CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

1.NORNAZIHAH SAHMAN 2. KHADIJAH ARIFIN 3. NURHAFIZAH HAMZAH 4. NURSYUHAIDAH THAZALI 5. SITI NAZIRAH AHMAD

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To explain about the anatomy and physiology of the pulmonary. To describe about Chronic Obstructive Pulmonary Disease and its pathophysiology. To list out the etiology, clinical manifestation, complication and the treatment for COPD. To carry out the nursing process.

COPD is a disease which air flow is obstructed by emphysema, chronic bronchitis or both. The air flow obstruction is usually progressive and irreversible, and it may be associated with airway hyperreactivity. COPD is the fourth leading cause of death in the United States.( Ventura, Peters,Martin and Maurer,1997;Wilcox,1998)

People with COPD commonly become symptomatic during the middle adult year, and the incidence of COPD increases with age.

The airway obstruction that occurs will reduce air flow. In chronic bronchitis excessive accumulation of mucus and secretion blocks the airway. In emphysema impaired gas exchange (oxygen and carbon dioxide) result from destruction of the walls of the alveoli and cause the enlargement of alveoli. In asthma, inflamed constricted the airways and obstruct the air flow.

Smoking depresses the activity of scavenger cells and affect the cilliary cleansing mechanism of the respiratory tract, the function of to keep the breathing passage free of inhaled irritants, bacteria and other foreign matter. Smoking also irritates the goblets cells and mucus glands, causing an increased accumulation of mucus.

Exposure to tobacco smoke accounts for an estimated 80% to 90% of COPD cases (Rennard, 1998) Passive smoking Occupational exposure Ambient air pollution Genetic abnormalities (deficiency of alpha1antitrypsin) Bronchitis Emphysema

Dyspnea Cough Weight loss Increases of mucus Shortness of breath Wheezing sound Breathing through pursed lips

Respiratory insufficient Respiratory failure Pneumonia Atelectasis Pneumothorax Pulmonary hypertension (corpulmonale)

Medical

Metered Dose Inhaler (MDI) Nebulizer Bronchodilators Oxygen therapy Breathing exercise

Surgical

When medical therapy effective, lung transplantation may be an option.

NURSING DIAGNOSE Ineffective airway clearance related to excessive accumulation of mucus evidence by wheezing sound

GOAL/ NURSING OBJECTIV INTERVENTION E Patient can breath effectively with 16 to 20 bpm. -Assess respiratory status to monitor current status and response to treatment. -Monitor intake and output, daily weight to prevent dehydration because it can cause respiratory secretion become thicker. -Encourage a fluid intake to help keep mucous secretion thin. -Place patient in fowlers position to promote chest expansion. -Provide supplemental oxygen as ordered to maintain adequate blood and tissue oxygenation

EVALUATION

-Patient can breath normally.

NURSING DIAGNOSE Imbalance nutrition related to unable to consume a full meal without resting evidence by weight loss.

GOAL/ OBJECTI VE To ensure patient get enough nutrition.

NURSING INTERVENTION -Assess nutritional status to differentiate nutritional status from body type rather than assume a nutritional impairment. -Observe and document food intake to provide direction for supplementation if needed -Place seated or in highfowlers position for meal to promote lung expansion and reduce dyspnea. -Provide mouth care prior to meals this help enhance the appetite. -If unable to maintain oral intake, consult with the physician about the feeding to maintenance of caloric and

EVALUATION

-Patients weight maintained to the normal BMI. -Patient get full nutrition.

Chronic Obstructive Pulmonary Disease is one of the most common lung disease. It makes it difficult to breath. There are two main form that can cause COPD which are chronic bronchitis and emphysema. Those diseases can cause the airway become narrowed that can leads to a limitation of the air flow.