Chronic Obstructive Pulmonary Disease

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Hello, my name is Barbara Bethard and today I will be discussing the disease process called chronic obstructive pulmonary disease If at any time you are unable to hear or understand what I am saying please raise your hand so I can alleviate any problems. All right? Lets start then

COPD is a lung disease in which the airways of the lungs have become partially obstructed, making breathing difficult. In the United States COPD includes chronic bronchitis and emphysema. COPD is the 4th leading cause of death in the USA and in the world.. The leading cause of COPD is smoking, although exposure to other lung irritants such as chemicals, dust or pollution over a long enough period of time may also contribute to COPD COPD develops slowly, most patients with COPD are diagnosed in their late 40s to 50s. Many times patients that are diagnosed with COPD have stopped smoking years prior and this contributes to the altered emotional state many COPD patients exhibit.

With normal respiration oxygen enters through the nose and mouth, travels through the trachea and into the large and small tubes in the lungs called bronchi and bronchioles. From there the oxygen goes through the alveoli where oxygen is passed into the blood and carbon dioxide is removed. The alveoli are normally elastic and stretch with inspiration and go back to normal shape with expiration. This elasticity helps move the oxygen in and out of the lungs.

But with COPD the alveoli have lost their elasticity and will not fill with air which causes the airways to stay obstructed. That causes the lungs to swell, the bronchial become inflamed and thick and that causes mucus to be produced which contributes further to obstruction of the airways. With the increase in mucous the COPD patient will have chronic productive cough and sputum that is usually white to pale yellow. The eventual cause of death for COPD patients is when the heart and lungs can no longer function or when a severe respiratory illness occurs.

Signs of COPD include chronic cough, increase in color or amount of sputum, shortness of breath especially with exercise, wheezing, tightening of the chest.

Tests to diagnose COPD after the physicians history and physical include spirometer test, which is a measurement of how much oxygen the patient has on expiration as well as how fast the patient is able to blow out after taking a deep breath. Other tests include pulmonary function testing, chest x-ray and arterial blood gases.

The stages of COPD are AT RISK which the patient has history of respiratory irritants,cough and productive sputum. MILD COPD where airflow is limited and patient has chronic cough and productive sputum MODERATE COPD, has worsening of limited airflow,shortness of breath with exertion,chronic cough and productive sputum.It is at this stage that most patients seek out medical assistance SEVERE or END STAGE COPD the patient exhibits severe airflow limitation,shortness of breath at rest,respiratory failure or CHF occur, quality of life is poor, episodes of dyspnea or infection lead to multiple emergency room visits and in house hospitalizations.

So all of that is pretty cut and dried but what does the nurse need to focus on? Prevention of infection, instruction on how to mange this severe chronic illness, ways to cope with the emotional toll of struggling to breathe and the psychosocial aspects of anger,guilt,blame,denial that many patients experience.

However, perhaps the best thing to do is to become as far as possible and without smoking a cigarette!! A COPD patient and for this I need your cooperation Everybody take a deep breath…don’t let it out…now breathe but remember you cannot let that original breath out..now go have a nice life…do your job,eat,walk,rest,play all while trying to breathe with what you have left Hard to do isn’t it? So all of that is pretty cut and dried but what does the nurse need to focus on?

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Chronic Obstructive Pulmonary Disease - Presentation Transcript

Chronic Obstructive Pulmonary Disease Barbara Bethard, RN, BC, MSN July 13, 2006
COPD
- Lung disease
- Lungs are partially obstructed
- Breathing is difficult
- Chronic bronchitis and emphysema
- Smoking
- Long term exposure to other respiratory irritants
- Develops slowly
Physiology of Respiration
- Nose and mouth to trachea
- Into large tubes called bronchi and bronchioles
- Alveoli and into blood
- Carbon dioxide is removed
- Normal alveoli are elastic
- Stretch with inspiration
- This keeps air moving in and out of the lungs
Physiology of a Patient with COPD
- Alveoli have lost all elasticity
- Become more like a balloon that will not hold air
- Lungs swell, bronchioles become inflamed and thick
- Mucous production increases
- Productive cough develops
- Sputum is white to pale yellow
- Death is caused by inability of heart and lungs to function
Signs of COPD
- Chronic cough
- Productive sputum
- Shortness of breath with exertion
- Wheezing
- Feelings of tightening in the chest
Tests used to Diagnose COPD
- Spirometer
- Chest x ray
- Pulmonary function testing
- Arterial blood gases
- Pulse oximetry
Stages of COPD
- AT RISK: history of respiratory irritants, cough with productive sputum
- MILD: limited airflow, cough with productive sputum
- MODERATE: severe airflow limitation, shortness of breath, productive cough
- SEVERE or END STAGE: severe airflow limitation, shortness of breath at rest, respiratory failure, CHF, increased infections
Focus for the Nurse
- Prevention of infection
- Meds, diet, signs to report
- Ways to manage chronic illness
- Methods to cope with emotional stress
- Psychosocial aspects
- Need for referrals to other healthcare team members, such as therapy, social or pastoral services
Become a Patient with COPD
- TAKE A DEEP BREATH
- DO NOT LET IT OUT
- NOW BREATHE BUT DO NOT LET OUT THAT ORIGINAL BREATH
- LIVE,WORK, REST,PLAY, DRESS, EAT, SPEAK; DO ALL THE DAILY LIFE THINGS YOU TAKE FOR GRANTED ALL WITHOUT LETTING OUT THAT ORIGINAL BREATH