Chronic Obstructive Pulmonary Disease

WHAT YOU SHOULD KNOW:

Chronic obstructive pulmonary disease, or COPD, is a long-term lung disease that causes breathing problems. The term COPD is used to describe certain diseases that partially block airflow in the lungs. The most common types of COPD are emphysema (em-fi-SEE-mah) and chronic bronchitis (brong-KEYE-tis). People often have emphysema and chronic bronchitis at the same time. Treatments for COPD include medicines to help you breathe easier, lung exercises, and avoiding colds and the flu. You may need oxygen as your COPD gets worse.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

The risks of COPD depend on how bad your lungs are and your general health. As your COPD gets worse over time, you may have pain, trouble sleeping, or anxiety. You may need to use oxygen to help you breathe. You may lose too much weight. Having COPD may increase your risk of having lung cancer. Smoking also increases this risk, and increases the risk of your COPD getting worse. Lung infections in people with COPD may be life threatening. You may die from having COPD.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Call button: You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.

Activity: At first you may need to rest in bed. It may be easier for you to breathe if you rest with the head of your bed raised. You can also breathe easier if you rest your head on three or four pillows. Resting in a reclining chair may also help you breathe better. Another way to breathe easier is by saving your energy and resting more. If you have trouble breathing, call your caregiver right away. You may get out of bed when your breathing has improved.

Tests: Tests help caregivers find out what is causing your illness and how your body is handling it. Other tests are used to help caregivers plan your treatment. You may need one or more of the following tests:

• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Blood gases: This test is also called an arterial blood gas or ABG test. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. The groin is the area where your abdomen meets your upper leg. Your blood is tested for the amount of "gases" in it, such as oxygen, acids, and carbon dioxide.
  
  
• Bronchoscopy: This test may be done to look inside your airways and lungs. Caregivers use a bronchoscope to do this test. It is a long tube with a light and magnifying glass on the end. The scope goes in your mouth and into your lungs. Your caregiver may give you medicine for pain or to help you relax during the bronchoscopy. Caregivers may also do a bronchoalveolar lavage through the scope. This is when fluid and cells are sucked up from your lungs to be sent to the lab for tests.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Heart monitor: This is also called an ECG, electrocardiogram, or telemetry. Sticky pads are placed on your chest or different parts of your body. Each pad has a wire leading to a small portable box (telemetry unit), or to a TV-type screen. This lets caregivers see a tracing of the electrical activity of your heart. The heart monitor may help caregivers see problems with the way your heart is beating. Do not remove any wires or sticky pads without asking your caregiver first.
  
  
• Pulmonary function tests: Pulmonary function tests, also called PFTs, help caregivers learn how well your lungs work. PFTs may also help your caregivers decide on the best treatment for you. During the tests, you breathe into a mouthpiece connected to a machine. The machine measures how much air you breathe in and out over a certain amount of time. This helps caregivers to see how well your lungs are moving and working.
  
  
• Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
  
  
• Sputum sample: Sputum (mucus from your lungs) is collected in a special cup when you cough. It is sent to a lab for tests. The sputum may show what germ is causing your illness. It can also help your caregiver choose what medicine is best for you.
  
  
• 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
  
  
• Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Medicines: Your caregiver may give you the following kinds of medicines:

• Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Bronchodilators: You may need bronchodilators to help open the air passages in your lungs, and help you breathe more easily.
  
  
• Diuretics: This medicine is often called "water pills". Diuretics help your body get rid of extra fluid (edema) in your legs and ankles. This medicine may also help get rid of extra fluid in your lungs or around your heart. It may also decrease your blood pressure. You may urinate more often when taking diuretics.
  
  
• Steroids: Steroid medicine may help to open your air passages so you can breathe easier.

Treatment options: Your treatment may change if your illness is not being controlled. This is often decided after you have tests. You may have some of the following treatments alone or together.

• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you. Ask your caregiver before taking off your oxygen. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.
  
  
• Breathing treatments: You may need breathing treatments to help open your airways so you can breathe easier. A machine may be used to help you breathe in medicine. A caregiver helps you with these treatments. At first you may need them more often. As you get better, you may only need the treatments when you are having trouble breathing.
  
  
• Postural drainage (PD): This treatment uses body position and gravity to help bring up sputum (mucus) from your lungs. Your caregiver will place you in different positions to help the sputum drain to larger air passages. Then you can cough it out more easily. During postural drainage, your caregiver may also lightly clap on your back and chest with their hands, or use a small machine that vibrates on your skin. This breaks up the sputum in your lungs, making it easier to cough up. Postural drainage may make it easier for you to breathe, decrease the chance of infection, and help you get better faster.
  
  
• NPPV: Noninvasive positive-pressure ventilation, or NPPV, may help you breathe without using a breathing tube in your throat. Instead, a machine helps your lungs fill with air by using a mask or a mouthpiece. If a mask is used, it may go over your nose and mouth, or just your nose. Extra oxygen may be given to you through the machine also. NPPV may help you avoid needing a breathing tube, or may be used if you do not want one.
  
  
• Ventilator: A ventilator is a special machine that can breathe for you if you cannot breathe well on your own. You may have an endotracheal tube (ET tube) in your mouth or nose. A tube called a trach may go into an incision (cut) in the front of your neck. The ET tube or trach is hooked to the ventilator. The ventilator can also give oxygen to you.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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