Introduction
Long-term exposure to irritants such as cigarette smoke, air pollution, occupational dust, and chemicals is typically linked to the etiology of COPD. Genetics, respiratory infections, and age are other variables that might impact the development of COPD. These irritants result in tissue damage, inflammation, and oxidative stress, constricting the airways chronically and over time.
Eighty to ninety percent of cases of COPD are caused by cigarette smoking (Hancock et al., 2018). However, not every smoker will get COPD, indicating that there may be hereditary predispositions for certain people. Inflammation and lung damage influenced by respiratory infections like pneumonia and the flu can further hasten the onset of COPD.
Pathophysiology in COPD
The pathogenesis of COPD includes structural alterations in the lungs and persistent inflammation. The inflammation damages the airway walls and encourages mucus production, further narrowing the airway. Lung flexibility and gas exchange are reduced due to structural alterations, including lung tissue loss and air sac expansion.
The inflammation in COPD is characterized by infiltrating immune cells, such as neutrophils and macrophages, into the lungs (Oliver & Milne, 2023). The cytokines and other inflammatory mediators these cells release fuel the inflammatory response and harm the tissue. The pathogenesis of COPD also involves oxidative stress, which is an imbalance between the generation of reactive oxygen species (ROS) and the cells’ capacity to neutralize them (Petrie et al., 2021). The oxidation of proteins, lipids, and DNA by ROS can result in tissue damage and cell death.
Clinical Diagnostics
Pulmonary Function Tests (PFTs)
PFTs are a collection of exams that assess lung health in diagnosing COPD. The most popular PFT, spirometry, gauges a patient’s ability to breathe in and out and how rapidly they can exhale (Cousins et al., 2020). Diffusion capacity tests and lung volume measurements are more PFTs that can offer more specific information regarding lung function.
Imaging Tests
Chest X-rays and CT scans are imaging procedures that can examine the lungs’ internal structure and rule out other underlying diseases that can manifest similarly symptomatic situations, such as lung cancer.
Arterial Blood Gas (ABG) Testing
ABG testing, which examines the blood’s levels of oxygen and carbon dioxide, can help determine how seriously advanced COPD patients’ respiratory failure is affecting them. Decisions on the need for further oxygen therapy, for example, can be guided by the results of this test.
Laboratory Testing
Complete Blood Count CBC
By measuring the blood cells, a CBC can detect anemia, which is frequent in COPD patients and can exacerbate symptoms (Hancock & Wiseman, 2020).
Electrolyte Levels
Patients with COPD who use diuretics or have other concomitant conditions are more likely to experience electrolyte abnormalities. By keeping an eye on electrolyte levels, issues like cardiac arrhythmias can be avoided.
Inflammatory Markers
In individuals with COPD, higher levels of inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), may indicate disease activity. By monitoring these signs, you can make treatment decisions and spot exacerbations.
Evidence-Based Nursing Care
Nursing care is essential in managing COPD and can support patient and caregiver independence, wellness, and quality of life. Nursing care must also include patient education, which can aid patients and their families in understanding the condition, its treatment, and the value of self-care. Smoking cessation, regular exercise, and a healthy diet are just a few self-management techniques that can help COPD patients control their symptoms and enhance their general well-being (Pal et al., 2022). Patients and nurses can collaborate to create individualized care plans considering each patient’s requirements and preferences.
Conclusion
Nursing care for patients with COPD may involve the management of symptoms, such as dyspnea and cough, as well as the prevention and management of exacerbations, in addition to patient education and self-management techniques. Patients and their families may also receive psychological and emotional support from nurses because dealing with a chronic illness may be difficult and stressful.
References
Hancock, K., Yang, I. A., & Frith, P. A. (2018). Inhaled corticosteroids in COPD: when are they needed, when not needed and when harmful?. Web.
Cousins, J. L., Wood-Baker, R., Wark, P. A., Yang, I. A., Gibson, P. G., Hutchinson, A.,… & McDonald, V. M. (2020). Management of acute COPD exacerbations in Australia. ERJ Open Research, 6(2). Web.
Hancock, D. K., & Wiseman, R. (2020). The ABC of COPD • the medical republic. The Medical Republic. Web.
Oliver, B., Milne, S. (2023). Explainer: What is chronic obstructive pulmonary disease? The Conversation. Web.
Pal, A., Howarth, T. P., Rissel, C., Messenger, R., Issac, S., Ford, L.,… & Heraganahally, S. (2022). COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation. BMJ Open Respiratory Research, 9(1), e001295. Web.
Petrie, K., Toelle, B. G., Wood-Baker, R., Maguire, G. P., James, A. L., Hunter, M.,… & Abramson, M. J. (2021). Undiagnosed and misdiagnosed chronic obstructive pulmonary disease: data from the BOLD Australia study. International journal of chronic obstructive pulmonary disease, 467-475. Web.