COPD caused by Chronic Bronchitis

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COPD caused by Chronic Bronchitis by Mind Map: COPD caused by Chronic Bronchitis

1. Pathophysiology

1.1. Inflammation of the bronchi and bronchioles due to chronic exposure to irritants

1.1.1. Irritants: cigarette smoke, dust, fumes

1.1.1.1. trigger inflammation, vasodilation, mucosal edema, congestion, and broncho spasm

1.1.2. Increases the number and size of mucus-secreting glands

1.2. Impairs air flow and gas exchange

1.3. acerbation occurs often related to an infection

1.3.1. airway becomes narrow

1.3.2. airflow resistance increases

1.3.3. expiration becomes slow and difficult

1.4. Productive cough lasting 3 or more months in 2 consecutive years

1.5. Common recurrent infection

2. Priority assessment

2.1. Ask patient about risk factors

2.1.1. age- more common in older adults

2.1.2. gender- more common is men

2.1.3. occupational history

2.2. obtain a smoking history

2.3. Ask the patient about breathing problems while talking

2.4. Ask about the presence, duration, or worsening of wheezing, coughing, and shortness of breath.

2.5. ask about the time of day when Sputum production is the highest

2.6. Weigh patient and compare the weight with previous weights

2.6.1. unplanned weight loss is common

2.7. assess paitents general appearance

2.7.1. patient with COPD is thin with a loss of muscle mass in their extremities. They tend to be slow moving and slightly stooped.

2.7.1.1. look at the patients posture, mobility, muscle mass. and weight in proportion to height

2.7.2. Check the patients chest for retractions and asymmetric chest expansion.

2.7.2.1. Auscultate the chest and assess the depth of inspiration and any abnormal breath sounds

2.7.2.1.1. wheezes are normal

2.7.2.1.2. reduced breath sounds are normal

2.7.3. assess the patients anxiety and fear

3. Priority Labs and Diagnostics

3.1. ABGs

3.1.1. ABG's can identify abnormal gas exchange

3.1.2. compare current ABG's with past ABG's

3.2. Spirometry

3.3. Chest xray

3.4. CT scan

4. Priority nursing interventions/patient teaching

4.1. Teach the patient to focus on airway maintenance, monitoring breathing techniques, positioning, effective coughing, oxygen therapy, exercise conditioning, suctioning, hydration, and use of a vibratory positive-pressure device

4.2. Teach the patient how to be a partner in COPD management

4.3. Airway maintenance is the most important focus of interventions to improve gas exchange

5. Medications

5.1. bronchodilator

5.2. steroid

5.3. oxygen therapy

6. Potential complications

6.1. Secondary polycythemia vera due to hypoxemia

6.2. Pulmonary hypertiensino due to reactive vasoconstriction from hypoxemia

6.3. Cor pulmonate from chronic pulmonary hypertension

7. Actual complications/ side effects

7.1. Color: dusty to cyanotic

7.2. Increase hbg

7.3. Digital clubbing

7.4. Cardiac

7.4.1. enlargement

7.5. Respiratory

7.5.1. hypoxia

7.5.2. respiratory acidosis

7.5.3. hypercapnia

7.5.4. increase respiratory rate

7.5.5. dyspnea

7.5.6. recurrent cough and an increase in sputum productions

7.6. CNS

7.6.1. Nervousness

7.6.2. Anxiety