Nursing Diagnosis for COPD – What is COPD and How is it Diagnosed?

COPD Nursing Diagnosis
National Heart Lung and Blood Institute

COPD – (Chronic Obstructive Pulmonary Disease) is one of the most common lung diseases. COPD makes breathing difficult for those infected with the disease. There are two main forms of COPD:

  • Chronic bronchitis, which involves a long term cough with mucus. With this condition, your bronchial tubes become inflamed and narrowed and your lungs produce more mucus, which can further block the narrowed tubes. You develop a chronic cough trying to clear your airways.
  • Emphysema, which involves damage to the lungs over time. This lung disease causes destruction of the fragile walls and elastic fibers of the alveoli. Small airways collapse when you exhale, impairing airflow out of your lungs.

Causes

Smoking is the main cause of COPD. The more a person smokes, the more likely that person will develop COPD. But some people smoke for years and never get COPD.

In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema.

Other risk factors for COPD:

  • Exposure to certain gases or fumes in the workplace
  • Exposure to heavy amounts of secondhand smoke and pollution
  • Frequent use of a cooking fire without proper ventilation

Symptoms of COPD:

  • Cough that lasts for a long period of time
  • Coughing up mucus
  • Shortness of breath, especially when you are exerting more energy such as climbing stairs or exercising
  • Lung infections such as the flu, pneumonia, or acute bronchitis that last a long time
  • Wheezing when you breathe
  • Feeling fatigue
  • Unintended loss in weight
  • Ineffective cough
  • Imbalanced Nutrition
  • Lack of Energy
  • Tightness in chest
  • Frequent respiratory infections

Testing for COPD

The best test for COPD is a lung function test called spirometry. The test involves blowing out as hard as you can into a small machine that tests the capacity of your lungs. You can see the results of the spirometry test immediately after the test is administered.

A stethoscope can also be used to listen to the lungs to try and detect COPD. This method isn’t always the most accurate because sometimes the lungs can sound normal even when a person has COPD.



Imaging tests of the lungs, such as x-rays and CT scans, have also been found to be helpful. Again this method of testing for COPD can have limitations. For instance with an x-ray, the lungs may look normal even when a person has COPD.

A CT scan is probably the most reliable way to test for chronic obstructive pulmonary disease because it  will usually show signs of COPD. A blood test called Arterial Blood Gas may be done to measure the amounts of oxygen and carbon dioxide in the blood to indicate any signs of COPD.

Risk Factors:

  • Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking.
  • People with asthma who smoke. The combination of asthma, a chronic inflammatory airway disease, and smoking increases the risk of COPD even more.
  • Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors and dusts in the workplace can irritate and inflame your lungs.
  • Exposure to fumes from burning fuel – people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD.
  • Age. COPD develops slowly over years, so most people are at least 40 years old when symptoms begin.
  • Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the cause of some cases of COPD.

Diagnosis and Treatments

COPD is commonly misdiagnosed — former smokers may sometimes be told they have COPD, when in reality they may have a less common lung condition. To diagnose COPD your doctor will review your signs and symptoms as well as discuss your family and medical history, and any exposure you’ve had to lung irritants such as cigarette smoke and other fumes.

There is no cure for COPD. But there are many things you can do to relieve symptoms and keep the disease from getting worse. If you smoke, now is the time to quit. This is the best way to slow lung damage.



Medicines Used to Treat COPD Include:

  • Quick relief medication to help open the airways
  • lung inflammation reducing drugs
  • Anti inflammatory drugs to reduce swelling in the airways
  • Long term antibiotics

In severe cases or during flare-ups, you may be prescribed:

  • Steroids by mouth or through an IV
  • Bronchodilators through a nebulizer
  • Oxygen therapy
  • Assistance from a BiPAP machine to help breathing using a mask, or through the use of an endotracheal tube.

Your health care provider may prescribe antibiotics during symptom flare-ups, because an infection can make COPD worse. Oxygen therapy at home may be needed if you have a low level of oxygen in your blood. Pulmonary rehabilitation does not cure COPD, but it can teach you to breathe in a different way so you can stay active and feel better.

Living with COPD can be a challenge — especially as it becomes harder to catch your breath. You may have to give up some activities you previously enjoyed. It can help to share your fears and feelings with your family, friends and doctor. You may also want to consider joining a support group for people with COPD. You may benefit from counseling or medication if you feel depressed or overwhelmed.

Nursing Diagnosis for COPD