COPD patho
Abnormal inflammatory response of lungs to noxious particles or gases-most commonly smoking
What 2 conditions are included in COPD?
Chronic bronchitis
-chronic productive cough
Emphysema
-alveoli destruction
How does cigarette smoking cause COPD?
reduces ciliary function, increased mucus production, alveoli destruction
Describe manifestations of COPD that are similar to asthma manifestations
Inability to exhale, high residual volume, dyspnea, cough, wheezing, prolonged expiratory time
Describe manifestations of COPD that are not like asthma manifestations
Barrel chest
Digital clubbing
Thin/weight loss
R-sided HF (later in disease)
What is a major difference between COPD and Asthma regarding their baselines?
COPD will never return to normal baseline, leading to chronic manifestations like clubbing and barrel chests
Asthma returns to baseline/normal function between attacks, therefore damage is reversible
What is the earlier manifestation of COPD?
Intermittent cough-usually in the morning
Why can people with COPD have bluish-red colored skin?
The body tries to compensate for chronically low oxygen by producing more red blood cells, causing red coloring
The lack of oxygen causes blue coloring
Explain COPD Acute Exacerbations
What is the most common cause?
Acute worsening of the patient’s respiratory symptoms: the frequency and severity of exacerbations increases as the disease progresses
An infection, such as an URI
How is COPD diagnosed?
Same as asthma: pulomary function tests
Reduced FEV/FVC ratio
Increased residual volume
How do we determine if a COPD patient qualifies for supplemental home oxygen?
6-minute walk test: if they drop below 88% while walking for 6-mins, they qualify
How are secondary bacterial infections prevented in COPD patients?
daily or episodic azithromycin- low dose to prevent complications or for anti-inflammatory effects
How can supplemental oxygen cause infections in those with COPD?
Because it must be humidified, the oxygen tubing can harbor bacterial growth from the moisture
Explain early and late signs of hypoxia
Early:
Restlessness
Anxiety
Tachycardia
Late:
Bradycardia
Extreme restlessness
Dyspnea
How can we support nutrition in COPD patients?
Rest for at least 30 mins before eating
Use bronchodilator before meals
Oxygen during meals
Prep foods in advance to conserve energy
High-calorie foods first
Limit liquids at mealtime
Eat 5-6 small meals
