Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)

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Included In This Lesson

Study Tools For Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)

COPD Pathochart (Cheatsheet)
Barrel Chest COPD (Image)
COPD management (Mnemonic)
COPD Overview (Chronic Obstructive Pulmonary Disease Overview) (Picmonic)

Outline

Chronic Obstructive Pulmonary Disease (COPD)

Definition/Etiology:

  • Preventable, treatable disease characterized by progressive airflow limitation
  • Associated with abnormal inflammatory response that is not fully reversible

 

Pathophysiology:

The two types of COPD are chronic bronchitis and emphysema

  • Chronic bronchitis is defined as cough and sputum production for at least 3 months during 2 consecutive years
  • Emphysema is characterized by destruction of alveoli

 

Clinical Presentation:

Chronic Bronchitis Emphysema
“Blue bloater” “Pink puffer”
Productive cough Cough uncommon
Stocky build Thin
Onset 40–50 years old Onset 50–70 years old
Normal respiratory rate Tachypnea
Hypoxemia PaO2 normal or slightly decreased
Increased PaO2 PaCO2 low or normal until end-stage
Cyanosis Barrel chest
Polycythemia Accessory muscle use
Cor pulmonale Tripod position
Peripheral edema Pursed-lip breathing
Risk for pulmonary embolism Hyperresonance on percussion
Enlarged heart on X-ray Lung over inflation on X-ray Low diaphragm on X-ray

 

Collaborative Management:

Assessments:

  • ABG, CBC (check for polycythemia)
  • Chest X-ray

Interventions:

  • Supplemental oxygen to SpO2 90–92%
    • Nasal cannula or Venturi mask to control oxygen delivery
    • Monitor for return to baseline SpO2
    • Monitor for decrease in respiratory rate; if so, reduce or discontinue oxygen
  • Noninvasive positive pressure ventilation (CPAP, BiPAP)
  • Bronchodilators, IV corticosteroids, antibiotics as needed
  • Bed rest in High Fowler position or sit on edge of bed with legs dangling
  • IV rehydration
  • Monitor for arrhythmias

 

Evaluation | Patient Monitoring | Education:

  • Immunizations
  • Avoid respiratory infection exposure
  • Eat small, frequent meals to allow maximal chest excursion
  • Adequate hydration to keep secretions moist
  • Smoking cessation

 

Linchpins: (Key Points)

  • Chronic disease, abnormal inflammatory response
  • Air trapping
  • Treat exacerbations

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

  • Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
  • Egging, D. (2017). Respiratory Emergencies and Thoracic Trauma. In CEN Online Review. Emergency Nurses Association.

View the FULL Transcript

When you start a FREE trial you gain access to the full outline as well as:

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  • 6,500+ Practice NCLEX Questions
  • 2,000+ HD Videos
  • 300+ Nursing Cheatsheets