Chronic Obstructive Pulmonary Disease/ Chronic Airflow Limitation

CHRONIC BRONCHITIS

Causes:

1. Cigarette Smoking
2. Respiratory Tract Infection
3. Environmental Pollutants

Pathophysiology:

ASTHMA

Pathophysiology:

EMPHYSEMA

• Presence of overdistended, non-functional alveoli, which may rupture, resulting to loss of aerating surface.

Pathophysiology:

Assessment in COPD:

1. Cough
2. Dyspnea
3. Chest Pain
4. Sputum Production
5. Adventitious Breath Sounds
6. Pursed lip breathing
7. Tends to assume upright, leaning forward position.
8. Alteration in LOC
9. Alteration in skin color (Pallor to cyanosis)
10. Alteration in skin temperature (Cold to touch)
11. Voice changes
12. Decrease metabolism - weakness, fatigue, anorexia, weight loss
13. Alteration in thoracic anatomy (barrel chest)
14. Clubbing of fingers
15. Polycytemia

Collaborative Management:
1. Rest. To reduce oxygen demands of tissues.
2. Increase fluid intake. To liquefy mucus secretions.
3. Good oral care. To remove sputum and prevent infection.
4. Diet: increase calorie, increase protein, decrease carbohydrates

• High calorie diet provides source of energy.
• High protein diet helps maintain integrity of alveolar walls.
• Low carbohydrate diet limits carbon dioxide production (natural end product). The client has difficulty in exhaling carbon dioxide.

5. O2 therapy 1 to 3 lpm (2 lpm is safest)

• Do not give high concentration of oxygen. The drive for breathing may be depressed.

6. Avoid cigarette smoking, alcohol, and environmental pollutants. These inhibit mucociliary function.
7. CPT – percussion, vibration, and postural drainage.
8. Bronchial hygiene measures

• Steam inhalation
• Aerosol inhalation
• Medimist inhalation