destruction of the fragile walls and elastic

Chronic Obstructive Pulmonary Disease fibers of the alveoli. Then the small

airways collapse when you exhale, and

Definition of COPD
impairing airflow out of your lungs.
Chronic obstructive pulmonary disease -
CHRONIC BRONCHITIS - is inflammation of
COPD or Chronic Obstructive Pulmonary Disease
the lining of the bronchial tubes, which carry air
is a chronic inflammatory lung disease that causes
and from the air sacs (alveoli) of the lungs. It's
obstructed airflow from the lungs.
characterized by daily cough and mucus (sputum)
- it is a common respiratory condition production.
characterized by airflow limitation
- People who have bronchitis often cough
- COPD is the name for a group of lung
up thickened mucus, which can be
conditions that cause breathing
discolored.
difficulties.
- This also cause airway obstruction
2 types of COPD
because in this condition, your bronchial
EMPHYSEMA - is a condition in which the
tubes become inflamed and narrowed and
alveoli at the end of the smallest air passages
your lungs produce more mucus, which
(bronchioles) of the lungs are destroyed as a result
can further block the narrowed tubes. You
of damaging exposure to cigarette smoke and
develop a chronic cough trying to clear
other irritating gases and particulate matter.
your airways

- In emphysema, the inner walls of the
lungs' air sacs are damaged, causing them
to eventually rupture. This creates one
larger air space instead of many small
ones and reduces the surface
available for gas exchange.
- Emphysema is one of the cause of airway
obstruction. The lung disease causes
Emphysema and chronic bronchitis are the two
most common conditions that contribute to
COPD. These two conditions usually occur
together and can vary in severity among
area individuals with COPD
Although COPD is a progressive disease that gets
worse over time, COPD is treatable. With proper
management, most people with COPD can
achieve good symptom control and quality of life,
as well as reduced risk of other associated
conditions.
Signs and symptoms of COPD
 Shortness of breath- In COPD is
caused by too much air remaining in the
lungs, decreasing the amount of room left
in the lungs to breathe.
 Frequent coughing or wheezing- it's
most often caused by excess mucus
obstructing the airways.
 Chest tightness- or chest
discomfort that feels like
squeezing, or fullness.
 Excess phlegm or sputum- Some patients
with COPD have increased
production and secretion because of an
overabundance of goblet
oversized mucus glands in their airways
compared with healthy people.
 Lack of energy- COPD reduces airflow
into your lungs, making breathing difficult
and labored. It also reduces the oxygen
supply your whole body receives. Without
enough oxygen, your body will feel tired
and exhausted
 Unintended weight- is a sign of severe
COPD. At this stage of the
disease, damage to your lungs becomes so
severe that your lung volume expands in
size, which eventually flattens your
diaphragm, reducing the amount of space
between your lungs and stomach.
Laboratory test for COPD:
 Spirometry - The most effective and
common method for diagnosing COPD is
spirometry. It’s also known as a pulmonary
pain or function test or PFT. This easy, painless test
pressure, measures lung function and capacity
 Brochodilator Reversibility test - This test
combines spirometry with the use of a
mucus bronchodilator, which is medicine to help
open up your airways.
cells and
 Blood Test - A blood test can show other
conditions that can cause similar symptoms
to COPD, such as a low iron level and a high
concentration of red blood cells in your
blood.
 Genetic Testing - While smoking and
exposure to harmful substances in the
environment are the main causes of COPD,
there’s also a hereditary risk factor for this
 condition. A family history of premature Inflammation is present in the lungs,

COPD may signal that you have the particularly the small airways, of all people who

condition. smoke. This normal protective response to the

inhaled toxins is amplified in COPD, leading to

 Chest X-ray or CT scan - A CT scan is a
tissue destruction, impairment of the defence
type of X-ray that creates a more detailed
mechanisms that limit such destruction, and
image than a standard X-ray. Any type of X-
disruption of the repair mechanisms. In general,
ray that doctor chooses will give a picture of
the inflammatory and structural changes in the
the structures inside the chest, including
airways increase with disease severity and persist
heart, lungs, and blood vessels.
even after smoking cessation. Besides
 Electrocardiogram - It might request an
inflammation, two other processes are involved in
electrocardiogram (ECG or EKG) to
the pathogenesis of COPD—an imbalance
determine if shortness of breath is being
between proteases and antiproteases and an
caused by a heart condition as opposed to a
imbalance between oxidants and antioxidants
lung problem. The breathing difficulties
(oxidative stress) in the lungs.
associated with COPD can lead to cardiac
Causes of COPD
complications including abnormal heart

rhythms, heart failure, and heart attack. 1. Smoking - smoking is the main cause of

COPD. According to study about 85 to 90 percent

Pathophysiology
of all COPD cases are caused by cigarette

smoking. When a cigarette burns, it creates more

than 7,000 chemicals, many of which are harmful.

The toxins in cigarette smoke weaken your lungs'

defense against infections, narrow air passages,

cause swelling in air tubes and destroy air sacs—

all contributing factors for COPD.

2. Your environment- What you breathe every emphysema. It increases your risk of both

day at work, home and outside can play a role in developing and dying from COPD.

developing COPD. Long-term exposure to air Approximately 85 to 90 percent of COPD cases

pollution, secondhand smoke and dust, fumes and are caused by smoking. Female smokers are

chemicals (which are often work-related) can nearly 13 times as likely to die from COPD as

cause COPD. women who have never smoked; male smokers

are nearly 12 times as likely to die from COPD as

3. Genetics - You're more likely to develop
men who have never smoked.
COPD if you smoke and have a close relative

with the condition, which suggests some people's Medical management will be given to a patient

genes might make them more vulnerable to the with COPD:

condition. Around 1 in 100 people with COPD

 Oxygen therapy- Long-term oxygen
has a genetic tendency to develop the condition,
therapy is used for COPD if you have low
called alpha-1-antitrypsin deficiency. Alpha-1-
levels of oxygen in your blood. It is used
antitrypsin is a substance that protects your lungs.
mostly to slow or prevent right-sided heart
Without it, the lungs are more vulnerable to
failure. It can help you live longer.
damage
 Inhalers- The inhalers available for

Risk factors of COPD people with COPD help improve

breathing by opening up the airways.

1. Exposure to air pollution
Inhalers are often effective for rapid
2. Breathing secondhand smoke
symptom relief and to minimize episodes
3. Working with chemicals, dust and fumes of breathlessness.

4. A genetic condition called Alpha-1 deficiency  Tablet’s doctor may recommend taking

tablets or capsules as well like

5. A history of childhood respiratory infection
Theophylline tablets, Mucolytics,
COPD Risk Factors Smoking is the biggest risk
Antibiotics
factor for chronic obstructive pulmonary disease

(COPD), which includes chronic bronchitis and

 The major types of surgery for COPD: Sputum production

- Patients with chronic bronchitis manifest

 Bullectomy- is the surgical removal of a
unproductive coughs. Our nursing
bulla, which is a dilated air space in the
responsibility is to prepare the doctor’s
lung parenchyma measuring more than 1
order if his physician will allow us to
cm.
collect his sputum for sputum culture to
 Lung Volume Reduction (LVRS)-
determine if the patient is risk for
a large area of damaged lung is removed
pneumonia.
to allow the remaining lung tissue to

expand when you breathe in.

Keep O2 saturation 88.89%
 Lung transplantation- offers an effective
- COPD patient are stimulated to breathe
treatment modality for patients with end-
due to low oxygen levels because of
stage chronic obstructive pulmonary
obstructive airflow. So they are stimulated
disease (COPD). The exact determination
to breath by low oxygen levels rather than
of when to refer, list and offer transplant
high carbon dioxide levels which is how a
as well as the preferred transplant
person with healthy lungs is stimulated to
procedure type remains unclear.
breathe whenever their carbon dioxide
Nursing management levels are high and it stimulates them to

Monitor the respiratory system breath to blow that off but not in this case

- We must assess the breathing pattern and we don’t want to give them too much

oxygen saturation of the client in order for oxygen through nasal cannula because

us to be aware if the client is needed for their body is will not give incetive to

nasotracheal suction. We must observe if breathe. They might stop breathing and

the patient is using accessory muscle the patient will hypoventilate which

while breathing and we must monitor his increase the carbon dioxide even more and

oxygen saturation. become toxic.

Administer breathing treatments

- One of the best regiment to treat the

COPD is to administer respiratory therapy

such as nebulizer treatments. Nebulizer

treaments is being administer for the

patient has a short acting bronchiodilators

like albuterol atrovent. And If we

administer respiratory therapy we should

give this medication at the scheduled time.

Health teaching

- For their nutritional needs we must

encourage the client to consume high

calorie and protien meals small frequent

and start hydrated for 2-3 liters per day.

Avoid sick people to prevent worsening of

the illness. We must advice the client to

avoid irritants such as hot humid and

strong perfume. Let us encourage our

client to stop smoking and avoid extreme

cold environment. The patient should

register of vaccination for COPD.