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Transcript
LAGUARDIA COMMUNITY COLLEGE
CITY UNIVERSITY OF New York
DEPARTMENT OF NATURAL & APPLIED SCIENCE
PRACTICAL NURSING PROGRAM
Group presentation on Respiratory
SCL 104
Title: Chronic Obstructive Pulmonary
Disease (COPD)
Student's name: Anaise Ikama
Date: July 23,2007
Group: #1
Subtitles: Tests Dx, medical & surgical treatments, prevention, nursing care and client
Teaching
A chronic and progressive obstruction of airflow in the lungs is a characteristic of chronic
obstructive pulmonary disease also known as COPD, and people who are at risk for getting this
diagnosis have never heard of the disease; and in many cases, COPD is regarded as asthma
because of symptoms such as dyspnea (difficulty breathing). Environmental exposure that put us
at risk for developing COPD include smoking, dust, and heavy long - term exposure to second
hand smoke, air pollutant and other chemicals. Not only are environmental exposure putting
people at risk for developing COPD, also a deficiency of an enzyme, known as alpha-antitrypsin,
that prevents lung tissue destruction. Therefore, if you find yourself with signs and symptoms of
chronic obstructive pulmonary disease, the following tests may be recommended by your
physician: Pulmonary function test, Chest x-ray, arterial blood gas analysis or computerized
tomography.
In a pulmonary function test, a spirometry is used. With this machine, the nurse or the
physician will ask the client to blow into a large tube which is connected to a spirometer to
identify "how much air your lung can hold and how fast you can blow the air out of your lungs"
(Mayoclinic.com). This machine also helps detect the diagnosis before you have symptoms of
COPD.
With the chest x-ray, emphysema, one of the main causes of COPD can be identified.
Emphysema is a "destruction of alveolar walls leading large abnormal air spaces in the lungs"
(Burke, LeMone & Mohn-Brown. 2007. pp 556). The chest x-ray also helps in ruling out heart
failure and other lung problem.
In arterial blood gas analysis, oxygen deficiency is measured to determine if
administration of oxygen will be necessary. Another screening test is computerized tomography
(CT) scan; an x-ray that produces a more detailed image of internal organs compared to a
conventional x-rays. It also determines if the client will benefit from surgery for COPD.
Usually once diagnosed with COPD, the client can begin the treatment, however the
treatment of COPD is only to reduce the risk of complication and improves one's ability to
perform some activity of daily life. For any smoke out there, the most essential step is to quit
smoking, which is the only way to keep COPD from getting worse and lose the ability to breathe.
In addition to quitting smoking, bronchodilators may be prescribed by clients' primary care
givers. Bronchodilators "are medications that relaxed the muscles that wrap around [the airways],
allowing the tubes to become larger and easier to breath through" (www.thoracic.org). This also
helps relieve coughing and shortness of breathes.
In addition to bronchodilators, inhaled steroids can be administered. Steroids also known
as corticosteroids are inhaled or pills medications used to reduce swelling in the breathing tubes.
Inhaled steroids may take a week or more to notice the benefits. Pills in the other hand, act
within 24 hours, but can cause side effect such as weight gain, increase in blood sugar,
osteoporosis and mood changes.
Due to impaired body defense mechanisms, smoking or long exposure to air pollution,
irritation and inflammation of the bronchiole can occur. These two characteristics of the bronchioles
can lead to chronic bronchitis
-
a chronic inflammatory airway disorder that causes thick secretion
that obstructs airflow. As a result to this respiratory infection, a physician will prescribe antibiotics
to help fight bacterial of respiratory infection, which can aggravate symptoms of COPD if not
treated. Besides taking medications prior to reduce the risk of COPD, surgery such as lung volume
reduction and lung transplant can be performed. A lung volume reduction surgery "is the removal of
the upper portion of the inflated air sacs including some good air sacs... that are pressing on healthy
lung causing healthy air sacs to poorly" (www.thoracic.org). This surgery creates extra space in a
client's chest cavity, which may help the client breathe much better. Unlike lung volume reduction,
where only a portion of the lung is removed, in lung transplant one or both lungs are replaced.
Due to impaired defense mechanism, a client with COPD can have the following
complications: respiratory infection such as influenza, pneumonia, therefore an annual flu shot and
regular pneumoccocal vaccine can help. An increase in blood pressure in pulmonary vein, lungs
cancer and feeling of depression due to progressive and incurable disease which keeps the client
from doing activity of daily life.
Patient teaching, as healthcare providers, nurses should "teach the client with COPD effective
coughing and breathing mechanics...advice client to maintain fluid intake of 2 to 2 Yz quarts of fluid
daily...discuss aerobis physical exercise (e.g., walking for 20 minutes at least three times
weekly)...Stress the importance or ...eating small frequent meal, and using nutritional supplement as
needed...reinforce teaching about prescribed medications, including purpose, use and expected
effects...Finally advice clients... to wear an identification band and carry a list of their medications at
all times" (Burke, LeMone & Mohn-Brown. 2007. pp 559-550). Knowing the clear cause of the
chronic obstructive pulmonary disease, the nurse should teach their patients to never smoke or quit
smoking, take bronchodilators as ordered, avoid exposure to harmful chemical, dust and
occupational exposure to chemical fumes or lung irritant should wear mask.
Worked Cited
American Thoracic Society. Patient Information Series: 'Chronic Obstructive
Pulmonary Disease." 2006. Retrieved June 26,2007, from
\v\vw.thoracic.org
Burke, Karen M. & Priscilla LeMone & Elaine L. Mohn-Brown. 2007. Medical
Surgical Nursing Care: 2nd Ed. (pp 556-5560). Upper Saddle River, New
Jersey. Pearson.
MayoClinic.com. Tools for healthier lives. "COPD": March 15,2007. Retrieved
June 26, 2007, from \vww.mavoclinic.com/health/copd/DSO0916