Question

1. Which laboratory results are consistent with long term COPD?

2. A client with a diagnosis of chronic obstructive pulmonary disease (COPD) is being discharged from the hospital. Describe appropriate patient teaching before discharge? Cover at least two teaching topics.

3. Describe the similarities and differences for clients with COPD (emphysema vs bronchitis?)

Answer 1

1. A blood test taken from an artery or Arterial Blood Gas (ABG), can be tried for blood gas levels which may show

• low oxygen (hypoxaemia)
• high carbon dioxide (respiratory acidosis if pH is likewise decreased).
• Both these may contribute to respiratory acidosis.

A blood test taken from a vein may show

• a high blood tally (reactive polycythemia), a reaction to long haul hypoxemia.

These findings are consistent in long term COPD

2. The health education for COPD patients include

• No smoking: Inform and educate them the effect of chronic smoking. Help to get rid of smoking habit with the aid of support groups. Help to identify OTC medicines which can help get rid of the habit.
• Teach breathing techniques like pursed lip breathing to help them in case of shortness of breath
• Advise to stay away from dust, smoke and fumes. Any irritant or airway hypersensitive items , they have to keep a distance.
• Always carry your medicines wherever you travel, be it for work or a tour. Always have a list of your medicines with you, in case of emergency. Be regular and have correct dose of medications. Don't stop medications or increase the dose without consulting your health care provider.
• Eat healthy foods, include lots of fruits, vegetables and plenty of non caffeinated drinks. Exercise regularly and consult the health care provider, before starting a heavy exercise regimen. Do your tasks slowly, without straining the respiratory system. Avoid psychological stressors and take up ways like meditation to relax yourself.
• Avoid contact with sick people to prevent infection, as COPD people are very prone to respiratory tract infections. Keep a regimen for own health and try to maintain it. Get help whenever you feel sick.

3. The emphysematous patients are called blue bloaters and patients with bronchitis are called pink puffers.

The similarities between emphysema and chronic bronchitis:

• Both the above conditions usually occur together and constitute COPD.
• Smoking is a leading cause of both conditions.
• Risk factors like family history to lung disease and exposure to smoke and fumes are common for both conditions
• Both conditions may present with shortness of breath, wheezing, frequent cough and cardiac issues.
• Both conditions have no complete cure, but only symptomatic management.
• The treatment for both conditions include Oxygen therapy, bronchodilators, steroids etc.

Difference between emphysema and chronic bronchitis :

• Emphysema involves the gradual destruction of the air sacs in the lungs (alveoli), hindering breathing; Chronic bronchitis is the condition causes a person’s lungs to become very inflamed affecting the windpipe and passageways of the lungs and is the result of severe irritation or infection.
• Chronic bronchitis produce frequent cough; Emphysema presents mainly with shortness of breath
• Patients with emphysema have symptoms such as a barrel chest, enlarged lungs, shortness of breath, and weight loss; Patients with chronic bronchitis will have symptoms such as shortness of breath, chronic cough, excessive mucus production and wheezing which can lead to pulmonary hypertension.
• Emphysema can be genetically inherited condition like alpha 1 antitrypsin deficiency
• GERD can lead to chronic bronchitis.
• Emphysema is irreversible and may require reduction surgery ; Bronchitis can be controlled well with quitting smoking habit and yearly flu vaccines.

.