WK 3: COPD Flashcards
What is COPD
Chronic obstructive pulmonary disease, or COPD, refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema and chronic bronchitis.
Pathophysiology of COPD
· Airflow limitations during forced exhalation due to loss of elastic recoil
· Airflow obstruction due to mucus hypersecretion, mucosal edema, and bronchospasm
o Primary process is inflammation
§ Inhalation of noxious particles
§ Mediators released cause damage to lung tissue
§ Airways inflamed
§ Parenchyma destroyed
o Supporting structures of lungs are destroyed.
§ Air goes in easily but remains in the lungs.
§ Bronchioles tend to collapse.
Causes barrel-chest look
What are Risk factors of COPD?
· Tobacco smoke
· Occupational chemicals and dust
· Air pollution
· Infection
· Heredity
Aging
Effects of tobacco smoke in COPD
Effects of nicotine
- Stimulates the sympathetic nervous system
- Increases heart rate (HR)
- Causes peripheral vasoconstriction
- Increases blood pressure (BP) and cardiac workload
- Compounds problems in coronary artery disease (CAD)
Effects on respiratory tract
- Increased production of mucus
- Hyperplasia of goblet cells
- Lost or decreased ciliary activity
Clinical manifestations of COPD
o Develops slowly
o Dyspnea usually prompts medical attention.
§ Occurs with exertion in early stages
§ Present at rest with advanced disease
o Causes chest breathing
§ Use of accessory and intercostal muscles
§ Inefficient
o Characteristically underweight with adequate caloric intake
§ Anorexia
§ Chronic fatigue
o Physical examination findings
§ Prolonged expiratory phase
§ Wheezes
§ Decreased breath sounds
§ Increased Anterior-posterior diameter
o Bluish-red colour of skin
§ Polycythemia and cyanosis
Complications of COPD: Cor pulmonale
- Hypertrophy of right side of heart
- Result of pulmonary hypertension
- Late manifestation of chronic pulmonary heart disease
- Eventually causes right-sided heart failure
Complications of COPD: Acute exacerbations of COPD
§ Sustained worsening of symptoms
§ Signaled by change in usual
· Dyspnea
· Cough
· Sputum
§ Characterized as purulent or nonpurulent exacerbations
§ Associated with poorer outcomes
§ Primary causes
· Infection
· Noninfectious causes: Air pollution, allergens, irritants, cold air
Complications of COPD: Acute respiratory failure
§ Caused by
· Exacerbations
· Cor pulmonale
· Discontinuing bronchodilator or corticosteroid medication
Complications of COPD: Depression/anxiety
§ Approximately 10 to 42% of COPD patients experience depression.
§ They are 85% more likely to experience anxiety disorders.
If the patient becomes anxious because of dyspnea, teach pursed-lip breathing.
Diagnosis of COPD
· CXR
· ABGs
· Cough
· Sputum production
· Dyspnea
· Exposure to risk factors
Bronchodilators for COPD
· Relax smooth muscle in the airway
· Reduce airway resistance and dynamic hyperinflation of the lungs
· Improve ventilation of the lungs
· Dec. Dyspnea and inc. FEV
Inhaled corticosteroids for COPD
- Inhaled Corticosteroid + Long-acting beta-agonist (LABA) - Advair (fluticasone propionate+ salmeterol), Symbicort (budesonide + formoterol)
inhaled corticosteroid + Long-acting muscarinic antagonist + LABA - BREZTRI, Trelogy elipta
Interprofessional management of COPD
· pulmonary rehabilitation
· O2 therapy
nutritional therapy.
Assessment of COPD
§ Obtain complete health history and conduct a complete physical assessment.
Health promotion of COPD
§ Abstain from or stop smoking
§ Avoid or control exposure to occupational and environmental pollutants and irritants
§ Early detection of airway disease
§ Early diagnosis and treatment of respiratory tract infection
§ Awareness of family history of COPD and AAT deficiency
§ Education
§ Exercise
