CHRONIC OBSTRUCTIVE PULMONARY DISEASE

 COPD is also known as chronic obstructive
lung disease (COLD), chronic obstructive
airway disease (COAD), chronic airflow
limitation (CAL) and chronic obstructive
respiratory disease (CORD)
 Chronic obstructive pulmonary disease (COPD)
refers to chronic bronchitis and emphysema, a
pair of two commonly co-existing diseases of
the lungs in which the airways become
narrowed. This leads to a limitation of the
flow of
 air to and from the lungs causing
 shortness of breath.

 In
COPD, less air flows in and out of the
airways because of one or more of the
following:
 The airways and air sacs lose their
elastic quality.
 The walls between many of the air sacs
are destroyed.
 The walls of the airways become thick
and inflamed.
 The airways make more mucus than
usual, which tends to clog them.

 It is the 4th leading cause of mortality and
12th leading cause of disability in the
united states.
 In 2020 COPD is the 3rd leading cause of
death.

 1)Smoking
 2) Occupational exposures- exposure to
workplace dusts found in coal mining, gold
mining, and the cotton textile industry and
chemicals such as cadmium, isocyanates, and
fumes from welding have been implicated in
the development of airflow obstruction.
 3) Air pollution
 4) sudden airway constriction in response to
inhaled irritants,
 5) Bronchial hyperresponsiveness, is a
characteristic of asthma.

 6)Genetics-Alpha 1-antitrypsin deficiency
is a genetic condition that is responsible
for about 2% of cases of COPD. In this
condition, the body does not make enough
of a protein, alpha 1-antitrypsin. Alpha 1-
antitrypsin protects the lungs from
damage caused by protease enzymes, such
as elastase and trypsin, that can be
released as a result of an inflammatory
response to tobacco smoke.

NUTRITION

INFECTIONS

SOCIO ECONOMIC STATUS

AGING POPULATION

 Abnormal inflammatory response of the
lungs due to toxic gases.

 Responseoccurs in the airways
,parenchyma & pulmonary vasculature.

 Narrowing of the airway takes place

 Destruction
of parenchyma leads to
emphysema.

 Destruction of lung parenchyma leads to an imbalance
of proteinases/antiproteinases.
(this proteinases inhibitors prevents the destructive
process)

 Pulmonary vascularchanges
 Thickening of vessels
 Collagen deposit
 Destruction of capillary beds.

 Mucus hypersecretion(cilia dysfunction,airflow
limitation,corpulmonale(RVF))


 Chronic cough and sputum production

 Chronic cough
 Sputum production
 Wheezing
 Chest tightness
 Dyspnoea on exertion
 Wt.loss
 Respiratory insufficiency
 Respiratory infections
 Barrel chest- chronic hyperinflation leads
to loss of lung elasticity.

 1) Bronchitis
 2) Emphysema
 Bronchitis :-
 Bronchitis (bron-KI-tis) is a condition in which
the bronchial tubes become inflamed.

 acute (short term) and
 chronic (ongoing).
 Infections or lung irritants cause acute
bronchitis.
 Chronic bronchitis is an ongoing, serious
condition. It occurs if the lining of the
bronchial tubes is constantly irritated and
inflamed, causing a long-term cough with
mucus.

 Chronic bronchitis:
 It is defined as the presence of cough and
sputum production for atleast 3 months.

 Irritants irrritate the airway

 Excess mucus production

 Inflammation

 Cause the mucus secreting glands and goblet cells to
increase in number.
 Ciliary function is reduced.

 More mucus production

Bronchial walls become thickened and lumen narrows and
mucus plug the airway


Alveoli adjacent tto the bronchioles may
become damaged and fibrosed.

Alter function of alveolar macrophages.

infection

 sore throat,
 fatigue (tiredness),
 fever, body aches,
 stuffy or runny nose,
 vomiting, and
 Diarrhea
 persistent cough
 cough may produce clear mucus
 shortness of breath

 coughing,
 wheezing, and
 chest discomfort.
 The coughing may produce large amounts
of mucus. This type of cough often is
called a smoker's cough.

 History - medical history
 •Whether you've recently had a cold or
the flu
 •Whether you smoke or spend time around
others who smoke
 •Whether you've been exposed to dust,
fumes, vapors, or air pollution -

 Mucus -to see whether you have a
bacterial infection
 chest x ray,
 lung function tests,
 CBC
 ABG analysis

 MEDICAL MANAGEMENT
 SURGICAL MANAGEMENT
 NURSING MANAGEMENT

 IMPROVE VENTILLATION
1. BRONCHO DILATORS LIKE BETA2
AGONISTS(ALBUTEROL),ANTICHOLINERGIC
S(IPRATROPIUM BROMIDE-ATROVENT).
2. METHYLXANTHINES(THEOPHYLLINE,AMIN
OPHYLLINE)
3. CORTICOSTEROIDS
4. OXYGEN ADMINISTRATION

 REMOVE BRONCHIAL SECRETION
 PROMOTE EXERCISES
 CONTROL COMPLICATIONS
 IMPROVE GENERAL HEALTH

 BULLECTOMY
BULLAE ARE ENLARGED AIRSPACES THAT
DO NOT CONTRIBUTE TO VENTILLATION BUT
OCCUPY SPACE IN THE THORAX,THESE AREAS
MAY BE SURGICALLY EXCISED
 LUNG VOLUME REDUCTION SURGERY
 IT INVOLVES THE REMOVAL OF A PORTION
OF THE DISEASED LUNG PARENCHYMA.THIS
ALLOWS THE FUNCTIONAL TISSUE TO EXPAND.
 LUNG TRANSPLANTATION

 ASSESSMENT
 PHYSICAL EXAMINATION
 DIAGNOSIS
 INTERVENTION

 IMPAIRED GAD EXCHANGE RELATED TO
DECREASED VENTILLATION AND MUCOUS
PLUGS
 INEFFECTIVE AIRWAY CLEARENCE RELATED
TO EXCESSIVE SECRETION AND INEFFECTIVE
COUGHING
 ANXIETY RELATED TO ACUTE BREATHING
DIFFICULTIES AND FEAR OF SUFFOCATION
 ACTIVITY INTOLERENCE RELATED TO
INADEQUATE OXYGENATION AND DYSPNOEA

 IMBALANCED NUTRITION LESS THAN BODY REQUIREMENT
RELATED TO REDUCED APPETITE,DECREASED ENERGY LEVEL
AND DYSPNOEA

 DISTURBED SLEEP PATTERN RELATED TO
DYSPNOEA AND EXTERNAL STIMULI
 RISK FOR INFECTION RELATED TO
INEFFECTIVE PULMONARY CLEARENCE

 Definition:-Emphysema is defined as
enlargement of the air spaces distal to
 the terminal bronchioles, with
 destruction of their walls of the alveoli.
 Pathology :
 As the alveoli are destroyed the alveolar
surface area in contact with the
capillaries decreases.
 Causing dead spaces (no gas exchange
takes place)

 Leads to hypoxia.
 In later stages:
 CO2 elimination is disturbed and
increase in CO2 tension in arterial blood
causing

 Respiratory acidosis
 (Decrease pulmonary blood flowis
increased forcing the RV to maintain high
B.P. in PA.)

 Centrilobular-Therespiratory bronchiole
(proximal and central part of the acinus)
is expanded. The distal acinus or alveoli
are unchanged. Occurs more commonly in
the upper lobes.

 Panlobular-The entire respiratory acinus,
from respiratory bronchiole to alveoli, is
expanded. Occurs more commonly in the
lower lobes, especially basal segments,
and anterior margins of the lungs.

a) History
b) PFT
c) Spirometry-to find out airflow
obstruction.
d) ABG analysis
e) CT scan of the lung.
f) Screening of alpha antitrypsin deficiency
g) X-ray radiography may aid in the
diagnosis.

 DISTURBED SLEEP PATTERN RELATED TO
DYSPNOEA AND EXTERNAL STIMULI
 RISK FOR INFECTION RELATED TO
INEFFECTIVE PULMONARY CLEARENCE
 IMBALANCED NUTRITION LESS THAN BODY
REQUIREMENT RELATED TO REDUCED
APPETITE,DECREASED ENERGY LEVEL AND
DYSPNOEA

 Respiratory insufficiency
 Respiratory failure
 Pneumonia
 Pneumothorax
 Pulmonary artery hypertension.

 TAKEYOUR MEDICATIONS REGULARLY AS
PRESCRIBED,IF YOU HAVE ANY DOUBT RING
YOUR HOSPITAL.

 EXERCISEREGULARLY EVERYDAY OR ELSE
ATLEAST 4 OUT OF 7 DAYS.

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

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