COPD: Chronic Obstructive Pulmonary Disease
(Chronic Obstructive Lung Disease)

Chronic Obstructive Pulmonary Disease(COPD): a progressive disorder of the lungs and airways. It affects oxygen and carbon dioxide gas exchange and causes chronic inflammation and narrowing of the small airways, affecting air outflow. COPD includes such diseases as emphysema and chronic bronchitis.

Emphysema: destruction of lung tissue, causing a reduced expiratory flow rate and over-inflated alveoli (air sacs); a progressive disease that is irreversible.

Chronic Bronchitis: inflammation of the mucous membrane of the bronchus with excessive mucus secretion in the bronchial tree; occurs as a result of irritation to tissue that causes swelling and hypertrophy of the mucus-producing cells.

Contributing Factors: Cigarette smoking, exposure to pollutants: industrial, air and chronic respiratory infections.

Signs / Symptoms: Dyspnea on exertion, Shortness of breath, Wheezing, Thick mucus production, Restlessness, Fatigue, Anorexia, Weight loss, Persistent cough: productive or nonproductive, Malaise, Somnolence, Peripheral cyanosis with clubbing.

Complications: Cor pulmonale, Acute respiratory failure, Peptic and esophageal reflux, Pneumonia, Polycythemia, Dysrhythmias and Hepatomegaly

Health advices for COAD patients:
- Regular follow-up visits are necessary
- Should avoid persons with infections, especially upper respiratory tract infections. It is necessary to seek
medical care at the beginning of infections
- Should take vaccines for influenza and pneumococcal pneumonia.
- The environmental control is important: it is better to avoid dry air by using a humidifier; maintain the room temperature at 22'C to 26'C. Always keep warm and avoid chilling.
- Should avoid going out in cold temperatures, which may cause bronchospasm.
- Should not smoke and avoid secondhand smoke.
- Should exercise to tolerance and to avoid fatigue by planning rest periods during the day.
- Should limit activity on days of high air pollution.
- Should avoid emotional stress.
- Should avoid constipation and straining at stool.
- Should maintain high-calorie diet as indicated.
- Encourage fluid intake of 2000-3000 ml per day, unless contraindicated, to keep secretions liquid.
- Should rest before and after meals if shortness of breath increases at mealtime.

Source of references: Mosby's Handbook of Patient Teaching,
by Mary Canobbio
Health World Magazine
CT/No. 34 (Oct, 2003)