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)
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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.
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Adult 2 Final
Concepts Covered:
- Immunological Disorders
- Liver & Gallbladder Disorders
- Upper GI Disorders
- Neurological Emergencies
- Emergency Care of the Neurological Patient
- Central Nervous System Disorders – Brain
- Peripheral Nervous System Disorders
- Central Nervous System Disorders – Spinal Cord
- Infectious Respiratory Disorder
- Respiratory Disorders
- Noninfectious Respiratory Disorder
- Oncology Disorders
- Hematologic Disorders
- Oncologic Disorders
- Cardiac Disorders
- Acute & Chronic Renal Disorders
- Renal Disorders
- Urinary Disorders
- Vascular Disorders
- Emergency Care of the Cardiac Patient
- Pregnancy Risks
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