Question

d. Hemoptysis e. Paroxysmal coughing D. Medical Management of persons with COPD 1. Nursing care: Teach client 1. Stop smoking F. 2. breathing Teach techniques Fluids Small frequent meals 3. 4. diet 5. 6. Administer oxygen as ordered 8. G. Oxygen administration 1. Normal sti 2. Stimulus to breathe for persons with COPD is 3. Do not giveoxygen levels to persons with COPD give 。

Answer 1

D.Medical management of persons with COPD?

1: Inhaled medications are preferred, used in combination with each other. Proper administration of inhaled medication is extremely important, thus patient education is key
*Medical management is broken up into three parts
1. Relief: short acting B2 agonists (bronchodilator, sympathomimetic) - albuterol most common
2. Control:
-inhaled corticosteroids to control airway inflammation (common meds include Pulmicort and Flovent)
-anticholinergic to dry up excessive secretions (Atrovent is common)
-xanthine bronchodilators (theophylline is common)
3. Preventive:
-long-acting B2 agonists used in combo with inhaled steroids (Serevent)
-long-acting anticholinergics (Spiriva)

F. Teach Breathing Techniques.

2. Techniques such as pursed-lip breathing help reduce respirations while improving the expiratory phase (by increasing laminar flow of expired air). Tell the patient that slow, controlled expiration postpones small-airway collapse, thereby reducing air trapping that occurs with forced expiration or

Pursed-lip breathing is a breathing exercise where inhalation of air slowly through nose and exhalation slowly through the mouth by pursing the lips. Pursed-lip breathing primarily slows down the respiratory rate and assists in emptying the lungs of retained CO2.

5. High fat and protein and loww carbohydrate diet

7. Quit smoking

8. Teach regarding the energy conservation techniques

G. Neural (CNS) and chemical changes in the blood (O2, CO2, bicarbonate). Inspiration is stimulated by chemoreceptors in the medulla, aorta, and carotid (stimulus to breathe is normally driven by CO2 level) Inspiration depends on chest wall movement and lung expansion. Expiration is dependent on elastic recoil, does not depend on muscle involvement.

Normally when the carbon dioxide level in the body is increased there is the strongest stimulus to breathe more and rapidly. Same as that when the carbon dioxide concentration in the blood is low, the brain decreases the frequency and depth of breaths.

H.Stimulus to breathe for persons with COPD :

COPD pts have adapted to a high carbon dioxide level because the elastic recoil of the lungs and thorax is lost. The CO2 chemoreceptors have essentially stopped functioning. The stimulus to breathe is now driven by decreased O2 level.

When excessive O2 is given to a pt with COPD the stimulus to breathe is lost/gone/depressed. Hypoventilation results, carbon dioxide is retained. The patient goes into respiratory arrest. Too much O2 and the patient will stop breathing.

I. Do not give excessive oxygen levels to persons with COPD