Chronic

obstructive
pulmonary
disease
(COPD)

Dr. Walaa Nasr

Lecturer of Adult Nursing
Second year

COPD
Out

lines

What is the COPD?

Overview
Causes of COPD
Symptoms of COPD
What's the difference between COPD
and asthma?
Diagnostic tests needed for COPD
Medical management of COPD
Preventive measures
Nursing intervention
Outlook and Prognosis

COPD

Definition
COPD,
or
chronic
obstructive
pulmonary
disease, is a progressive
disease that makes it hard
to breathe. "Progressive"
means the disease gets
worse over time.

COPD
Overview

COPD
Overview

In COPD, less air flows in and out of

the airways because of one or more
of the following:
The airways and air sacs lose their
elastic quality.
The walls between many of the air
sacs are destroyed.
The walls of the airways become
thick and inflamed.
The airways make more mucus than
usual, which tends to clog them.

COPD
Causes

Smoking
Air

pollution
genetic (hereditary)
risk

COPD
Symptoms
Productive

cough
Breathlessness
Chest infection
Other symptoms of COPD can
be more vague, weight loss,
tiredness and ankle swelling.

Difference between COPD and

Asthma

In COPD there is permanent damage to the

airways. The narrowed airways are fixed, and so
symptoms are chronic (persistent). Treatment to
open up the airways, is therefore limited.

In asthma there is inflammation in the airways

which makes the muscles in the airways
constrict. This causes the airways to narrow.
The symptoms tend to come and go, and vary
in severity from time to time. Treatment to
reduce inflammation and to open up the
airways usually works well.

COPD is more likely than asthma to cause a

chronic (ongoing) cough with sputum.

Difference between COPD and asthma

(cont)

Night
time
waking
with
breathlessness
or
wheeze
is
common in asthma and uncommon
in COPD.

COPD is rare before the age of 35

whilst asthma is common in under35.

COPD

Diagnostic tests

Symptoms
Physical examination
Sample of sputum
Chest x-ray
High-resolution CT (HRCT scan)
Pulmonary
function
test
(spirometery)
Arterial blood gases test
Pulse oximeter

COPD

Medical management
Give antibiotics to treat infection

Give bronchodilators to relieve bronchospasm,

reduce airway obstruction, mucosal edema and
liquefy secretions.

Chest physiotherapy and postural drainage to

improve pulmonary ventilation.

Proper hydration helps to cough up secretions or

tracheal suctioning when the patient is unable to
cough.

Steroid therapy if the patient fails to respond to

more conservative treatment.

COPD

Medical management (cont)

Stop smoking

Oxygenation
episodes

In asthma adrenaline ( epinephrine) SC if the bronchospasm

not relieved.

Aminophylins IV if the above treatment does not help.

IV corticosteroids for patients with chronic asthma or

frequent attack.

Sedative or tranquilizers to calm the patient.

Increase fluids intake to correct loss of diaphoresis and

inaccessible loss of hyperventilation.

Intubations and mechanical ventilation if there is respiratory

failure.

with

low

concentration

during

the

acute

COPD
Preventive measures

To prevent irritation and infection of the

airways, instruct the patient to:

Avoid exposure to cigarette, pipe, and

cigar smoke as well as to dusts and
powders.

Avoid use of aerosol sprays.

Stay indoors when the pollen count is high.

Stay indoors when

humidity are both high

temperature

and

COPD
Preventive measures (cont)

Use air conditioning to help decrease

pollutants and control temperature

Avoid exposure to persons known to have

colds or other respiratory tract infection

Avoid enclosed, crowded areas during

cold and flu season.

Obtain immunization against

and streptococcal pneumonia.

influenza

COPD
Preventive measures (cont)

To ensure prompt, effective treatment

of a developing respiratory infection,
instruct the patient to do the following:-

Report any change in sputum color

character, increased tightness of the
chest, increased dyspnea, or fatigue.

Call the physician if ordered antibiotics

do not relieve symptoms within 24
hours.

COPD
Nursing intervention

Assessment
History
Patient's environment
Work
history,
exercise
pattern, smoking habits
The onset & development of
symptoms
Sleeping positions

COPD
Nursing intervention (cont)

Physical examination
Signs of heavy smokers

Observe for clubbing

Distended neck vein on expiration

The presence of barrel chest

Observe for abdominal breathing

The use of pursed lips breathing

and chest movement

Auscultate the chest& listen for

musical wheezes characteristics of
chronic bronchitis

COPD
Nursing intervention (cont)

review the results of diagnostic procedure:

Arterial blood gases
Pulmonary function tests
X-ray films
Nursing diagnosis

Ineffective
breathing
increase need of O2

pattern

related

to

Ineffective
airway
clearance
related
excessive accumulation of secretions

to

Impaired gas exchange related to impaired

expiration &co2 retention

COPD
Nursing intervention (cont)

Activity
intolerance
inadequate oxygenation

related

to

High risk for ineffective individual

coping related to chronic disease, its
effects& its treatment

High risk for altered health maintenance

related to insufficient knowledge of
prevention, identification and treatment
of respiratory complication of COPD