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What conditions include COPD?
- Emphysema,
- Chronic Bronchitis
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What sort of etiologies are involved with COPD?
- Smoking #1, can be both, but more often emphysema.
- Pollution
- Infection--Recurring URI’s
- Heredity--Antitrypsin Deficiency (ATT) (can be young with no Hx of smoking, but will still present with COPD emphysema).
- Aging
- --Loss of elastic recoil
- --Less functional alveoli
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COPD pathophysiology
- Primary process is inflammation due to:
- Inhalation of noxious particles
- Mediators released cause damage to lung tissue
- Airways inflamed
- Parenchyma destroyed
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Emphysema pathophys
- Destruction/breakdown of alveoli-->impaired (reduced) gas exchange
- Loss of elasticity of bronchioles--> “Air trapping” & “CO2 retainer”
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What are Bullaes and Blebs?
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Pathyphys of Chronic Bronchitis
Presence of chronic, productive cough for 3+ months in each of 2 successive years after other causes have been ruled out.
- Hyperplasia of mucus cells-->^ mucous production
- Increased goblet cells
- Bye-bye cilia--> ^ mucous accumulation.
- Inflammation -->narrow airways--> blockage.
- Dysfunctional macrophages -->infections
- Alveoli & capillaries are normal
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COPD SnSs
- Dyspnea
- Intermittent coughing with small amounts of sputum
- Overdistention of alveoli = barrel chest
- Chest breathing = accessory muscle use
- Hypoxemia--partial pressure arteriol (Pa) O2
- Hypercapnia (, ^CO2Late)
- Bluish-red skin
- Polycythemic--increased blood cells including hemoglobin--> thick blood.
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COPD Complications
- Cor pulmonale: Rt side heart enlargement due to compensation for COPD. Look it up.
- Pulmonary hypertension
- Acidosis due to ^CO2 levels.
- Polycythemia, again, increase blood cells--> blood thickening.
- Peptic ulcer disease (PUD) & GERD: due to treatment with corticoidsteroids.
- Acute respiratory failure (ARF)
- Pneumonia
- Depression & Anxiety
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COPD collaborative care
- Smoking cessation
- Drug therapy
- Oxygen therapy
- Surgical therapy
- Nutrition
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What is Proning?
 - repositioning to maximize expansion and aid breathing.
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