Chronic Obstructive Pulmonary Disease COPD is not a single condition, but rather a group of diseases of the lungs. chronic complication that cannot be reversed

COPD Flashcards by Nurse Anesthetist

What is COPD?

Chronic Obstructive Pulmonary Disease
COPD is not a single condition, but rather a group of diseases of the lungs.
chronic complication that cannot be reversed

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What are the 2 main TYPES of Chronic Obstructive Pulmonary Disease (COPD)

emphysema
chronic bronchitis

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What 3 main symptoms do Asthma and COPD share?

wheezing
cough
shortness of breath

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Asthma is usually diagnosed in ___ and is often related to ___

childhood
allergies

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COPD is usually diagnosed in ___ and its related to ___.

OLDER patients
long-term smoking

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Asthma usually has a __ cough.

dry

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COPD has a ___ cough.

productive

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Asthma symptoms ____ between episodes

disappear

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COPD symptoms progressively ___.

worsen

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Q: What is the main characteristic of COPD?

inability to expire air effectively

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A form of COPD characterized by:
* inflammation of the bronchial tubes (airways) that leads to excessive mucus production, causing cough and difficulty breathing
* Bronchial walls become thick

Chronic Bronchitis

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Chronic Bronchitis patients become susceptible to recurrent ___.

respiratory infections

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2nd type of COPD characterized by:
* Progressive damage to the alveoli (air sacs) in the lungs.
* alveoli wall is destroyed leading to air trap and making it difficult to exhale fully

Emphysema

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What is a major cardiovascular complication of COPD?

Cor pulmonale (right-sided heart failure)
* due to long-term high blood pressure in the pulmonary arteries (aka pulmonary hypertension).

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A patient with long-term COPD is diagnosed with cor pulmonale. Which of the following findings should the nurse expect?

A. Crackles in the lower lobes
B. Peripheral edema and jugular vein distention
C. Elevated blood pressure and bradycardia
D. Wheezing with inspiration and expiration

Answer: B. Peripheral edema and jugular vein distention

Rationale: Cor pulmonale is right-sided heart failure caused by pulmonary hypertension from chronic lung diseases like COPD. Peripheral edema and jugular vein distention are classic signs of right-sided heart failure.

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A nurse is assessing a patient with COPD. Which complication should the nurse monitor for if the patient develops pulmonary hypertension?

A. Left-sided heart failure
B. Right-sided heart failure
C. Myocardial infarction
D. Pulmonary embolism

Answer: B. Right-sided heart failure

Rationale: Cor pulmonale, or right-sided heart failure, is a complication of COPD caused by increased pressure in the pulmonary arteries from long-term lung damage. This condition leads to hypertrophy and failure of the right ventricle.

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COPD 4 Most Common Risk Factors

Tobacco Smoke: Accounts for 80-90% of cases
Passive Smoking: Includes second and third-hand smoke
Increased age
Asthma
Occupational exposures
Air pollution
genetics abnormalities: Alpha-1 deficiency

Most COMMON S/S of PROGRESSED COPD
(not seen in Asthma)

List 9

Chronic cough
Sputum production
Dyspnea @ rest
Thin with Barrel Chest
Accessory muscle use
Polycythemia due to chronic hypoxia
Cyanosis and clubbing of fingers
Musculoskeletal wasting
Depression

Which device would the nurse teach a patient with COPD to blow into to loosen pulmonary secretions?

A. Incentive spirometer
B. Peak flow meter
C. Flutter valve device
D. Holding chamber (spacer)

C. Flutter valve device
(blow air into device= causes vibrations to release secretions)

5 Diagnostic studies for COPD

Pulmonary Function Tests
Spirometry: assess lung function and diagnose COPD or asthma
ABG’s: evaluate oxygen and carbon dioxide levels in the blood
Chest XRay: rule out other issues
Echocardiogram: evaluates function of ventricles/cor pulmonale

ABG lab results for COPD in the LATE stages?

Low PaO2,
elevated PaCO2
low-normal pH
increased HCO3: body’s way of compensating

If patient is NOT a smoker, what diagnostic tests will be anticipated?

Alpha-1 Antitrypsin Levels: To check for deficiency, especially if there are symptoms of lung disease.

2 RESPIRATORY complications of COPD

Respiratory insufficiency and respiratory failure

Define:

Atelectasis

partial or complete collapse of a lung or a section of a lung due to alveoli becoming deflated or filled with fluid.

Define: Pneumothorax

condition where air leaks into the space between the lung and the chest wall, causing the lung to collapse partially or completely.

Which is a type of obstructive airway disease that causes gradual destruction of the alveoli, causing shortness of breath? A. Chronic bronchitis B. Cor pulmonale C. Asthma D. Emphysema

D. Emphysema

Which test might be ordered to diagnose COPD or to track the effectiveness of treatment? A. Echocardiogram B. Pulmonary Function Test C. Arterial Blood Gas D. Chest x-ray

B. Pulmonary Function Test (*all can be done but MOST used for lung funtion is B*)

What is the **most cost-effective** intervention to reduce the risk of developing COPD?

Smoking Cessation:

Medical Management for COPD List 7

* **Vaccines** – (flu, pneumonia, Covid) * **Bronchodilators**: SAMA/LAMA, SABA/LABA -Often used in combination with **corticosteroids** * Alpha1-antitrypsin therapy * Antibiotics * Mucolytic agents * Antitussive agents: *suppress coughing* * **Vasodilators**

MED used for **COPD Exacerbations** ONLY

**Roflumilast (Daliresp)**- (PDE4 inhibitor) – *reduces risks for exacerbations*

Name 2 **palliative surgical procedures** for COPD (*do not cure*)

1.Bullectomy 2.Lung Volume Reduction Surgery

What is done in bullectomy?

* Bullae are enlarded spaces that do not contribute to ventilation and take up space in thorax. * These are surgically removed.

What is done in Lung Volume Reduction Surgery

* Surgically removes lung tissue allowing functional tissue to expand, resulting in improved elastic recoil, decreased dyspnea, and improved lung function * option for patients with advanced or end-stage COPD

The ONLY cure for COPD

**Lung Transplantation** * Costly & limited by shortage of donor organs

How does COPD lead to chronic **HIGH levels** of Carbon Dioxide (CO2)?

* In COPD patients, **chronic high levels of CO2 cause the body to adapt** to this abnormal condition. * Over time, the brain becomes **less sensitive to changes in CO2** levels. * As a result, even when CO2 levels rise, the **body does not respond as strongly or quickly as it normally would**.

Should you withold oxygen from a hypoxic COPD patient?

You should **NEVER** withhold oxygen from a COPD patient if they are hypoxic, but **use it cautiously**

Why is **oxygen therapy** a **concern** for COPD patients?

**COPD patients have a different drive to breathe than normal people**. * Oxygen binds to hemoglobin more easily than carbon dioxide. * Administering excessive oxygen to COPD patients can lead hemoglobin to release carbon dioxide to pick up oxygen. * This results in a spike in CO2 levels, potentially worsening the patient’s condition.

What is considered a **normal O2 saturation range** for COPD patients?

88-92% may be normal and acceptable for them

Define: It **measures** the amount of oxygen dissolved in the blood and is an important indicator of how well oxygen is being transported from the lungs to the bloodstream

PaO2

CO2 normal levels

**35-45 mmHg** (*assess respiratory function and metabolic status- too much = Acid in body*)

Pt education for COPD patients List 5 (most important)

* Breathing and airway clearance exercises * Activity pacing/**energy conservation** * **Oxygen therapy**: no smoking * **Nutritional therapy**: *low carb, high calories, high protein- are needed bc they are thin*, not so much fluids. * **Coping measures** – psychosocial/emotional

REview: 4 COPD Complications

1. COPD Exacerbations 2. Cor Pulmonale: *diuretics, O2, antbx, bronchodilators, meds* 3. Acute Respiratory Failure