webinar jan 2018 copd1/18/2018 13 be aware of the diagnosis review/discuss triggers help to reduce...
TRANSCRIPT
1/18/2018
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Presented by UIC College of Nursing
Describe COPD.
Identify red flags for a COPD exacerbation.
Identify COPD triggers or risk factors.
Differentiate between long‐acting inhalers and emergency use inhalers.
Identify tools for long‐term self‐management of COPD.
ChronicObstructivePulmonaryDisease
Preventable Treatable Chronic
Never goes away
Difficult to empty air out of lungs
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COPD = Chronic Bronchitis and/or Emphysema
Asthma is NOT the same as COPD, but there can be overlap and many people with COPD also have asthma.
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What is Emphysema?
What is Chronic Bronchitis?
Swelling, mucous
Restricted air flow
Increased shortness of breath
FatigueDecreased activity
Decreased quality of
life
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Causes of COPD:
SMOKING
CIGARETTE SMOKE
Air pollution
Genetics?
How do I know if I have COPD?
Shortness of breath
Wheeze
Cough
Mucous/Phlegm
Doesn’t go away
See your healthcare provider
COPD
Risk for:
Infections, Pneumonia
Heart Disease
Cancer
How does a healthcare provider know if I have COPD?
Symptoms
Breathing tests (Spirometry;
Pulmonary Function Tests)
How much air in and out?
How fast breathe out?
How much oxygen gets into blood?
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Other pulmonary function tests:
Lung volume measurement
Diffusing capacity
6 Minute Walk Test
Arterial Blood Gas
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Stop smoking
Annual flu shot
Pneumonia vaccine
Medications
Oxygen
Pulmonary rehabilitation/Daily Physical Activity
Surgery
Lung volume reduction
Lung transplant
Additional steps for self‐management:
Breathing exercises using handheld incentive spirometer
Pulse Oximetry
▪ Log results over time; with and without symptoms
▪ Learn your expected normal range
Medicines will
Improve overall well‐being
Improve ability to perform daily activities
Reduce symptoms
Prevent symptoms
Reduce “exacerbations” or attacks
MUST be taken as prescribed
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Inhaler medicines are used most often
Bronchodilator Inhalers
▪ Short acting
▪ Long acting
Steroid inhalers
Other medications (less often)
Bronchodilator Inhalers: SHORT/FAST Acting
Short acting beta agonists
▪ “SABAs”
▪ Albuterol; Levalbuterol
Short acting Anticholinergics
▪ Ipratropium
Short acting Combination Inhaler
Bronchodilator Inhalers LONG Acting
Long acting beta agonists “LABAs”
▪ salmeterol (“Serevent”)
Long acting anticholinergics or antimuscarinics “LAMAs”
▪ Tiotropium (Spiriva);
Long acting combination medication
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Steroid Inhalers (combination)
Advair; Symbicort
Metered Dose Inhaler (MDI)
Dry Powder Inhaler
Soft Mist Inhaler
MDI
Technique with a spacer
(Up To Date, 2018)
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Dry Powder Inhaler Technique
(expl. Advair)
(Up To Date, 2018)
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Soft Mist Inhaler (SMI) Technique
(expl. Respimat)
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Nebulizer
Upon the following symptoms, COPD patients should contact their healthcare provider within six hours:
Shortness of breath does not cease with bronchodilator treatments inhaled one hour apart
Wheezing does not cease with bronchodilator treatments inhaled one hour apart
(Avail, 2018)
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If COPD patients experience the following symptoms, they should contact their healthcare provider within 24 hours:
Sputum changes in color, odor, stickiness or thickness
Ankle swelling persists after a night of sleeping with feet up
Waking up twice or more at night being short of breath
Severe fatigue (Avail, 2018)
Contact healthcare provider immediately:
(Avail, 2018)
Inability to speak Confusion during acute infection
Severe shortness of breath Forgetfulness during acute infection
Trouble breathing Severe weakness
Inability to speak in full sentences
Fever 101 degrees or greater
Cannot be awakened easily Shaking chills
Speech slurring during acute infection
Blood in sputum
Exhaustion during acute infection
May need a new medicine or a new delivery manner
Increase in short acting beta agonists and anticholinergics
May need nebulizer administration
Steroid medication by mouth (increases blood sugar)
Steroid medication intravenous: Hospitalize
Antibiotic
By mouth at home
Intravenous‐at hospital
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Be aware of the diagnosis Review/discuss triggers Help to reduce triggers
exposure Advocate for smoking
cessation Know the medications
prescribed and how prescribed
Remind to use short/fast acting inhaler when symptomatic
Keep list of meds current Know the individualized
range of normal pulse oximetery results
Encourage physical activity Encourage breathing
exercises Explore Pulmonary
Rehabilitation programs and eligibility
Have the physician’s name and contact number
Call the provider if person is symptomatic
Call 911 if severe
Avail Clinical Research. (2018). COPD signs and symptoms. Retrieved from https://www.availclinical.com/clinical‐trials/chronic‐obstructive‐pulmonary‐disease‐copd/copd‐signs‐symptoms/
Up To Date. Han, MK., Dransfield, MT, Martinez, FJ. (2017). Chronic Obstructive Pulmonary Disease: Definition, clinical manifestations, diagnosis and staging. Retrieved from https://www.uptodate.com/contents/chronic‐obstructive‐pulmonary‐disease‐definition‐clinical‐manifestations‐diagnosis‐and‐staging?search=COPD&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H2840639245
Up To Date. Patient Education: COPD. Topic 15430 Version 11.0. (2018) Retrieved from https://www.uptodate.com/contents/chronic‐obstructive‐pulmonary‐disease‐copd‐including‐emphysema‐the‐basics
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