Overview
This lecture covered COPD pathophysiology, clinical management, NCLEX-style questions, and detailed information about the Remar Skills Lab, focusing on hands-on nursing skills training for students and new nurses.
COPD: Key Concepts
- COPD (Chronic Obstructive Pulmonary Disease) is an irreversible, progressive respiratory disease causing airflow limitation.
- Main risk factor: long-term smoking; rarely caused by other factors.
- COPD includes chronic bronchitis ("blue bloater") and emphysema ("pink puffer"), each with distinct symptoms.
- Chronic bronchitis: productive cough, obesity, excess mucus; emphysema: thin patients, severe dyspnea, air trapping.
- Common symptoms: chronic hypoxia, dyspnea at rest and with activity, mental status changes during exacerbations.
- Oxygenation targets are lower for COPD patients; avoid over-oxygenation (no more than 2 L/min).
- High hematocrit (>55%) may indicate compensatory erythrocytosis, increasing the risk for blood clots.
- Management includes nonpharmacologic (smoking cessation, pulmonary rehab, breathing exercises, nutrition), medications (bronchodilators, corticosteroids, theophylline), and antibiotics only for bacterial infections.
- Theophylline toxicity risk: therapeutic range 10–20 mcg/mL; interacts with many drugs.
COPD: NCLEX-Style Questions Review
- Barrel chest in COPD is associated with flattening of the diaphragm due to air trapping.
- Priority in COPD exacerbation with SOB and fever: arterial blood gas analysis.
- In critical COPD cases with low oxygen and high hematocrit, notify the healthcare provider immediately.
- Bronchodilators are the priority medication for acute airway obstruction in COPD with respiratory acidosis.
Remar Skills Lab Overview
- Located in Jacksonville, FL, the lab offers a two-day hands-on nursing skills experience.
- Focuses on essential nursing skills: communication, bedside report, vital signs, safe medication administration, IV/phlebotomy, ostomy and trach care, code response, NG tube placement, and team-based learning.
- Class size is limited to 10 participants per session for individualized attention.
- Open to RNs, LPNs, and nursing students (V2 completion required).
- Certificates of completion are provided (not a license).
- Additional options: IV therapy certification, AHA instructor courses, CNA exam prep, and business training for nurse entrepreneurs.
Logistics & Registration
- Registration: remarnurse.com/skills; $300 for two days (16 hours total).
- Sessions scheduled monthly; early registration required.
- International nurses welcome; in-person attendance mandatory.
Key Terms & Definitions
- COPD — Chronic Obstructive Pulmonary Disease; irreversible airflow limitation, mainly due to smoking.
- Barrel chest — Increased anterior-posterior chest diameter from chronic air trapping.
- Blue bloater — COPD patient with chronic bronchitis; obese, cyanotic, productive cough.
- Pink puffer — COPD patient with emphysema; thin, pursed-lip breathing, less cough.
- Theophylline — Bronchodilator with a narrow therapeutic range and toxicity risk.
- Erythrocytosis — Elevated red blood cell count as compensation for chronic hypoxia.
- Skills lab — Simulated environment for hands-on nursing skills practice.
Action Items / Next Steps
- Review COPD content in study materials (focus on pathophysiology, symptoms, management, and NCLEX priorities).
- Register for the Remar Skills Lab if hands-on training is needed.
- Complete V2 program before attending the skills lab.
- Use remarnurse.com/skills for more information or to express interest in skills training.
- Write out a weekly study plan and sign up for your NCLEX test date if ready.