Caitlin Rodenburg Chronic Obstructive Pulmonary Disease (COPD) COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long­term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke, but air pollution, chemical fumes, or dust can also cause it.
+
The inhaled irritants cause inflammatory cells such as neutrophils, CD8 T­lymphocytes,
B cells and macrophages to accumulate.
When activated, these cells start a cascade that triggers

the release of inflammatory mediators such as tTNF­α,IFN­γ,CRP, interleukins, and fibrinogen.
These mediators maintain the inflammatory process and lead to tissue damage. The chronic inflammation is present from the outset of the disease and leads to structural changes in the lung and causes airflow limitation (Think COPD Differently, 2012). Structural changes caused by the inflammatory response associated with COPD leads to narrowing of the airways. Factors that contribute to this include: peribronchial fibrosis, build­up of scar tissue from damage to the airways and over­multiplication of the epithelial cells lining the airways (Think COPD
Differently, 2012). These in turn will cause the loss of lung tissue elasticity as a result of destruction of the structures supporting and feeding the alveoli. This means that the small airways collapse during exhalation, impeding airflow, trapping air in the lungs and reducing lung capacity. At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include
● A cough that produces a lot of mucus
● Shortness of breath, especially with physical activity
● Wheezing
● Chest tightness

Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant.
Quitting smoking is the most important step you can take to treat COPD.
Common medications used in the treatment of COPD include (Kinman, 2014):
● Short­acting Bronchodilators­
○ Albuterol (Vospire ER, in Combivent, in Duoneb)
○ levalbuterol (Xopenex)
○ ipratropium (Atrovent)
● Long­acting Bronchodilators­
○
○
○
○
○
○

tiotropium (Spiriva) salmeterol (Serevent) formoterol (Foradil, Perforomist) arformoterol (Brovana) indacaterol (Arcapta) aclidinium (Tudorza)

Nursing Interventions for COPD:
●
●
●
●
●
●
●
●

Monitor vital signs daily to detect impaired gas exchange
Monitor all urine and stools for blood daily to detect for internal bleeding
Auscultate lungs q4h to detect decreased or