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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Concepts Covered:

  • Respiratory Emergencies
  • Noninfectious Respiratory Disorder
  • Immunological Disorders
  • Emergency Care of the Trauma Patient
  • Intraoperative Nursing
  • Renal Disorders
  • Disorders of Pancreas
  • Acute & Chronic Renal Disorders
  • Infectious Respiratory Disorder
  • Postoperative Nursing
  • Shock
  • Cardiac Disorders
  • Vascular Disorders
  • Hematologic Disorders
  • Female Reproductive Disorders
  • Shock
  • Emergency Care of the Cardiac Patient
  • Cardiovascular
  • Endocrine
  • Integumentary Disorders
  • Integumentary Disorders
  • Circulatory System

Study Plan Lessons

Chest Tube Assessment Nursing Mnemonic (Two AA’s)
Chest Tube Management
Chest Tube Management
Chest Tube Management Case Study (60 min)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care Plan (NCP) for Pulmonary Embolism
COPD management Nursing Mnemonic (COPD)
COPD Concept Map
COPD (Chronic Obstructive Pulmonary Disease) Labs
Chronic Obstructive Pulmonary Disease (COPD) Case Study (60 min)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)
COPD Exacerbation for Progressive Care Certified Nurse (PCCN)
Blunt Chest Trauma
Respiratory Trauma for Certified Emergency Nursing (CEN)
Respiratory Trauma Module Intro
Malignant Hyperthermia
Metabolic Acidosis (interpretation and nursing diagnosis)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care Plan (NCP) for Pneumonia
Pneumonia Risk Factors Nursing Mnemonic (VENTS)
Postoperative (Postop) Complications
Nursing Care Plan (NCP) for Restrictive Lung Diseases
Artificial Airways
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Pneumonia
Pneumothorax for Certified Emergency Nursing (CEN)
Respiratory Alkalosis
Ventilator Settings
Central Line Dressing Change
Nursing Care and Pathophysiology for Hypovolemic Shock
Intake and Output (I&O)
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Enoxaparin (Lovenox) Nursing Considerations
Positioning (Pressure Injury Prevention and Tourniquet Safety) for Certified Perioperative Nurse (CNOR)
Thrombin Inhibitors
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Diabetic Emergencies for Certified Emergency Nursing (CEN)
Diabetes Management
Metabolic Acidosis (interpretation and nursing diagnosis)
Metformin (Glucophage) Nursing Considerations
MI Surgical Intervention
Nursing Care and Pathophysiology for Cardiogenic Shock
Cardiac (Heart) Enzymes
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Endocarditis for Certified Emergency Nursing (CEN)
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Cardiac Course Introduction
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Congestive Heart Failure Concept Map
COPD Exacerbation for Progressive Care Certified Nurse (PCCN)
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
02.14 Shock Stages for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
03.04 DKA vs HHNK for CCRN Review
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Cardiac (Heart) Enzymes
Atrial Flutter
Myocardial Infarction (MI) Case Study (45 min)
Burns for Certified Emergency Nursing (CEN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
EKG (ECG) Course Introduction
Electrical A&P of the Heart
The EKG (ECG) Graph
EKG (ECG) Waveforms
Calculating Heart Rate