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COPD/ CHRONIC OBSTRUCTIVE LUNG DISEASE /
CHRONIC AIRFLOW LIMITATION
➢ It is a long-term pulmonary disorder characterized by increased airway resistance

Risk Factors: Remember the word CAL
C - Cigarette Smoking (Most important risk factor)
A – Allergens
L – Long respiratory infections

Chronic Bronchitis (Blue Bloater)
➢ Inflammation of the bronchi
➢ Hypersecretion of mucus

➢ Productive Cough
➢ Crackles

Emphysema (Pink Puffer)
Breakdown of the elasticity of
the lungs

Obstruction of the airways
Increased airway resistance

Decreased lung recoil
Barrel chest

IMPARED GAS EXCHANGE

Signs and Symptoms: Remember the word COPD
C = Cyanosis
Carbon Dioxide is increased – Respiratory Acidosis
Cardiac dysrhythmias
O = Oxygen is decreased – Hypoxemia – Decreased 02 Saturation
Orthopnea

P = Prolonged expiration
Pulmonary Hypertension
Pulmonary Function Test – Decreased vital capacity
D = Dyspnea
Decrease in weight
Do use accessory muscle for breathing – Hypertrophy of muscles
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The nurse should wash hands and wear gloves to guard against infections
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Prepare the client
> Explain the procedure
> Provide privacy
> Position the client:
- Unconscious = Side lying with the head of the bed lowered
- Conscious = Upright
3
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Inspect and clean the oral tissues:
>Use foam swabs or gauze; or wrap small gauze around a tongue depressor and
use cleaning solution to clean the oral mucosa
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Discard used items properly
6
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Document the activity

OXYGEN DELIVERY SYSTEMS:
1
...
Face Mask
> Simple: Delivers oxygen concentration of 40-60 %
: Flow rate: 5-8L per minute
> Partial Rebreather: Delivers oxygen concentration of 60-90 %
: Flow rate: 6-10L per minute
> Non-Rebreather: Delivers the highest oxygen concentration of 95-100%
: Flow rate: 10-15L per minute
> Venturi: Delivers a precise low concentration of oxygen of 24-40% or 24 to 50%
: Blue adapter: 24% at 4L per minute
: Green adapter: 35% at 8L per minute
: Flow rate: 4-10L per minute

3
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Transtracheal Oxygen Delivery
: Delivers less oxygen directly to the trachea through a small, narrow plastic
cannula that is surgically inserted into the trachea
: Flow rate: 0
...
Therapeutic Effect – Suppression of the cough reflex
2
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Examples:
Non opioids: Benadryl
Opioids: Codeine
4
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Cough and do breathing every 2 hours to prevent atelectasis
b
...

c
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Gradual change in position to prevent orthostatic hypotension
e
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Therapeutic Effect – Relaxes the smooth muscles of the bronchi which causes
bronchodilation
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Side Effect and Adverse Effect:
> Blood sugar elevation (hyperglycemia), Restlessness, Oral dryness, Nausea
and vomiting, Nervousness and tremors, Convulsions (Life threatening effect), Headache
and dizziness, Insomnia (CNS stimulant), Increased cardiac rate (Palpitations)

3
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Nursing Implications:
a
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Routinely check serum levels every 6 to 12 months
c
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No eating of charcoal-broiled foods daily
e
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Must take the drug with meals or after meals
g
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DECONGESTANTS
1
...
Side Effect and Adverse Effect:
> Restlessness, Hypertension, Hyperglycemia, Insomnia
3
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Nursing Implications:
a
...

b
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DO NOT take caffeinated drinks in large amount

EXPECTORANT AND MUCOLYTICS
1
...
Side Effect and Adverse Effect:
> Mild headache, Urticaria, Common GI upset like nausea and vomiting, Upper
pharyngeal irritation, Skin rashes
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Examples:
Expectorants: Guaifenesin (Robitussin)

Mucolytic: Acetylcysteine (Mucomyst)
3
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Maintain Fluid intake of 1
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Upright positioning before attempting to cough
c
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Use sugarless gum or hard candy to relieve oral discomfort
e

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