CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It’s typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.
Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. These two conditions usually occur together and can vary in severity among individuals with COPD.
- Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It’s characterized by daily cough and mucus (sputum) production.
- Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter.
Although COPD is a progressive disease that gets worse over time, COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.
COPD symptoms often don’t appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues.
Signs and symptoms of COPD may include:
- Shortness of breath, especially during physical activities
- Chest tightness
- A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish
- Frequent respiratory infections
- Lack of energy
- Unintended weight loss (in later stages)
- Swelling in ankles, feet or legs
People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than the usual day-to-day variation and persist for at least several days.
When to see a doctor
If you see any of the above symptoms, see a doctor. Talk to your doctor if your symptoms are not improving with treatment or getting worse, or if you notice symptoms of an infection, such as fever or a change in sputum. Seek immediate medical care if you can’t catch your breath, if you experience severe blueness of your lips or fingernail beds (cyanosis) or a rapid heartbeat, or if you feel foggy and have trouble concentrating.
Causes and risk factors:
- Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and marijuana smokers also may be at risk, as well as people exposed to large amounts of secondhand smoke.
- People with asthma. Asthma, a chronic inflammatory airway disease, may be a risk factor for developing COPD. The combination of asthma and smoking increases the risk of COPD even more.
- Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs.
- Exposure to fumes from burning fuel. In the developing world, people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD.
- Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the cause of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.
Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. COPD causes them to lose their elasticity and over-expand, which leaves some air trapped in your lungs when you exhale. COPD can cause many complications, includingrespiratory infections, heart, lung cancer, high blood pressure in lung arteries, depression.
Unlike some diseases, COPD typically has a clear cause and a clear path of prevention, and there are ways to slow the progression of the disease.
- The majority of cases are directly related to cigarette smoking, and the best way to prevent COPD is to never smoke — or to stop smoking now.
- Occupational exposure to chemical fumes and dusts is another risk factor for COPD. If you work with these types of lung irritants, talk to your supervisor about the best ways to protect yourself, such as using respiratory protective equipment.
- Get an annual flu vaccination and regular vaccination against pneumococcal pneumonia to reduce your risk of or prevent some infections.
Home Nursing for COPD:
Tools to help you care for yourself and take charge of your own COPD treatment can be offered to help you be as independent as possible:
- Nursing services, physical therapy, occupational therapy, speech therapy and social work
- Education about your COPD medications and breathing exercises such as pursed-lip and diaphragmatic breathing
- Support so you can achieve your personal goals and follow a plan of care developed specifically for you
- Education about clearing your airway and conserving energy
- Education for your caregiver to include them in your COPD treatment plan
- Improve your ability to stay active
- Reduce your chances of needing to go to the hospital
- Prevent and treat COPD exacerbations (flare-ups)
- Make sure your home is safe so you can stay as healthy as possible
COPD home nursing plan may include:
- Checking your oxygen level, heart rate and blood pressure
- Daily checks for symptoms of a COPD exacerbation (flare-up)
- Clearing your lungs using techniques like controlled coughing, huff coughing or suctioning
- Avoiding things that could irritate your lungs such as smoke, dust, mold, mildew, trash and household chemicals
- Using medications such as inhalers, nebulizers and oxygen
- Exercise and Breathing techniques
- Rescue Inhalers – fast-acting COPD medication used when symptoms have gotten worse
- Oxygen Therapy – to increase the level of oxygen in the blood
COPD has no cure yet. However, lifestyle changes and COPD treatments can help you feel better, stay more active and slow the progress of the disease.