Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD)

Definition/Etiology:

• Preventable, treatable disease characterized by progressive airflow limitation
• Associated with abnormal inflammatory response that is not fully reversible

Pathophysiology:

The two types of COPD are chronic bronchitis and emphysema

• Chronic bronchitis is defined as cough and sputum production for at least 3 months during 2 consecutive years
• Emphysema is characterized by destruction of alveoli

Clinical Presentation:

Collaborative Management:

Assessments:

• ABG, CBC (check for polycythemia)
• Chest X-ray

Interventions:

• Supplemental oxygen to SpO2 90–92%
  • Nasal cannula or Venturi mask to control oxygen delivery
  • Monitor for return to baseline SpO2
  • Monitor for decrease in respiratory rate; if so, reduce or discontinue oxygen
• Noninvasive positive pressure ventilation (CPAP, BiPAP)
• Bronchodilators, IV corticosteroids, antibiotics as needed
• Bed rest in High Fowler position or sit on edge of bed with legs dangling
• IV rehydration
• Monitor for arrhythmias

Evaluation | Patient Monitoring | Education:

• Immunizations
• Avoid respiratory infection exposure
• Eat small, frequent meals to allow maximal chest excursion
• Adequate hydration to keep secretions moist
• Smoking cessation

Linchpins: (Key Points)

• Chronic disease, abnormal inflammatory response
• Air trapping
• Treat exacerbations