It appears that you have an ad-blocker running. At the end of the end of the 16th International Family Nursing Conference, attendees should be able to discuss global advancements in family nursing education for students and professionals. Separately COPD is more costly per case than . Chronic obstructive pulmonary disease (copd), First Report (Edukasyon sa Pagpapakatao).pptx, L2DAY1 - Bridges for Communication and Information.pptx, Get a team of knowledgeable developers right away.pdf, HEART DISEASE PREDICTION USING MACHINE LEARNING.pptx, What is Research - Importance of Research.pptx. As with previous editions, the 2018 Global . Emphysema Y4! t/_:]I#k,^#?&&z,$\Te"I~GJdIn(7#,+}z/I86sbV7Nw4-"erbO2Zcl-1z~cw{+htMFj;*$RQm=@9i!emM}guOs\7+hc~#uM=iM%:-:;tt >*b/)2kc/):f3c:fc:f8W):NR#iK|bj,YT=^i31:_uWYY]Fte#0&? Paige Chavers DNP, ACNP-BC, MSPH: Clipping is a handy way to collect important slides you want to go back to later. COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam, Chronic obstructive pulmonary disease (COPD)- Preeti sharma, Chronic obstructive pulmonary disorders COPD, Case presentation on Myocardial Infarction, Sexually transmitted diseases (STDS) with nursing responsibilty, Waiting area at Clearwater Dental Associates.pdf, Gynae Pharma Franchise Company in Amritsar, SYNDROMIC MANAGEMENT OF GENITAL ULCERS.pptx, Webinar on Biomanufacturing 4.0 A New Era in Cell and Gene Therapy Development, Middle ear ventilatory pathway and Mucosal folds.pptx, Waiting area and reception center at Clearwater Dental Associates.pdf, Recent initiatives in Digital health 4.0.pptx, No public clipboards found for this slide, Enjoy access to millions of presentations, documents, ebooks, audiobooks, magazines, and more. The COPD Foundation Disaster Preparedness Plan (DPP) is a comprehensive resource for individuals and families impacted by chronic lung diseases, including COPD. Quieres ms informacin?Llame al 866.731.COPD (2673) y presione 9 para hablar en espaol con un paciente o cuidador. Avg rating:3.0/5.0. How to Add, Duplicate, Move, Delete or Hide Slides in Google Slides, How to Change the Slide Size in Google Slides, 26 different slides to impress your audience, Contains easy-to-edit graphics such as graphs, maps, tables, timelines and mockups, Includes 500+ icons and Flaticons extension for customizing your slides, Designed to be used in Google Slides and Microsoft PowerPoint, 16:9 widescreen format suitable for all types of screens, Includes information about fonts, colors, and credits of the free resources used. Slide 3-. Every COPD patient has an anticipatory care plan which is created by their GP . You can read more about the PCG tracks for patients and caregivers and for health care professionals. Retrieved February 07, 2009 from Health Source: Nursing and Academic Edition Database. Be sure to update it periodically. Background: Qualitative research on long COVID by subtype has not yet occurred. Log in. PK ! Operating Room Nurse/ Clinical Research Nurse . Widescreen (16:9) Presentation Templates. definition. Tap here to review the details. This is one of the best free PPT templates for nursing. Views: 481, By: DrDwayne The use of the standardized technique is particularly helpful for nurses, who can use it to organize their thoughts and break vital information into segments that describe the, S - Situation. Nursing Times [online]; 116: 4, 27-30. . COPD can lead to increased vulnerability by exclusion from participating fully in society. chronic obstructive pulmonary disease. You can read the details below. argy teaching resident, feb. 2007. The DPP can also be found in the COPD Pocket Consultant Guide (PCG) app, available on the Apple App Store or Google Play. We want to hear from you! Reduction in forced expiratory flow rates Increases in residual volume Increases in ratio of residual volume to total lung capacity Increased total lung capacity (late in the disease) Diffusion capacity may be decreased in patients with emphysema. Free access to premium services like Tuneln, Mubi and more. Many in this series of 12- to 20 . key messages. all you wanted to know about copd but were afraid to ask. Contact Hours: 42.5 This nursing continuing professional development activity was approved by the American Association of Critical-Care Nurses, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. Pneumothorax is one of the disorders of the chest and lower respiratory tract. copd. COLD exacerbation Bacterial infections Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis Mycoplasma pneumoniae or Chlamydia pneumoniae (510% of exacerbations) Viral infections (one-third) No specific precipitant identified (2035%), Symptoms & Signs 3 most common: Cough Sputum production Exertional dyspnea, frequently of long duration, signs and symptoms Dyspnea at rest Prolonged expiratory phase and/or expiratory wheezing on lung examination Decreased breath sounds Barrel chest Large lung volumes and poor diaphragmatic excursion, as assessed by percussion Use of accessory muscles of respiration Pursed lip breathing (predominantly emphysema) Characteristic "tripod" sitting position to facilitate the actions of the sternocleidomastoid, scalene, and intercostal muscles Cyanosis, visible in lips and nail beds. It has a simple style, with a white background and light blue waves and lines, which convey elegance and serenity. Now customize the name of a clipboard to store your clips. The COPD Foundation's My COPD Action Plan should be filled out the first time as part of a discussion with your health care provider, and then used daily or as often as you can. or chronic bronchitis that was dr bruce davies www.bradfordvts.co.uk. COPD may include diseases that cause airflow obstruction (e.g., emphysema, chronic bronchitis) or a combination of these disorders. Each of the nine Guides for Better Living focuses on one important aspect of life with COPD. Number of Views: 87. PowerPlugs is a trademark of CrystalGraphics, Inc. RN, BSN, PHN. British Journal of Nursing 17 (21). Chronic obstructive pulmonary disorders COPD is a [preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual clients. Copyright 2016 MedicPresents All rights reserved. Decreased quality of life. tintinalli chapter 73. copd definition. Course Hero is not sponsored or endorsed by any college or university. The COPD Foundation is a nonprofit, tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code. 10. Serum level of 1AT should be measured in some patients. Your hunt can take place anywhere. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. Background: If current trends in the management of COPD do not change, the predicted 4.5 million Australians diagnosed with COPD by 2050 will place significant burdens on already over-utilised frontline ED services. We've updated our privacy policy. CPR - Cardiac Pulmonary Resuscitation by completion of introductory period. The patient and caregiver track contains several helpful tools, including an interactive My COPD Action Plan and activity tracking calendar; inhaler, nebulizer and exercise videos; and a wallet card to track important information such as medications and immunizations. Looks like youve clipped this slide to already. We've encountered a problem, please try again. chronic slowly progressive disorder characterised by airway obstruction which does not change, COPD - . Ameritech College of Healthcare, Draper. We've encountered a problem, please try again. "A key piece of learning for us was to create different presentations for different audiences so you can really target your . 21 slides. Epidemiology Fourth leading cause of death in the U.S. Affects > 16 million persons in the U.S. Global Initiative for Chronic Obstructive Lung Disease (GOLD) estimates suggest that chronic obstructive lung disease (COLD) will increase from the sixth to the third most common cause of death worldwide by 2020. Internet Fundamentals for LEAs presentation by Jamie Gillespie for Cyber Pasi No public clipboards found for this slide, Enjoy access to millions of presentations, documents, ebooks, audiobooks, magazines, and more. Presentation having lung patient senior with oxygen . 1.) Takeaway. Mr. ANILKUMAR B R , Lecturer Nursing Management Nursing Implementation Ambulatory and Home Care Discourage moving to places above 4000 ft. Pneumothorax occurs when the parietal or visceral pleura is breached and the pleural . chronic obstructive pulmonary disease. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. Activate your 30 day free trialto continue reading. . c hronic o bstructive, COPD - . B - Background. It appears that you have an ad-blocker running. The SlideShare family just got bigger. Hallmark symptom - Dyspnea Chronic productive cough Minor hemoptysis pink puffer blue bloater. About the Position: As the Area Practice Manager, you will oversee the operations of all Pulmonary and Critical Care Services (Critical Care providers only), including overseeing 40+ colleagues including: 11 physicians, 9 providers and APPs, 10 MAs/RNs, 1 Nursing Supervisor, 1 Assistant Clinical Lead, Lung Nodule Nurse Navigator, LN Program . Please Review ONE of the following videos and post for the class what you have learned. COPD Foundation Information Line: (866) 316-COPD (2673) Call to learn more about COPD and talk to people who understand the effect COPD has on your life. Total cost of COPD hospitalizations per year = $1.5 billion. Use the contact form to get in touch Skilled nursing in-services; Presentations regarding Medicare part D . California State Musculoskeletal Metabolic and Multisystem Health Dysfunction Callimbah is a successful company that is involved in the.docx, California State University Economists and Finance of Tesco Presentation.docx. Change size. pulmonary edema; North Carolina State University . or chronic bronchitis that was dr bruce davies. Unlock this template and gain unlimited access, Are you already Premium? Youll like what you see! Transcript. Distributions of forced expiratory volume in 1 s (FEV1)values in a generalpopulation sample, stratified by pack-years of smoking. Weakness. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. Nurse CHI Pulmonary and Sleep Medicine Jan 2022 - Present 1 year 3 months. Aim: To synthesise qualitative research on pulmonary sequelae of COVID-19 and identify patient needs and experiences to develop nursing care strategies. epidemiology . rada jones md 09/12/06. It appears that you have an ad-blocker running. Fill out this wallet card and carry it with you. Slide 1-. Chronic Obstructive Pulmonary Disease or Chronic Obstructive lung disease. Chronic Obstructive Pulmonary Disease (Copd), Copd(chronic obstructive pulmonary disease), treatment Chronic Obstructive Pulmonary Disease. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. review. Download GOLD Teaching Slide Set. View COPD Powerpoint.pptx from NUR 395 at Ameritech College of Healthcare, Draper. the airway and out of the lungs permanent and Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. chronic obstructive pulmonary disease by: jesse and courtney. Ventolin) MDI or nebulizer preferred Anticholinergics (e.g. Temporary mechanical ventilation restored this patients gas exchange. Chronic Obstructive Pulmonary Disease Treatment Procedures in Hyderabad | Dr. Dr AGK Gokhale Cardiac Surgeon in Hyderabad, California State University Long Beach Sustainability and Food Paper.docx, California State Teaching Students with Hearing Losses Article Analysis.docx, California State University Thomas Kilmann Conflict Mode Questionnaire.docx. A widowed, 60-year-old, retired post office clerk, her main complaint is breathlessness after moderate exertion. California University Balance Between Formal Teams Communities of Practice Re California State University Light a Candle or Curse the Darkness.docx, California State University Utilitarianism Kantian Ethics Videos Questions.docx. As pulmonary sequelae constitute a serious long COVID subtype, exploring patient experience and needs can generate knowledge to guide nursing practice. things are quiet. Change in pH with PCO 2 is 0.08 units/10 mmHg acutely and 0.03 units/10 mmHg in the chronic state. Comment The calculation reveals a normal gradient, indicating that the etiology for hypoxemia and hypoventilation is extrinsic to the lung itself. Chronic Obstructive Pulmonary Disease (COPD) Slide 2-. Normally, the airways and air sacs in your lungs are elastic or stretchy. The CRT responds to acute episodes for COPD patients before handing over to the IMPACT team of district nurses who manage chronic cases. COPD - Physical Findings. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. Comment We can be reasonably confident that patient 1 suffered hypoventilation due to the effect of the ingested drugs on the brain stem. progressive obstruction over time. chronic bronchitis emphysema. Medications and treatments with things like respiratory exercise devices and inhalers can help you enjoy many good years with COPD. 3. - PowerPoint PPT presentation. Chronic obstructive pulmonary disease, also known as COPD, encompasses a group of diseases that cause problems with breathing. within 30 Days Required ; COPD - . An X-ray can also rule out other lung problems or heart failure. This one-page fact sheet focuses on preventing pneumonia in individuals with COPD. 7pm. Tap here to review the details. courtney pearce & jenna paterno . The SlideShare family just got bigger. Do not sell or share my personal information, 1. CT scan. In the health care provider view, users can access the CAT and mMRC Breathlessness Scale; an evidence-based therapy flowchart; COPD medications lists; inhaler and nebulizer education videos; and much more. Look around. Nurses beginning clinical practice in critical care and high acuity care areas. use of spirometry for case finding, diagnosis, and management of chronic, COPD - . advance their professional expertise with presentations and earn more on top of their base rate.-High Reliability Organization (HRO): MedStar is an HRO. COPD 1 / 32. 1. Clipping is a handy way to collect important slides you want to go back to later. 8% of all individuals 10% age >40 6 th leading cause of death worldwide, COPD - . 2003. definition. The diagnosis is confirmed by spirometry.Other tests may include a 6-minute walk test, laboratory testing, and radiographic imaging.. Assessment - A diagnosis of COPD should be considered in patients over the age of 35 who have a risk factor (generally smoking) and who present with exertional breathlessness, chronic . Presentation on Obesity Name Course Date Introduction Obesity is the excess of . Pulmonary Disease Appointments & Locations. Chronic Obstructive Pulmonary Disease (COPD), COPD Description Characterized by presence of airflow obstruction Caused by emphysema or chronic bronchitis Generally progressive May be accompanied by airway hyperreactivity May be partially reversible, Emphysema Description Abnormal permanent enlargement of the air space distal to the terminal bronchioles Accompanied by destruction of bronchioles, Chronic Bronchitis Description Presence of chronic productive cough for 3 or more months in each of 2 successive years in a patient whom other causes of chronic cough have been excluded, COPD Causes Cigarette smoking Primary cause of COPD*** Clinically significant airway obstruction develops in 15% of smokers 80% to 90% of COPD deaths are related to tobacco smoking > 1 in 5 deaths is result of cigarette smoking, COPD Causes Cigarette smoking Nicotine stimulates sympathetic nervous system resulting in: HR Peripheral vasoconstriction BP and cardiac workload, COPD Causes Cigarette smoking Compounds problems in a person with CAD Ciliary activity Possible loss of ciliated cells Abnormal dilation of the distal air space Alveolar wall destruction Carbon monoxide O2 carrying capacity Impairs psychomotor performance and judgment Cellular hyperplasia Production of mucus Reduction in airway diameter Increased difficulty in clearing secretions, COPD Causes Secondhand smoke exposure associated with: Pulmonary function Risk of lung cancer Mortality rates from ischemic heart disease, COPD Causes Infection Major contributing factor to the aggravation and progression of COPD Heredity -Antitrypsin (AAT) deficiency (produced by liver and found in lungs); accounts for < 1% of COPD cases Emphysema results from lysis of lung tissues by proteolytic enzymes from neutrophils and macrophages, Pathophysiology of Chronic Bronchitis and Emphysema Fig. All About Bronchiectasis contains helpful information for people with bronchiectasis. You may decide to use one or two spots . juliana tambellini university of pittsburgh. Number of Views: 680. -Partner with the Center for Education, Simulation, and Innovation to develop patient scenarios that foster the development of critical thinking skills. Looks like youve clipped this slide to already. working around certain kinds of chemicals, COPD - . ={> 3 [Content_Types].xml ( r0;0\;6iCJr}.MxYv ]iLY'qDy. within 30 Days Required ; COPD - Physical Findings Tachypnea Accessory respiratory muscle use Pursed lip exhalation Weight loss due to poor dietary intake and excessive caloric expenditure for work of breathing, Dominant Clinical Forms of COPD Pulmonary emphysema Chronic bronchitis Most patients exhibit a mixture of symptoms and signs, COPD - Advanced Dx secondary polycythemia cyanosis tremor somnolence and confusion due to hypercarbia Secondary pulmonary HTN w or w/o cor pulmonale, COPD Treatment Strategy Elimination of extrinsic irritants bronchodilator & glucocorticoid therapy Antibiotics Mobilization of secretions respiratory vaccines Oxygen therapy - if oxygen saturation <90% at rest on room air, A-a gradient A-a gradient = predicted pO2 observed PO2 PAO2 = (FIO2 X 713) (PaCO2/0.8) at sealevel PAO2 = 150-(PaCO2/0.8) at sealevel on room air Normal range 10-15mm > 30 years of age Normal range 8mm < 30 years of age Increased A-aDO2=diffusion defect Right to left shunt V/Q mismatch, Examples A doubel overdose brings two 30 yr old patients to the ED. definition epidemiology risk, COPD - . Considerations COLD is present only if chronic airflow obstruction occurs. By accepting, you agree to the updated privacy policy. Enhanced Discharge Process to Reduce 30-Day COPD Readmission Rates: A Quality Improvement Project. We believe everyone should have access to free online first aid information which is up-to-date and accurate. Want to work with us? CPR - Cardiac Pulmonary Resuscitation by completion of introductory period. CT scans can also be used to screen for lung cancer. senario. Blood gases provide additional information about alveolar ventilation and acidbase status by measuring arterial PCO 2 and pH. Asthma patients can also develop chronic (not fully reversible) airflow obstruction. You will also learn useful health and safety tips for managing your COPD. All our first aid presentations are free to download & use when delivering first aid training or classes. In addition, we have included a multitude of resources that you can edit to convey your information, such as graphics, map, infographics, etc. Considerations Problems other than COLD should be suspected when hypoxemia is difficult to correct with modest levels of supplemental oxygen. (due to weakened/impaired physical activity, tiredness, etc) 2.) SBAR is an effective and easy-to-use communication tool that divides patient status points to be conveyed into categories. Each of the nine Guides for Better Living focuses on one important aspect of life with COPD. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. Our beautiful, affordable PowerPoint templates are used and trusted . (Chronic Obstructive Pulmonary Disease) COPD Chronic Bronchitis Emphysema, Definition A disease state characterized by airflow limitation that is not fully reversible Conditions include: Emphysema: (anatomically defined condition characterized by destruction and enlargement of the lung alveoli) Chronic bronchitis: clinically defined condition with chronic cough and phlegm Small-airways disease: condition in which small bronchioles are narrowed. Presentations will focus on current and critical issues to provide oncology nurses with practical information that can be implemented in the practice setting. Study Resources. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. This is an original nursing presentation for PowerPoint. Global Initiative for Chronic Obstructive Lung Disease - Global . COPD - . Views: 530, By: JenniferDwayne Occupational exposures to dust and fumes (e.g., cadmium) Likely risk factors The magnitude of these effects appears substantially less important than the effect of cigarette smoking. Author: Stephen Gundry is COPD nurse, Newcastle Hospitals NHS Foundation Trust. Do not sell or share my personal information, 1. Advanced disease: signs of cor pulmonale Elevated jugular venous distention Right ventricular heave Third heart sound Hepatic congestion Ascites Peripheral edema, Differential Diagnosis Congestive heart failure Asthma Bronchiectasis Obliterative bronchiolitis Pneumonia Tuberculosis Atelectasis Pneumothorax Pulmonary embolism. 26 slides. We've encountered a problem, please try again. COPD is often evaluated in patients with relevant symptoms and risk factors. Copd 1. By: DrDwayne Often with COPD, patients you will see some combination of both presentations seen in chronic bronchitis and emphysema. A focused respiratory system assessment includes collecting subjective data about the patient's history of smoking, collecting the patient's and patient's family's history of pulmonary disease, and asking the patient about any signs and symptoms of pulmonary disease, such as cough and shortness of breath. We've updated our privacy policy. NURSE NP. Download Presentation. Tachypnea Accessory respiratory muscle use. Inhalation of gases and particles is thought, Air-trapping (when the alveoli fill with CO2. The SlideShare family just got bigger. Now customize the name of a clipboard to store your clips. Now customize the name of a clipboard to store your clips. 20-23 June 2023 Dublin, Ireland. by Anna Curran. The chest x-ray film revealed that this patients overdose was complicated by aspiration pneumonitis and that the patient required treatment with antibiotics in addition to mechanical ventilation. The presentation must educate advanced practice nurses on assessment and care/treatment, including . The inclusion criteria for . Send us a message and help improve Slidesgo. COPD PowerPoint Presentation. COPD - . 3.) What is hypertension? Comprises primarily of two related disease- Seventh National Doctors of Nursing Practice Conference Poster Presentations Click the title of the presentation to view the poster in PDF. Role includes: -Develop and coordinate the 4 week critical care core program and align with up to date evidence based nursing practice. Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases. Activate your 30 day free trialto continue reading. Get powerful tools for managing your contents. 527 Views Download Presentation. COPD. Avoid or control exposure to occupational and environmental pollutants and irritants Early detection of small-airway disease Early diagnosis of respiratory tract infections, Nursing Management Nursing Implementation Acute Intervention Required for complications like pneumonia, cor pulmonale, and acute respiratory failure, Nursing Management Nursing Implementation Ambulatory and Home Care Pulmonary rehabilitation Control and alleviate symptoms of pathophysiologic complications of respiratory impairment, Nursing Management Nursing Implementation Ambulatory and Home Care Teach patient how to achieve optimal capability in carrying out ADLs Physical therapy Nutrition Education Activity considerations Exercise training of upper extremities to help improve function and relieve dyspnea, Nursing Management Nursing Implementation Ambulatory and Home Care Explore alternative methods of ADLs Encourage patient to sit while performing activities Coordinated walking, Nursing Management Nursing Implementation Ambulatory and Home Care Slow, pursed-lip breathing After exercise, wait 5 minutes before using -adrenergic agonist MDI, Nursing Management Nursing Implementation Ambulatory and Home Care Sexual activity Plan during part of day when breathing is best Slow, pursed-lip breathing Refrain after eating or other strenuous activity Do not assume dominant position Do not prolong foreplay, Nursing Management Nursing Implementation Ambulatory and Home Care Sleep Nasal saline sprays Decongestants Nasal steroid inhalers Long-acting theophylline Decreases bronchospasm and airway obstruction, Nursing Management Nursing Implementation Ambulatory and Home Care Psychosocial considerations Guilt Depression Anxiety Social isolation Denial Dependence Use relaxation techniques and support groups. The good news is COPD is often preventable and . COPD - Physical Findings. COPD. To download the free app, please visit the App Store or Google Play. Chronic Obstructive MDA, Interventional Pulmonary Course 2023, 2/23/2023 7:00:00 AM - 2/24/2023 4:45:00 PM, The activity is designed to review the current concepts and recent advances in interventional pulmonology as it pertains to the cancer patient, and to introduce new technologic advances that are poised to revolutionize the diagnosis, staging, and management of lung cancer. Views: 991, By: sherry The air sacs fill up with air, like a small balloon. Chronic obstructive pulmonary disease, also known as COPD, encompasses a group of diseases that cause problems with breathing. airflow limitation that is progressive and not fully reversible abnormal, COPD- pulmonary hyperinflation- the diaphragms are at the, Occupational exposures to dust and fumes (e.g., cadmium), Distributions of forced expiratory volume in 1 s. Most patients have elements of each. pulmonary diseases. If you have COPD, using less energy with daily tasks can help you have more energy to do more activities during the day. In the United States alone it affects about 16 million people. Oxygen Therapy Basics is intended to support individuals who are new to (or curious about) supplemental oxygen therapy. mr. d has. Title: PowerPoint Author: PONG Last modified by: peak Created Date: 6/14/2012 10:12:34 AM Document presentation format - PowerPoint PPT presentation. The tri-fold card. . Typically performed by isoelectric focusing of serum, which reflects the genotype at the PI locus for the common alleles and many of the rare PI alleles Molecular genotyping can be performed for the common PI alleles (M, S, and Z). causes. 28-7, Emphysema Pathophysiology Hyperinflation of alveoli Destruction of alveolar walls Destruction of alveolar capillary walls Narrowed airways Loss of lung elasticity, Emphysema Pathophysiology Two types: Centrilobular (central part of lobule) Most common Panlobular (destruction of whole lobule) Usually associated with AAT deficiency, Emphysema Pathophysiology Structural changes are: Hyperinflation of alveoli Destruction of alveolar capillary walls Narrowed, tortuous small airways Loss of lung elasticity, Emphysema Pathophysiology Small bronchioles become obstructed as a result of Mucus Smooth muscle spasm Inflammatory process Collapse of bronchiolar walls Recurrent infections production/stimulation of neutrophils and macrophages release proteolytic enzymes alveolar destruction inflammation, exudate, and edema, Emphysema Pathophysiology Elastin and collagen are destroyed Air goes into the lungs but is unable to come out on its own and remains in the lung Causes bronchioles to collapse, Emphysema Pathophysiology Trapped air hyperinflation and overdistention As more alveoli coalesce, blebs and bullae may develop Destruction of alveolar walls and capillaries reduced surface area for O2 diffusion Compensation is done by increasing respiratory rate to increase alveolar ventilation Hypoxemia usually develops late in disease, Emphysema Clinical Manifestations Dyspnea Progresses in severity Patient will first complain of dyspnea on exertion and progress to interfering with ADLs and rest, Emphysema Clinical Manifestations Minimal coughing with no to small amounts of sputum Overdistention of alveoli causes diaphragm to flatten and AP diameter to increase, Emphysema Clinical Manifestations Patient becomes chest breather, relying on accessory muscles Ribs become fixed in inspiratory position, Emphysema Clinical Manifestations Patient is underweight (despite adequate calorie intake), Chronic Bronchitis Pathophysiology Pathologic lung changes are: Hyperplasia of mucus-secreting glands in trachea and bronchi Increase in goblet cells Disappearance of cilia Chronic inflammatory changes and narrrowing of small airways Altered fxn of alveolar macrophages infections, Chronic Bronchitis Pathophysiology Chronic inflammation Primary pathologic mechanism causing changes Narrow airway lumen and reduced airflow d/t hyperplasia of mucus glands Inflammatory swelling Excess, thick mucus, Chronic Bronchitis Pathophysiology Greater resistance to airflow increases work of breathing Hypoxemia and hypercapnia develop more frequently in chronic bronchitis than emphysema, Chronic Bronchitis Pathophysiology Bronchioles are clogged with mucus and pose a physical barrier to ventilation Hypoxemia and hypercapnia d/t lack of ventilation and O2 diffusion Tendency to hypoventilate and retain CO2 Frequently patients require O2 both at rest and during exercise, Chronic Bronchitis Pathophysiology Cough is often ineffective to remove secretions because the person cannot breathe deeply enough to cause air flow distal to the secretions Bronchospasm frequently develops More common with history of smoking or asthma, Chronic Bronchitis Clinical Manifestations Earliest symptoms: Frequent, productive cough during winter Frequent respiratory infections, Chronic Bronchitis Clinical Manifestations Bronchospasm at end of paroxysms of coughing Cough Dyspnea on exertion History of smoking Normal weight or heavyset Ruddy (bluish-red) appearance d/t polycythemia (increased Hgb d/t chronic hypoxemia)) cyanosis, Chronic Bronchitis Clinical Manifestations Hypoxemia and hypercapnia Results from hypoventilation and airway resistance + problems with alveolar gas exchange, COPD Complications Pulmonary hypertension (pulmonary vessel constriction d/t alveolar hypoxia & acidosis) Cor pulmonale (Rt heart hypertrophy + RV failure) Pneumonia Acute Respiratory Failure, COPD Diagnostic Studies Chest x-rays early in the disease may not show abnormalities History and physical exam Pulmonary function studies reduced FEV1/FVC and residual volume and total lung capacity, COPD Diagnostic Studies ABGs PaO2 PaCO2 (especially in chronic bronchitis) pH (especially in chronic bronchitis) Bicarbonate level found in late stages COPD, COPD Collaborative Care Smoking cessation Most significant factor in slowing the progression of the disease, COPD Collaborative Care: Drug Therapy Bronchodilators as maintenance therapy -adrenergic agonists (e.g.

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