What are the medical interventions to be expected for chronic obstructive pulmonary disease?
Chronic obstructive pulmonary disease, commonly referred to as COPD, is a group of progressive lung diseases. Show
The most common of these diseases are emphysema and chronic bronchitis. Many people with COPD have both of these conditions. Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow. Bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to build up. It’s estimated that about 30 million people in the United States have COPD. As many as half are unaware that they have it. Untreated, COPD can lead to a faster progression of disease, heart problems, and worsening respiratory infections. COPD makes it harder to breathe. Symptoms may be mild at first, beginning with intermittent coughing and shortness of breath. As it progresses, symptoms can become more constant to where it can become increasingly difficult to breathe. You may experience wheezing and tightness in the chest or have excess sputum production. Some people with COPD have acute exacerbations, which are flare-ups of severe symptoms. Early symptomsAt first, symptoms of COPD can be quite mild. You might mistake them for a cold. Early symptoms include:
You might start making subtle changes, such as avoiding stairs and skipping physical activities. Worsening symptomsSymptoms can get progressively worse and harder to ignore. As the lungs become more damaged, you may experience:
In later stages of COPD, symptoms may also include:
Symptoms are likely to be much worse if you currently smoke or are regularly exposed to secondhand smoke. Learn more about the symptoms of COPD. Most people with COPD are at least 40 years old and have at least some history of smoking. The longer and more tobacco products you smoke, the greater your risk of COPD is. In addition to cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can cause COPD. Your risk of COPD is even greater if you have asthma and smoke. Other causesYou can also develop COPD if you’re exposed to chemicals and fumes in the workplace. Long-term exposure to air pollution and inhaling dust can also cause COPD. In developing countries, along with tobacco smoke, homes are often poorly ventilated, forcing families to breathe fumes from burning fuel used for cooking and heating. There may be a genetic predisposition to developing COPD. Up to an estimated 5 percent of people with COPD have a deficiency in a protein called alpha-1-antitrypsin. This deficiency causes the lungs to deteriorate and also can affect the liver. There may be other associated genetic factors at play as well. There’s no single test for COPD. Diagnosis is based on symptoms, a physical exam, and diagnostic test results. When you visit the doctor, be sure to mention all of your symptoms. Tell your doctor if:
Exam and testsDuring the physical exam, your doctor will use a stethoscope to listen to your lungs as you breathe. Based on all this information, your doctor may order some of these tests to get a more complete picture:
These tests can help determine if you have COPD or a different condition, such as asthma, a restrictive lung disease, or heart failure. Learn more about how COPD is diagnosed. Treatment can ease symptoms, prevent complications, and generally slow disease progression. Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory therapists. Oxygen therapyIf your blood oxygen level is too low, you can receive supplemental oxygen through a mask or nasal cannula to help you breathe better. A portable unit can make it easier to get around. SurgerySurgery is reserved for severe COPD or when other treatments have failed, which is more likely when you have a form of severe emphysema. One type of surgery is called bullectomy. During this procedure, surgeons remove large, abnormal air spaces (bullae) from the lungs. Another is lung volume reduction surgery, which removes damaged upper lung tissue. Lung volume reduction surgery can be effective at improving breathing, but few patients undergo this major, somewhat risky procedure. Lung transplantation is an option in some cases. Lung transplantation can effectively cure COPD, but has its many risks. There is a less invasive method of improving the efficiency of airflow in people with severe emphysema called endobronchial valves (EBV), which are one-way valves that divert inspired air to healthy lungs and away from non-functioning, damaged lungs. In 2018, an EBV device called the Zephyr Endobronchial Valve was approved by the FDA and has been shown to improve lung function, exercise capacity and quality of life for patients living with emphysema. Lifestyle changesCertain lifestyle changes may also help alleviate your symptoms or provide relief.
Learn more about the different treatment options for COPD. Medications can reduce symptoms and cut down on flare-ups. It may take some trial and error to find the medication and dosage that works best for you, but these are some of your options: Inhaled bronchodilatorsMedicines called bronchodilators help loosen tight muscles in your airways. They’re typically taken through an inhaler or nebulizer. Short-acting bronchodilators last from 4 to 6 hours. You only use them when you need them. For ongoing symptoms, there are long-acting versions you can use every day. They last about 12 hours. For people with COPD who experience shortness of breath or trouble breathing during exercise, the American Thoracic Society strongly recommends a long-acting-beta-agonist (LABA) combined with a long-acting muscarinic antagonist (LAMA). These bronchodilators work by relaxing tightened muscles in the airways, which widens your airways for better air passage. They also help your body clear mucus from the lungs. These two types of bronchodilators can be taken in combination by inhaler or with a nebulizer. Here’s a list of recommended LABA/LAMA bronchodilator therapies:
CorticosteroidsLong-acting bronchodilators are commonly combined with inhaled glucocorticosteroids. A glucocorticosteroid can reduce inflammation in the airways and lower mucus production. The long-acting bronchodilator can relax the airway muscle to help the airways stay wider. Corticosteroids are also available in pill form. Phosphodiesterase-4 inhibitorsThis type of medication can be taken in pill form to help reduce inflammation and relax the airways. It’s generally prescribed for severe COPD with chronic bronchitis. TheophyllineThis medication eases chest tightness and shortness of breath. It may also help prevent flare-ups. It’s available in pill form. Theophylline is an older medication that relaxes the muscle of the airways, and it may cause side effects. It’s generally not a first-line treatment for COPD therapy. Antibiotics and antiviralsAntibiotics or antivirals may be prescribed when you develop certain respiratory infections. VaccinesTo lower risk of other respiratory infections, ask your doctor if you should get a yearly flu shot, pneumococcal vaccine, and a tetanus booster that includes protection from pertussis (whooping cough). Learn more about the drugs and medications used to treat COPD. There’s no specific diet for COPD, but a healthy diet is important for maintaining overall health. The stronger you are, the more able you’ll be to prevent complications and other health problems. Choose a variety of nutritious foods from these groups:
Also, remember to go easy on the salt. It causes the body to retain water, which can strain breathing. LiquidsDrink plenty of fluids. Drinking at least six to eight 8-ounce glasses of non-caffeinated liquids a day can help keep mucus thinner. This may make the mucus easier to cough out. Limit caffeinated beverages because they can interfere with medications. If you have heart problems, you may need to drink less, so talk to your doctor. Weight managementMaintaining a healthy weight is important. It takes more energy to breathe when you have COPD, so you might need to take in more calories. But if you’re overweight, your lungs and heart may have to work harder. If you’re underweight or frail, even basic body maintenance can become difficult. Overall, having COPD weakens your immune system and decreases your ability to fight off infection. Eating habitsA full stomach makes it harder for your lungs to expand, leaving you short of breath. If you find that this happens to you, try these remedies:
Check out these 5 diet tips for people with COPD. COPD requires lifelong disease management. That means following the advice of your healthcare team and maintaining healthy lifestyle habits. Since your lungs are weakened, you’ll want to avoid anything that might overtax them or cause a flare-up. Here’s a list of things to consider as you adjust your lifestyle.
One measure of COPD is achieved by spirometry grading. There are different grading systems, and one grading system is part of the GOLD classification. The GOLD classification is used for determining COPD severity and helping to form a prognosis and treatment plan. There are four GOLD grades based on spirometry testing:
This is based on the spirometry test result of your FEV1. This is the amount of air you can breathe out of the lungs in the first second of a forced expiration. The severity increases as your FEV1 decreases. The GOLD classification also takes into account your individual symptoms and history of acute exacerbations. Based on this information, your doctor can assign a letter group to you to help define your COPD grade. As the disease progresses, you’re more susceptible to complications, such as:
Learn more about the different stages of COPD. COPD and lung cancer are major health problems worldwide. These two diseases are linked in a number of ways. COPD and lung cancer have several common risk factors. Smoking is the number one risk factor for both diseases. Both are more likely if you breathe secondhand smoke, or are exposed to chemicals or other fumes in the workplace. There may be a genetic predisposition to developing both diseases. Also, the risk of developing either COPD or lung cancer increases with age. It was estimated in 2009 that between 40 and 70 percent of people with lung cancer also have COPD. This same 2009 study concluded that COPD is a risk factor for lung cancer. A 2015 study suggests they may actually be different aspects of the same disease, and that COPD could be a driving factor in lung cancer. In some cases, people don’t learn they have COPD until they’re diagnosed with lung cancer. However, having COPD doesn’t necessarily mean you’ll get lung cancer. It does mean that you have a higher risk. That’s another reason why, if you smoke, quitting is a good idea. Learn more about the possible complications of COPD. Worldwide, it’s estimated that about 65 million people have moderate to severe COPD. About 16 million adults in the United States have a diagnosis of COPD. Most people with COPD are 40 years of age or older. The majority of people with COPD are smokers or former smokers. Smoking is the most important risk factor that can be changed. In up to 5 percent of people with COPD, the cause is a genetic disorder involving a deficiency of a protein called alpha-1-antitrypsin. COPD is a leading cause of hospitalizations in industrialized countries. In the United States, COPD is responsible for a large amount of emergency department visits and hospital admissions. In the year 2000, it was noted that there were over 700,000 hospital admissions and approximately 1.5 million emergency department visits. COPD is the third leading cause of death in the United States. More women than men die from COPD each year. It’s projected that the number of patients diagnosed with COPD will increase by more than 150 percent from 2010 to 2030. Much of that can be attributed to an aging population. Check out more statistics about COPD. COPD generally reduces life expectancy, though the outlook varies considerably from person to person. People with COPD who never smoked may have a modest reduction in life expectancy, while former and current smokers are likely to have a larger reduction. COPD tends to progress slowly. You may not even know you have it during the early stages. Once you have a diagnosis, you’ll need to start seeing your doctor on a regular basis. You’ll also have to take steps to manage your condition and make the appropriate changes to your daily life. Early symptoms can usually be managed, and certain lifestyle choices can help you maintain a good quality of life for some time. As the disease progresses, symptoms can become increasingly limiting. People with severe stages of COPD may not be able to care for themselves without assistance. They’re at increased risk of developing respiratory infections, heart problems, and lung cancer. They may also be at risk of depression and anxiety. Besides smoking, your outlook depends on how well you respond to treatment and whether you can avoid serious complications. Your doctor is in the best position to evaluate your overall health and give you an idea about what to expect. Learn more about the life expectancy and prognosis for people with COPD. Read this article in Spanish. What is the most important intervention in chronic obstructive pulmonary disease?Smoking cessation continues to be the most important therapeutic intervention for COPD. Most patients with COPD have a history of smoking or are currently smoking tobacco products. A smoking cessation plan is an essential part of a comprehensive management plan.
What are the nursing interventions for COPD?Nursing Interventions. Inspiratory muscle training. This may help improve the breathing pattern.. Diaphragmatic breathing. Diaphragmatic breathing reduces respiratory rate, increases alveolar ventilation, and sometimes helps expel as much air as possible during expiration.. Pursed lip breathing.. What are 3 treatments for COPD?It is important to talk to your doctor about your treatment options and to get answers to all of your questions.. COPD Medications. ... . Pulmonary Rehabilitation. ... . Supplemental Oxygen. ... . Endobronchial Valve (EBV) Treatment. ... . Surgery. ... . Clinical Trials. ... . Complementary Therapies. ... . Palliative Care and COPD.. |