Understanding COPD: Pathophysiology and Diagnosis

Sep 12, 2024

NCLEX Review: COPD (Chronic Obstructive Pulmonary Disease) - Part 1

Introduction

  • Presented by Sarah from RegisteredNurseAriene.com
  • Part of a two-part series on COPD
  • Focus in Part 1: Pathophysiology, signs and symptoms, types, and diagnosis
  • Part 2 will cover medications and nursing interventions
  • Resources: Quiz and notes available along with the video

What is COPD?

  • Definition: A pulmonary disease causing chronic obstruction of airflow from the lungs
  • Key Points:
    • Limited airflow due to chronic inflammation causing bronchiole deformation and narrowing
    • Excessive mucus production
    • Loss of elasticity in alveolar sacs leading to difficulty in exhaling
    • Irreversible condition, varying in severity

Causes

  • Environmental factors:
    • Smoking is a major cause
    • Exposure to air pollution, irritants at work, etc.
  • Symptoms typically appear in middle age

Types of COPD

  • Chronic Bronchitis (Blue Bloaters):
    • Cyanosis due to hypoxemia
    • Edema leading to right-sided heart failure
    • Pathophysiology involves inflammation, mucus production, and airway narrowing
  • Emphysema (Pink Puffers):
    • Lack of cyanosis due to hyperventilation
    • Loss of alveolar elasticity
    • Leads to barrel chest and use of accessory muscles

Signs and Symptoms

  • Mnemonic: LUNG DAMAGE
    • L: Lack of energy
    • U: Unable to tolerate activity
    • N: Nutrition poor due to high caloric expenditure from breathing
    • G: Gases abnormal (high CO2, low O2)
    • D: Dry/productive cough (chronic)
    • A: Accessory muscle usage for breathing
    • A: Abnormal lung sounds (diminished, crackles, wheezing)
    • M: Modification of skin color (pink to cyanosis)
    • A: Anterior-posterior diameter increase (barrel chest)
    • G: Gets in tripod position to breathe
    • E: Extreme dyspnea

Complications

  • Heart disease, especially right-sided heart failure
  • Pneumothorax (lung collapse)
  • Lung infections (e.g., pneumonia)
  • Increased risk of lung cancer

Diagnosis

  • Spirometry:
    • Measures lung volume during inhalation and exhalation speed and volume
    • Focuses on FVC (force vital capacity) and FEV (force expiratory volume)
    • Low readings indicate restrictive breathing and severity

Conclusion

  • Part 1 covers patho, symptoms, types, and diagnosis of COPD
  • Part 2 will focus on treatment and nursing care
  • Additional resources include a quiz and video subscription options