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Chronic Obstructive Pulmonary Disease (COPD) - Coggle Diagram
Chronic Obstructive Pulmonary Disease (COPD)
Causes
Outdoor air pollution
Any factor that affects lung growth during gestation and childhood (low birth weight, respiratory tract infections)
Occupational dusts and chemicals (vapors, irritants, fumes)
Inherited mutation in the alpha1-antitrypsin gene
Tobacco smoke (cigarette, pipe, cigar, secondhand smoke)
Genetic and epigenetic factors
Complications
Troublesome or severe breathlessness
Increased sputum and purulence or darkening of sputum color
Worsening cough
Increased wheeziness
Raised heart rate
Respiratory rate of 20% or more above normal
Upper respiratory tract infection
Raised temperature
Pathophysiology
Emphysema/Chronic Bronchitis are types of COPD
--> Peripheral airway inflammation and narrowing of the airways
--> Airflow limitation and destruction and loss of alveoli, terminal bronchioles, surrounding capillary vessels and tissues
--> More airflow limitation and decreased gas transfer capacity
Extend of airflow limitation determined by severity of inflammation, development of fibrosis within the airway, and presence of exudates
--> Reduced airflow on exhalation leads to air trapping = reduced inspiratory capacity = breathlessness on exertion and reduced exercise capacity
Low oxygen levels and raised blood carbon dioxide levels result from impaired gas transfer and can worsen as the disease progresses
Assessments
Assess and monitor respirations and breath sounds, note rate and sounds, inspiratory and expiratory ratio
Auscultate breath sounds, note adventitious breath sounds
Note presence and degree of dyspnea
Observe for signs and symptoms of infection
Monitor ABGs, pulse oximetry, chest x-ray
Diagnostic Tests
Based on history of symptoms, physical examination, chest imaging, pulmonary function tests and blood gas analysis
Lung function tests measure amount of air inhaled and exhaled-- spirometry
Chest x-ray
CT scan of the lungs
Arterial blood gas analysis measures how well the lungs bring o2 into blood and remove co2
Lab tests to determine if it is genetic or to determine the cause of symptoms and rule out other conditions
Treatments
Medications
Chest physical therapy-- deep breathing and postural drainage
Oxygen therapy in individuals with hypoxemia
Teaching: nutritional counseling, respiratory hygiene, recognition of the early signs of infection, techniques to relieve dyspnea-- pursed lip breathing
Smoking cessation
Medications
Bronchodilators, inhaled anticholinergic agents of beta-agonists
Albuterol, Levalbuterol, Formoterol, Aclidinium
Roflumilast (phosphodiesterase E4 inhibitor) and mucolytics
Inhaled corticosteroids, antibiotics
Fluticasone, Budesonide
Azithromycin
Oxygen therapy
Antioxidants and anti-inflammatory drugs