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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