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COPD
COPD CARDS
| Term | Definition |
|---|---|
| COPD | Chronic Obstructive Pulmonary Disease |
| Pathophysiology of COPD | Airflow limitation is progressive Associated with an abnormal inflammatory response to particles or gases |
| COPD usually includes components of? | Emphysema Chronic Bronchitis |
| Pathophysiology of COPD | Body attempts to repair itself, narrowing occurs in small peripheral arteries Over time scar tissue is formed due to the injury-repair process Airway narrows due to scar tissue |
| These physiologic alterations in oxygenation often result from? | Exposure to cigarette smoke Use of tobacco products Release of inflammatory mediators |
| These physiologic alterations in oxygenation often result from? | Smoking Infections - recurrent Air pollution Heredity Aging |
| Signs & Symptoms of COPD | Chronic cough Sputum production Dyspnea on exertion |
| Signs & Symptoms of COPD | Weight loss Increased work of breathing Use of accessory muscles to breath Energy-depletion |
| Classifications of COPD Stage 0 | At risk Chronic Cough |
| Classifications of COPD Stage 1 | Mild Reduced pulmonary function Forced Expiratory Function greater than 80% predicted |
| Classifications of COPD Stage 2 | Moderate Further reduction in pulmonary function; 50% FEV1 less than 80% predicted |
| Classifications of COPD Stage 3 | Severe Further reduction in pulmonary function; 30% FEV1 less than50% predicted |
| Classifications of COPD Stage 4 | Very Severe Chronic respiratory failure; FEV1 <30% predicted |
| What is FEV1 ? | Forced Expiratory volume is less than 70% |
| Pathophysiology of Emphysema | Destruction of the walls of over-distended alveoli Abnormal distention of the air spaces beyond the terminal bronchioles Impaired gas oxygen and carbon dioxide exchange it is the end stage of a process that progresses over years |
| Structural changes in Emphysema include ? | Hyperinflation of alveoli Destruction of alveolar walls Destruction of alveolar capillary walls Narrowed tortuous small airways Loss of lung elasticity |
| Types of Emphysema: Panlobular ( panacinar) | Destruction of the respiratory bronchiole, alveolar duct, and alveolus Air spaces in lobule are enlarged Little inflammatory disease Hyper inflated (hyper expanded) chest |
| Signs & Symptoms: Panlobular | Barrel chest Short of breath (SOB) Dyspnea on exertion (DOE) Weight loss Chest rigid - ribs fixed |
| Types of Emphysema: Centrilobular ( centroacinar) | Pathologic changes take place mainly in secondary lobule Alterations in ventilation - perfusion ratios |
| Signs & Symptoms: Centrilocular | Chronic hypoxemia, hypercapnia Polycythemia Episodes of right-sided heart failure Central cyanosis Respiratory failure Peripheral edema - treated with diuretic therapy |
| Pathophysiology of Chronic Bronchitis | Chronic bronchitis defined as the presence of a chronic productive cough for 3 months in each of 2 successive years in a patient that has had excluded the other causes of the cough. |
| Causes of Chronic Bronchitis | Smoking of exposure of smoke Environmental pollutants - airway irritation Recurrent respiratory infections Exacerbations most common in the winter |
| Pathophysiology of Chronic Bronchitis | Bronchial tubes narrowed Impaired air flow Inflammation Excess mucus production Bronchospasm (respiratory smooth muscle constriction) |
| Signs and Symptoms of Chronic Bronchitis | Productive frequent cough Cough exacerbated by respiratory irritants and cold damp air Bronchospasm frequent respiratory infections Hypoxemia and hypercapnia from hypo ventilation Cyanosis Normal weight to obese |
| Complications of COPD | The chronic alteration in oxygenation that occurs in COPD and the associated conditions of emphysema and chronic bronchitis, can result in life threatening complications including respiratory insufficiency and respiratory failure |
| Acute Respiratory Failure (ARF) | Sudden deterioration of gas exchange Life threatening Develops after acute respiratory infection or bronchitis Often wait too long to seek treatment for respiratory infection |
| Signs and Symptoms of Acute Respiratory Failure | increasing cough Fever Dyspnea Fatigue Hypo ventilation Persistent elevation CO2 levels Respiratory suppression |
| Management of Acute Respiratory Failure | Careful O2 Administration Artificial ventilation Treat underlying infection |
| Cor Pulmonale | Cor Pulmonale is the hypertrophy of the right side of the heart with or without congestive heart failure. Results in pulmonary hypertension Caused by constriction of the pulmonary vessels in response to alveolar hypoxia |
| Signs and Symptoms of Cor Pulmonale | Right ventricle dilation Systemic venous congestion S3 gallop JVD Hepatomegaly and RUQ tenderness Ascites Peripheral edema Weight gain. |
| Peptic Ulcer Disease | Increased incidence in COPD patients Reason in unknown Possibly due to use of long term steroid therapy for COPD Possibly related to stress of chronic illness |
| Diagnostic Exams and Tests for COPD | ABG's are monitored Low PaO2 Elevated PaCO2 Decreasing pH ncreased bicarbonate levels Pulse oximetry - baseline oxygen levels Chest x-ray CT scan |
| Treatment of Patients with COPD | •Medications ◦Bronchodilators Antimuscarinic Short Acting Antimuscarinics (SAMAs) such as ipratropium Long Acting Antimuscarinis (LAMAs) such as tiotropium |
| Treatment of Patients with COPD | Corticosteroids Prednisone (oral) methylprednisone iv Anti infectives Methylxanthines such as theophylline Beta2 Agonists Short Acting Beta2 Agonists (SABA) such as albuterol Long Acting Beta2 Agonists (LABA) such as salmeterol |
| Oxygen Toxicity | Decreased vital capacity Cough Chest pain Nausea and vomiting paresthesia Nasal stuffiness Sore throat Malaise, fatigue |
| Patient Teaching for COPD | •Pursed-lip breathing •Diaphragmatic breathing •Coughing |
Created by:
shanze86
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