COPD and Emphysema Overview

COPD and Emphysema

• COPD: Chronic Obstructive Pulmonary Disease
• Emphysema: Gradual damage to lung tissue, destruction of alveoli
• Blue Bloaters: Cyanosis due to low oxygen levels in the blood
• Pink Puffers: Compensatory puffing or prolonged expiration due to CO2 trapping
• Barrel Chest: Increased anterior/posterior diameter of the chest
• Clubbing of fingers: Late sign of COPD
• Signs and symptoms: Hypoxia (restlessness), dyspnea, barrel chest, diminished breath sounds, fatigue, non-productive cough, hyperresonance upon percussion.

Nursing Diagnosis: Ineffective Airway Clearance

• Increased mucus
• Thick, tenacious white or gray sputum
• Productive cough

Medical Management

• Bronchodilators: Beta agonists (albuterol, salbutamol, isoproterenol)

Nursing Management

• Promote Airway: increase fluid to loosen secretions, coughing to expel secretions, suctioning as needed, chest percussion therapy (CPT), postural drainage
• Promote Breathing: Positioning (orthopneic position), pursed lip breathing (inhale through nose, exhale through mouth twice as long), mechanical ventilation (non-invasive, IPPB)
• Health Teaching: Rest, avoid smoking, infection prevention (handwashing, avoid crowded places), diet (increase calories and protein, decrease carbohydrates)

Atelectasis

• Collapse of one or more parts of the lung
• Affects alveoli, the tiny air sacs in the lungs

Types of Atelectasis

• Compressive atelectasis: Fluid, air, blood, or tumors push on the lung causing collapse.
• Resorptive atelectasis: Oxygen and carbon dioxide move into the bloodstream and no new air moves into the alveoli, causing them to collapse. Commonly occurs due to surgery requiring anesthesia.
• Obstructive atelectasis: Also known as resorptive atelectasis, occurs when something like mucus, a tumor, or an inhaled object blocks the inside of the lungs.
• Contraction atelectasis: Lung scarring (fibrosis) causes the alveoli to not open properly.

Clinical Manifestation of Atelectasis

• Dyspnea (shortness of breath), cough, sputum production, tachycardia, tachypnea, pleural pain, central cyanosis, orthopnea
• In acute atelectasis involving a large amount of lung tissue (lobar atelectasis), marked respiratory distress.
• In chronic atelectasis, similar symptoms as acute atelectasis, but alveolar collapse predisposes patients to infection distal to the obstruction.

Pneumonia

• Inflammation of the lungs, often caused by infection.
• Aspiration pneumonia: Entry of exogenous or endogenous substances into the lower airway.
• Common pathogens: Anaerobes, Staphylococcus aureus, Streptococcus species, and Gram-negative bacilli.
• Other aspirated substances: Gastric contents, exogenous chemical contents, or irritating gasses.
• Risk factors: Heart failure, diabetes, alcoholism, COPD, AIDS.

Pneumonia in Immunosuppressed Hosts

• Pneumonia can occur with the use of corticosteroids, other immunosuppressive agents, chemotherapy, nutritional depletion, broad-spectrum antimicrobials, AIDS, genetic immune disorders, and long-term advanced life support technology.

Passageway of Respiration

• Mouth/nose > pharynx > larynx > trachea > lungs > bronchus > bronchioles > alveoli.
• Alveoli are the dead end of the inhaled air and are close to the blood.
• Oxygen enters the blood from alveoli and carbon dioxide moves from the blood to the alveoli to be exhaled.

This quiz focuses on the key concepts of Chronic Obstructive Pulmonary Disease (COPD) and Emphysema, including their signs and symptoms, nursing diagnoses, and medical management. Test your knowledge on the characteristics and management strategies related to these respiratory conditions.