Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD)

Definition: A group of diseases that cause airflow blockage and breathingrelated problems. COPD includes asthma, chronic bronchitis, and emphysema. COPD is a slowly progressive disease of airways that is characterized by gradual loss of lung function. Incidence: COPD occurs most often in Pts ≥25 years and represents fourth leading cause of death in the U.S. Onset: COPD develops slowly, and it may be many years before symptoms start to develop. Etiology: COPD is caused by repeated exposure to inhaled fumes and other irritants that damage lung and airways. Cigarette smoking is most common cause of COPD. Clinical Findings: Cough productive of sputum, shortness of breath, wheezing, and chest tightness. Three Types of COPD ■ Asthma:. ■ Chronic Bronchitis: Characterized by productive cough lasting >3 months during 2 consecutive years and airflow obstruction caused by excessive tracheobronchial mucus production. ■ Emphysema: Characterized by abnormal, permanent enlargement of the distal air spaces past the terminal bronchioles, loss of elasticity, distal air space distention, and alveolar septal destruction. Nursing Focus ■ Position Pt to maximize ease of breathing (HOB 30–45 degrees). ■ Teach “pursed-lipped” breathing to decrease air trapping. ■ Stage activities to conserve energy and decrease oxygen demand. ■ Encourage frequent small feedings of high-calorie foods/liquids to maximize calorie intake. ■ During an exacerbation, assess and maintain ABCs, notify RT/MD, and implement collaborative care such as meds and IV fluid as ordered. ■ Monitor vital signs and document response to prescribed therapies. Patient Teaching ■ Provide Pt and family with literature on specific type of COPD. ■ Explain actions, dosages, side effects, and adverse reactions of meds. ■ Provide instructions on proper use of metered dose inhalers. ■ Instruct Pt to seek immediate medical attention if symptoms are not relieved with prescribed meds.