What does COPD stand for and how is it defined?
Chronic Obstructive Pulmonary Disease — a preventable, progressive respiratory disorder causing partially reversible airway obstruction, lung hyperinflation, and systemic symptoms with increasing exacerbations.
What are the two main diseases under COPD?
Emphysema (alveolar damage, air trapping) and chronic bronchitis (airway inflammation, mucus production).
Describe the main pathophysiologic changes in COPD.
Chronic inflammation → airway narrowing, mucus hypersecretion, alveolar destruction → air trapping, hyperinflation, impaired gas exchange, and ventilation–perfusion mismatch.
What happens to alveoli in emphysema?
Alveoli enlarge and lose surface area for gas exchange; walls collapse → air trapping → decreased ventilation.
What happens to bronchioles in chronic bronchitis?
Bronchioles become inflamed and narrowed, cilia damaged, and excessive mucus produced → airflow limitation and cough.
What is the hallmark symptom of COPD?
Progressive dyspnea (shortness of breath), initially with exertion, later at rest.
List other common physical findings in COPD.
Barrel chest, accessory muscle use, tripod position, wheezes, decreased breath sounds, chronic cough with sputum, cyanosis, nail clubbing.
What is “barrel chest”?
An increased anteroposterior chest diameter caused by lung hyperinflation and air trapping.
What are the 6 key nursing concepts related to COPD?
Impaired gas exchange, inflammation, fatigue, weight loss, potential for infection/pneumonia, and acid–base imbalance.
Identify major risk factors for COPD.
Smoking/vaping, genetic (alpha-1 antitrypsin deficiency), occupational dust/chemicals, frequent respiratory infections, and aging.
What assessments are used to diagnose COPD?
History, environmental exposure, physical exam, psychosocial screening, ABGs, sputum and WBCs, chest imaging, and spirometry confirming airflow limitation.
What psychosocial issues are common in COPD?
Anxiety, depression, social isolation, poor coping due to chronic breathlessness.
Describe typical ABG findings in advanced COPD.
Chronic respiratory acidosis: ↑ PaCO₂, ↓ PaO₂, compensatory ↑ HCO₃⁻.
What are nursing goals in COPD management?
Alleviate dyspnea, improve health status, prevent acute exacerbations (AECOPD), and reduce mortality.
Define AECOPD.
Acute Exacerbation of COPD — a sudden worsening of symptoms (dyspnea, cough, sputum) requiring medical intervention.
What is NIV and why is it used?
Non-Invasive Ventilation (e.g., BiPAP) supports ventilation without intubation, improving gas exchange and reducing CO₂ retention.
What oxygen saturation range is targeted for COPD clients on O₂ therapy?
88–92% — prevents hypoxia without suppressing hypoxic drive to breathe.
Name first-line non-pharmacologic interventions for COPD.
Breathing techniques (diaphragmatic & pursed-lip), upright/tripod positioning, effective coughing, exercise conditioning, suctioning PRN, hydration ≥ 2 L/day, and O₂ therapy per order.
Which breathing techniques are taught to COPD clients?
Pursed-lip breathing (slows exhalation, prevents airway collapse) and diaphragmatic breathing (improves ventilation).
What are the main medication classes for COPD?
Bronchodilators (short & long acting), inhaled corticosteroids, combination inhalers, and oral anti-inflammatories if needed.
What are short-acting bronchodilators used for?
Quick relief of dyspnea during acute symptoms or exacerbations (e.g., salbutamol/ventolin).
What are long-acting bronchodilators used for?
Maintenance therapy to prevent symptoms and improve exercise tolerance.
How do corticosteroids help in COPD?
Reduce airway inflammation, mucus production, and frequency of exacerbations.
Why are COPD patients at risk for infection?
Damaged cilia and mucus stasis promote bacterial growth, leading to pneumonia risk.
