Chronic Obstructive Pulmonary Disease (COPD) is a progressive, preventable respiratory disease characterized by limited airflow and shortness of breath, with causes including chronic bronchitis and emphysema. Diagnosis involves patient history, physical assessment, and various tests like spirometry, with treatment options including pharmacological therapy, oxygen therapy, and surgical management when necessary. Effective management includes regular medication, exercise, vaccination, and lifestyle modifications to improve quality of life.

1. COPD (CHRONIC
OBSTRUCTIVE PULMONARY
DISEASE)
Presented by:
Sonam

2. COPD (CHRONIC OBSTRUCTIVE
PULMONARY DISEASE)
• CHRONIC OBSTRUCTIVE LUNG DISEASE (COLD),
• CHRONIC OBSTRUCTIVE AIRWAY DISEASE (COAD),
• CHRONIC AIRFLOW LIMITATION (CAL), AND
• CHRONIC OBSTRUCTIVE RESPIRATORY DISEASE
(CORD).

3. INTRODUCTION
• A pair of two commonly co-existing disease of the lungs in
which the airways become narrowed.
• Leads to a limitation of the flow of air to and from the lungs
causing shortness of breath.
• Is a preventable and treatable slowly progressive respiratory
disease of airflow obstruction involving the airways,
pulmonary parenchyma, or both.

4. EPIDEMIOLOGY

7. CAUSES
• .

10. CHRONIC BRONCHITIS
•Cough with expectoration
for at least 3 months a
year for more than 2
consecutive years and
there is no other cause of
expectoration.

11. .
TYPES:
•SIMPLE CHRONIC BRONCHITIS
•CHRONIC MUCOPURULENT BRONCHITIS
•CHRONIC BRONCHITIS WITH
OBSTRUCTION/CHRONIC ASTHMATIC
BRONCHITIS

12. EMPHYSEMA
•Permanent & destructive
enlargement of airspaces
distal to the terminal
bronchioles with out
obvious fibrosis and
with loss of normal
architecture

13. TYPES:

17. CLINICAL FEATURES

22. ASSESSMENT AND DIAGNOSTIC
EVALUATION
HEALTH HISTORY
• Cold or flu or respiratory difficulty
• Pattern of symptom development
• Exertion increase the dyspnea
• Limits of the patients tolerance for exercise
• Smoke or spend time around others who smoke
• Exposed to dust, fumes, vapors, or air pollution

23. CONTD…
• At what times during the day does the patient complain most of
fatigue and shortness of breath
• Any discomfort or pain in any part of the body
• Exposed to risk factors (types, intensity, duration)
• Past medical history of respiratory diseases
• Family history of chronic obstructive pulmonary disease or other
chronic respiratory diseases
• Eating and sleeping habits
• Impact of respiratory disease on quality of life

24. CONTD…
• Smoking history
• Occupational exposure
• The triggering events (e.g., Exertion, strong odors, dust,
exposure to animals)
• History of exacerbations or previous hospitalizations for
respiratory problems
• Comorbidities present
• Current medical treatments
• Available social and family support
• Potential for reducing risk factors (e.g., Smoking cessation)

26. PHYSICALASSESSMENT
• Notice the position the patient assume during the interview
• Vital signs especially respiratory rate and its depth and respiratory
pattern
• Character of respirations? Even and without effort
• Can the patient complete a sentence without having to take a breath
• Contraction of the abdominal muscles during inspiration
• Use of accessory muscles of the shoulders and neck when breathing
• Patient take a long time to exhale (prolonged expiration)
• Central cyanosis evident

27. CONTD…
• Neck veins engorged
• Peripheral edema
• Coughing
• Color, amount, and consistency of the sputum
• Clubbing of the fingers
• Types of breath sounds (i.e., Clear, diminished or distant, crackles, and
wheezes)
• Sensory deficits
• Short- or long-term memory impairment
• Increasing stupor
• Apprehension

28. DIAGNOSTIC EVALUATION
• ABG analysis- to assess baseline oxygenation and gas exchange
• Screening of alpha 1 antitrypsin deficiency – done for patients
with age less than 45 years and for those with family history of
COPD
• CT scan- not done routinely, by may help in differential diagnosis
• Spirometry is used to evaluate airflow obstruction, which is
determined by the ratio of FEV1 to FVC
• PFT- to help confirm the diagnosis of COPD, determine disease
severity, and monitor disease progression

31. .

33. MEDICAL MANAGEMENT
1) Risk reduction

34. Contd…
2) Pharmacological therapy
 For grade I – mild COPD – a short acting bronchodilator
 For grade II or III COPD – a short acting bronchodilator
and regular treatment with one or more long acting
bronchodilator
 For grade III or IV COPD (severe or very severe) – regular
treatment with one or more bronchodilators and/or inhaled
corticosteroids for repeated exacerbations.

35. Contd…
Use of pressurized metered-dose inhaler
(pmdi)
• Drugs include:
o Short acting beta agonist (salbutamol,
albuterol, levabuterol) and
o Long acting beta agonists (salmetrol,
formoterol, indacterol),
o Muscuranic agonists(anticholinergics –
ipratropium bromide) and
o Combination agents (fenoterol and
ipratropium).
o Corticosteroids

37. Contd…
• Other medications: alpha 1 antitrypsin augmentation therapy,
antibiotic agents, mucolytic agents, antitussive agents, vasodilators.
• Vaccine: such as influenza vaccine can reduce serious morbidity and
death in patients with COPD by approximately 50%.
3) Management of exacerbations: Roflumilast may be used to
reduce the risk of exacerbations. It is a selective phosphodiesterase-4
(PDE4) inhibitor.
4) general principles of oxygen therapy: To increase the baseline
resting partial pressure of arterial oxygen to increase the baseline
resting partial pressure of arterial oxygen

38. SURGICAL MANAGEMENT
1. BULLECTOMY: TO REMOVE DAMAGED AIR SACS IN THE LUNGS
2. LUNG VOLUME REDUCTION SURGERY

39. LUNG
TRANSPLANTATION

40. PULMONARY REHABILITATION
• PATIENT EDUCATION
• BREATHING EXERCISES
• ACTIVITY PACING
• SELF CARE ACTIVITIES

41. Contd…
• PHYSICAL CONDITIONING
• OXYGEN THERAPY
• NUTRITIONAL THERAPY
• COPING MEASURES
• PALLIATIVE CARE

42. NURSING MANAGEMENT
•Ineffective airway clearance related to excessive
secretion and ineffective coughing
•Impaired breathing pattern related to decreased
ventilation and mucous plugs
•Activity intolerance related to inadequate oxygenation
and dyspnea
•Risk of potential complication related to chronic
pulmonary obstructive disease

43. COMPLICATIONS
o Respiratory insufficiency
o Respiratory failure
o Pneumonia
o Chronic atelectasis
o Respiratory infections
o Pneumothorax
o Pulmonary artery hypertension.

44. GENERALADVISE
 Take the medications regularly as prescribed, if having any
doubt reach to the nearby hospital.
 Exercise regularly every day or else at least 4 out of 7 days.
 Remember to take vaccination regularly
 Stay away from infections by maintaining good hygiene
 Quit smoking
 Eat a regular balanced diet
 Drink plenty of plain fresh water at least 1.5l/day
 Drink caffeinated drinks and alcohol in moderation
 Get plenty of sleep

45. CONCLUSION
• Chronic obstructive pulmonary disease is a preventable and
treatable progressive lung disease. People with COPD works
harder to breathe, which can lead to shortness of breath, and/or
feeling tired. Early in the disease, people with COPD may feel
short of breath when they exercise.
• A person with COPD may have obstructive bronchitis,
emphysema, or a combination of both conditions. The amount of
each of these conditions differs from person to person. With
proper use of MDI, pulmonary rehabilitation and following
medical management the disease progression can be reduced and
surgical management is the last resort for these patients.

46. REFERENCES
 Brunner and suddharths. Textbook of medical and surgical nursing. 13th edition vol. I. .New
delhi: reed elsevier india pvt. Ltd.; 2014. Pg. No. 360- 395
 Lewis. Medical surgical nursing. Assessment and management of clinical problems. 2015. New
delhi. Elsevier vol. I. Pg. No. 461-493
 Joyce M. Black and jane hokanson; medical surgical nursing; volume 2, 8th edition, reed elsevier,
india pvt.
 Https://www.Thoracic.Org/.../patient-resources/resources/copd-intro.Pdf
 Https://www.Who.Int/medicines/areas/priority_medicines/BP6_13COPD
• Research hyperlinks:
 Altman, pablo et al. “Comparison of peak inspiratory flow rate via the breezhaler®, ellipta® and
handihaler® dry powder inhalers in patients with moderate to very severe COPD: a randomized
cross-over trial.” BMC pulmonary medicine vol. 18,1 100. 14 jun. 2018, doi:10.1186/s12890-
018-0662-0
 Ali, lilas et al. “Need of support in people with chronic obstructive pulmonary disease.” Journal
of clinical nursing vol. 27,5-6 (2018): e1089-e1096. Doi:10.1111/jocn.14170

47. THANK
YOU