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Chronic Obstructive Pulmonary Disease image , NURSING IMPLEMENTATION,…
Chronic Obstructive Pulmonary Disease
PATHOPHYSIOLOGY
Chronic inflammation of airways, lung parenchyma and pulmonary blood vessels
inflammatory cells (neutrophils, macrophages, lymphocytes) attract inflammatory mediators (leukotrienes and interleukins)
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Oxidants are produced by cigarette smoke, inhaled particles and/or are released from macrophages & neutrophils and causes magnification of inflammation
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RISK FACTORS
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Heredity
α1- Antitrypsin deficiency
a genetic abnormality that can lead to COPD because activity of proteases like elastase cannot be inhibited, which leads to alveolar destruction
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COMPLICATIONS
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Depression, Anxiety, Panic
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NURSING EVALUATION
improvement in sleeping pattern where patient can sleep a minimum of 5 hours over 24 hours and feel refreshed and well rested
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maintain body weight and normal serum levels that is appropriate for sex, height and age
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baseline respiratory function with normal breath sounds & lung rate, rhythm and depth bilaterally
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NURSING ASSESSMENT
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Subjective Data
Current Health
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Cough
if productive → consistency, colour, quantity
Past Health History
exposure to irritants, chemicals, pollution, secondary smoke
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record all medications, supplemental oxygen and complementary therapies used
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Objective Data
General
- BMI
- anxiety, depression
- distress and restlessness
- using extra energy/work to breathe
Integumentary
- cyanosis
- pallor/ruddy colour
- poor skin turgor, easily bruised
- peripheral edema
Respiratory
- use of accessory muscles
- shallow and rapid breathing
- increased expiration
- chest movements decreased
- wheezing, crackles
- decreased ability to speak
- hyper-resonance + dull lung sounds
- breath sounds are diminished
Cardiovascular
- dysrhythmia
- tachycardia
- third heart sound on the right side
- distension of the jugular vein
Muscoloskeletal
- muscle atrophy
- increase in anteroposterior diameter (barrel chest)
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CLINICAL MANIFESTATIONS
- dyspnea
- orthopnea
- palpations
- anorexia
- weight loss or gain
- difficulty in eating
- constipation
-bloating
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- prolonged expiration
- wheezes
- decreased breath sounds
- productive, recurrent cough
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- headache
- memory loss
- cannot concentrate
- depression, anxiety, panic
- insomnia and fatigue
NURSING IMPLEMENTATION
Health Promotion
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Avoid large crowds during the peak of the influenza season for older patients and those with respiratory issues
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Patient Education
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Regular exercise starting with slower, shorter walks and increasing pace and intensity as tolerated and as they get stronger
dosage, safety, purpose, types, schedule, side effects
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Occupational Therapist
- explain use of home oxygen therapy and equipment management
- assess and create a plan to participate in ADLs
- helps with home management
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α1- Antitrypsin - an enzyme that protects the lung from injury by proteases that digest and breakdown the alveolar walls
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Submitted by Kemesha O'Connor and Athira Mohan for NURS 2522 on March 10, 2021