Chronic obstructive pulmonary disease (COPD), also known as chronic airflow limitation, is a group of disorders associated with persistent or recurrent obstruction of airflow, which include chronic bronchitis, emphysema and asthma. These conditions frequently overlap. Most commonly, bronchitis and emphysema occur together. Asthma frequently occurs alone without the triad of bronchitis, emphysema and asthma.

The most chronic lung disease, COPD affects an estimated 17 million persons in the US. The incidence is currently rising and the most common cause is smoking cigarettes.

Nursing Interventions for Chronic Obstructive Pulmonary Disease (COPD)

1. Provide nursing care for the client with chronic bronchitis or emphysema.
• Administer prescribed medications, which may include antibiotics, broncodilators, mucolytic agents and corticosteroids. Antibiotics should be administered at the first sign of infection, such as change in sputum. Opioids, sedatives and tranquilizers, which can further depress respirations, should be avoided.
• Clear airways with postural drainage, percussion or vibrating and suctioning as appropriate.
• Promote infection control. Encourage the client to obtain influenza and pneumonia vaccines at prescribed times.
• Improve breathing patterns. Demonstrate and encourage diaphragmatic and purse lip breathing. Have the client take a deep breath and blow out against closed lips.
• Administer oxygen. A low arterial oxygen level is the client’s primary drive for breathing. Oxygen flow rate should be no more than 2 to 3 L per minute. Higher levels will cause the client to quit breathing.
• Discuss the importance of smoking cessation and avoiding second-hand smoke. Discuss ways to quit smoking and make appropriate referrals. Compromise is not acceptable; the client must stop smoking.
2. Provide nursing care for the client with asthma.
• Administer prescribed medications, which may include adrenergics, bronchodilators and corticosteroids for acute attack. Encourage use of a cromolyn inhaler as prophylactic treatment.
• Provide treatment during an acute asthmatic attack. Stay with the client and keep him calm and in an upright position. Do purse-lip breathing with the client; encourage relaxation techniques.
• Implement measures to prevent asthmatic attacks. Teach the client with the following skills: (1) Identify and eliminate or minimize exposure to pulmonary irritants. (2) Remove rugs and curtains from the home, change air filters frequently, keep the home as dust free as possible, and keep windows closed during windy and high pollen days.
• Use an inhaler and take medications as prescribed, and notify the health cre provider when not gaining complete relief.
• Notify the health care provider when a respiratory infection occurs.
• Obtain influenza and pneumonia vaccines at prescribed times.

More Nursing Interventions.