CHRONIC OBSTRUCTIVE PULNONARY DISEASE (COPD) Chronic obstructive pulmonary disease is a disease state in which airflow is obstructed by emphysema

, chronic bronchitis, or both. The airflow obstruction is usually progressive, irreversible, and associated with airway hyperactivity, resulting in narrowing of peripheral airways, airflow limitation, and changes in the pulmonary vasculature. Causes of COPD: Most cases of chronic obstructive pulmonary disease (COPD) develop after repeatedly breathing in fumes and other things that irritate and damage the lungs and airways. Cigarette smoking is the most common irritant that causes COPD. Pipe, cigar, and other types of tobacco smoke can also cause COPD, especially if the smoke is inhaled. Breathing in other fumes and dusts over a long period of time may also cause COPD. The lungs and airways are highly sensitive to these irritants. They cause the airways to become inflamed and narrowed, and they destroy the elastic fibers that allow the lung to stretch and then return to its resting shape. This makes breathing air in and out of the lungs more difficult. Other things that may irritate the lungs and contribute to COPD include: - Working around certain kinds of chemicals and breathing in the fumes for many years - Working in a dusty area over many years - Heavy exposure to air pollution Being around secondhand smoke (smoke in the air from other people smoking cigarettes) also plays a role in an individual developing COPD. Genes—tiny bits of information in your body cells passed on by your parents—may play a role in developing COPD. In rare cases, COPD is caused by a gene-related disorder called alpha 1 antitrypsin deficiency. Alpha 1 antitrypsin (an-te-TRIP-sin) is a protein in your blood that inactivates destructive proteins. People with antitrypsin deficiency have low levels of alpha 1 antitrypsin; the imbalance of proteins leads to the destruction of the lungs and COPD. If people with this condition smoke, the disease progresses more rapidly. Signs & Symptoms: The signs and symptoms of chronic obstructive pulmonary disease (COPD) include: - Cough - Sputum (mucus) production - Shortness of breath, especially with exercise - Wheezing (a whistling or squeaky sound when you breathe) - Chest tightness

coping with chronic disease. Although it has been shown that corticosteroids do not slow the decline in lung function. respiratory therapy treatments. the more severe the disease. pathophysiology and changes with COPD. A short trial course of oral corticosteroids may be prescribed for patients with stage II or III COPD to see if pulmonary function improves and symptoms decrease. and inefficient. symptom alleviation. Long term oxygen therapy has been shown to improve the patient’s quality of life and survival. and helps the patient to control the rate and depth of respiration. and sometimes helps expel as much air as possible during expiration. Depending on the length and setting of the program. communicating with the health care team. smoking cessation. If you continue to smoke. and planning for the future. nutrition. prevents collapse of small airways. prevents collapse of small airways. . medications and home oxygen therapy. sexuality and COPD. Pursed lip breathing helps to slow expiration. which reduces the respiratory rate. and not everyone with COPD has a cough. these medications may improve symptoms. and helps to slow expiration. Nursing Management: Patient Education – is a major component of pulmonary rehabilitation and includes a broad variety of topics. With practice.A cough that doesn't go away and coughing up lots of mucus are common signs of COPD. the more inefficient the breathing pattern. However. the lung destruction is faster than if you stop smoking. rapid. Oxygen Therapy – It can be administered as long term continuous therapy. These often occur years before the flow of air in and out of the lungs is reduced. Other Medications – Patients should receive a yearly influenza vaccine and the pneumococcal vaccine every 5 to 7 years as preventive measured. enabling the patient to gain control of dyspnea and reduce feelings of panic. this type of upper chest breathing can be changed to diaphragmatic breathing. The severity of the symptoms depends on how much of the lung has been destroyed. topics may include normal anatomy and physiology of the lung. Breathing Exercise – The breathing pattern of most people with COPD is shallow. It also promotes relaxation. Medical Management: Bronchodilators – It relieve bronchospasm and reduce airway obstruction by allowing increased oxygen distribution throughout the lungs and improving alveolar ventilation. or to prevent acute dyspnea. during exercise. Corticosteroids – Inhaled and systemic corticosteroids (oral or intravenous) may also be used in COPD but are used more frequently in asthma. increases alveolar ventilation. not everyone with a cough and sputum production goes on to develop COPD.

a program of inspiratory muscle training may be prescribed to help strengthen the muscles used in breathing. and travel. Activity Pacing – A patient with COPD has decreased exercise tolerance during specific periods of the day. Bibliography: www. work. depression. Coping Measures – Any factors that interferes with normal breathing quite naturally induces anxiety.gov/health/dci/Diseases/Copd/Copd_Causes. Physical Conditioning – PC techniques include breathing exercises and general exercises intended to conserve energy and increase pulmonary ventilations. and the breathing pattern improve. Suzanne & Bare.asp Smeltzer.nhlbi. the patient is encouraged to assume increasing participation in self care activities.nih. airway clearance.html www. Oxygen Therapy – Oxygen supplied to the home comes in compressed gas. Self Care Activities – As gas exchange. 2004. liquid or contractor systems.Inspiratory Muscle Training – Once the patient masters diaphragmatic breathing. Medical Surgical Nursing. Portable oxygen systems allow the patient to exercise. LWW. because bronchial secretions collect in the lungs during the night while the person is lying down. . Nutritional Therapy – Nutritional assessment and counseling are important aspects in the rehabilitation process for the patient with COPD. There is close relationship between physical fitness and respiratory fitness. and changes in behavior. This is especially true on arising in the morning.aarc. Brenda.org/klein/causes.

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