Critical Care to Patients

Pulmonary Disorder:

Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Definition:
            Chronic obstructive pulmonary disease (COPD) is a term used to describe progressive lung diseases, which include emphysema, chronic bronchitis and chronic asthma. The common symptoms of COPD are progressive limitations of the airflow into and out of the lungs and shortness of breath. Emphysema and chronic bronchitis are closely related and patients with COPD may have both, which affects lung function. Emphysema involves destruction of the alveoli in the lungs. Chronic bronchitis is characterized by chronic cough and mucus production.

            COPD symptoms, when ignored, usually lead to hospitalization in intensive care (ICU) units.

Nursing Care:
    • People with chest deformities or neurologic conditions that cause shallow breathing benefit from mechanical devices that assist breathing, such as continuous positive airway pressure, which delivers oxygen through a nose or face mask that prevent airways collapse, even at the end of a breath. Additional respiratory support can be provided with a mechanical ventilator. The primary treatment for acute massive atelectasis, a common complication in COPD, is removal of the underlying cause.

    • If the blockage cannot be removed by coughing or by suctioning the airways then it should be removed by bronchoscopy.

    • Oxygen administration relieves symptoms and prolongs survival.

    • Careful intervention is essential because progressive pulmonary hypertension and cor pulmonale often leads to severe fluid retention, life threatening shortness of breath, shock, and death.

    • It is important for the nurses to remain with patients during episodes of acute respiratory distress.

    • Nurses have to assess patients for hypoxemia/hypoxia and administer appropriate oxygen therapy for individuals for all levels of dyspnea.

    • Medications include bronchodilators, beta 2 agonists,...