COPD

1. Epidemiology

1.1. Consider both bronchitis and emphysema together under the rubric of COPD. Third leading cause of death in the United States, over 15 million persons with COPD (Hammer & McPhee, 2019). Cigarette smoking remains the principle cause Chronic dust and chemical perfume exposure are also contributing risk factors Increased age, men, whites and persons of lower socioeconomic status are more at risk

2. Pathophysiology

2.1. Inspired irritants result in airway inflammation with infiltration of neutrophils, macrophages, and lymphocytes into the bronchial chest wall (Huether & McCance, 2014). Continual bronchial inflammation causes bronchial edema, an increase in size and number of mucous glands and goblet cells in the airway epithelium, smooth muscle hypertrophy with fibrosis, and narrowing of the airway (Huether & McCance, 2014).

3. Clinical Presentation

3.1. Cough with sputum production Wheezing Coarse crackles Tachycardia Breath sounds decreased in intensity SOB with exertion Clubbed fingers Barrel Chest Cyanosis

4. Diagnosis

4.1. Based on history of symptoms, physical examination, chest imaging, pulmonary function tests, and blood gas analysis

5. Treatment

5.1. Bronchodilators Mucolytics Antioxidants Anti-inflammatory drugs Chest physical therapy Oxygen