Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by airflow restriction, commonly resulting from smoking and environmental factors, leading to symptoms like cough, wheezing, and difficulty breathing. While there is no cure, management includes lifestyle changes, medications, and surgical options to improve quality of life. Patients with COPD are at higher risk for additional health issues and may require comprehensive care, including monitoring and education on self-management.

1. CHRONIC
OBSTRUCTIVE
PULMONARY
DISEASE

2. is a common lung disease causing restricted airflow and
breathing problems. It is sometimes called emphysema or
chronic bronchitis.
In people with COPD, the lungs can get damaged or
clogged with phlegm. Symptoms include cough,
sometimes with phlegm, difficulty breathing, wheezing and
tiredness.
Chronic Obstructive Pulmonary
Disease (COPD)

3. tobacco exposure from active smoking or passive exposure to second-hand smoke
occupational exposure to dusts
fumes or chemicals
indoor air pollution: biomass fuel (wood, animal dung, crop residue) or coal is
frequently used for cooking and heating in low- and middle-income countries with
high levels of smoke exposure
early life events such as poor growth in utero, prematurity, and frequent or severe
respiratory infections in childhood that prevent maximum lung growth
asthma in childhood
a rare genetic condition called alpha-1 antitrypsin deficiency, which can cause
COPD at a young age.
COPD develops gradually over time, often resulting from a
combination of risk factors:

4. Classifications of COPD
Chronic bronchitis - refers to a chronic cough with the production of phlegm resulting from inflammation
in the airways.
Emphysema - usually refers to destruction of the tiny air sacs at the end of the airways in the lungs.

5. COPD is not curable but symptoms can improve if one avoids smoking and exposure to air
pollution and gets vaccines to prevent infections. It can also be treated with medicines, oxygen
and pulmonary rehabilitation.
People with COPD also have a higher risk for other health problems. These include:
lung infections, like the flu or pneumonia
lung cancer
heart problems
weak muscles and brittle bones
depression and anxiety.
Common symptoms of COPD develop from mid-life onwards. As COPD progresses, people find it
more difficult to carry out their normal daily activities, often due to breathlessness. There may be
a considerable financial burden due to limitation of workplace and home productivity, and costs
of medical treatment.

6. Pathophysiology

7. Medical Management
Laboratory tests
Arterial Blood Gas (ABG) Analysis
Pulse Oximetry
Spirometry
Complete Blood Count (CBC)
Procedures
Chest X-ray
Computed Tomography (CT) Scan
Sputum Analysis
Bronchoscopy
Exercise Testing

8. Surgical Management
Lung Volume Reduction Surgery (LVRS)
Reduce the volume of the damaged parts of the lung to improve the function of the remaining
healthier lung tissue.
Typically involves the removal of damaged or diseased lung tissue, usually from the upper lobes
Can lead to improved lung function, exercise tolerance, and quality of life.
Bullectomy
Remove large air-filled spaces (bullae) from the lungs that have formed as a result of emphysema,
which can compress healthy lung tissue and reduce lung function
Surgical removal of one or more bullae, often using a minimally invasive approach.
Can lead to reduced symptoms, improved lung function, and better quality of life.

9. Lung Transplantation
Replace a diseased lung with a healthy donor lung to restore normal lung function.
Types of Lung Transplant
Single-Lung Transplant: Replaces one lung while the other lung remains.
Double-Lung Transplant: Replaces both lungs.
End-stage COPD with severe impairment and poor quality of life despite maximal medical therapy.
Advanced disease with significant comorbidities managed and assessed.
Can greatly improve survival, exercise capacity, and quality of life.
Risks include rejection of the transplanted lung, infection, and the need for lifelong immunosuppressive
therapy.
Endobronchial Valve Therapy
Use of one-way valves to block airflow to diseased parts of the lung, allowing healthier parts to expand and
function better.
Small, minimally invasive procedure performed via bronchoscopy to place valves in the airways.
Can improve lung function, exercise capacity, and symptoms.

10. Assess symptoms: Shortness of breath, cough, sputum production, and chest tightness.
Evaluate impact on daily life: Ability to perform activities of daily living, and any recent changes in condition.
Regularly monitor respiratory rate, heart rate, blood pressure, and temperature.
Assess oxygen saturation using pulse oximetry.
Observe for signs of exacerbation or deterioration.
Monitor peak flow rates and respiratory patterns.
Assess weight, appetite, and signs of malnutrition or obesity.
Nursing Management
Assessment and Monitoring
Respiratory Management
Teach and reinforce techniques such as pursed-lip breathing and diaphragmatic breathing to help manage
breathlessness.
Administer supplemental oxygen as prescribed.
Educate patients on the safe use of oxygen equipment and the importance of maintaining adequate oxygen
levels.
Instruct on effective coughing techniques and postural drainage.
Assist with chest physiotherapy or nebulizer treatments as needed.

11. Provide information about COPD, its progression, and the importance of medication adherence.
Counsel on smoking cessation and provide resources for quitting smoking.
Encourage regular physical activity and exercise, tailored to the patient's ability.
Educate on a balanced diet and proper hydration to support overall health and manage symptoms.
Teach patients and families to recognize signs of exacerbations, such as increased breathlessness or changes in
sputum.
Nursing Management
Patient Education and Self-Management
Psychosocial Support
Identify and address any signs of anxiety or depression related to COPD.
Provide support or refer to mental health professionals if needed.
Encourage participation in support groups or COPD education programs.
Emergency Preparedness
Develop and review a COPD action plan with the patient, outlining steps to take during exacerbations.
Ensure patients know when and how to contact healthcare providers in an emergency.

12. A. Short-Acting Beta-Agonists (SABAs)
Examples: Albuterol (Ventolin, ProAir), Levalbuterol (Xopenex)
Provide rapid relief of acute bronchospasm by relaxing airway muscles.
B. Long-Acting Beta-Agonists (LABAs)
Examples: Salmeterol (Serevent), Formoterol (Foradil, Perforomist)
Provide sustained relief of bronchospasm for up to 12 hours or more.
C. Short-Acting Anticholinergics (SAMAs)
Examples: Ipratropium bromide (Atrovent)
Relax airway muscles and reduce mucus production.
D. Long-Acting Anticholinergics (LAMAs)
Examples: Tiotropium (Spiriva), Aclidinium (Tudorza), Umeclidinium (Incruse)
Provide long-term control by preventing bronchoconstriction and reducing mucus production.
Bronchodilators Pharmacological
Treatment

13. Examples: Fluticasone (Flovent), Budesonide (Pulmicort), Beclometasone (Qvar)
Reduce inflammation and mucus production in the airways.
Inhaled Corticosteroids (CS)
Combination Inhalers
A. ICS/LABA Combinations
Examples: Fluticasone/Salmeterol (Advair), Budesonide/Formoterol (Symbicort),
Mometasone/formoterol (Dulera)
Combine the anti-inflammatory effects of ICS with the bronchodilatory effects of LABAs.
B. LAMA/LABA Combinations
Examples: Umeclidinium/Vilanterol (Anoro Ellipta), Glycopyrrolate/Formoterol (Bevespi
Aerosphere)
Provide both long-acting bronchodilation and improved symptom control.

14. Example: Roflumilast (Daliresp)
Reduces inflammation and relaxes airways by inhibiting the enzyme phosphodiesterase-4
Phosphodiesterase-4 (PDE4) Inhibitors
Systemic Corticosteriods
Examples: Prednisone, Methylprednisolone
Used for short-term management of acute exacerbations to reduce inflammation quickly.
Not recommended for long-term use due to potential side effects.
Mucolytics and Expectorants
Examples: Acetylcysteine (Mucomyst), Carbocysteine (Mucomyst)
Help to thin and loosen mucus, making it easier to cough up.
Antibiotics
Examples: Azithromycin, amoxicillin-clavulanate, doxycycline.
Use in exacerbations
Prescribed during acute exacerbations if a bacterial infection is suspected.

15. Nursing Care Plan

16. Nursing Care Plan

17. Nursing Care Plan

18. Thank you for
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