Chronic Obstructive Pulmonary Disease (COPD)
- Definition: A group of chronic disorders characterized by airflow obstruction that is generally progressive but may be partially reversible; sometimes accompanied by airway hyperreactivity. Diseases included are emphysema, chronic bronchitis, and bronchiectasis. (AKA chronic obstructive lung disease–[COLD]).
- Pathophysiology: Varies with specific disease. There may be inflammation, mucociliary clearance impairment, and bronchial wall destruction.
- Etiology: Varies according to specific disease. History of cigarette smoking or smoke exposure, air pollution or toxic exposure, repeated infection. Risk factors are male sex, nonwhite race, low socioeconomic status, and hyperresponsive airways.
- Manifestations: Dyspnea, cough, wheezing, barrel-shaped chest, prolonged expiratory phase of respirations, use of accessory muscles in forced expiration, breath sounds difficult to auscultate, skin color may be deep pink (due to high RBC count stimulated by hypoxia).
- Med Tx: Smoking cessation, inhaled ipratropium bromide, pneumococcal vaccine, yearly flu vaccine, chest physiotherapy, supplemental O2 and antibiotics as needed; acute exacerbations may be treated similarly to asthma.
- Nsg Dx: Impaired gas exchange, ineffective airway clearance, activity intolerance, altered nutrition, less than body requirements, risk for infection.
- Nsg Care: Small, frequent meals high in calories and protein, fluid intake of at least 3 L per day for adults, encourage avoidance of smoke, monitor for infection and signs of acute air hunger.
- Prognosis: Condition, by definition, is chronic and is usually progressive; improvement is possible for some patients with appropriate therapy.