Chronic Obstructive Pulmonary Disease, Nursing

Slide 1: Title Slide
Title: Understanding COPD: Definition, Diagnosis, Pathophysiology, Management, and Nursing Care Plan

Subtitle: A comprehensive guide for nursing students

Slide 2: Definition of COPD
Definition:
COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.

Main characteristics:

Progressive airflow limitation

Often associated with smoking

Includes emphysema and chronic bronchitis

Slide 3: Types of COPD
Chronic Bronchitis:

Inflammation of bronchial tubes, leading to excess mucus production

Symptoms: Chronic cough, sputum production

Emphysema:

Damage to alveolar walls, leading to air trapping

Symptoms: Shortness of breath, barrel chest

Slide 4: Diagnosis of COPD
Methods of Diagnosis:

Pulmonary Function Test (PFT):

Measures forced expiratory volume (FEV1) and forced vital capacity (FVC)

Arterial Blood Gas (ABG):

Measures oxygen and CO2 levels

Chest X-ray/CT Scan:

Identifies lung damage

History and Symptoms:

Cough, sputum, and breathlessness history

Smoking history

Slide 5: Pathophysiology of COPD
Airflow Obstruction:

Chronic inflammation leading to narrowing of airways

Destruction of alveolar walls (emphysema)

Increased mucus production (chronic bronchitis)

Increased Work of Breathing:

Air trapping and limited gas exchange

Progressive Hypoxia & Hypercapnia:

Reduced oxygen supply and increased carbon dioxide retention

Slide 6: Management of COPD
Pharmacological Treatment:

Bronchodilators (Beta-agonists, Anticholinergics)

Corticosteroids (oral or inhaled)

Oxygen Therapy

Antibiotics (for infections)

Non-pharmacological Treatment:

Pulmonary Rehabilitation

Breathing exercises (e.g., pursed-lip breathing)

Lifestyle changes (e.g., smoking cessation)

Vaccinations (e.g., flu, pneumonia)

Slide 7: Nursing Care Plan for COPD
Assessment:

Monitor respiratory rate, lung sounds, oxygen saturation

Assess for signs of distress (e.g., use of accessory muscles)

Record smoking and environmental exposure history

Nursing Diagnoses:

Impaired Gas Exchange

Ineffective Airway Clearance

Activity Intolerance

Goals:

Maintain optimal oxygen levels

Enhance airway clearance

Increase physical activity tolerance

Interventions:

Administer bronchodilators and corticosteroids

Educate on smoking cessation

Promote breathing exercises and positioning

Ensure proper nutrition and hydration

Educate on recognizing exacerbations

1. Respiratory Notes
Do not upload or share without owner permission
©copyright anuragjoseph
INSTAGRAM-@medical_lectures_by_anurag

2. Restrictive Lung Disease
There is restriction to airflow in
inspiration
Patient has problem in inspiration due to
compression of lungs
Due to some etiology lung is not able to
expand properly thus decreasing tidal
volume
Diseases in restrictive lung disease
Pulmonary effusion
Pulmonary fibrosis
Thoracic cage disorder
Pleural thickening
Pneumothorax
Poliomyelitis
GBS
SPIROMETRY-
FEV1/FVC= 0.8<

3. Obstructive Lung disease
There is restriction to airflow in expiration
Patient has problem in expiration due to
dilation of Alveoli and obstruction of
bronchus in lungs
Due to some etiology lung becomes
hyperventilated and alveoli becomes
distended thus increasing lung residual
volume
Obstructive lung diseases
COPD
EMPHYSEMA
ASTHAMA
CHRONIC BRONCHITIS
BRONCHIECTASIS
SPIROMETRY-
FEV1/FVC= 0.8>

4. VENTILATION DISEASE
There is impairment in gas exchange due
to collection of fluid in Alveoli thus
causing failure to external respiration
And causing deoxygenated blood to
recirculate causing Cyanosis and other
related symptoms
ventilation lung disease
Pneumonia
Pneumothorax

5. Perfusion disease
There is impairment in pulmonary blood
flow back to heart due to obstruction of
pulmonary capillaries generally caused
due to pulmonary hypertension
Perfusion lung disease
Pulmonary Hypertension
Pulmonary embolus
Pulmonary obstruction
Pulmonary endothelial dysfunction

6. COPD
COPD is a chronic obstructive pulmonary disease, characterized by chronic bronchoconstriction, inflammation of bronchus and
bronchioles mucus membrane (chronic bronchitis and asthma) , dilation of alveoli (emphysema), hyperventilation of lungs
It involves triad of disease i.e. Chronic Bronchitis, asthma, emphysema.
COPD causes an obstruction to airflow out of the lungs, i.e. patient faces difficulty in expiration
Chronic bronchitis
asthma
emphysema

7. COPD ETIOLLOGY
•Environmental factors-dust, pollution, allergies
•Occupational factors-working in factories that
produce fumes and smoke and other irritant
•Lifestyle factors-smoking, sedentary lifestyle, stress
and smoking marijuana and other substance abuse
•Biological/genetic/heredity factors-alpha anti trypsin
deficiency, weak cilliaryaction, past history of COPD
in family

8. COPD PATHOPHYSIOLOGY
Due to ETIOLOGY -lifestyle factor-smoking (nicotine), occupational factors-dust smokes, fumes, gases, genetic
factors-alpha anti trypsindeficiency allergies and past family history
Irritation of bronchus and Bronchioles mucus membrane stimulating goblet cells leading to increased mucus
production
Bronchoconstriction and decreased size of lumen thus decreases airflow patency
Mucus accumulation and cilliarydysfunction deregulates coughing mechanism and impairs ability to cough out
mucus
Mucus build up increases and reaches Alveoli along with other irritant that stimulates Macrophage/ phagocytes
that brings Neutrophils into action which secretes Protease and elastase
Elastasedestroys elastic connective tissue of Alveoli leading to loss of elastic recoil of alveoli

9. Alveoli loses ability to retract, causing hyperventilation and dilation of alveoli
Increased residual volume, and increased airflow resistance in expiration as bronchus and bronchioles loses it property to
exert pressure against the airflow leading to collapse of bronchioles
Residual volume increase causes Barrel Chest, and increased resistance to pulmonary blood flow
Pulmonary hypertension causes backflow of deoxygenated blood back into the heart causing right ventricular hypertrophy
Hypoxemia and hypercapnia
Backflow of blood into the tissues causes edema and backflow into vital organs such as liver causes Hepatomegaly and
Splenomegaly
Heart unable to meet the metabolic demand of the body
Right sided heart failure and multiple system failure

10. SYMPTOMS AND CLINICAL MANIFESTATIONS
Productive coughing
Bronchoconstriction
Exertionaldyspneoa
Tripod position
Barrel chest
Neck muscle hypertrophy
Edema
ST segment inversion in ECG
Blue bloater(Chronic Bronchitis)-cyanosis and edema
Pink puffer(Emphysema)-barrel chest and erythema
Pursed lip breathing
Chest pain due to overuse of intercostal,
accessory muscles and abdominal muscles
©copyright anuragjoseph

11. Pink puffer vsblue bloater
©copyright anuragjoseph

12. Diagnostic Manifestation
•Spirometry-FEV1/FVC= 0.8>
•Chest Xray-Hyperinflation of lungs, pulmonary artery disease, Right
Ventricle Hypertrophy
•Abganalysis-respiratory acidosis
•Oxygen saturation by pulse oxymetry
•Ecg-ST segment inversion
•Physical examination chest circumference, breathing rate, apical
pulse, edema assessment, neck muscle hypertrophy, cyanosis.