General medicine, chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease

1. ASSESSMENT OF COPD roll no: 6,14,15,16,22,26,30,41

2. CONTENTS: - Classification of airflow limitation severity in COPD Refined ABCD Assessment Tool Non – pharmacological Assessment

3. Goals of COPD Assessment : - T o determine the level of airflow limitation. -Its impact on the patient’s health status. - Risk of future events ( such as exacerbations, hospital admissions or death).

4. Classification of Airflow Limitation Severity (Based on Post Bronchodilator FEV1

5. Refined ABCD Assessment Tool: - Refined ABCD assessment tool is latest and advanced assessment of COPD. - It categorizes the patient into A,B,C,D groups. - ABCD groups will be derived from patient symptoms and their history of exacerbation.

6. Non – pharmacological Assessment : Life style modification Smoking Cessation: Elimination of tobacco Smoking has been convincingly shown to reduce decline in pulmonary function and to prolong survival in patients with COPD. Reducing exposure to noxious particles and gases Sustained smoking cessation in mild to moderate COPD is accompanied by a reduced decline in forced expiratory volume in 1 second (FEV1) compared to persistent smokers.. In regions where indoor burning of biomass fuels are important, the introduction of non smoking cooking develops or alternative fuels should be encouraged.

7. 2. Nutritional assessment Is a crucial aspect of care for individuals with COPD Proper nutrition can help improve overall health,support lung function and improve the quality of life Some of the important measures are: A high protein diet(1.2-1.7 gm/day) should be included with moderate amount of carbohydrates, Carbohydrates should includes complex carbohydrates like wheat oats grains fruits and vegetables since these provide sustained energy. Limit the intake of simple sugar like candies soft drinks (carbonated drinks). Avoid salt intake as excess sodium can lead to fluid retention which can exacerbate the condition. Hydration level should be well maintained to keep mucus thin and easier. Increase in dietary fats to compensate for reduced carbohydrate Increase intake of omega-3 fatty acids Increase in vitamin A and C Smaller frequent meals is suggested sice large meals can cause discomfort and bloating Regularly monitor weight and nutritional status

8. 3. Vaccination : a. Influenza vaccine: Annually b. Polyvalent pneumococcal vaccine: Once in 5-7 years; >65yrs (PCV 13) In COPD patient <65yrs (PPSV 23) with an FEV1 <40% predicted or comorbidities especially cardiac comorbidities.