COPD - clinical pattern sheets PDF

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clinical pattern sheets...

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Cardio Clinical Patterns Sheet COPD Definition / Description This is a term used to describe the clinical presentation of airways obstruction, mainly due to the presence of chronic bronchitis or emphysema.

Populations / Risk Factors      

Smokers Genetic factors Environmental – air pollution Men are slightly more at risk Happens in older generation (60’s70’s) Asthma

Symptoms - (Distribution, description, daily pattern cough, sputum breathlessness etc.)      

Cough – starts early morning, in later stages more frequent and becomes irritant and dry Sputum – early morning, it is mucoid and little infection to begin, as progresses copious amounts of purulent secretions are produced Dyspnoea Wheeze - this reflects narrowing of airways, loudest on expiration Cyanosis - clubbing and oedema – reflecting altered physiology in circulatory system Visible signs of airway obstruction – e.g. abdominal bounce and filling of the jugular vein

Clinical Signs - (e.g. Ausculation, palpation, TPR, BP))

        

PT has increased levels of CO2 in the blood Decreased levels of o2 Leads to severe shortness of breath PT appears pink – but working hard to achieve the degree of oxygenation The severe dyspnoea reduces exercise tolerance causing anxiety & depression PT use purse lip breathing Increase in the peripheral air spaces due to the alveolar destruction, causing the chest to over expand Lung volumes increased X-ray the lung fields are long, thin and translucent, reflecting a lot of air

Investigations - (Chest x rays, lung function tests, ABGS haematology, exercise

tests))       

Respiratory function tests Sputum culture Chest X-ray CT scan Blood gases, pulse oximetry Electrocardiogram, echocardiography Assessing the quality of life/perceived breathlessness ( Borg scale )

Medical management options       

Measured in 3 stages; prevention, chronic stable COPD and acute exacerbations Prescribing vaccination, 2 must effective are – influenza and streptococcus Inhaled steroids e.g. prednisolone, reduce the number of exacerbations Long-acting bronchodilators e.g. salmeterol also may reduce exacerbations Oxygen therapy Bullectomy – is the removal of emphysematous bullae Lung transplant – for younger PT

Physiotherapy treatment options    

Advise to stop smoking Pulmonary rehab classes Education on how to manage breathlessness Nebulizers – aid with sputum clearance and drug therapy

Useful Resources http://www.nhs.uk/Conditions/Chronic-obstructive-pulmonarydisease/Pages/Treatment.aspx...