Respiratory Diseaeses

1. Chronic Obstructive
Pulmonary
disease

2. Out lines
- Irtroduction “what’s the copd?”
- Anatomy of the lung
- Function of the lung
- Definition of “Chronic obstructive pulmonary
disese ”
- Pathophysiology
Types-

3. Out lines “cont.”
- Causes
- Clinical manifestation
- Assessment and diagnostic test
- Complications
- Medical Management
- Nursing diagnosis
- Nursing management

4. Introduction
Chronic obstructive pulmonary disese
“copd” is a general term for a group of
diseases that cause progressive damage
to the lung.
It’s affect 5% of population and it is
associated with high mobidity and
mortality .

7. Anatomy of the lung

8. The lungs are pyramid-shaped, paired organ
connected to the trachea by the right and left
bronchi
On the inferior surface, the lungs are bordered by
the diaphragm.
The lungs are enclosed by the pleurae.
The right lung is shorter and wider than the left
lung
Left lung occupies a smaller volume than the right.
The cardiac notch of the left lung, and it allows
space for the heart
The apex of the lung is the superior region

9. FUNCTION OF THE LUNG
Oxygen enters our lungs as part of the air
that we breathe.
It goes to the blood vessels deep in our
lungs and then on to all parts of our body.
As our body uses oxygen, it makes a
waste product called carbon dioxide.

10. DIFINITION
Chronic obstructive pulmonary disease:-
Is a common, preventable and treatable
disease that is characterized by persistent
respiratory symptoms and airflow limitation
that is due to airway and/or alveolar
abnormalities usually caused by significant
exposure to noxious particles or gases .
The air flow limitation or obstruction in COPD
is not fully reversible .

11. PATHOPHYSIOLOGY
Abnormal inflamation
response to lung and its
chronic and recurrent
and attemp to repair
inflamation by scar
tissue that caused
narrowing the airway
lumen and distruction
of gas exchange unit
“alveoli”

13. Classifications “types”
-Emphysema
-Chronic bronchitis

14. •Emphysema
Disease of the airway
characterized by
distruction of the walls
of alveoli (gas
exchange unit)
overdistented

15. •Chronic bronchitis
Disease of the airway
defined as presence of
cough and septum
production is category
of COPD

16. Causes
- Age
- Asthma
- Smoking
- Pollution
- Chemical exposure

17. •Risk factors

19. •Symptoms
-Primary symptoms :-
Chronic cough
Chronic Septum production
Dyspnea
-Late sympoms :-
W.T loss
Pt use accessory muscle “shoulders” in
inspiration

22. ASSESSMENT AND DIAGNOSTIC TEST
- Obtain health history
- Pulmonary function study
- ABG
- Chest x-ray
- Ct scan
Chest x-ray
Ct scan

23. Complications
- Respiratory failure
- Pulmonary arterial hypertension
- Infection from ventilation support
- Chronic Atelectosis
- Infections
- Pneumonia
- Pneumotharax

24. Medical management
1-) Risk Reduction (Stop Smoking
, Exposure To Chemicals )
2-) Pharmacologic :-
“ Bronchodilators ,
Anticholinergic”  Delivered
Through Inhalation , Nebulization
, Oral
Corticosteroids Antibiotics
Oxygen Theraby

25. MEDICAL MANAGEMENT (Cont.)
3-) Surgical thetaby :-
Lung volume surgery
Bullectomy
Lung transplantation
Pulmonary rehabilitation

26. Nursing diagnosis
- Ineffective airway clearance related ineffective
cough
- In effective breathing pattern related to
shortness of breathing
- Impaired gas exchange due to chronic
inhalation toxins
- Impaired gas exchange due to inadequate
ventilation perfusion
- Activity intolerance related to fatigue ,

27. Nursing management
1-) Patient education :-
Home oxygen theraby , nutrition ,
medication , smoking cession ,
breathing exercises
2-) Bbreathing exercise :-
Objectives Prevent collapse ,
improve respitatory function , cough
and deep breathing exercise 12hrs
3-) Inspiratory muscle training
:-
Objective  strength the muscle in
Spirometer

28. 4-) Activity pacing :-
- Such as :-
Walking , Bathing ,
Climping stairs to prevent secreation that
collected in the lung
- Increase fluid intake
- Position pt in semi sitting position
- Nutrition theraby :-
- Small frequent meal
- Provide high caloriti intake

29. Ineffective airway clearance related
to ineffective cough :-
Ineffective airway clearance : inability to clear
secreation or obstruction from the respiratory tract to
maintain clear airway.
Nursing diagnosis :-
May be related to: -bronchospasm
-Fatigue -Allergic airway
-Hyperplasia of bronchial walls
-Increased production of secreations
Possibly evidenced by: -Presestent cough without suptum
productions
-change of depth/rate of breathing

30. RationaleNURSING INTERVENTION
Some degree of bronchospasm is
present with obstructions in
airway and may or may not be
manifested in adventitious breath
sounds such as scattered, moist
crackles (bronchitis); faint
sounds, with expiratory wheezes
(emphysema); or absent breath
sounds (severe asthma).
Auscultate breath sounds.Note
adventitious breath sounds
(wheezes, crackles, rhonchi).
Tachypnea is usually present to
some degree and may be
pronounced on admission or
during stress or concurrent acute
infectious process. Respirations
Assess and monitor respirations
and breath sounds, noting rate
and sounds (tachypnea, stridor,
crackles, wheezes).

31. Elevation of the head of the bed
facilitates respiratory function by
use of gravity; however, patient
in severe distress will seek the
position that most eases
breathing. Supporting arms and
legs with table, pillows, and so
on helps reduce muscle fatigue
and can aid chest expansion.
Assist patient to assume position
of comfort (elevate head of bed,
have patient lean on overbed
table or sit on edge of bed).
Precipitators of allergic type of
respiratory reactions that can
trigger or exacerbate onset of
acute episode.
Keep environmental pollution to a
minimum such as dust, smoke,
and feather pillows, according to
individual situation.
To maximize effort
Demonstrate effective coughing
and deep-breathing techniques.

32. Provides patient with some means
to cope with or control dyspnea
and reduce air-trapping.
Encourage abdominal or pursed-
lip breathing exercises.
To gain or maintain open airway
Position head midline
with flexion on appropriate for
age/condition
Cough can be persistent but
ineffective, especially if patient is
elderly, acutely ill, or debilitated.
Coughing is most effective in an
upright or in a head-down
position after chest percussion.
Observe characteristics of
cough (persistent, hacking,
moist). Assist with measures to
improve effectiveness of cough
effort.
For monitoring progression or
regression of disease process an
complications. Note: pulse oximetry
readings detect changes in saturation,

33. To ascertain status & note
progress
Auscultate breath sounds &
assess air mov’t
To help to liquefy
secretions.
Instruct the patient to
increase fluid intake
To prevent possible
aspirations
Turn the patient q 2 hours
These techniques will
prevent possible
aspirations and prevent any
untoward complications
Demonstrate chest
physiotherapy, such as
bronchial tapping when in
cough, proper postural
drainage.
More aggressive measures
to maintain airway patency.
Administer
bronchodilators if
prescribed.

34. Reference : -
https://nurseslabs.com/chronic-
obstructive-pulmonary-disease-copd/
https://www.who.int/respiratory/copd/
https://www.mayoclinic.org/diseases-
conditions/copd/symptoms-causes/
Text book; brunner and suddarth’s
medical surgical 13th edition