CHRONIC OBSTRUCTIVE

PULMONARY DISEASE [COPD]

DEFINITION
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that over time makes it
hard to breathe.
TYPES OF COPD
There are two main forms of COPD:
• Chronic bronchitis, which involves a long-term cough with mucus.
• Emphysema, which involves damage to the lungs over time.
CAUSES
• Tobacco exposure
• Occupational exposure to dusts, fumes, or chemicals;
• Indoor air pollution
• Early life events such as poor growth in utero, prematurity, and frequent or severe respiratory
infections in childhood that prevent maximum lung growth;
• Asthma in childhood; and/or
• A rare genetic condition called alpha-1 antitrypsin deficiency, which can cause COPD at a young
age.
RISK FACTORS

• Exposure to air pollution

• Breathing secondhand smoke

• Working with chemicals, dust and fumes

• A genetic condition called Alpha-1 deficiency

CLINICAL MANIFESTATION

❖ Chronic cough.
❖ Shortness of breath while doing everyday activities (dyspnea)
❖ Frequent respiratory infections.
❖ Blueness of the lips or fingernail beds (cyanosis)
❖ Fatigue.
❖ Producing a lot of mucus (also called phlegm or sputum)
❖ Wheezing.
DIAGNOSTIC EVALUATION

1. History collection.
2. Physical examination
3. Lung (pulmonary) function tests.

4. Chest X-ray.

5. CT scan.

6. Arterial blood gas analysis.

7. Laboratory tests. Lab tests aren't used to diagnose COPD, but they may be used to determine the cause of
your symptoms or rule out other conditions. For example, lab tests may be used to determine if you have the
genetic disorder alpha-1-antitrypsin deficiency, which may be the cause of COPD in some people. This test
may be done if you have a family history of COPD and develop COPD at a young age.
MANAGEMENT

 The aims of management in COPD are therefore to:

• reduce airflow obstruction
• reduce symptoms and improve quality of life
• prevent or reduce secondary medical complications
SURGICAL MAGEMENT
• Bullectomy is a procedure where doctors remove one or more of the very large bullae or blebs from the
lungs. Bullae are large air sacs that form from hundreds of destroyed alveoli. These air spaces can become so
large that they crowd out the better functioning lung and interfere with breathing. For those people,
removing the destroyed air sacs improves breathing.

• Lung Volume Reduction Surgery (LVRS) is a procedure to help people with severe emphysema affecting
the upper lung lobes. LVRS is not a cure for COPD but can improve one's exercise capacity and quality of
life. The goal of the surgery is to reduce the size of the lungs by removing about 30 percent of the most
diseased lung tissues so that the remaining healthier portion can perform better. LVRS also can allow the
diaphragm to return to its normal shape, helping you breathe more efficiently. The surgery has been shown to
help improve breathing ability, lung capacity and overall quality of life among those who qualify for it.
NURSING MANAGEMENT

NURSING DIAGNOSES -
• Impaired gas exchange due to chronic inhalation of toxins.
• Ineffective airway clearance related to bronchoconstriction, increased mucus production,
ineffective cough, and other complications.
• Ineffective breathing pattern related to shortness of breath, mucus, bronchoconstriction, and
airway irritants.
• Self-care deficit related to fatigue.
 Activity intolerance related to hypoxemia and ineffective breathing patterns