Chronic Obstructive Pulmonary Disease (COPD) encompasses chronic bronchitis and emphysema, primarily caused by long-term exposure to irritants like cigarette smoke. Emphysema involves progressive damage to lung alveoli, leading to airflow obstruction, while chronic bronchitis is characterized by a persistent cough with sputum production. Management strategies include medications, oxygen therapy, and lifestyle changes, emphasizing the importance of smoking cessation.

1. CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
Ms. Jyoti Chand
MS.C Nursing

2. DEFINITION
• COPD is also known as chronic obstructive lung disease.
• COPD is a chronic inflammatory lung disease that causes
obstruction to the airflow from the lungs. It is caused by long-term
exposure to irritating gases or particulate matter, most often from
cigarette smoke.

3. OR
COPD is a disease characterized by airflow obstruction, which is
progressive & irreversible, it includes:
Emphysema
Chronic Bronchitis

4. Emphysema
• It is long- term, progressive, irreversible disease of lungs that
affects the respiratory system. Emphysema is a condition that
involves damage to the walls of the air sacs (alveoli) of the lung
making it difficult to breath.

5. Causes
Causes of emphysema are:
Cigarette smoking- commonest
Deficiency of alfa 1 antitrypsin enzyme
Occupational exposure to chemical irritants
Pollution exposure
Poorly ventilated house

6. TYPES
Centriacinar
Emphysema
Panacinar
Emphysema

8. 1) Centriacinar:
• It affects the respiratory bronchioles and involves the upper lobes.
It is associated with smoking.
2) Pan acinar :
• it affects the alveoli & alveolar ducts and eventually the respiratory
bronchioles , involves the lower lobes.

9. Clinical Features
Dyspnea
Tachypnoea
Pink Puffer
Barrel chest
Cough
Weight loss

10. Pathophysiology
Due to smoking or deficiency of ∝ 1 antitrypsin
Decrease elasticity of alveoli
Dilation/ enlargement of air spaces distal to terminal bronchioles
Collapse of respiratory bronchioles

11. Cont..
Airway obstruction
Reduce lung surface area for gas
exchange
Emphysema

12. Diagnostic evaluation
• History collection
• Physical examination
• Chest x-ray
• CT scan
• ABG Analysis
• Complete blood count
• Sputum examination
• Pulmonary function test

13. Management
• Oxygen therapy
• Bronchodilators (salbutamol)
• Cortico-steroids (Betamethasone)
• Postural Drainage
• Deep breathing exercises

14. Surgical Management
• Bullectomy: enlarge air spaces which does not participants in
gases exchange are surgically removes.
• Lung volume reduction: Part of affected airway is removed
which enhance the gas exchange in healthy tissue.
• Lobectomy: removal of affected lobe.

15. Nursing Management
• Monitor vital signs, oxygen saturation, breath sounds, and arterial blood
gases.
• Emphasize smoking cessation and avoidance of other external irritants (e.g.,
dust and allergens).
• Supervise respiratory exercises, such as pursed-lip breathing.
• Provide orthopenic position.
• Encourage fluids to maintain hydration.
• Teach use of inhalers and other special equipment (e.g., spacer, peak
expiratory flow meter)

16. CHRONIC BRONCHITIS

17. DEFINITION
• Chronic bronchitis is one of the obstructive airway disorders,
commonly seen in smokers. Chronic bronchitis is defined clinically
as persistent cough with sputum production for at least 3 months
in at least 2 consecutive years.
• Chronic bronchitis patients are often referred as “ blue bloaters”.

18. Pathophysiology

19. Virus , bacteria, smoke or other environmental pollutants irritate airways
Hypersecretion of mucus & inflammation
Bronchial wall become thickened
Bronchial lumen narrow, mucus plugged airways
Airflow limitation
Bronchitis

20. Pathology
Gross: Edematous mucosa with excessive mucous secretion
Microscopic: There is hypertrophy of submucosal glands,
accumulation of alveolar macrophages and lymphocytes.

21. Complications
• Obstruction of the airway by mucus, leading to bronchiectasis or
atelectasis.
• Pulmonary hypertension