Week 2 COPD

Question 1

What is COPD?

Answer 1

1. Airflow limitation : alveoli elasticity lost = emphysema
2. Airflow obstruction: mucous (bronchitis)

Question 2

What are 6 risk factors for COPD?

Answer 2

1. Cigarette smoking
2. Occupational chemicals
3. Dust recurring infection
4. Heredity (AAT gene)
5. Asthma
6. Aging

Question 3

What are 5 signs of COPD?

Answer 3

1. Weight loss
2. Wheezing
3. Chronic dyspnea
4. Cough & Sputum
5. Chest tightness

Question 4

what is the late stage of COPD called?

Answer 4

Cor Pulmonale

Question 5

COPD symptoms

Answer 5

1. Fatigued easily
2. Resp infections frequent
3. accessory muscles
4. orthopneic (hard to breathe laying down- sit up)
5. Thin/weight loss
6. Wheezing
7. pursed-lip breathing
8. Chronic cough
9. Barrel chest
10. Dyspnea
11. hard to expire air- prolonged
12. bronchitis - increased sputum
13. digital clubbing

Question 6

what will the ABGs of someone with COPD be like?

Answer 6

Hypoxemia - low PAO2
Hypercapnia - high PACO2
HCO3 elevated when chronic

Question 7

What will the CBC of someone with COPD look like?

Answer 7

-WBC increased if infection
- Increased HBG and HCT - polycythemia because body is trying to make more RBC to get more oxygen

Question 8

What will electrolytes be like for someone with COPD?

Answer 8

electrolytes can change due to resp. acidosis

Question 9

What tests are done to diagnose COPD?

Answer 9

1. Pulmonary Fuction tests
   - vital capacity (VE)
   - residual volume (RD)
   - forced expiratory volume (FEV)
2. severity is diagnosed by FEV1 - 1 sec of exhalation
3. Chest xray - hyperinflation & flattened diaphragm

Question 10

What are the 9 interventions for COPD?

Answer 10

1. stop smoking
2. Drugs
3. breathing techniques
4. O2 thearpy
5. Nutritional therapy
6. Hydration therapy
7. Exercise therapy
8. pulmonary rehab programs
9. Surgery (reduction - LVRS)/(transplant)

Question 11

What is the most effective intervention to help COPD?

Answer 11

Stop smoking

Question 12

What are the 4 drugs used for COPD?

Answer 12

1. SABA - salbutamol (ventolin) rescue - bronchodilator
2. LABA - Sameterol (Serevent) - bronchodilator
3. Anticolingergics - Atrovent (Ipatropium brominde ) - brochodilates & decrease mucous
4. Steroid anti-inflammatory - Hydrocortisone or prednisone

Question 13

What are 2 advantages of O2 for COPD?

Answer 13

1. reduce work of breathing
2. reduce workload on the heart b/c PaO2 is maintained

Question 14

Are weight loss and malnutrition common with COPD? why ?

Answer 14

Yes
b/c full stomach makes it hard to breathe
hard to breathe while eating

Question 15

When eating, how can someone with COPD decrease dyspnea?

Answer 15

1. rest 30 min before eating
2. brochodilator
3. prepare food ahead of time - smaller meals
4. High calorie, high protein foods

Question 16

How much water should someone with COPD drink?

Answer 16

2L/day to help thin secretions

Question 17

What 2 things is COPD exacterbated by?

Answer 17

Resp infections
Unhealthy air quality

Question 18

What is a resp rate COPD people experience?

Answer 18

40-50 breaths/per min

Question 19

Are people with COPD more prone to virus’ or bacterial infections and why?

Answer 19

Bacterial b/c of increases in mucous

Question 20

What are 3 things people with COPD can do to prevent exacerbations besides stop smoking?

Answer 20

1. avoid crowds
2. get PN and Flu vaccines
3. stay inside if air quality is poor

Question 21

What are 3 medications that are stepped up when someone has COPD until they are stable?

Answer 21

1. inhaled bronchodilators
2. antibiotics (if infection)
3. Oral systemic steroids

Question 22

What are 4 interventions of a COPD exacerbation?

Answer 22

1. meds
2. oxygen
3. rest
4. ventilation and intubation (if needed)

Question 23

What are 3 complications of COPD?

Answer 23

1. cor pulmonale
2. cardiac dysrhythmias
3. Depression/anxiety/panic

Question 24

What is Cor Pulmonale?

Answer 24

-When air trapping is bad so lung tissue pressure increases and blood vessels narrow making blood flow and perfusion difficult.
- rt side of heart works hard, becomes inefficient, back up to venous system
- distended neck veins & perepheral swelling

Question 25

Why does COPD cause cardiac complication?

Answer 25

1. decreased O2 to the heart muscle = dysrhythmias