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Encompasses pulmonary emphysema and chronic bronchitis
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Not reversible
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Destruction of alveoli, narrowing of bronchioles, and trapping of air resulting in loss of lung elasticity
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Cigarette smoking (main causative factor)
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Exposure to air pollution
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Passive smoke inhalation
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Alpha-antitrypsin deficiency (inability to break down pollutants)
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Advanced age
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Occupational dust and chemical exposure
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Dyspnea w/ productive cough
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Fatigue
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Difficult exhalation, use of pursed lip breathing
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Clubbed fingernails
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Wheezing
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Weight loss
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Crackles
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Respiratory acidosis w/ hypoxia
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Barrel chest
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Shallow, rapid respirations
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Inflammation and hyper secretions of mucus in the bronchi and bronchioles caused by chronic exposure to irritants
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Cigarette smoking (main causative factor))
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Exposure to air pollution and other environmental irritants
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Productive cough
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Thick, tenacious sputum
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Hypoxemia
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Respiratory acidosis w/ hypoxia
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Chest x-ray
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Pulmonary function tests: air remains trapped in lungs
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Pulse oximetry: often less than 90%
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ABGs: Chronic respiratory acidosis
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Computed tomography (CT)
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Monitor respiratory status
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Monitor cardiac status for signs of right-sided failure
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Position pt upright and leaning forward
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Schedule activities to allow for frequent rest periods
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Administer oxygen therapy as prescribed
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Use incentive spirometry, breathing techniques, & effective coughing
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Encourage fluids 2-3 L/day unless contraindicated
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Encourage a high calorie diet
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Provide emotional support
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Reinforce teaching about immunizations for pneumonia & influenza
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Bronchodilators
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Beta-adrenergic agents
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Cholinergic antagonists
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Corticosteroids
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Methylxanthine
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Anti-inflammatory agents
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Mucolytic agents
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Chest physiotherapy/pulmonary drainage
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Lung reduction surgery
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Breathing techniques
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Oxygen therapy
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Medications
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Nutrition
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Refrain from smoking
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Infection prevention measures
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Pulmonary rehabilitation
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Activity pacing
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Cor pulmonale
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Carbon Dioxide Toxicity
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Pneumonia
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Tuberculosis
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Laryngeal Cancer
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Lung Cancer
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