Diagnosis dan Penatalaksanaan PPOK & ASMA

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DIAGNOSIS DAN
PENATALAKSAAN
PPOK & ASMA
Abdul Rahman
RSUD BANTEN

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28. Beban Global ASMA
Asthma is one of the most common chronic diseases worldwide
with an estimated 300 million affected individuals
Prevalence is increasing in many countries, especially in children
Asthma is a major cause of school and work absence
Health care expenditure on asthma is very high
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Normal bronchiole/
Asthmatic bronchiole

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TATALAKSANA DI KLINIK / PKM

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TATALAKSANA DI UGD

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82. T H A N KT H A N K
Y O UY O U

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COPD
Chronic obstructive pulmonary
disease is a slowly progressive
disease that is characterized by a
gradual loss of lung function
COPD includes chronic bronchitis,
chronic obstructive bronchitis, or
emphysema, or combinations of
these conditions

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Epidemiology
20.3 million Americans report having
asthma
5,000 deaths annually from asthma
12.1 million Americans reported being
diagnosed with COPD
119,000 deaths annually from COPD
COPD is the 4th
leading cause of
death in the U.S.

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Chronic Bronchitis
Inflammation of the
main airway passages
(bronchi) to the lungs,
which results in the
production of excess
mucous, a reduction in
the amount of airflow
in and out of the lungs,
and shortness of
breath

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Emphysema
A respiratory
disease
characterized by
breathlessness
brought on by the
enlargement, or
over-inflation of,
the air sacs
(alveoli) in the
lungs

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Signs and symptoms
Wheezing
Coughing
Sputum production
Shortness of breath
Chest tightness

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Diagnosis
Clinical symptoms
Chest x-ray
Lung function tests
ABGs

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Nursing diagnosis
Ineffective airway clearance r/t secretions
Impaired gas exchange r/t altered supply
O2
Altered health maintenance r/t ineffective
individual coping
Risk for infection r/t inadequate defense
system
Knowledge deficit of COPD
Altered role performance r/t changes in
role

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Nursing DX
Ineffective breathing pattern r/t
musculoskeletal impairment , decreased
energy
Inability to sustain spontaneous
ventilation r/t muscle fatigue
Activity intolerance r/t imbalance of O2
supply

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Clinical Features of COPD Patients
Mild COPD: no abnormal signs, smokers
cough, little or no breathlessness
Moderate COPD: breathlessness
with/without wheezing, cough with/without
sputum
Severe COPD: breathlessness on any
exertion/at rest, wheeze and cough
prominent, lung inflation usual, cyanosis,
peripheral edema, and polycythemia in
advanced disease

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Diagnosis
Spirometry
Breathing test which measures the amount and rate at
which air can pass through the airways
Bronchodilator Reversibility Testing
Relaxing tightened muscles around the airways and
opening up airways quickly to ease breathing
Other pulmonary function testing
Diffusion capacity
Chest X-ray
Arterial Blood Gas
Shows oxygen level in blood

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Medical Management of COPD
Patient
Smoking cessation and elimination of
environmental pollutants
Palliative measure such as regular
exercise, good nutrition, flu and
pneumonia vaccines
Bronchodilators, corticosteroids,
anticholinergics, and NSAIDs

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Management of COPD Patient
Review history for concurrent heart disease
Avoid treatment if upper respiratory tract infection is
present
Treat in upright position
Avoid rubber dam in severe cases
Use pulse oximetry (if pulse ox <91%, use low flow 2-
3L/min)
Avoid Nitrous oxide/oxygen in severe cases
Avoid barbiturates, narcotics, antihistamines, and
anticholinergics
If patient is on steroid regimen, supplement as needed
Drug interactions with COPD medication