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 101: Week 12

Concepts Covered:

  • Emergency Care of the Respiratory Patient
  • Respiratory Disorders
  • Respiratory Emergencies
  • Noninfectious Respiratory Disorder
  • Infectious Disease Disorders
  • Oncology Disorders
  • Infectious Respiratory Disorder
  • Concepts of Population Health
  • Integumentary Disorders
  • Respiratory System
  • Studying
  • Emergency Care of the Trauma Patient

Study Plan Lessons

Acute Respiratory Distress
ABG (Arterial Blood Gas) Oxygenation
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Airway Suctioning
ARDS Case Study (60 min)
Chest Tube Management
Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)
Coronavirus (COVID-19) Nursing Care and General Information
Cystic Fibrosis (CF)
Fluticasone (Flonase) Nursing Considerations
Influenza – Flu
Lung Cancer
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of Pneumonia
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Blunt Chest Trauma
Communicable Diseases
Isolation Precaution Types (PPE)
Isoniazid (Niazid) Nursing Considerations
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Tuberculosis
Pulmonary Hypertension for Certified Emergency Nursing (CEN)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Pneumonia Labs
Vent Alarms
Ventilator Settings
Bronchodilators
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Respiratory Course Introduction
Causes of Poor Gas Exchange Nursing Mnemonic (All People Can Value Lungs)
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan for Pulmonary Edema
ABG (Arterial Blood Gas) Interpretation-The Basics
Airway Suctioning
Alveoli & Atelectasis
Biopsy
Blunt Thoracic Trauma
Breathing Movements