Understanding Chronic Obstructive Pulmonary Disease

Document created by kbass Employee on Dec 29, 2016Last modified by mbrajuha on Mar 8, 2017
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Information for Patients and Families Living with End-Stage COPD

 

Chronic Obstructive Pulmonary Disease (COPD) is a group of lung diseases that includes chronic bronchitis, emphysema and asthma. Breathing is the body's way of getting oxygen to the blood. With COPD, the movement of air out of the lungs is decreased. Breathing becomes hard and the body may not get the oxygen it needs. This guide helps patients and families cope with COPD.

 

Symptom

Shortness of breath, difficulty breathing

What is happening

As COPD progresses, the flow of air out of the lungs is decreased. The body may not be able to take in the oxygen it needs or release the carbon dioxide that builds up. This causes shortness of breath.

 

What to do

  • Find the most comfortable position for breathing. Sitting up straight or leaning on an over-bed table may be helpful. Try raising the head of the bed. Loosen any tight clothing.
  • Use oxygen as ordered. Do not change oxygen settings without talking to the hospice nurse. Remove extra oxygen tubing to increase airflow during severe episodes.
  • Use a fan to increase air movement; keeping the room cool can help too.
  • Talk to your nurse about medicine to reduce pain, anxiety and restlessness.
  • Use nebulizer treatments or inhalers as ordered.
  • Discuss breathing techniques with the nurse.
  • If shortness of breath continues, call the nurse.

 

Symptom

Edema, swelling of the feet and legs

What is happening

The heart and lungs work together to provide oxygen and move blood. The kidneys help to balance fluid in the body. As COPD progresses, the heart may have trouble pumping blood through the lungs. The kidneys try to hold onto as much fluid as possible. This fluid usually collects in the feet and legs or sometimes other parts of the body.

 

What to do

  • Take medications as ordered. Some needed medications may increase swelling.
  • Elevate feet and legs when sitting or lying down.
  • Avoid tight shoes, socks or clothing.
  • Be careful when moving to prevent injury to fragile skin.
  • Ask the nurse if changes in diet, such as limiting salt, would be helpful.
  • Notify the nurse of any new swelling or increase in symptoms.

 

Symptom

Feeling weak and tired

What is happening

As lung disease (COPD) progresses, breathing becomes much harder. As the body tries to get the oxygen it needs, chest and abdominal muscles work harder to move air in and out. This uses both physical and mental energy.

 

What to do

  • Choose the activities that are most important.
  • Try to do things at the time of day when energy is highest.
  • Rest and relax often.
  • Have everything for bathing (towel, washcloth, soap and toothbrush/paste) within easy reach. Use a shower chair for the shower or tub.
  • Have a chair at the sink to sit on while getting ready. Place a mirror at chair level.

 

Symptom

Cough, wheezing

What is happening

Increased mucous is common. Attempts to clear mucus may cause coughing. Wheezing may be heard when airways are narrowed by secretions or swelling.

 

What to do

  • Increase the humidity by using a cool mist humidifier or vaporizer.
  • Drink plenty of fluids to thin mucous. Warm drinks may be helpful.
  • Talk to the hospice nurse about medications to help loosen secretions or to relieve cough.
  • Nebulizer treatments or inhalers may be helpful for wheezing.
  • Report yellow or green sputum to the hospice nurse.
  • Suctioning a patient too weak to cough is usually not helpful. Suctioning is distressing and often increases secretions and decreases oxygen levels.
  • To help clear secretions, raise the head of the bed or prop with pillows. Change positions often.

 

Symptom

Change in amount or color of sputum, which may be green, yellow or blood-tinged; fever; increased fatigue; increased tightness in chest; increased shortness of breath

What is happening

Infection causes the lining of the airways and lungs to become inflamed and to produce more mucous. The swelling and excess mucous decrease airflow in and out of the lungs. This may be a sign of bronchial infection (acute bronchitis).

 

What to do

  • Call the hospice nurse when these symptoms occur.
  • Use oxygen as ordered. Do not change oxygen settings without talking to the nurse.
  • Sit in reclined position to help lungs expand.
  • Use nebulizer treatments or inhalers if ordered.
  • Use Tylenol for fever.
  • Use a cool mist humidifier or vaporizer to thin secretions.
  • If antibiotics are prescribed, it is important to take all of the medication ordered.

 

Symptom

Anxiety; nervousness; restlessness; agitation

What is happening

Fear, anger, sadness, pain, loneliness or shortness of breath may cause anxiety. Decreased oxygen to the brain may cause increased restlessness, agitation and shortness of breath.

 

What to do

  • Use oxygen as ordered. Do not change oxygen settings without talking to the hospice nurse.
  • Take anti-anxiety or pain medication as ordered.
  • Practice relaxation and deep breathing exercises. The nurse or social worker can instruct on these techniques.
  • Ask the chaplain about spiritual resources that may increase emotional peace.
  • Loved one should stay with the patient during time of increased anxiety to provide emotional support.
  • If symptoms continue, call the nurse.

 

 

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