planning self-care activities and determining the
best time for bathing, dressing, and daily activities.
1.Nursing Diagnosis: Impaired gas exchange
and airway clearance due to chronic inhalation of
toxins
Goal: Improvement in gas exchange
2.Nursing Diagnosis: Impaired gas exchange
related to ventilation–perfusion inequality
Goal: Improvement in gas exchange
3.Nursing Diagnosis: Ineffective airway
clearance related to bronchoconstriction,
increased mucus production, ineffective cough,
bronchopulmonary infection, and other
complications
Goal: Achievement of airway clearance
4.Nursing Diagnosis: Ineffective breathing
pattern related to shortness of breath, mucus,
bronchoconstriction,
and airway irritants
Goal: Improvement in breathing pattern
5.Nursing Diagnosis: Self-care deficits related to
fatigue secondary to increased work of breathing
and insufficient
ventilation and oxygenation
Goal: Independence in self-care activities
6. Nursing Diagnosis: Activity intolerance due to
fatigue, hypoxemia, and ineffective breathing
patterns
Goal: Improvement in activity tolerance
7.Nursing Diagnosis: Ineffective
coping related to reduced socialization,
anxiety, depression, lower activity level,
and the inability to work
Goal: Attainment of an optimal level of
coping

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