COPD (Chronic Obstructive Pulmonary Disease)
A progressive lung disease causing airflow limitation
Definition
Chronic Obstructive Pulmonary Disease (COPD) is a progressive, partially reversible lung disease characterized by chronic inflammation and airflow limitation. It encompasses chronic bronchitis and emphysema.
Risk Factors
- Smoking (primary cause)
- Occupational dust/chemical exposure
- Indoor air pollution (biomass fuel)
- Alpha-1 antitrypsin deficiency (genetic)
Signs and Symptoms
Chronic productive cough, dyspnea on exertion progressing to rest, wheezes and prolonged expiration, barrel chest, pursed-lip breathing, use of accessory muscles, and clubbing in advanced disease.
Key Nursing Considerations
- Oxygen: Titrate to SpO2 88 to 92%. High-flow O2 can suppress hypoxic drive.
- Teach pursed-lip breathing and tripod positioning.
- Pneumococcal and annual influenza vaccinations.
- Smoking cessation is the most effective intervention.
- Monitor for cor pulmonale (right-sided HF from pulmonary hypertension).
Medications
Short-acting bronchodilators (albuterol), long-acting bronchodilators (tiotropium, salmeterol), inhaled corticosteroids, oxygen, and pulmonary rehab.
NCLEX Relevance
O2 titration and pursed-lip breathing are classic questions.