COPD

COPD. NUR 4267 AUDRA A. HICKS, MSN, RN, RRT FALL 2026.

Course objectives slide that lists the objectives as follows: Identify risk factors for select respiratory disorders (CO3). Discuss clinical manifestations, including priority assessments for clients with the selected respiratory disorders. (CO2) Describe the diagnostic results used to confirm selected respiratory disorders. (CO3) Test knowledge on the pharmacological management of respiratory disorders (CO3). Articulate priorities of care for select respiratory disorders (CO5). Debate nursing actions in the care of clients with selected respiratory disorders (CO2, CO3) Construct a nursing process map in the care of clients with select respiratory disorders. (CO5) Develop teaching and support strategies for the management of patients with respiratory disorders. (CO6, CO7) Assess knowledge of nursing skills necessary to stabilize and support the care of clients with select respiratory disorders (CO3)..

COPD Overview. Definition COPD is a chronic progressive lung disease characterized by airflow limitation that is not fully reversible. Includes: Emphysema → destruction of alveoli causing air trapping Chronic Bronchitis → inflammation of bronchi with excess mucus production Key outcome: Impaired oxygenation Carbon dioxide retention Progressive respiratory decline.

Etiology and Risk Factors Slide that discusses: Primary causes: Cigarette smoking (major cause) Alpha-1 antitrypsin deficiency Occupational dust exposure Chemical irritants Air pollution Secondhand smoke Recurrent respiratory infections Advanced age Prevention: Smoking cessation Influenza vaccine Pneumonia vaccine.

Slide titled "Clinical Manifestations" on a green chalkboard-style background. The left side lists common clinical manifestations of chronic obstructive pulmonary disease (COPD). Respiratory manifestations include: Dyspnea on exertion Chronic productive cough Wheezing Crackles Chest tightness Physical findings include: Barrel chest Tripod positioning Accessory muscle use Pursed-lip breathing Respiratory rate greater than 20 breaths per minute Cyanosis in late-stage disease Clubbing in late-stage disease Weight loss in advanced disease Anxiety Crackles Oxygen saturation below 90% The right side contains a medical illustration comparing a normal lung with lungs affected by COPD. Enlarged diagrams show: A normal alveolus with an open airway Chronic bronchitis, characterized by thickened airway walls, narrowed airways, and increased mucus production Emphysema, characterized by enlarged alveoli and destruction of alveolar walls leading to loss of elastic recoil The illustration visually demonstrates airflow obstruction and structural lung damage associated with COPD..

Slide titled "What Does This Patient Look Like?" on a green chalkboard-style background. The left side lists the expected physical appearance of a client with chronic obstructive pulmonary disease (COPD). Expected appearance includes: Difficulty speaking in full sentences Labored breathing Anxiety Lean body habitus Barrel chest Tripod positioning Prolonged expiration Visible use of accessory muscles during breathing The right side contains a medical illustration showing a client lying in a hospital bed with two healthcare providers standing nearby. The client appears to be experiencing respiratory distress, while the providers are observing and assessing the patient's condition. The image reinforces the characteristic appearance of a patient with advanced COPD, including increased work of breathing and the need for ongoing clinical assessment..

BLUE BLOATER-PINK PUFFER. Slide displaying a side-by-side comparison of the two major clinical presentations of chronic obstructive pulmonary disease (COPD): chronic bronchitis and emphysema. The left panel is titled "Blue Bloater – Chronic Bronchitis" and illustrates an adult with a larger body build and a bluish skin tone, representing chronic hypoxemia. The accompanying text lists common findings, including: Chronic productive cough Purulent sputum Coughing up blood (hemoptysis) Mild shortness of breath early in the disease Cyanosis caused by low oxygen levels Peripheral edema related to cor pulmonale Crackles and wheezes Prolonged expiration Obesity Complications listed include: Secondary polycythemia due to chronic hypoxemia Pulmonary hypertension Cor pulmonale resulting from chronic pulmonary hypertension The right panel is titled "Pink Puffer – Emphysema" and illustrates a thin adult with a barrel-shaped chest leaning forward in a tripod position, representing increased work of breathing. The accompanying text lists common findings, including: Shortness of breath Minimal cough Increased minute ventilation Pink skin color with pursed-lip breathing Accessory muscle use Cachexia Hyperinflation and barrel chest Decreased breath sounds Rapid respiratory rate Complications listed include: Pneumothorax caused by ruptured bullae Weight loss due to the increased energy required for breathing The slide emphasizes the contrasting clinical characteristics of chronic bronchitis and emphysema while noting that many patients with COPD have features of both conditions..

Slide titled "Diagnostic Evaluation" on a green chalkboard-style background. The slide outlines common diagnostic tests used to evaluate chronic obstructive pulmonary disease (COPD). Assessment tools include: Comprehensive health history Physical assessment Pulmonary function testing findings include: Decreased forced expiratory volume in one second (FEV1) Decreased forced vital capacity (FVC) FEV1/FVC ratio less than 70%, indicating persistent airflow obstruction Laboratory findings include: Arterial blood gases (ABGs), discussed on the following slide Complete blood count (CBC), with elevated hematocrit suggesting chronic hypoxemia and elevated white blood cell count if infection is present Sputum culture to identify respiratory pathogens when infection is suspected Imaging findings include: Chest X-ray showing lung hyperinflation and a flattened diaphragm, findings commonly associated with COPD Decorative chalkboard-themed graphics, including a light bulb icon and pieces of chalk, are present and do not convey instructional content..

Slide titled "ABG Interpretation" on a green chalkboard-style background. The slide summarizes common arterial blood gas (ABG) findings associated with chronic obstructive pulmonary disease (COPD). Typical findings include: Hypoxemia: Partial pressure of arterial oxygen (PaO₂) less than 80 mmHg, indicating decreased oxygenation. Hypercapnia: Partial pressure of arterial carbon dioxide (PaCO₂) greater than 45 mmHg, indicating carbon dioxide retention. Respiratory acidosis: Develops as a result of carbon dioxide retention. Clients with chronic COPD may demonstrate metabolic compensation due to long-term adaptation. Decorative classroom-themed graphics, including a graduation cap, diploma, light bulb, chalk, and chalkboard drawings, are present for visual design only and do not provide instructional content..

Slide titled "Treatment Goals" displayed on a classroom-themed chalkboard. The slide lists the primary goals of managing chronic obstructive pulmonary disease (COPD). Primary treatment goals include: Slow disease progression Reduce modifiable risk factors Improve oxygenation Reduce the frequency and severity of exacerbations Improve ventilation Prevent respiratory infections Improve quality of life Decorative classroom graphics include an illustrated instructor standing beside the chalkboard, a wall clock, classroom plants, chalk, and chalkboard drawings. These elements are decorative and do not provide instructional content..

Slide titled "Medical Management (Stable COPD)" on a classroom-themed chalkboard. The slide summarizes common medications used to manage stable chronic obstructive pulmonary disease (COPD) and the recommended order for administering inhaled medications. Medication categories include: Bronchodilators: Albuterol Ipratropium Theophylline Anti-inflammatory agents: Fluticasone Prednisone Montelukast Mucolytics: Acetylcysteine Guaifenesin The slide also lists the recommended inhaler sequence: Albuterol Ipratropium Corticosteroid Decorative classroom graphics, including computer and book icons, a wall clock, plants, and classroom décor, are present for visual design only and do not convey instructional content..

Alt Text (ADA-Compliant): Slide titled "COPD Exacerbation Management" on a classroom-themed chalkboard. The slide summarizes the recommended treatment and monitoring priorities for a client experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD). Treatment during an acute exacerbation includes: Oxygen therapy Inhaled bronchodilators Oral glucocorticoids Antibiotic therapy when a bacterial infection is suspected Non-invasive positive pressure ventilation (BiPAP) for appropriate clients with respiratory failure Key monitoring priorities include: Signs of respiratory muscle fatigue Carbon dioxide (CO₂) retention Increased work of breathing Decorative classroom graphics, including a wall clock, chalk, plants, a light bulb icon, and a school building illustration, are present for visual design only and do not convey instructional content..

Nursing Interventions. Respiratory management: High Fowler’s positioning Oxygen administration (goal 90–92%) Encourage coughing Incentive spirometry Suction secretions when needed Monitor: Pulse oximetry Respiratory effort ABGs Breath sounds.

Breathing Techniques. Pursed Lip Breathing Inhale through nose Exhale slowly through pursed lips Diaphragmatic Breathing Deep abdominal breathing Strengthens respiratory muscles Benefits: Improves ventilation Decreases air trapping Reduces dyspnea.

Nutrition & Activity Management. Nutrition priorities: Small frequent meals High calorie diet High protein diet Increase fluids to 2L/day Activity: Rest periods Pulmonary rehabilitation Walking 20–30 min 3–4 times weekly.

Major complications: Respiratory infection Acute respiratory failure Secondary spontaneous pneumothorax Right-sided heart failure Cor pulmonale Signs of worsening: Increased dyspnea Decreased SpO₂ Fever Increased secretions.

Cor Pulmonale (Right-Sided Heart Failure). Pathophysiology: Air trapping → Increased pulmonary pressure → Right ventricular strain Manifestations: Distended neck veins Peripheral edema Fatigue Enlarged liver Dyspnea.

Collaborative Care Team. Consult: Respiratory therapy Nutrition services Pulmonary rehabilitation Home health services Community support programs Family caregiver education.

Patient Education. Teach patient to: Stop smoking Take medications correctly Recognize exacerbation symptoms Prevent respiratory infection Maintain hydration Use oxygen safely Receive annual vaccines Pace activities.

Nursing Diagnoses. Priority diagnoses: Impaired gas exchange Ineffective airway clearance Activity intolerance Anxiety Risk for infection.

Nursing Process. Recognize cues Analyze cues Prioritize hypotheses Generate solutions Take action Evaluate outcomes Priority: Airway → Breathing → Oxygenation.

COPD is: Progressive Irreversible Requires lifelong management Focus on: Oxygenation Ventilation Preventing exacerbations Patient education Preserving quality of life.

References. Manning, L., & Zager, L. R. (2019). Medical surgical nursing concepts made insanely easy! : a new approach to the Next Generation NCLEX®! I Can Publishing. Althoff, A., & Assessment Technologies Institute (Contributors). (2023). RN adult medical-surgical nursing: Review module (12th ed.). Assessment Technologies Institute. Hoffman, J. J., & Sullivan, N. J. (2024a). Davis advantage for medical-surgical nursing: Making connections to practice(3rd ed.). F.A. Davis Company..

END OF SLIDE PRESENTATION. THANK YOU.