COPD: Causes, Diagnosis, and Treatment

Study Notes

Approximately 14 million people in the US have COPD.
COPD is the third leading cause of death in the US.
COPD is a group of lung diseases that cause airflow blockage and breathing problems.
Two main types are chronic bronchitis (bronchi) and emphysema (alveoli).
COPD is caused by chronic inflammation of the bronchioles and alveoli.
COPD causes airflow limitation that makes it difficult to breathe.
Symptoms include wheezing, coughing, and shortness of breath.

Bronchodilators:
- β2-Adrenergic agonists:
  - Short-acting (examples: albuterol)
  - Long-acting (example: salmeterol)
- Anticholinergics:
  - Ipratropium (Atrovent)
  - Tiotropium (Spiriva) -Long-acting
- Methylxanthines(example: theophylline):
  - Monitor theophylline levels in blood
  - Theophylline toxicity can cause nausea, vomiting, confusion, tremors
Corticosteroids: - Inhaled corticosteroids - for moderate to severe cases - Intravenous corticosteroids
Antibiotics: - Azithromycin (Zithromax)
Phosphodiesterase Inhibitors (example: roflumilast) - for smooth muscle relaxation

Improve oxygenation
Keep O2 saturation > 90% during rest, sleep, and exertion
PaO2 greater than 60 mm Hg (via ABG)
Long-term oxygen therapy (Home)
Improves survival
Increases exercise capacity
Improves cognitive performance
Oxygen therapy can cause complications such as: - Combustion - CO2 narcosis - Oxygen toxicity

Clients with COPD may require frequent assessments related to respiratory function, including respiratory rate, oxygen saturation, and lung sounds.
Nurses play a vital role in educating patients about COPD management, including medication administration, smoking cessation, and pulmonary rehabilitation.
Support patients with COPD in finding resources and support networks.
The nurse will need to recognize the symptoms and risk factors associated with COPD, such as smoking history, exposure to air pollution, and genetic predisposition.
The nurse's role is to assess patient tolerance of medications and treatments, and to monitor for side effects.
The nurse will need to assess the patient's understanding of their condition, treatment plan, and lifestyle modification strategies to help control COPD.
Assess the patient's functional capacity and their ability to engage in pulmonary rehabilitation programs.

Monitor for signs of respiratory distress, such as wheezing, dyspnea, and cyanosis.
Administer medications as prescribed, including bronchodilators, corticosteroids, and antibiotics.
Encourage patients to use proper inhaler technique.
Provide oxygen therapy as prescribed.
Assist with pulmonary rehabilitation programs, which can help improve exercise tolerance and quality of life.
Educate patients about the importance of smoking cessation and avoiding exposure to secondhand smoke.
Teach patients how to practice deep breathing exercises to improve lung capacity.
Encourage fluid intake to help thin respiratory secretions.
Provide emotional support and resources for patients with COPD.
Monitor patients for signs of complications, such as respiratory failure, pneumonia, and pneumothorax.
Ensure that patients have access to appropriate respiratory care services, such as home oxygen therapy, nebulizer therapy, and pulmonary rehabilitation.