CHRONIC the lung disease present, various symptoms

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                       Chronic obstructive
pulmonary disease is a phrase used to discuss ongoing lung diseases including
chronic bronchitis, emphysema, refractory asthma, etc. (Kleinschmidt, P. 2014,
June 06)  This condition is distinguished
by increasing breathlessness. Some of  the indication of COPD can be  sputum production and long term cough, wheezing
and awful life threatning shortness of breath. in some individuals, chronic
cough an sputum production are the first signs that they are at risk for
developing the airflow obstruction and shortness of breath that is
characteristic of  COPD. in others,
shortnes of breath may be the first indication of the disease.  According to the World Health Organization,
COPD was the fourth leading cause of death worldwide in 2006. Almost 3 million
people died from the disease in countries as diverse as Canada, Japan, China,
Brazil, Great Britain, and France. ( Jørgen Vestbo, J. (2013, February 15)

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               Cigarette smoking is, by far,
the most important risk factor for COPD. pipes, cigar, and other types of
tobacco use and passive exposure to smoke are also risk factors. other risk
factirs for COPD that have been identified include, exposure to occupational
dusts and chemicals, recurrent lung infections, airway hyperresponsivenes, low
birth weight, and socioeconomic factors.

     COPD is characterized by a chronic
inflammatory response throughout the airway, lung tissues, and pulmonary
vasculature. with this chronic inflammatory response, macrophages,
T-lymphocytes, and neutrophils are increased in various parts of the lung. The
inflammatory process of COPD lead to repeated cycles of injury and repair of
the airway wall. The repair



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process results in
structural remodeling of the airway wall with increasing collagen content and
scar tissue formation, which narrows the lumen and produces fixed airway obstruction.

        Regardless of the lung disease
predominating in the patient with COPD, the end result is that progressive
airflow obstruction leads to a chronic ventilation perfusion mismatch with
blood flowing past the unaerated lung, resulting in hypoxia. Depending on the
lung disease present, various symptoms including barrel chest, cyanosis, and
clubbing may occur. (Mosenifar, Z. 2014, October 30)

           Several classes of medications are
used to decrease symptoms and complications of COPD, although they have not
been shown to modify the long-term decline in lung function of such patients.
Medications commonly used include beta-adrenergic agonists, anticholinergics,
corticosteroids, methylxanthines, and a combination of one or more of these drugs.
(NHLB,2017) Bronchodilators are the main pharmacotherapy for COPD. They relieve
bronchospasm, reduce airway obstruction, and improve alveolar ventilation.
Oxygen delivery is actually considered a prescription therapy and is to be
administered with great caution. In advanced COPD, oxygen therapy for more than
15 hours per day has been shown to improve the patient’s quality of life and

        On discharge, the patient with COPD
requires considerable patient and family teaching. patients do well in a
climate with minimal shifts in temperature and humidity, and no extremes of
heat and cold. ( Algusti, A. G. 2017, April).  The patient and family can be taught to avoid
environmental and occupational irritants, how to use respiratory devices, and
how to correctly use oxygen delivery systems. In addition, the patient can be
instructed to have good nutrition and avoid excess weight gain or loss and to
avoid substances, such as nicotine, alcohol, and drugs.

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My patient has a history
of COPD, due to long term smoking, about 25 years. As pharmacotherapy she has
been prescribed albuterol 2.5 mg and ipratropium bromide. during discharge the
patient and family are educated on smoking cessation and management and
treatments for COPD.


COPD is characterized by
progressive airflow limitation that is not fully reversible. The airflow
limitation is associated with an inflammatory response of the lungs to noxious
gases. There are many causes and smoking is the primary cause. The patient and
the family should be taught on how manage ang and treat the patient, teach them
to avoid environmental irritants and the important of stop smoking.