Chronic Obstructive Pulmonary Disease (COPD)
Overview
- COPD is an umbrella term for two main conditions: emphysema and chronic bronchitis.
- Characterized by chronic airflow obstruction, decreased oxygen (O2), and increased carbon dioxide (CO2).
- Main risk factor: Smoking is the number one risk factor for developing COPD.
Pathology
Emphysema
- Pathology: Damaged and enlarged alveoli, loss of lung elasticity.
- Key features: Loss of lung tissue recoil and air trapping.
- Signs: Referred to as "pink puffers" due to hyperventilation and redness in the chest and face.
- Other characteristics: Weight loss, barrel chest, severe dyspnea.
Chronic Bronchitis
- Pathology: Chronic productive cough and sputum production for >3 months over 2 consecutive years.
- Key features: Mucus secretion and airway obstruction.
- Signs: Referred to as "blue bloaters" due to mucus obstruction and cyanosis (bluish skin discoloration).
- Other characteristics: Overweight, chronic cough, wheezing.
Oxygen Saturation and Therapy
- Normal O2 saturation: 95-100%.
- COPD patients may have baseline as low as 88%.
- Administer oxygen with caution to avoid loss of drive to breathe.
Prevention and Vaccination
- Stay up to date on vaccines like influenza and pneumococcal vaccines to prevent infections.
Dietary Modifications
- Emphysema: Increase caloric intake, eat small frequent meals high in protein to avoid diaphragm pressure.
- Chronic Bronchitis: Increase fluid intake to thin mucus secretions, drink fluids between meals.
Breathing Techniques
- Pursed lips: Promotes CO2 elimination.
- Diaphragmatic breathing: Uses diaphragm instead of accessory muscles.
- Huff coughing: Helps clear mucus from lungs and airways.
Medications
- Bronchodilators: Improve airflow by dilating airways. Administered before corticosteroids.
- Corticosteroids: Decrease inflammation, examples include prednisone, hydrocortisone.
- Administer bronchodilator first, then corticosteroid after 5 minutes.
Important Points
- COPD is characterized by decreased oxygen and increased CO2.
- Smoking is the primary risk factor.
- Emphysema: Air trapping, small frequent meals.
- Chronic Bronchitis: Chronic mucus production, increased fluid intake.
- Low oxygen saturation is expected in COPD patients.
For further learning, consider accessing additional resources such as interactive worksheets and practice questions.