Chronic Obstructive Pulmonary Disease (Review)
- Also known as chronic obstructive lung disease and chronic airflow limitation
- Chronic obstructive pulmonary disease is a disease state characterized by airflow obstruction caused by emphysema or chronic bronchitis.
- Progressive airflow limitation occurs, associated with an abnormal inflammatory response of the lungs that is not completely reversible.
- Chronic obstructive pulmonary disease leads to pulmonary insufficiency, pulmonary hypertension, and cor pulmonale.
Watch this video.
- Exertional dyspnea
- Wheezing and crackles
- Sputum production
- Weight loss
- Barrel chest (emphysema) (Fig. 58-11)
- Use of accessory muscles for breathing
- Prolonged expiration
- Cardiac dysrhythmias
- Congestion and hyperinflation seen on chest xray.
- ABG levels that indicate respiratory acidosis and hypoxemia
- Pulmonary function tests that demonstrate decreased vital capacity
- Monitor vital signs.
- Administer a low concentration of oxygen (1 to 2 L/min) as prescribed; the stimulus to breathe is a low arterial PO2 instead of an increased PCO2.
- Monitor pulse oximetry.
- Provide respiratory treatments and CPT.
- Instruct the client in diaphragmatic or abdominal breathing techniques and pursed-lip breathing techniques.
- Record the color, amount, and consistency of sputum.
- Suction fluids from the client’s lungs, if necessary, to clear the airway and prevent infection.
- Monitor weight.
- Encourage small frequent meals to maintain nutrition and prevent dyspnea.
- Provide a high-calorie, high-protein diet with supplements.
- Encourage fluid intake up to 3000 mL/day to keep secretions thin, unless contraindicated.
- Place the client in a Fowler’s position and leaning forward to aid in breathing (Fig. 58-13).
- Allow activity as tolerated.
- Administer bronchodilators as prescribed, and instruct the client in the use of oral and inhalant medications.
- Administer corticosteroids as prescribed for exacerbations.
- Administer mucolytics as prescribed to thin secretions.
- Administer antibiotics for infection if prescribed.