Chronic Obstructive Pulmonary

Disorders

•The fifth leading cause of death in the US.

•It is characterized as a varying combinations of
Asthma, Chronic Bronchitis and Emphysema
•Other terms used for COPD are: COLD (Chronic
Obstructive Lung Disease), CAL ( Chronic airflow
limitation)
 Asthma
Etiology:
Asthma is a potentially reversible obstructive airway disorder
characterized by airway inflammation and
hyperresponsiveness.
Assessment:
• Collect ass essential information.
(Medications, allergies, known cardiac disease, sleep disruption)
 Asthma
Pathophysiology:
• It has long term consequences.
• It has two phases of attacks. Phase 1 (early Stage) and Phase 2 (late Phase)
• The early phase begins when triggers such as allergies, irritants, infections,
exercise or gastroesophageal activate the inflammatory process.
• The late phase begins 5-6hrs after the early phase.
• During the late phase which can last several hours or days , the airway are are
hyperreactive (very sensitive)
 Asthma
Complications:
• Right-sided heart failure, pneumothorax,
worsening hypoxemia, acidosis, and
respiratory or cardiac arrest.
 Asthma
Signs and Symptoms:
• Patient may exhibt dyspenea, productive cough, use of accessory
muscles of respiration, Audible expiratory wheezing, tachychardia,
and tachypnea.

Medical Diagnosis:
Airflow coming from the patient’s lungs is significantly less than
expected.
 Asthma
Medical treatment:
• using bronchodilators and anti-inflammatory drugs.

Interventions:
• Monitor the patient’s respiratory rate, pattern, and effort.
Support patient in fowler’s position, and give oxygen as ordered.
Chronic Bronchitis and Emphysema
Pathophysiology:
• A degenerative, nonreversible disease
characterized by the enlargement of the
airway beyond the terminal bronchioles.
• Two types of Emphysema: Centrilobular and
Panlobular
Chronic Bronchitis and Emphysema
Chronic Bronchitis- bronchial inflammation
characterized by increase production of mucus
and chronic cough that persist for at least 3
months of the year for at lease 3 years.
Chronic Bronchitis and Emphysema
Assessment:
• The presenting symptoms are often dyspnea, cough, chest pain, or a
combination of these.
• Obtain medical history
• Current medications and allergies
• Inquire about exposure to smoke or other respiratory irritants.
• Observe the patient’s posture, color, respiratory effort, and use of accessory
muscle of respiration.
• Check vitals
• Check patients neck for distenation of veins.
• Inspect the shape of the thorax.
• Inspect nails for clubbing, pallor, or cyanosis
• Inspect and Palpate the feet and ankles for edema.
Chronic Bronchitis and Emphysema
Complications:
• Respiratory failure and heart failure.
• Fcators that can lead to complications are,
infections, air pollution, continued smoking
and left ventrical failure, myocardial infarction,
pulmonary embolism, spontaneous
pneumothorax, and adverse effects of drugs
Chronic Bronchitis and Emphysema
Signs and Symptoms:
• Chronic Bronchitis- productive cough, excertional
dyspnea, and wheezing.
• The red blood cell count is typically elevated to
compensate for the inadequate oxygen in the blood.
• Dyspnea and excretion are the main symptoms of
Emphysema
• Depression and irritability are also common in
patients with COPD
Chronic Bronchitis and Emphysema
Medical Diagnosis:
The most reliable diagnostic test for COPD are
the pulmonary function test, which reveals a
decreased force expiratory volume and forced
vital capacity accompined by increased in
functional residual capacity and residual
volume.
Chronic Bronchitis and Emphysema
Medical Treatment:
Bronchodialators, including beta-adrenergics
and Anti-cholinergics, are ordered to decrease
airway resistance and the work of breathing.
The therapeutic blood level is 5 to 15
micrograms per milliliters (mcg/mL)
Chronic Bronchitis and Emphysema
Interventions:
• Monitor the patient’s vital signs and arterial
blood gasses for signs of inadequate
oxygenation.
• Place patient in high Fowlers position or
seated on the bedside with arms folded on the
overbed table to promotefull expansionof the
lungs.
 Bronchiectasis
• And abnormal dilation and distortion of the
bronchi and bronchioles that is usually
confined to one lung lobe or segment.
• The most prominent signs of Bronchiecatsis
are coughing and the production of large
amounts of purulent sputum.
 Bronchiectasis
Treatment: