COPD DEFENATION.pptxjjj

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Chronic Obstructive

Pulmonary Disease



:NTRODUCTIONIWe will focus on the points below:

Definition.

Etiology/ Indication.

Pathophysiology.

Clinical Manifestation.

Management:

Medical Management.

Nursing Management.

Nursing Process:

Assessment.

Nursing Care Plan.

Health Education.



COPD DEFENATION:Chronic obstructive pulmonary disease

(COPD) is a lung disease in which the lungs

are damaged gradually by making it hard to

breathe,, due to the narrowing of thebronchustubes

This leads to a limitation of the flow of air to

and from the lungs causing shortness of

breath.





COPDOFETIOLOGY1- Smoking

2- Air pollution

)antitrypsin-1alphaknown asenzyme(Genetics-3

4- Other risk factors

Increasing age,

allergy,

airway infection





:ANIFESTATIONSMLINICALC

Cough

Sputum (mucus) production

Increase work of breathing , especially with

exercise

Wheezing

Chest tightness

Shortness of breath ( dysapnea) persisting for

months to years.

Wight loss.



:ANAGEMENTM

Medical Management:*RISK Reduction:

-avoid continued exposure to smoking (at work or social settings).

-avoid continued smoking.

*Pharmacologic Therapy:

Bronchodilators:

-relieve bronchospasm by altering smooth muscle tone.

-reduce airway obstruction by allowing increased oxygendistribution throughout the lungs and improving alveolarventilation.

-can be delivered through inhaler by nebulization\metered-

dose inhalers[MDIs]\ beta2 agonist (e.g salbutamol)Corticosteroids:

May improve the symptoms of COPD.

Other medications:

Antibiotic agents, vasodilators and narcotics..



*Management of Exacerbations

*oxygen Therapy:

To increase the baseline resting partial arterialpressure of oxygen Pao2 to at least 60mmHg and

an arterial oxygen saturation SaO2 at least 90%.

*Surgical Management:

Bullectomy.-

Lung volume reduction surgery.-

Lung Transplantation.-

*pulmonary Rehabilitation

-patient Education. -Activity Pacing. -

nutritional therapy.

-Breathing Exercises. -oxygen therapy



NURSING MANAGEMENT:

Achieving Airway Clearance.

Assess the patient.

Promoting Home and

Community-Based Care.

-Teaching patients

self -care.

-continuing Car Nursing managementimproving

breathing patterns.

-activity tolerance.

-.

Monitoring potential complications:

risk for respiratory failure-SOB-fatigue-dysapnea-tachycardia.

-



:ROCESSPURSINGNAssessment:

Health History:

Assess if the patient has been exposed to risk

factors.

If the patient has any past medical history of

respiratory diseases, including asthma, allergy or

respiratory infection.

If the patient has a family history of COPD or

other chronic respiratory diseases.

Patient's smoking history.

Period of having respiratory difficulty.



Physical assessment:

Assess the pulse and respiratory rates. Ability of a patient to complete a sentence without

having to take a breath.

Assess if the patient take a long time to exhale.

Presence of cough. Color, amount and consistency of the sputum.

Presence of weakness and lack of energy.



THEWITHPRESENTMAYPATIENTCOPD

:FOLLOWING

Increased shortness of breath. Wheeze.

Chest tightness.

Increased cough and sputum production.

Pyrexia.

fatigue.

Confusion.

Decreased exercise tolerance.



)):CTUAL(( A PLANCAREURSINGNNursing

diagnosis

Goals Nursing orders / interventions

Impaired gas

exchange related to

ventilation-

perfusion inequality.

Improve the gas

exchange within

2 hours.

y Administer bronchodilators as prescribed.

a) Inhalation is the preferred route.

b) Observe for side effects: tachycardia, dysrhythmias, nausea and

vomiting.

y Evaluate effectiveness of nebulizer.

a) Assess for decreased shortness of breath, decreased wheezing

or crackles, loosened secretions and decreased anxiety.

b) Ensure that treatment is given before meals to avoid nausea &

vomiting.

y Instruct and encourage patient in diaphragmatic breathing and

effective coughing.

y Administer oxygen by the method prescribed.

a) Evaluate effectiveness; observe for signs of hypoxemia.

b) Monitor Spo2.

c) Analyze ABGs & compare with baseline.



CONT«««

Rational Outcome criteria

y Bronchodilators dilate the airways. The

medication dosage is carefully adjusted

for each patient.

y Combining medication with aerosolized

bronchodilators is typically uses to

control bronchoconstriction in an acuteexacerbation.

y These techniques improve ventilation by

opening airways to facilitate clearing the

airways of sputum. Gas exchange is

improved and fatigue is decreased.

y O2 will correct the hypoxemia.

y Verbalizes need for bronchodilators and for

taking them as prescribed.

y Evidences minimal side effects; heart rate

near normal, absence of dysrhythmias.

y Reports a decrease in dyspnea.

y Show an improved expiratory flow rate.

y Demonstrates diaphragmatic breathing and

coughing.

y Uses O2 equipment appropriately when

indicated.

y Evidence improved ABGs or Spo2.



Nursing diagnosis Goals Nursing orders /

interventions

Ineffective breathing

pattern related to

shortness of breath,

mucus,

bronchoconstriction

and airway irritants.

Improve the

breathing

pattern

within 1

hour.

y Teach patient diaphragmatic and

pursed- lip breathing.

y Encourage alternating activity

with rest periods. Allow patient

to make some decisions ( bath,

shaving) about care based on

tolerance level.

y Encourage use of an

inspiratory muscle trainer if

prescribed.



CONT«««.

Rational Outcome criteriay This helps patient prolong

expiration time and decreases air

trapping. With these techniques,

patient will breathe more

efficiently and effectively.

y Pacing activities allow patient to

perform activities without

excessive distress.

y This strengthens and conditionsthe respiratory muscles.

y Patient practices pursed- lip and

diaphragmatic breathing and uses

them when short of breath and

with activity.

y Shows signs of decreased

respiratory effort and paces

activities.

y uses inspiratory muscle trainer as

prescribed.

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