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Copd (chronic Obstructive Pulmonary Disease)

AMBULATORY CARE:

COPD (chronic obstructive pulmonary disease)

is a lung disease that causes breathing problems. COPD usually develops from years of irritation and inflammation in your lungs. Obstructive means airflow is blocked. This limits airflow out of your lungs. Smoking, breathing in pollution, genetics, or a history of lung infections can increase your risk for COPD.

Inspiration and Expiration

Common symptoms include the following:

  • Shortness of breath
  • A dry cough
  • Coughing fits that bring up mucus from your lungs
  • Wheezing and chest tightness

Call your local emergency number (911 in the US) if:

  • You feel lightheaded, short of breath, and have chest pain.

Call your doctor if:

  • You are confused, dizzy, or feel faint.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You cough up blood.
  • You have increased shortness of breath.
  • You need more medicine than usual to control your symptoms.
  • You are coughing or wheezing more than usual.
  • You are coughing up more mucus, or it has a new color or odor.
  • You gain more than 3 pounds in a week.
  • You have a fever, a runny or stuffy nose, and a sore throat, or other cold or flu symptoms.
  • Your skin, lips, or nails start to turn blue.
  • You have swelling in your legs or ankles.
  • You are very tired or weak for more than a day.
  • You notice changes in your mood, or changes in your ability to think or concentrate.
  • You have questions or concerns about your condition or care.

COPD diagnosis:

Your healthcare provider will examine you and ask about your symptoms. Tell him or her how long you have had symptoms, what makes them worse, and how they affect your life. He or she will ask if a family member has COPD or breathing problems. He or she will ask if you are a current or former smoker. Tell your provider about other medical conditions you have, such as heart disease or asthma. Also tell him or her about all medicines you take. You may also need any of the following:

  • Lung function tests are used to help confirm COPD or find if it is severe. Spirometry measures the airflow into and out of your lungs. A lung volume test measures the amount of air your lungs can hold. The amount of oxygen that gets into your blood when you breathe may also be measured.
  • Blood tests check for infection and measure oxygen levels in your blood. Blood tests may also be used to find if you have alpha-1 antitrypsin deficiency. This is a genetic condition that can increase your risk for COPD. Blood tests may also show if you have any nutrition problems, such as low vitamin levels.
  • A chest x-ray is done to check for other lung problems.
  • CT scan pictures may be taken of your lungs. You may be given contrast liquid to help your lungs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

Treatment:

Healthcare providers will work with you to create a care plan. The plan will contain goals defined by you and your providers. It will include steps to help you reach your goals within a specific time frame. The plan may change over time as your goals and needs change. The following may be included in your plan:

  • Medicines may be used to open your airway or decrease swelling and inflammation in your lungs. Medicines can relieve certain kinds of symptoms. A short-acting medicine relieves symptoms quickly. This may be called rescue medicine. A long-acting medicine controls or prevents symptoms. This may be called maintenance medicine. Your care plan will have directions for when to take each kind of medicine. Your healthcare provider will give you more information about the medicines you are given and how to use them safely.
  • Oxygen may help you breathe easier and feel more alert if you have severe COPD.
  • Surgery is sometimes done if all other treatments have failed. A lung reduction is surgery to remove part of your damaged lung. A lung transplant is the replacement of your lung with a donor lung.

Help make breathing easier:

  • Use pursed-lip breathing any time you feel short of breath. Take a deep breath in through your nose. Slowly breathe out through your mouth with your lips pursed. Try to take 2 times as long to breathe out as to breathe in. This helps you get rid of as much air from your lungs as possible. You can also practice this breathing pattern while you bend, lift, climb stairs, or exercise. It slows down your breathing and helps move more air in and out of your lungs.
    Breathe in Breathe out
  • Avoid anything that makes your symptoms worse. Stay out of high altitudes and places with high humidity. Stay inside, or cover your mouth and nose with a scarf when you are outside in cold weather. Stay inside on days when air pollution or pollen counts are high. Do not use aerosol sprays such as deodorant, bug spray, and hairspray.
  • Exercise daily. Exercise for at least 20 minutes each day to help increase your energy and decrease shortness of breath. Talk to your healthcare provider about the best exercise plan for you.
    Walking for Exercise

Manage COPD and help prevent exacerbations:

COPD is a serious condition that gets worse over time. A COPD exacerbation means your symptoms suddenly get worse. It is important to prevent exacerbations. An exacerbation can cause more lung damage. COPD cannot be cured, but you can take action to feel better and prevent exacerbations:

  • Do not smoke. If you currently smoke, quitting is the best way to keep COPD from getting worse. Nicotine and other substances can cause lung irritation or damage and make it harder for you to breathe. Do not use e-cigarettes or smokeless tobacco. They still contain nicotine. It may be hard to quit smoking. Your healthcare provider can help you find resources if you need help to quit. For support and more information:
    • Smokefree.gov
      Phone: 1- 800 - 784-8669
      Web Address: www.smokefree.gov
  • Avoid secondhand smoke. This is smoke another person exhales. Even if you have never smoked or have quit, it is important to avoid secondhand smoke. This smoke can also cause lung damage or trigger an exacerbation.
  • Go to pulmonary rehabilitation (rehab) if directed. Rehab is a program run by specialists who help you learn to manage COPD. Examples include a pulmonologist (lung specialist), dietitian, or exercise therapist. The specialists will help you make a plan to avoid triggers that cause an exacerbation.
  • Take your medicines as directed. Refill your medicines before you are out so that you do not miss a dose. Ask your healthcare provider if you have any questions on how to take your medicines.
  • Protect yourself from germs. Germs can get into your lungs and cause an infection. An infection in your lungs can create more mucus and make it harder to breathe. An infection can also create swelling in your airway and prevent air from getting in. You can decrease your risk for infection by doing the following:
    • Wash your hands often with soap and water. Carry germ-killing gel with you. You can use the gel to clean your hands when soap and water are not available.
      Handwashing
    • Do not touch your eyes, nose, or mouth unless you have washed your hands first.
    • Always cover your mouth when you cough. Cough into a tissue or your shirtsleeve so you do not spread germs from your hands.
    • Try to avoid people who have a cold or the flu. If you are sick, stay away from others as much as possible.
  • Drink more liquid. Liquid will help to keep your air passages moist and help you cough up mucus. Ask how much liquid to drink each day and which liquids are best for you.
  • Ask about vaccines. Influenza (the flu) and pneumonia can become life-threatening for a person who has COPD. Get a flu vaccine each year as soon as it becomes available. The pneumonia vaccine may be given every 5 years, or as directed. Ask about other vaccines you may need and when to get them.

Make decisions about your choices for future treatment:

Ask for information about advanced medical directives and living wills. These documents help you write down your choices for treatment and for end-of-life care, such as hospice. It is best to complete them when you feel well and can think clearly about your wishes. The information can then be kept for future use if you are in the hospital or become very ill.

Follow up with your doctor as directed:

You may need more tests. Your doctor may refer you to a specialist, depending on your needs. Some specialist services may be available through your pulmonary rehab program. Your doctor may also refer you to home health care or palliative (comfort) care. Write down your questions so you remember to ask them during your visits.

© Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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