Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough which may or may not produce mucus. COPD progressively worsens with everyday activities such as walking or dressing becoming difficult.
The two most common conditions of COPD are emphysema and chronic bronchitis, and they have been the two classic COPD phenotypes. Emphysema is defined as enlarged airspaces (alveoli) whose walls break down resulting in permanent damage to the lung tissue. Chronic bronchitis is defined as a productive cough that is present for at least three months each year for two years. Both of these conditions can exist without airflow limitation when they are not classed as COPD. Emphysema is just one of the structural abnormalities that can limit airflow and can exist without airflow limitation in a significant number of people. Chronic bronchitis does not always result in airflow limitation but in young adults who smoke the risk of developing COPD is high. Many definitions of COPD in the past included emphysema, and chronic bronchitis but these have never been included in GOLD report definitions.
The most common cause of COPD is tobacco smoking, other risk factors include indoor and outdoor pollution and genetics. In developing countries, common sources of indoor air pollution are the use of biomass fuels such as wood and dry dung fuel for cooking and heating. Most people living in European cities are exposed to damaging levels of air pollution. A number of occupations and associated substances including cadmium dust or fumes, and dust from grains that promote respiratory symptoms has been published in the UK. Long-term exposure to any of these irritants causes an inflammatory response in the lungs, resulting in narrowing of the small airways and breakdown of lung tissue.The diagnosis is based on poor airflow as measured by spirometry.
Most cases of COPD can be prevented by reducing exposure to risk factors such as smoking and indoor and outdoor pollutants. While treatment can slow worsening, there is no conclusive evidence that any medications can change the long-term decline in lung function. COPD treatments include smoking cessation, vaccinations, pulmonary rehabilitation, inhaled bronchodilators, and corticosteroids. Some people may benefit from long-term oxygen therapy, lung volume reduction (surgical) or (bronchoscopic), and lung transplantation. In those who have periods of acute worsening, increased use of medications, antibiotics, corticosteroids, and hospitalization may be needed.
10 List of Nursing Diagnosis for COPD
- Ineffective airway clearance related to: bronchoconstriction, increased sputum production, ineffective cough, fatigue / lack of energy, bronchopulmonary infection.
- Ineffective breathing pattern related to: shortness of breath, mucus, bronchoconstriction, airway irritants.
- Impaired gas exchange related to: ventilation perfusion inequality.
- Activity intolerance related to: imbalance between oxygen supply with demand.
- Imbalanced Nutrition: less than body requirements related to: anorexia.
- Disturbed sleep pattern related to: discomfort, sleeping position.
- Bathing / Hygiene Self-care deficit related to: fatigue secondary to increased respiratory effort and ventilation and oxygenation insufficiency.
- Anxiety related to: threat to self-concept, threat of death, purposes that are not being met.
- Ineffective individual coping related to: lack of socialization, anxiety, depression, low activity levels and an inability to work.
- Deficient Knowledge related to: lack of information, do not know the source of information.