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COPD

COPD. Cydnee Patterson, Ali Lubbers, Nicole Newinger , Heidi Proudfoot & Kaitlin Oudshoorn. Senario. Mr. D has a hx of emphysema and Chronic bronchitis. He is 73 years old & a retired farmer. Recently he has found that he can no longer walk around his

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COPD

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  1. COPD Cydnee Patterson, Ali Lubbers, Nicole Newinger, Heidi Proudfoot & Kaitlin Oudshoorn

  2. Senario Mr. D has a hx of emphysema and Chronic bronchitis. He is 73 years old & a retired farmer. Recently he has found that he can no longer walk around his farm without extreme SOB. He is treated at the outpatient clinic today for increasing SOB, occuring even at rest

  3. Subjective Data • Reports sputum production increased over past week & color has changed to greenish/yellow • Has more sputum in morning & it gradually reduces throughout the day • Taking Salbutamol (Ventolin) inhaler & Fluticasone (Flovent) inhaler 2 puffs q6hrs • On no other meds @ this time

  4. Objective Data • Appears frail & older than stated age • Labored breathing & visible use of accessory muscles during respiration • Sitting in orthopneic position & using pursed-lip breathing • VS: BP normal; P 96; R 28; T 38.8c • AG: pH 7.36; PaO2 55 mm Hg; PaCo2 65 mm Hg • Upon chest assessment: crackles in lower lt. lobe; diffuse expiratory wheezing t/o chest; lower lt. lobe dull to percussion.

  5. http://video.about.com/copd/COPD.htm Chronic obstructive pulmonary disease (COPD) is a long term lung disease that usually includes emphysema and chronic bronchitis. It slowly damages the airways & air sacs making it difficult for the patient to breath. The disease includes symptoms such as shortness of breath, increased mucus and coughing. COPD cannot be cured, but it can be treated.

  6. Triggers of COPD • Viral Infection • Bronchiolitis • Deviation from diet • Discontinuation of Meds • Inhalation of environmental inhalants • Small airway mucosa hyperemia

  7. Pneumonia Could Mr. D. have pneumonia? • Pneumonia is an inflammation of the lung tissue caused by a microbial agent. Conditions such as COPD, and especially bronchitis, put individuals at an increased risk for developing such infections as their defense mechanisms are weakened. This inflammation causes the accumulation of fluid in the lungs, and can cause symptoms such as: • Greenish- yellow sputum production • Labored breathing with use of accessory muscles • Shortness of breath • Crackles on auscultation and dullness on percussion of affected lobe • Increased respiratory rate • Increased temperature  And Mr. D. has all of these symptoms! So could it be???

  8. As the nurse… • Smoking cessation • Medication education • Oxygen therapy • Positioning • Vaccinations • Diet • Exercise • Breathing techniques Now… lets try something…

  9. ABG’s

  10. Common Nursing Dx

  11. JEPOARDY

  12. Can you tell me how I got, how I got COPD? Discontinuation of medication Or a viral infection Can you tell me how I got, how I got COPD? Bronchiolitis or from switching your diet This may have worsened your disease Can you tell me how I got, how I got COPD? Being in a dusty place To much mucus in your airways This can make it harder to breath So this is how I got, how I got COPD… how I got COPD!!

  13. References Barnett, M. (2008a). Management of end-stage chronic obstructive pulmonary disease. British Journal of Nursing 17 (22). p. 1390-1394. Retrieved February 07, 2009 from Health Source: Nursing and Academic Edition Database. Barnett, M. (2008). Nursing management of chronic obstructive pulmonary disease. British Journal of Nursing 17 (21). p.1314-1318. Retrieved February 07, 2009 from Health Source: Nursing and Academic Edition Database. Causes and types of chronic obstructive pulmonary disorder (2009). Retrieved February 8, 2009, from http://video.about.com/copd/COPD.htm Celona, A.F. (20. 02). Diagnosing and treating community-acquired pneumonia. Physician Assistant, 26(1), 38-50 Celona, 2002; Mayo Foundation, 2007; Smeltzer & Bare, 2004 COPD (2009, January 8). Retrieved February 9, 2009, from http://www.lung.ca/diseases-maladies/copd-mpoc_e.php

  14. References COPD-ALERT 2000. (2008). It’s a matter of breath and death! Retrieved February 3, 2009, from http://www.copd-alert.com/COPD.html Day, R., Paul, P., Williams, B., Smeltzer, S., & Bare, B. (2007). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. 1st Canadian ed. Philadelphia, PA: Lippincott Williams & Wilkins. Essig, M. G. (2008). Seniors health: COPD's effect on the lungs. Retrieved February 8, 2009, from https://www.blueshieldca.com/hw/articles/hw_article.jsp?articleId=HWUG1539ABC&fromCategoryId=8&_requestid=1602421 Healthwise (2008, June 17). Arterial Blood Gases. Retrieved February 9, 2009, from http://www.webmd.com/a-to-z-guides/arterial-blood-gases Smeltzer, S.C. & Bare, B.G. (2004). Brunner & Suddarth’s textbook of medical-surgical nursing. Philadelphia, PA: Lippincott Williams & Wilkins. Tuder, R., Voelkel, N. (2000). COPD Exacerbation. Chest, 14, 376-379. Retrieved from www.chestjournal.org on Feb. 2, 2009.

  15. Name 3 causes of COPD exacerbation.

  16. Any of the following may exacerbate COPD: • Viral Infection- Brochiolitis- Deviation from diet- Discontinuation of Meds- Inhalation of environmental inhalants- Small airway mucosa • Hyperemia

  17. What 3 conditions or diseases(HINT: One we discussed…) are commonly associated with COPD exacerbation.

  18. Emphysema, Bronchiolitis, and Pneumonia.Asthma may also trigger COPD.

  19. True or False: Morphine should never be given to patients with COPD because it dangerously slows their respirations.

  20. False – True in that it does slow their respiration rates but in doing so, allows the breathing to be more efficient and reduces the feeling of breathlessness.

  21. What two common vaccinations are always suggested to COPD patients?

  22. S. Pneumonia & Influenza.

  23. What are two types of breathing that are useful to teach to patients with COPD?

  24. Pursed Lip and Abdominal breathing techniques.

  25. What are other causes of pneumonia besides viral & bacterial infection?

  26. Aspiration & Fungal.

  27. Name three health risks that increase likely hood of getting pneumonia?

  28. Pulmonary diseases, Smoking, Surgery, Trauma, Decrease immune system, Alcohol use, Hospitalization.

  29. How does the respiratory system of a healthy individual differ from that of an individual with COPD?

  30. In COPD the bronchial tubes become inflamed, narrowed and filled with mucous, lungs then loose elasticity and the alveoli burst creating large spaces.

  31. Name three non-specific symptoms of pneumonia.

  32. Headache, Dypsnea, Fatigue, Sweating, Chest pains, Chills, Cough, Decreased temperature in elderly.

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