7987740
Description
Chronic Obstructive Pulmonary
Disease #1
- Collabrative Practice
- There are 7 goals associated with managing AECOPD -
Prevention progression - Reduce the frequency of
exacerbation phases - Relieve breathlessness and
respiratory symptoms - Improve exersise and daily
activities - Treat exacerbation - Improve quality of life and
health status - Reduce risk of mortality (Lewis,
Heitkemper, Dirksen, Bucher, & Camera, 2014)
- someone with COPD mid 80s- low 90%. Oxygen can be dangerous and lead to further complications
-Increased risk of hypoxemia due to lack of ability to effectively exchange CO2 for O2.
- Signs of Hypoxemia : Skin colour changes,
Shortness of breath, confusion, wheezing,
rapid heart rate, and rapid breathing.
- Signs of Hypoxemia : Skin colour changes,
Shortness of breath, confusion, wheezing,
rapid heart rate, and rapid breathing.
- Smoking Cessation is a large focus for those with COPD
and also those that are excperincing exacerbation. 80-90%
of those with COPD were at one time a smoker. Smoking
leads to an accelerated rate of pulmonary function
decline. Thus causing a increased risk of exacerbation
and risk of severe complications. (Lewis, Heitkemper,
Dirksen, Bucher, & Camera, 2014)
- During exacerbation an individuals body can become decompensated due to the extreme
conditions; improving this by ensuring adequate nutrition, exercise and deep breathing and
coughing.
- In severe case of AECOPD surgical therapy many be indicated; -Lung volume reducation surgery;
reduces the size of the hyper nflated emphysematous lungs by 20-25% - Lung transpalant if
advanced.
- Drug Therapy A crucial part of
managing AECOPD. The use of oral
and parenteral corticosteroid use
is a rapid methode that reduces
the risk of relapse. (Carr, 2008) -A
corticosteroid in AECOPD
improves airflow and will recuce
the likeliness of alternative
treatment failures (CITATION) -
During a exacerbation period it
often leads to a increased amount
of drugs being used, and new
ones being introduced this is to
help quickly manage the
symptoms and seek a new
regimen.
- Ensure that client has recieved all vaccinations and their annual influenza and pneumoccacal
vaccine
- Avoid exposures to large crowds in peak of influenza season
- Avoid exposures to large crowds in peak of influenza season
- Oxygen is a drug that should be used with caution
- Ensure that client has recieved all vaccinations and their annual influenza and pneumoccacal
vaccine
- someone with COPD mid 80s- low 90%. Oxygen can be dangerous and lead to further complications
-Increased risk of hypoxemia due to lack of ability to effectively exchange CO2 for O2.
- There are 7 goals associated with managing AECOPD -
Prevention progression - Reduce the frequency of
exacerbation phases - Relieve breathlessness and
respiratory symptoms - Improve exersise and daily
activities - Treat exacerbation - Improve quality of life and
health status - Reduce risk of mortality (Lewis,
Heitkemper, Dirksen, Bucher, & Camera, 2014)
- Thearaputic Nursing Care
- Health Promotion
- Never smoke or stop smoking all together
- Avoid exposure to work and evenviromental pollutants and irratants
- Hand hygiene
- Vaccinations
- Regular check ups with doctor
- Early identification and treatment of respiratory tract infections
- Early detection of airway disease
- Early identification and treatment of respiratory tract infections
- Never smoke or stop smoking all together
- Education
- What is COPD?
- Nonpharmacolpgocal therapy:
breathing exercises, pursed lip
breathing, relaxation
techniques, exercise,
- Medications and
Correct Use of
Inhalation
Devices
- Home Oxygen
- Psychosocial/Emotional
Issues:
Dependency,
Itimacy,
depression,
anxiety,
panic,
support,
rehabitation
grouos
- End of LIfe: identifying
concerns, support decison
making and planning
- What is COPD?
- EXERCISE
- Energy Conserving Strategies
- Sexual Activity
- Sleep
- Psychosocial Considertions
- Energy Conserving Strategies
- Health Promotion
- Pathophysiology
- Bronchitis (Blue Bloater)
- 1. Chronic Inflammation and swelling of bronchial mucosa
results in scaring and increased fibrosis of the mucous
membranes and hyperplasia of mucous glands and goblet
cells.
- 2. Leads to thickenening of the bronchial walls
- 3. Obstruction of airflow
- 4. Increased levels of eosinophils at site of inflammation
- 5. Hypertropy of goblet cells leads to
increased production of mucous
- 6. Mucus production combined with
purulent exudate forms a bronchial
plug
- Often bacterial conolization contains bacteria of the H. influenza and S. pneumoniae groups
- 7. Narrowed airway and mucous plugs lead to
improper oxygenation, thus causing high airway
resistance
- 8. Increased oxygen demand
(Perfusion and ventialation
mismatch)
- 9. Can lead to oxygen desaturation (cyanosis) due to the inabiltity
to the alveoli exchanging CO2 for O2 slowly. This can lead to an
abundance of alternative issues.
- Can also lead to right sided heart failure and edema
- Can also lead to right sided heart failure and edema
- 9. Can lead to oxygen desaturation (cyanosis) due to the inabiltity
to the alveoli exchanging CO2 for O2 slowly. This can lead to an
abundance of alternative issues.
- 8. Increased oxygen demand
(Perfusion and ventialation
mismatch)
- Often bacterial conolization contains bacteria of the H. influenza and S. pneumoniae groups
- 6. Mucus production combined with
purulent exudate forms a bronchial
plug
- 5. Hypertropy of goblet cells leads to
increased production of mucous
- 4. Increased levels of eosinophils at site of inflammation
- 3. Obstruction of airflow
- 2. Leads to thickenening of the bronchial walls
- CITATION ALL FROM PATHO TEXT pg 482
- 1. Chronic Inflammation and swelling of bronchial mucosa
results in scaring and increased fibrosis of the mucous
membranes and hyperplasia of mucous glands and goblet
cells.
- Emphysema (Pink Puffer)
- 1. Reductions to the capillary bed occur due to
smoking, enviromental pollutants and certain
occupations.
- 2. Destroyed alveolar walls cause inflammation
- 3. Inflammation releases protolytic enzymes such as
macrophages and neutrophils
- 4. This loss of capillary bed causes reduced
pulmonary abilities and causes the loss of
elasticity
- 5. Loss of elasticity leads to less exchange of gas and
a increasing pressure around the airway lumen
- 6. Leads to airway resistance and decreased airflow
- 7. Air becomes trapped in distal alveoli and
they become distended which can collapse
with the pressure from airway obstruction
- 7. Air becomes trapped in distal alveoli and
they become distended which can collapse
with the pressure from airway obstruction
- 6. Leads to airway resistance and decreased airflow
- 5. Loss of elasticity leads to less exchange of gas and
a increasing pressure around the airway lumen
- 4. This loss of capillary bed causes reduced
pulmonary abilities and causes the loss of
elasticity
- 3. Inflammation releases protolytic enzymes such as
macrophages and neutrophils
- 2. Destroyed alveolar walls cause inflammation
- CITATION ALL FROM PATHO TEXT pg 487
- 1. Reductions to the capillary bed occur due to
smoking, enviromental pollutants and certain
occupations.
- Bronchitis (Blue Bloater)
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