class 4 COPD Flashcards
jan 22nd
what is COPD
preventable, treatable, slowly progressive respiratory disease characterized by airflow limitations that are not fully reversible
-may include chronic obstructive bronchitis and emphysema
step 1 of COPD development
exposure to irritating inhaled substance (smoking, workplace, resp infection)
-changes cellular makeup
step 2 of COPD development
the inflammatory response in airways and lungs
step 3 of COPD development
increased mucus production and narrowing of bronchioles, chronic hypoxia
-inc WBC and dec air exchange
step 4 of COPD development
hyperinflation of the alveoli
inspiration more difficult to reduce gas exchange
-diaphragm wont be able to fully contract
COPD risk factors
-smoking
-indoor or outdoor pollution
-occupational exposure
-second hand smoke
-genetics (alpha-1 antitrypsin deficiency (AAT))
-COPD develops over time, dx usally 40+
diagnosis criteria for chronic bronchitis
presence of a cough and sputum production for at least 3 months in each of 2 consecutive years
what is chronic bronchitis
inflammation of the bronchi
-vasodilaion, congestion, edema of mucosa
-bronchospasm
-inc mucus production and mucus plugging
-thickening of bronchial walls
-alveoli become damaged/fibrosed
what is emphysema
impaired gas exchange resulting from destruction of the walls of overdistended alveoli
-permanent overdistension of air spaces
-air passages are obstructed
-increased ventilatory “dead space”
-less function of lung tissue & inc work of breathing
clinical manifestations of COPD
-a progressive disease characterized by 1.chronic cough 2.sputum production 3.dyspnea
-weight loss
-use of accessory muscles (barrel chest)
-poor sleep, dec ADL’s
how may a patient present with empysema
in tripod pose + use of accessory muscles
-may exhale w pursed lips
how is COPD diagnosed
-health hx and physical assessment
-pulmonary function test
-spirometry
-ABGs
-chest xray
-ATT screening
-vitals w o2 sats
-skin assess
-phx,fhx, s&s
medication to improve COPD
- bronchodilators
- steroids
- oxygen
- smoking cessation aids
-alpha-1 antitrypsin augmentation therapy, antibiotic, mucolytic, antitussive, vasodilators, narcotics(codeine), vaccines
surgical management of COPD
bullectomy (remove air pockets in lungs before they pop)
lung transplant (not usually for COPD)
lung volume reduction (remove dead lung/space)
-pulmonary rehabilitation
nutrition for people with COPD
increased protein, calories, and carb diet d/t energy loss
offer boost