Chronic Obstructive Pulmonary Disorder (COPD)

Chronic obstructive pulmonary disorder includes chronic Bronchitis, Bronchiectasis, Emphysema, Empyema and the Asthma.

Bronchitis

Definition:

Chronic bronchitis is defined by the presence of chronic productive cough for minimum of 3 months per year for at least consecutive years in patients in whom other causes have been excluded, it is characterized by physiologically by hyper-trophy & hyper secretion of bronchial mucous glands.

Etiology:

1. Viral infection
2. Bacterial infection
3. Chemical irritants
4. Clinical features:
5. Cough
6. Frequent respiratory infection
7. Hypoxemia
8. Hyperpnoea
9. Cyanosis

Complications:

1. Pulmonale
2. Acute respiratory failure
3. Peptic ulcer
4. GERD
5. Pneumonia

Investigations:

1. X-ray film
2. ABG’s
3. ECG
4. EEG
5. Exercise testing with Oximetry

Medical Management:

1. Medical therapy depends upon symptoms
2. Specific therapy
3. Bronchodilators
4. Antibiotics
5. Oxygen inhalation

Nursing Management:

1. Promote patient’s comfort
2. Prevent from further complication
3. Provide ventilated rooms
4. Promote secretion- removal
5. Relaxation of exercise
6. Oxygen inhalation

Bronchiectasis

Definition:

Bronchiectasis is a disorder characterized by permanent, abnormal or irreversible dilation of the bronchial tree or one or more large bronchi

Etiology:

1. Bacteria
2. Virus (Adeno-virus, Influenza)

Clinical features:

Sign:

1. Cyanosis
2. Cough Symptoms:
3. Haemoptysis
4. Dysponea
5. Fatigue
6. Weakness
7. Weight loss

Investigations:

1. X-ray chest
2. Bronchography
3. Sputum examination
4. CT scanning

Medical Management:

1. Antibiotics
2. Bronchodilators

Surgical Management:

1. Segmentectomy
2. Lobectomy

Nursing Management:

1. ROM of the Chest
2. Maintaining good hydration to liquefy secretion
3. Maintaining good hygiene including oral hygiene
4. Adequate rest, diet, exercise
5. Avoidance from smoking
6. Provide ventilated room.

Emphysema

Definition:

Emphysema is defined as pathologically by destructive changes in alveolar walls and enlargement of air-spaces distal to the terminal non-respiratory bronchioles. It is characterized physiologically by increased lung compliance, decreased diffusing, capacity & increased air-way resistance

Etiology:

1. Idiopathic
2. Risk factors are:
3. Smoking
4. Heredity
5. Clinical features:
6. Dysponea
7. Cough
8. Hypoxemia
9. Under weight
10. Wheezing breath

Investigation:

1. X-ray
2. CBC

Medical Management:

1. Oxygen therapy
2. Physic-therapy

Nursing Management:

1. ROM of the Chest
2. Maintaining good hydration to liquefy secretion
3. Maintaining good hygiene including oral hygiene
4. Adequate rest, diet, exercise
5. Avoidance from smoking
6. Provide ventilated room