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Reduction in forced expiratory flow rates Increases in residual volume Increases in ratio of residual volume to total lung capacity Increased total lung capacity (late in the disease) Diffusion capacity may be decreased in patients with emphysema. June 2023. PK ! pulmonary edema; North Carolina State University . Chronic Obstructive Pulmonary Disease . It is important to keep a list of your medications and immunizations handy. feeling excessively sleepy or confused. progressive syndrome expiratory airflow obstruction chronic airway and lung parenchyma inflammation. Grace Parker (the patient's name has been changed) attends a nurse-led COPD clinic for routine reviews. Virus Transmission-Understanding and Predicting Pandemic Risk, Small Cell Lung Cancer (SCLC): Diagnosis Treatment and Natural History, Current Management of Hereditary Angioedema - Considerations to Optimize Individualized Care. Activate your 30 day free trialto unlock unlimited reading. Chronic Obstructive Pulmonary Disease (COPD) Slide 2-. Lung cancer Clubbing of the digits is not a sign of COLD.In patients with COLD, development of lung cancer is the most likely explanation for newly developed clubbing. Views: 837, By: DrDwayne We've updated our privacy policy. Click here to review the details. disease of the airway Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases. Causes Most cases of COPD occur as a result . Cigar and pipe smoking Passive (secondhand) smoking Associated with reductions in pulmonary function Its status as a risk factor for COLD remains uncertain. (due to weakened/impaired physical activity, tiredness, etc) 2.) 21 slides. The air sacs fill up with air, like a small balloon. 28-7, Emphysema Pathophysiology Hyperinflation of alveoli Destruction of alveolar walls Destruction of alveolar capillary walls Narrowed airways Loss of lung elasticity, Emphysema Pathophysiology Two types: Centrilobular (central part of lobule) Most common Panlobular (destruction of whole lobule) Usually associated with AAT deficiency, Emphysema Pathophysiology Structural changes are: Hyperinflation of alveoli Destruction of alveolar capillary walls Narrowed, tortuous small airways Loss of lung elasticity, Emphysema Pathophysiology Small bronchioles become obstructed as a result of Mucus Smooth muscle spasm Inflammatory process Collapse of bronchiolar walls Recurrent infections production/stimulation of neutrophils and macrophages release proteolytic enzymes alveolar destruction inflammation, exudate, and edema, Emphysema Pathophysiology Elastin and collagen are destroyed Air goes into the lungs but is unable to come out on its own and remains in the lung Causes bronchioles to collapse, Emphysema Pathophysiology Trapped air hyperinflation and overdistention As more alveoli coalesce, blebs and bullae may develop Destruction of alveolar walls and capillaries reduced surface area for O2 diffusion Compensation is done by increasing respiratory rate to increase alveolar ventilation Hypoxemia usually develops late in disease, Emphysema Clinical Manifestations Dyspnea Progresses in severity Patient will first complain of dyspnea on exertion and progress to interfering with ADLs and rest, Emphysema Clinical Manifestations Minimal coughing with no to small amounts of sputum Overdistention of alveoli causes diaphragm to flatten and AP diameter to increase, Emphysema Clinical Manifestations Patient becomes chest breather, relying on accessory muscles Ribs become fixed in inspiratory position, Emphysema Clinical Manifestations Patient is underweight (despite adequate calorie intake), Chronic Bronchitis Pathophysiology Pathologic lung changes are: Hyperplasia of mucus-secreting glands in trachea and bronchi Increase in goblet cells Disappearance of cilia Chronic inflammatory changes and narrrowing of small airways Altered fxn of alveolar macrophages infections, Chronic Bronchitis Pathophysiology Chronic inflammation Primary pathologic mechanism causing changes Narrow airway lumen and reduced airflow d/t hyperplasia of mucus glands Inflammatory swelling Excess, thick mucus, Chronic Bronchitis Pathophysiology Greater resistance to airflow increases work of breathing Hypoxemia and hypercapnia develop more frequently in chronic bronchitis than emphysema, Chronic Bronchitis Pathophysiology Bronchioles are clogged with mucus and pose a physical barrier to ventilation Hypoxemia and hypercapnia d/t lack of ventilation and O2 diffusion Tendency to hypoventilate and retain CO2 Frequently patients require O2 both at rest and during exercise, Chronic Bronchitis Pathophysiology Cough is often ineffective to remove secretions because the person cannot breathe deeply enough to cause air flow distal to the secretions Bronchospasm frequently develops More common with history of smoking or asthma, Chronic Bronchitis Clinical Manifestations Earliest symptoms: Frequent, productive cough during winter Frequent respiratory infections, Chronic Bronchitis Clinical Manifestations Bronchospasm at end of paroxysms of coughing Cough Dyspnea on exertion History of smoking Normal weight or heavyset Ruddy (bluish-red) appearance d/t polycythemia (increased Hgb d/t chronic hypoxemia)) cyanosis, Chronic Bronchitis Clinical Manifestations Hypoxemia and hypercapnia Results from hypoventilation and airway resistance + problems with alveolar gas exchange, COPD Complications Pulmonary hypertension (pulmonary vessel constriction d/t alveolar hypoxia & acidosis) Cor pulmonale (Rt heart hypertrophy + RV failure) Pneumonia Acute Respiratory Failure, COPD Diagnostic Studies Chest x-rays early in the disease may not show abnormalities History and physical exam Pulmonary function studies reduced FEV1/FVC and residual volume and total lung capacity, COPD Diagnostic Studies ABGs PaO2 PaCO2 (especially in chronic bronchitis) pH (especially in chronic bronchitis) Bicarbonate level found in late stages COPD, COPD Collaborative Care Smoking cessation Most significant factor in slowing the progression of the disease, COPD Collaborative Care: Drug Therapy Bronchodilators as maintenance therapy -adrenergic agonists (e.g. what is, COPD - . 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Sputum gram stain and culture (for COLD exacerbation), Imaging Chest radiography Emphysema: obvious bullae, paucity of parenchymal markings, or hyperlucency Hyperinflation: increased lung volumes, flattening of diaphragm Does not indicate chronicity of changes Chest CT Definitive test for establishing the diagnosis of emphysema, but not necessary to make the diagnosis, Diagnostic Procedures Pulmonary function tests/spirometry Chronically reduced ratio of FEV1 to forced vital capacity (FVC) In contrast to asthma, the reduced FEV1 in COLD seldom shows large responses (>30%) to inhaled bronchodilators, although improvements up to 15% are common. It appears that you have an ad-blocker running. Quieres ms informacin?Llame al 866.731.COPD (2673) y presione 9 para hablar en espaol con un paciente o cuidador. Ambient air pollution The relationship of air pollution to COLD remains unproven. The COPD Foundation's My COPD Action Plan should be filled out the first time as part of a discussion with your health care provider, and then used daily or as often as you can. Support groups. Many in this series of 12- to 20-page easy-to-read booklets feature interactive portions for patients and caregivers to discuss together. Goal: Develop a PowerPoint presentation on CONGESTIVE HEART FAILURE (CHF) (Please explain implications on cardiovascular and respiratory system) The presentation must provide information about the incidence, prevalence, and pathophysiology of Congestive Heart Failure to the cellular level. Causes and types of chronic obstructive . The inclusion criteria for . Pneumothorax occurs when the parietal or visceral pleura is breached and the pleural . courtney pearce & jenna paterno . 2. Author: Stephen Gundry is COPD nurse, Newcastle Hospitals NHS Foundation Trust. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. Hypertensionor high blood pressurecan happen steadily over long periods of time and have no clear cause, called primary hypertension,. Eneutron. How to Add, Duplicate, Move, Delete or Hide Slides in Google Slides, How to Change the Slide Size in Google Slides, 26 different slides to impress your audience, Contains easy-to-edit graphics such as graphs, maps, tables, timelines and mockups, Includes 500+ icons and Flaticons extension for customizing your slides, Designed to be used in Google Slides and Microsoft PowerPoint, 16:9 widescreen format suitable for all types of screens, Includes information about fonts, colors, and credits of the free resources used. Because this study aimed to explore nurse observations of COPD patients in a naturalistic setting (during home visits), eligible patients were identified and included as a third party during the data collection process. 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