History of Asthma

RISK FACTORS

Caucasian Women

Lower socioeconomic status

History of Asthma

(Story, 2014, p. 142)

CAUSATIVE FACTORS

Cigarette Smoking

Inhalation of pollution and chemical

irritants

(Story, 2014, p. 142)

SIGNS/SYMPTOMS

CHRONIC BRONCHITIS

Wheezing/Rhonchi, Edema, Weight

Gain, Chest pain, and Fever.

EMPHYSEMA

Dyspnea upon exertion, decreased

breath sounds, wheezing, chest

tightness, tachypnea, hypoxia,

hypercapnia and activity intolerance.

(Story, 2014, 143 and 144) PATHOPHYSIOLOGY

OF COPD

COPD encompasses 2 respiratory

diseases, chronic bronchitis and

emphysema. Once the inflammatory

process is activated, excessive mucus

production and bronchoconstriction

lead to bronchitis. Emphysema causes

different structural changes in response

to the inflammatory process, the

alveoli become enlarged and the

bronchiole collapse, causing lower

levels of oxygen in the bloodstream.

Reduced lung volume, elastic recoil,

surface tension and surfactant, along

with low lung compliance and

increased airway resistance are results

of these pathophysiologic changes.

(Higginson, 2010, p. 108)

MEDICAL

TREATMENTS

CHRONIC BRONCHITIS

Limited Oxygen Therapy,

bronchodilators, corticosteroids,

chest physiotherapy and increased

hydration.

EMPHYSEMA

Previously listed treatments, pursed lip

breathing and lung reduction therapy.

(Story, 2014, p. 143 and 144)

A recent systematic review showed

that an anticholinergic drug,

Tiotropium manages and prevents

COPD exacerbations better than the

β2-agonist, Salmeterol. (Vogelmeiter

et al, 2011, p. 1102)

LABORATORY/

DIAGNOSTIC TESTS

History of persistent, productive cough

for at least 3 months in a yr. for 2

consecutive yrs.

Physical Exam

Chest X-Ray

Pulmonary Function Tests

ABGs

CBC

(Story, 2014, p. 144)

NURSING

INTERVENTIONS

Teaching can be the most important

nursing intervention, i.e. Smoking

caseation, risk for infections and

breathing techniques. Promoting their

airway and gas exchange is a

necessity. Providing nutritional meals

and slowing the disease process are

important nursing interventions. A

recent meta-analysis showed that

Disease-Specific Education reduction

in hospital admissions, visits to the

ED, improved knowledge about their

disease and prevention of

exacerbations. (Tan et al, 2012, p.

292)

 

 

 

References

Higginson, R. (2010). COPD: pathophysiology and treatment. Nurse Prescribing, 8(3), 102-110.

Story, L. (2014). Pathophysiology a practical approach (2nd ed.). Burlington, MA: Jones &

Bartlett.

Tan, J., Chen, J., Liu, X., Zhang, Q., Zhang, M., Mei, L., & Lin, R. (2012). Feature Article: A

Meta-Analysis on the Impact of Disease-Specific Education Programs on Health

Outcomes for Patients with Chronic Obstructive Pulmonary Disease. Geriatric

Nursing, 33, 280-296. doi:10.1016/j.gerinurse.2012.03.001

Vogelmeier, C., Hederer, B., Glaab, T., Schmidt, H., Rutten-van Mölken, M. P., Beeh, K. M. &

Fabbri, L. M. (2011). Tiotropium versus salmeterol for the prevention of exacerbations of

COPD. New England Journal of Medicine,364(12), 1093-1103.