


Community Health Nursing II: Population Groups and
Community as Clients (303)

Home My courses Community Health Nursing II: Population Groups and Community as Clients (303)


FINALS_M13&14: NON-COMMUNICABLE DISEASE PREVENTION AND CONTROL C.CHRONIC RESPIRATORY DISEASES


C.CHRONIC RESPIRATORY DISEASES
 To do: View To do: Go through the activity to the end

C. CHRONIC RESPIRATORY DISEASES

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

● Chronic Obstructive Pulmonary Disease (COPD) refers to a disease

characterized by airflow limitation that is not fully reversible. The airflow
limitations is generally progressive and is normally associated with an
inflammatory response of the lungs due to irritants, COPD includes chronic
bronchitis and pulmonary emphysema.
DESCRIPTION
● It is a major cause of chronic morbidity and mortality throughout the world.

● COPD is currently the fourth leading cause of death in the world, and more
cases and deaths due to COPD can be predicted in the coming decades
because of smoking.

● COPD is usually due to chronic bronchitis and emphysema, both of which are
CAUSE AND RISK due to cigarette smoking. Cigarette smoking is the primary cause of COPD.
FACTORS

A. Chronic Bronchitis

• Chronic inflammation of the lower respiratory tract characterized by excessive

mucous secretion, cough, and dyspnea associated with recurring infections of
the lower respiratory tract characterized by three primary symptoms: chronic
cough, sputum production, and dyspnea on exertion

Clinical Manifestations

● Blue bloater

● Usually insidious, developing over a period of years

● Presence of a productive cough lasting at least 3 months a year for 2

successive years

● Production of thick, gelatinous sputum; greater amounts produced during

superimposed infections

https://uslt.aralinks.com/mod/lesson/view.php?id=19404&forceview=1 12/17/24, 11:09 AM

Page 1 of 5
 ● Wheezing and dyspnea as disease progresses

B. Emphysema

• Complex lung disease characterized by destruction of the alveoli,

enlargement of distal airspaces, and a breakdown of alveolar walls. There is a
slowly progressive deterioration of lung function for many years before the
development of illness.

TYPES OF COPD Clinical Manifestations

● Pink puffer

● Dyspnea, decreased exercise tolerance

● Cough may be minimal, except with respiratory infection

● Sputum expectoration

● Barrel chest – Increased anteroposterior diameter of chest due to air trapping

with diaphragmatic flattening

● Spirometry - used to evaluate airflow obstruction

● ABG levels – decreased Pao2, pH, and increased CO2

DIAGNOSTIC
● Chest X-ray – in late stages, hyperinflation, flattened diaphragm, increased
PROCEDURES
retrosternal space, decreased vascular markings, possible bullae

● Alpha-1-antitrypsin assay useful in identifying genetically determined

deficiency in emphysema

● Smoking cessation

● Bronchodilators to relieve bronchospasm

● Inhaled and systemic corticosteroids

MEDICAL
MANAGEMENT
● Alpha 1-antitrypsin augmentation therapy

https://uslt.aralinks.com/mod/lesson/view.php?id=19404&forceview=1 12/17/24, 11:09 AM

Page 2 of 5
 ● Antibiotic agents, Mucolytic agents Antitussive agents, vasodilators and
narcotics

● Pulmonary rehabilitation to reduce symptoms, improve quality of life and

increased physical and emotional participation in everyday activities

● Pursed-lip breathing helps slow expiration, prevents collapse of small airways,

and helps the patient control the rate and depth of respiration

● Instruct the patient to coordinate diaphragmatic breathing with activities

such as walking, bathing, bending, or climbing stairs

● Provide small frequent meals and offer liquid nutritional supplements to

improve caloric intake and counteract weight loss

● Administer low flow of oxygen (1-2L/min)

NURSING ● Administer bronchodilator as prescribed

INTERVENTIONS
● Adequately hydrate the patient

● Instruct the patient to avoid bronchial irritants

● If indicated, perform CPT int the morning and at night as prescribed

● Encourage alternating activity with rest periods

● Teach relaxation technique or provide a relaxation tape for patient

● Enroll patient in pulmonary rehabilitation program where available

● Monitor respiratory status, including rate and pattern of respirations, breath

sounds, and signs and symptoms of acute respiratory distress.

● Respiratory failure - In advanced COPD, peripheral airways obstruction,

parenchymal destruction, and pulmonary vascular abnormalities reduce the
lung's capacity for gas exchange, producing hypoxemia and, later on,
hypercapnia
COMPLICATIONS
● Cardiovascular disease - Pulmonary hypertension, which develops late in
the course of severe COPD), is the major cardiovascular complication of COPD
and is associated with the development of cor pulmonale and a poor
prognosis.

BRONCHIAL ASTHMA

● Asthma is a chronic disease. It is an inflammatory disorder of the airways in

which many cells and cellular elements play a role. Chronic inflammation
causes an associated increase in airway hyperresponsiveness that leads to
recurrent episodes of wheezing, breathlessness, chest tightness and
DESCRIPTION
coughing, particularly at night or in the early morning.

● These episodes are usually associated with widespread but variable airflow
obstruction that is often reversible either spontaneously or with treatment.

● Asthma development has both a genetic and environmental component.

a. Host factors
factors: predispose individuals to or protect them from developing
asthma

https://uslt.aralinks.com/mod/lesson/view.php?id=19404&forceview=1 12/17/24, 11:09 AM

Page 3 of 5
 ● Genetic predisposition

● Atopy or allergy

● Airway hyperresponsiveness

● Gender

● Race/Ethnicity

b. Environmental factors: influence susceptibility to development of

asthma in predisposed individuals, precipitate asthma exacerbations and/or
cause symptoms to persist
CAUSES AND RISK
FACTORS ● Indoor allergens

● Outdoor allergens

● Occupational sensitizers

● Tobacco smoke

● Air pollution

● Respiratory infections

● Parasitic infections

● Socioeconomic factors

● Family size

● Diet and drugs

● Obesity

Asthma Triggers

● Triggers are risk factors for asthma exacerbations. These cannot cause
asthma to develop initially, but can exacerbate established asthma. They
induce inflammation and/or provoke acute bronchoconstriction. It involves
further exposure to causal factors (allergens and occupational agents) that
have already sensitized the airways of the person with asthma.

● Other forms of triggers are irritant gases and smoke, house dustmite found
in pillows, mattresses, carpets; respiratory infection, inhaled allergens,
weather changes, cold air, exercise, certain foods, additives and drugs.

Three most common symptoms of asthma:

● Cough

CLINICAL ● Dyspnea
MANIFESTATIONS
● Wheezing

● Chest tightness, diaphoresis, tachycardia, and a widened pulse pressure,

hypoxemia and central cyanosis

● Recognize triggers that exacerbate asthma

● Avoid these triggers if possible, particularly smoking

KEY AREAS FOR
PREVENTION ● Promote exclusive breastfeeding as long as possible; early introduction to
cow's milk may predispose baby to allergies and possible asthma

https://uslt.aralinks.com/mod/lesson/view.php?id=19404&forceview=1 12/17/24, 11:09 AM

Page 4 of 5
 This lesson is not ready to be taken. ×

P revi ous ac ti vi ty
N ex t a c t i v i t y
Jump to...
B. DIABETES MELLITUS
D. CANCER

Stay in touch 

University of Saint Louis Tuguegarao

 usl.edu.ph
 Toll-free hotline: #89271
 [email protected]

https://uslt.aralinks.com/mod/lesson/view.php?id=19404&forceview=1 12/17/24, 11:09 AM

Page 5 of 5