COPD Flashcards
(12 cards)
Explain what the risk factors are for COPD
- Smoking
- Environmental Irritants: Long-term exposure to pollutants, chemicals, and dust can contribute to lung damage.
- Alpha-1 Antitrypsin Deficiency: A genetic condition leading to an increased risk of lung disease.
- Age
- Family History
What are signs and symptoms of COPD?
Signs
Increased RR
Use of accessory muscles
Cyanosis
Weight loss
decreased O2 levels
increased mucus production
Swelling of ankles (R/side HF) - severe COPD
Symptoms
Shortness of breath (dyspnea), especially with exertion
Fatigue
Wheezing
Frequent respiratory infections
Loss of appetite
Decreased physcial exercise tolerance
What were the patient M’s signs of COPD?
Bluish/purple tinged lips (cyanosis)
Pursed lip breathing
Barrel-shaped chest (due to hyperinflation)
Use of accessory muscles for breathing
Poor respiratory effort with labored breathing
Underweight
Fatigue
Explain the patho of COPD
Chronic Bronchitis:
Defined by productive cough (3mths-2yrs)
Bronchiole inflammation & oedema
Increased mucus production
Decreased cillia action
increase in airway resistance
Emphysema:
Exposure to irritants (ie smoke) causes inflammation which causes oxidative stress and leads to:
Destruction of alveoli, capillaries, & elastin
Decreased area for gas exchange
Enlarged air space (air trapped)
What are the complications of COPD?
Hypoxia: Low oxygen levels leading to cyanosis and respiratory failure.
Hypercapnia: Elevated carbon dioxide levels causing respiratory acidosis.
Cor Pulmonale: Right-sided heart failure resulting from prolonged pulmonary hypertension.
Increased Susceptibility to Infections: Due to impaired mucus clearance and lung function.
What tests and assessments can be done for COPD?
« Spirometry: Measures lung function, including FEV1 and FVC, to assess airflow limitation.
« Arterial Blood Gases (ABGs): Measures oxygen and carbon dioxide levels in the blood.
« Chest X-ray: Provides visual evidence of lung hyperinflation and structural changes.
« Sputum Analysis: Examines mucus for infections or other abnormalities.
What are medications that can help manage COPD?
▫ Bronchodilators: Dilate respiratory tract to enhance airflow
▫ Beta-Agonists (e.g., Salbutamol): Relax bronchial smooth muscle, leading to bronchodilation.
▫ Anticholinergics (e.g., Spiriva): Prevent bronchoconstriction by blocking acetylcholine receptors.
▫ Corticosteroids (e.g., Seretide): Reduce inflammation and mucus production.
▫ Oxygen Therapy: Maintains oxygen saturation in patients with chronic hypoxemia.
What are the other supports avail for COPD patients?
Pulmonary Rehabilitation: Exercise training and education to improve lung function and quality of life.
Nutritional Guidance: Proper nutrition is critical to maintain weight and muscle strength.
Smoking Cessation: Essential for preventing disease progression.
Why is smoking the leading cause of COPD (4 factors)?
- Chronic inflammation of aiways causing narrowing or obstruction
- Oxidative stress causing damage to the lung cells
- Mucus hypersecretion as the goblet cells in the respiratory tract are stimulated by smoke and increase mucus production
- Emphysema (main factor) which is the destruction of alveoli, capillaries, and elastin - this causes a decreased area for gas exchange with enlarged air space (air trapped)
What are the effects of CO2 retention on a COPD patient?
Respiratory Acidosis: As CO2 builds up, it can lead to respiratory acidosis, where the blood becomes more acidic. This can cause symptoms like confusion, drowsiness, and increased heart rate.
Hypoventilation: Patients might instinctively breathe less deeply to avoid discomfort, which can worsen CO2 retention.
Explain what a CO2 retainer is in relation to COPD
During normal breathing, the body expels CO2 as a waste product of metabolism. In COPD, the damaged lungs can’t efficiently remove CO2, especially during exacerbations.
What is important to remember when managing an excaberation of COPD in a CO2 retainer patient?
Oxygen therapy may be required, but care must be taken not to administer too much oxygen, as it can decrease the respiratory drive in some COPD patients
Usually aim for 88-92% SpO2
