ASTHMA AND COPD FULL DETAIL IN EASY PROCESS,
chronic obstructive pulmonary disease. DEFINATION AND REASONS, FACTORS OF IT, INTRINSIC AND EXTRINSIC FACTORS
2. COPD
Definition
COPD, or chronic obstructive
pulmonary disease, is a
progressive disease that makes it
hard to breathe. "Progressive"
means the disease gets worse
over time.
4. COPD
Overview
• In COPD, less air flows in and out of the airways
because of one or more of the following:
• The airways and air sacs lose their elastic quality.
• The walls between many of the air sacs are
destroyed.
• The walls of the airways become thick and
inflamed.
• The airways make more mucus than usual, which
tends to clog them.
8. COPD
Symptoms
• Productive cough
• Breathlessness
• Chest infection
• Other symptoms of COPD can be more
vague, weight loss, tiredness and ankle
swelling.
9. Difference between COPD and Asthma
• In COPD there is permanent damage to the airways. The
narrowed airways are fixed, and so symptoms are chronic
(persistent). Treatment to open up the airways, is therefore
limited.
• In asthma there is inflammation in the airways which
makes the muscles in the airways constrict. This causes the
airways to narrow. The symptoms tend to come and go,
and vary in severity from time to time. Treatment to reduce
inflammation and to open up the airways usually works
well.
• COPD is more likely than asthma to cause a chronic
(ongoing) cough with sputum.
10. Difference between COPD and asthma (cont…)
• Night time waking with breathlessness or
wheeze is common in asthma and uncommon in
COPD.
• COPD is rare before the age of 35 whilst asthma
is common in under-35.
11. COPD
Diagnostic tests
• Symptoms
• Physical examination
• Sample of sputum
• Chest x-ray
• High-resolution CT (HRCT scan)
• Pulmonary function test (spirometery)
• Arterial blood gases test
• Pulse oximeter
12.
13. COPD
Medical management
• Give antibiotics to treat infection
• Give bronchodilators to relieve bronchospasm, reduce
airway obstruction, mucosal edema and liquefy secretions.
• Chest physiotherapy and postural drainage to improve
pulmonary ventilation.
• Proper hydration helps to cough up secretions or tracheal
suctioning when the patient is unable to cough.
.
14. COPD
Medical management (cont…)
• Stop smoking
• Oxygenation with low concentration during the acute episodes
• In asthma adrenaline ( epinephrine) SC if the bronchospasm not relieved.
• Aminophylins IV if the above treatment does not help.
• Sedative or tranquilizers to calm the patient.
• Intubations and mechanical ventilation if there is respiratory failure.
15. COPD
Preventive measures
• To prevent irritation and infection of the airways,
instruct the patient to:
• Avoid exposure to cigarette, pipe, and cigar smoke as
well as to dusts and powders.
• Avoid use of aerosol sprays.
• Stay indoors when the pollen count is high.
• Stay indoors when temperature and humidity are both
high
16. COPD
Preventive measures (cont…)
• Use air conditioning to help decrease pollutants and
control temperature
• Avoid exposure to persons known to have colds or other
respiratory tract infection
• Avoid enclosed, crowded areas during cold and flu
season.
• Obtain immunization against influenza and streptococcal
pneumonia.
17. COPD
Preventive measures (cont…)
• To ensure prompt, effective treatment of a
developing respiratory infection, instruct the
patient to do the following:-
• Report any change in sputum color character,
increased tightness of the chest, increased
dyspnea, or fatigue.
• Call the physician if ordered antibiotics do not
relieve symptoms within 24 hours.
18. COPD
Nursing intervention
• Assessment
• History
• Patient's environment
• Work history, exercise pattern, smoking
habits
• The onset & development of symptoms
• Sleeping positions
19. COPD
Nursing intervention (cont…)
• Physical examination
Signs of heavy smokers
• Distended neck vein on expiration
• The presence of barrel chest
• Observe for abdominal breathing
• Auscultate the chest& listen for musical
wheezes characteristics of chronic bronchitis
20. COPD
Nursing intervention (cont…)
• review the results of diagnostic procedure:
• Arterial blood gases
• Pulmonary function tests
• X-ray films
• Nursing diagnosis
– Ineffective breathing pattern related to increase need of O2
– Ineffective airway clearance related to excessive accumulation
of secretions
– Impaired gas exchange related to impaired expiration &co2
retention