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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DRN 401, Week 8

Concepts Covered:

  • Adult
  • Shock
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Fundamentals of Emergency Nursing
  • Lower GI Disorders
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Substance Abuse Disorders
  • Communication
  • Legal and Ethical Issues
  • Immunological Disorders
  • Vascular Disorders
  • Gastrointestinal Disorders
  • Noninfectious Respiratory Disorder
  • Integumentary Disorders
  • Musculoskeletal Trauma
  • Central Nervous System Disorders – Brain
  • Emergency Care of the Trauma Patient
  • Urinary System
  • Disorders of Thermoregulation
  • Cardiovascular
  • Shock
  • Disorders of the Posterior Pituitary Gland
  • Endocrine
  • Disorders of Pancreas
  • Gastrointestinal
  • Upper GI Disorders
  • Multisystem
  • Neurological
  • Renal
  • Respiratory
  • Respiratory System
  • Emergency Care of the Neurological Patient

Study Plan Lessons

Advanced Cardiovascular Life Support (ACLS)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
3rd Degree AV Heart Block (Complete Heart Block)
Abuse and Neglect for Certified Emergency Nursing (CEN)
Acute Abdomen for Certified Emergency Nursing (CEN)
Acute Coronary Syndrome for Certified Emergency Nursing (CEN)
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Alcohol Withdrawal (Addiction)
Aggressive & Violent Patients
Advocacy & Moral Judgement for Progressive Care Certified Nurse (PCCN)
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Appendicitis for Certified Emergency Nursing (CEN)
Asthma for Certified Emergency Nursing (CEN)
Avulsions and Degloving Injuries for Certified Emergency Nursing (CEN)
AVPU Mnemonic (The AVPU Scale)
Bleeding for Certified Emergency Nursing (CEN)
Bowel Perforation for Certified Emergency Nursing (CEN)
Calcium and Magnesium Imbalance for Certified Emergency Nursing (CEN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)
Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Compartment Syndrome for Certified Emergency Nursing (CEN)
02.01 Hypertensive Crisis for CCRN Review
02.02 Cardiomyopathy for CCRN Review
02.14 Shock Stages for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
03.04 DKA vs HHNK for CCRN Review
05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
06.02 Poisoning for CCRN Review
06.03 Multi-System CCRN Important Points for CCRN Review
07.09 Meningitis for CCRN Review
07.10 Neurologic Review questions for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
10.02 Breath Sounds for CCRN Review
Increased Intracranial Pressure (ICP) for Certified Emergency Nursing (CEN)
Toxic Ingestion, Inhalation, Overdose for Progressive Care Certified Nurse (PCCN)