Chronic Obstructive Pulmonary Disease

WHAT YOU SHOULD KNOW:

• Chronic obstructive pulmonary disease (COPD) is a medical condition that causes breathing problems. COPD includes two main illnesses: chronic bronchitis and emphysema. COPD damages parts of your lungs called bronchiole tubes and alveoli. This can make it hard for you to breathe and do your daily activities. COPD is most often caused by tobacco smoke. It is also caused by air pollution, dust, and chemicals. You may have trouble breathing that gets worse with exercise. You may have a chronic (long-term) cough and chronic production of sputum (thick fluid from the lungs). You may also have wheezing (difficult breathing that makes a whistling sound).
  
  
• Your caregiver will diagnose you by taking a health history and doing a physical exam. Tests may include spirometry (measures how well you can breathe), a chest x-ray, and blood tests. COPD is a serious condition that gets worse over time. Lung damage from COPD cannot be reversed, but treatment may help prevent further damage. Treatment may include medicines, oxygen, and surgery. It may also include pulmonary rehabilitation. This program teaches you about your condition and how exercise and nutrition can help you be healthier. Treatment may help you breathe better and return to your normal daily activities.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Bronchodilators may make your mouth dry. You may have headaches, nausea, and seizures. It may be hard for you to sleep. You may also have tremors (uncontrolled movements) and hypokalemia ( low levels of potassium in the blood). Inhaled corticosteroids raise your risk of pneumonia (lung infection). Surgery for COPD can cause infection and respiratory failure. Lung transplant can cause rejection of the lung (when your body does not accept the lung).
  
  
• You may be more likely to get colds and the flu. Your lungs may not be able to send enough oxygen to your body. High blood pressure may occur in your lungs. You are at greater risk of having lung cancer. You may develop chest pain or heart disease. You can have a heart attack.
  
  
• Lack of oxygen may cause damage to your organs, such as your heart or kidneys. You are at greater risk of diabetes (disease caused by too much sugar in the blood). You may develop anemia (not enough red blood cells) and glaucoma (eye disease caused by too much fluid in the eye). You are at greater risk of having osteoporosis (decrease in bone mass) and broken bones. You may feel isolated because of your limited function. You may develop depression, anxiety, and trouble sleeping. Talk with your caregiver about these and other risks of COPD.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

• Bronchodilators: These help open your airways so you can breathe better. They are most often taken using one of the following devices:
  
  
  • Inhaler: This is a hand-held device that delivers medicine that you breathe in.
    
    
  • Nebulizer: This is a machine that turns liquid medicine into mist that you breathe in through a mouthpiece.
  
  
• Corticosteroids: These help you breathe better by decreasing swelling in your lungs. They may be inhaled or taken as a pill.
  
  
• Antibiotics: These are used to treat lung infections that may make your COPD symptoms worse.

Tests:

• Spirometry: A spirometer measures how well you can breathe. You will take a deep breath and then push the air out as fast as you can. This test measures how much air you are able to push out. This is called forced expiratory volume (FEV). The test results show caregivers how small your airways have become.
  
  
• Arterial blood gas test: This is also called an 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 oxygen, acids, and carbon dioxide. This test may show how serious your condition is and what treatment is best for you. You may have blood drawn for other tests.
  
  
• Sputum sample: Sputum is collected in a special cup when you cough. It is sent to a lab to check for a lung infection. If you have a lung infection, the sample can also help your caregiver choose what medicine is best for you.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use the x-ray to look for signs of damage to the lungs.

Treatment options:

• Pulmonary rehabilitation: This program lasts around 6 to 12 weeks and may help you function better with COPD. You will learn how to manage your symptoms and help keep them from returning. Pulmonary rehabilitation may include exercise training. This includes walking and other exercises that build up your lung strength. Caregivers may also teach you what foods can help you be healthier.
  
  
• Oxygen: You may need to use oxygen if you have severe COPD. You may use oxygen during exercise or to treat breathlessness. Or you may use oxygen all the time. Oxygen may be taken in through a nasal cannula or a face mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. You may also be given oxygen using these or other methods:
  
  
  • 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.
    
    
  • Invasive mechanical ventilation: This is when a breathing tube is put into your throat. You may have this if you cannot use NPPV.
  
  
• Surgery: You may need surgery if you have severe COPD and all other treatments have failed. A lung reduction is when part of your lung is removed to help you breathe better. A lung transplant is when your lung is replaced with a lung from a donor. Ask your caregiver for more information about surgery for COPD.

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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.

Learn more about Chronic Obstructive Pulmonary Disease (Inpatient Care)