Chronic Obstructive Pulmonary Disease

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Chronic Obstructive Pulmonary Disease by Mind Map: Chronic Obstructive Pulmonary Disease

1. Risk Factors

1.1. Genetics

1.1.1. Alpha-1-antitrypsin deficiency

1.1.1.1. Increase risk for lung and liver disease

1.2. Age

1.2.1. Occurs in people at least 40 years of age or older

1.3. Environmental

1.3.1. Occupations involved in with dust and chemicals

1.3.2. Exposure to fumes

1.3.2.1. Poor ventilated homes

1.4. Smoking

1.4.1. Exposure to tobacco smoke

1.4.1.1. Pipe smokers

1.4.1.2. Cigar smokers

1.4.1.3. Marijuana smokers

1.4.2. People with asthma who smoke

2. Production of sputum

3. Breakdown of connective tissue.

3.1. Destruction of alveolar walls, septae and capillaries

3.1.1. Impaired gas diffusion

3.1.2. Loss of elastic recoil

3.1.2.1. Bullae develops

3.1.3. Loss of alveolar attachments

3.1.3.1. Air trapping occurs during expiration

4. Bronchoconstriction

5. Hypoventilation

5.1. Hypoxemia

5.2. Hypercapnia

6. Pathogenesis

6.1. Emphysema

6.1.1. Alpha-1-antitrypsin deficiency

6.1.1.1. Breakdown of elastin fibers

6.1.2. Inflammation

6.1.2.1. Recruitment of neutrophils to bronchioles and alveoli

6.1.2.1.1. Proteolytic enzymes and elastase enzymes are released

6.2. Chronic bronchitis

6.2.1. Exposure to irritants cause inflammation in airways

6.2.1.1. Inflammation

6.2.1.1.1. Increase in oxidative stress, inflammatory mediators and cytokines

6.2.1.1.2. Enlargement of submucosal glands

6.2.1.1.3. Leukocytes and lymphocytes infiltrate bronchioles

7. Clinical Manifestations

7.1. Wheezing

7.2. Dyspnea

7.2.1. Cyanosis of lips and fingernail beds

7.2.2. Clubbing of fingernails

7.3. Chest tightness

7.4. Ongoing cough

7.4.1. With sputum

7.4.1.1. Grey

7.4.1.2. Yellow

7.4.1.3. White

7.5. Fever

7.6. Edema in ankles, feet, or legs

7.7. Colds or other respiratory infections

7.7.1. Flu

7.8. Lower muscle endurance or lack of energy

7.9. Weight loss

7.10. Barrel chest

8. Incidence/Prevalence

8.1. 3rd leading cause of death in the world

8.2. About 64 million people around the world have COPD

8.2.1. About 3 million deaths

8.2.1.1. About 90% occur in low and middle income countries

8.3. 12.7-14.7 million adults have COPD in U.S.

8.3.1. 120,000 deaths in U.S. per year

8.4. Highest incidence

8.4.1. Older adults

8.4.1.1. Occurs more often in females than males

8.4.2. People who smoke

8.4.2.1. About 80% of all COPD deaths

9. Diagnostics

9.1. Pulmonary function test

9.1.1. Spirometry

9.1.1.1. Evaluates airway obstruction

9.2. Forced vital capacity, forced expiratory volume, forced expiratory flow, residual volume, functional residual capacity

9.2.1. Indicates air trapping and airway obstructiom

9.3. Chest x-ray/chest CT scan

9.4. Arterial blood gas test

9.4.1. Determine severity of COPD

9.4.2. Measure oxygenation and gas exchange

9.5. Health history

9.6. Physical examination

9.7. Screening for alpha-1-antitrypsin levels

9.7.1. An enzyme that protects lung parenchyma

9.7.2. Performed at 45 years of age or younger

9.8. Oximetry

9.8.1. Determine adequate oxygenation

9.9. Sputum and culture sensitivity

9.9.1. Tests for Streptococcus pneumoniae and Haemophilus influenzae.

9.9.2. Identifies pathogens

9.10. Bronchogram

9.11. ECG test

9.12. ECG stress test

10. Treatments

10.1. Change lifestyle

10.1.1. Quit smoking

10.1.2. Avoid lung irritants

10.1.2.1. Second hand smoke

10.1.2.2. Dust

10.1.2.3. Fumes

10.1.2.4. Toxic chemicals

10.1.3. Eat meals that meet nutritional needs and take vitamins

10.2. Pharmacological

10.2.1. Bronchodilators

10.2.1.1. Relax muscles around airways

10.2.1.2. Take with glucocorticosteroids

10.2.1.2.1. Reduces inflammation in airway

10.2.2. Antibiotics

10.2.2.1. Help with respiratory infection

10.2.2.1.1. Amoxicillin

10.2.2.1.2. Doxycycline

10.2.2.1.3. Azithromycin

10.2.2.1.4. Erythromycin

10.2.3. Cough suppressants

10.2.4. Xanthines

10.2.4.1. Reduce mucosal edema and spasms

10.3. Vaccinations

10.3.1. Flu shot

10.3.2. Pneumococcal vaccine

10.4. Pulmonary rehabilitation

10.5. Oxygen therapy

10.5.1. Increase levels of O2 in blood

10.5.2. Improves breathing

10.5.3. Protects internal organs

10.6. Surgery

10.6.1. Bullectomy

10.6.1.1. Removing large air spaces in lungs will improve breathing

10.6.2. Lung Volume Reduction

10.6.2.1. Removing damaged lung tissue

10.6.3. Lung transplant

11. Sources

11.1. Belleza, M. (2017, September 26). Chronic Obstructive Pulmonary Disease (COPD) Nursing Care Management. Retrieved September 26, 2017, from https://nurseslabs.com/chronic-obstructive-pulmonary-disease-copd/

11.2. Chaudhry, S., Dua, B., & Wong, E. (n.d.). Chronic obstructive pulmonary disease (COPD). Retrieved September 26, 2017, from http://www.pathophys.org/copd/#Pathogenesis_pathophysiology_and_clinical_features

11.3. Chronic obstructive pulmonary disease (COPD). (2016, November). Retrieved September 26, 2017, from http://www.who.int/mediacentre/factsheets/fs315/en/

11.4. COPD. (2017, August 11). Retrieved September 26, 2017, from http://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/dxc-20204886

11.5. Diagnosis. (2017, April 28). Retrieved September 26, 2017, from https://www.nhlbi.nih.gov/health/health-topics/topics/copd/diagnosis

11.6. Pietrangelo, A. (2015, February 18). COPD by the Numbers: Facts, Statistics, and You. Retrieved September 26, 2017, from https://www.healthline.com/health/copd/facts-statistics-infographic#6

11.7. Nursing Central App