Chronic Obstructive
Pulmonary Disease
Pathophysiology Memory Trick Causes & Risk Factors
• Smoking
Chronic destruction of the lungs resulting in • Car mechanics
decreased gas exchange, leading to chronic air #1
trapping & high CO2 in the body.
Kaplan Question
Memory trick Risk factor for COPD
= client has smoked
for more than 30 years
C C
Chronic air trapping CO2 High
Lab Values
• Don't get tricked: Anemia is NOT common with these
patients, rather increased blood count.
C • ABG (arterial blood gas) Key numbers
O O Low PaO2 32 = Hypoxemia
Below 80 (Normal 80 - 100)
Signs & Symptoms
High PaCO2 = HyperCapnic
Emphysema “Pink puffer” pH less than 7.35 = Acidosis
P I N K PaCO2 - Over 45 = Acidosis
Pink skin & Increased chest No chronic cough
Keep Tripoding
Pursed-Lip breathing “Barrel Chest” (minimal) A B
0₂
pH
7.35 7.45
0₂
0₂
0₂ B A
PaCO₂
35 45
Normal
PaO₂
80 100
Memory trick
COPD - CO2 PrisoneD
Damage to the Alveoli results in loss of lung
elasticity & loss of inflation of lung tissue, Carbon Dioxide
resulting in loss of lung tissue recoil & air trapping. Carbon diACID
Chronic bronchitis “Blue bloater” HESI Question 65 mm Hg
Partial pressure of carbon
B L U E dioxide (PaCO2) is 65 mm Hg
C
This pt. with bronchitis is
Big & Blue skin Long term “chronic” Unusual lung sounds: experiencing hypercapnia
“Cyanosis” (hypoxia) COUGH & Sputum Crackles & Wheezes
Edema peripherally O O
(due to cor pulmo
Rice
0₂ Crispers
0₂
0₂
0
Respiratory Failure:
Hypoxemic respiratory failure = Low O2
Hypercapnic respiratory failure = HIGH CO2
Priority = BiPap
Inflammation of the bronchi & excessive mucus
production resulting in a chronic hacking cough Memory Trick
& recurrent infections. HyperCAP = Give BiPAP
#1 Monitor: Mental Status Change NCLEX TIP
Key sign: 88-93% • Restless
• Decreased LOC
Low O2 saturation for COPD • Confusion
clients is expected NORMAL