COPD

• COPD


  Chronic obstructive pulmonary disorder characterized by airflow limitations and inflammation caused by high exposure to noxious particles, gases, and smoking
• Chronic bronchitis


  • Characterized by a chronic productive cough that lasts for 3 months per year over 2 years
  • Irritant exposure such as smoking or pollution generates an inflammatory response in the bronchioles
  • Chronic inflammatory response stimulates goblet cells to increase in size and number (mucous gland hyperplasia) causing mucus hypersecretion
  • Chronic inflammation can also cause structural changes such as thickening of the bronchi walls, fibrosis, and smooth muscle hypertrophy, which narrow the airways making it hard to breathe
  • Increased mucus and irritant exposure cause cilia destruction and therefore impairs mucociliary clearance, increasing infection risk and obstruction of the airways
• Emphysema


  • Chronic inflammation due to irritant exposure leads to the release of the enzyme elastase, which breaks down the elastic fibers in the alveoli walls
  • This results in alveoli losing the recoil function and causes air trapping and hyperinflation
  • The destruction of alveoli reduces the surface area available for gas exchange leading to hypoxemia and hypercapnia
• Signs and symptoms of COPD

  • Persistent productive cough
  • Shortness of breath
  • Wheezing
  • Frequent respiratory infections
• Signs and symptoms of emphysema

  • Shortness of Breath (Dyspnea)
  • Chronic Cough
  • Wheezing
  • Tightness of chest
  • Barrel chested
  • Cyanosis
• Risk factors for COPD

  • Smoking
  • Occupational Exposure to Lung Irritants
  • Indoor Air Pollution
  • Genetics
  • Age
• Smoking effects on the lungs

  • Airway Irritation and Inflammation
  • Alveolar Damage
  • Decreased Lung Elasticity
  • Increased Mucus Production
  • Activation of Protease Enzymes
• Diagnostic tests for COPD

  • Spirometry
  • Peak Expiratory Flow (PEF) Measurement
  • Chest X-ray
  • Computed Tomography (CT) Scan
  • Arterial Blood Gas (ABG) Analysis
  • Pulmonary Function Tests (PFTs)
  • Six-Minute Walk Test
• COPD treatment


  • Cessation of smoking
  • Bronchodilators – long and short acting
  • Inhaled corticosteroids
  • Breathing exercises
  • Oxygen therapy
  • Dietary advice
  • Immunisations
  • A multi-disciplinary approach is required
• Complications of COPD


  • Respiratory Infections
  • Acute Exacerbations
  • Cor Pulmonale
  • Pulmonary Hypertension
  • Depression and Anxiety
  • Osteoporosis
  • Malnutrition
  • Sleep Disorders
  • Decreased Exercise Tolerance
• Nursing management of COPD

  • Dyspnoea
  • Ineffective airway clearance
  • Inability to carry out ADLs – activity intolerance
  • Anxiety
  • Infection prevention and management
  • Respiratory failure (end stage)
  • Palliative care
  • Multidisciplinary team input
• Nursing diagnoses for COPD

  • Ineffective Breathing Pattern
  • Activity Intolerance
  • Impaired Gas Exchange
  • Anxiety
  • Ineffective Self-Management