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Chronic Obstructive Pulmonary Disease (COPD) Cheat Sheet by

COPD

Encomp­asses pulmonary emphysema and chronic bronchitis
Not reversible

PULM­ONARY EMPHYS­EMA

Destru­ction of alveoli, narrowing of bronch­ioles, and trapping of air resulting in loss of lung elasticity

CONT­RIB­UTING FACTORS

Cigarette smoking (main causative factor)
Exposure to air pollution
Passive smoke inhalation
Alpha-­ant­itr­ypsin deficiency (inability to break down pollut­ants)
Advanced age
Occupa­tional dust and chemical exposure

MANI­FES­TAT­IONS

Dyspnea w/ productive cough
Fatigue
Difficult exhala­tion, use of pursed lip breathing
Clubbed finger­nails
Wheezing
Weight loss
Crackles
Respir­atory acidosis w/ hypoxia
Barrel chest
Shallow, rapid respir­ations

CHRONIC BRONCH­ITIS

Inflam­mation and hyper secretions of mucus in the bronchi and bronch­ioles caused by chronic exposure to irritants
 

CONT­RIB­UTING FACTORS

Cigarette smoking (main causative factor))
Exposure to air pollution and other enviro­nmental irritants

MANI­FES­TAT­IONS

Productive cough
Thick, tenacious sputum
Hypoxemia
Respir­atory acidosis w/ hypoxia

DIAG­NOSTIC PROCEDURES FOR COPD

Chest x-ray
Pulmonary function tests: air remains trapped in lungs
Pulse oximetry: often less than 90%
ABGs: Chronic respir­atory acidosis
Computed tomography (CT)

NURSING INTERV­ENT­IONS

Monitor respir­atory status
Monitor cardiac status for signs of right-­sided failure
Position pt upright and leaning forward
Schedule activities to allow for frequent rest periods
Administer oxygen therapy as prescribed
Use incentive spirom­etry, breathing techni­ques, & effective coughing
Encourage fluids 2-3 L/day unless contra­ind­icated
Encourage a high calorie diet
Provide emotional support
Reinforce teaching about immuni­zations for pneumonia & influenza
 

MEDI­CAT­IONS

Bronch­odi­lators
Beta-a­dre­nergic agents
Cholin­ergic antago­nists
Cortic­ost­eroids
Methyl­xan­thine
Anti-i­nfl­amm­atory agents
Mucolytic agents

THER­APEUTIC MEASURES

Chest physio­the­rap­y/p­ulm­onary drainage
Lung reduction surgery

CLENT EDUCATION & REFERRAL

Breathing techniques
Oxygen therapy
Medica­tions
Nutrition
Refrain from smoking
Infection prevention measures
Pulmonary rehabi­lit­ation
Activity pacing

COMP­LIC­ATIONS OF COPD

Cor pulmonale
Carbon Dioxide Toxicity
Pneumonia
Tuberc­ulosis
Laryngeal Cancer
Lung Cancer
                               

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