Chronic Obstructive Pulmonary Disease

About this course

Chronic obstructive pulmonary disease (COPD) is a group of diseases that are characterized by progressive and incurable airflow restriction. It has multiple clinical forms, including chronic bronchitis and emphysema, making breathing difficult. Although there is no cure available, in many instances, COPD is preventable, and can be managed. This course will discuss the causes, lung variations, and clinical presentations of COPD, along with possible treatment options.

Learning objectives

• Describe the anatomy and physiology of the lungs
• Define chronic obstructive pulmonary disease (COPD)
• Identify clinical presentations of COPD
• Describe treatment options for COPD
• Discuss nursing considerations for COPD patients

Course outline

22 sections · finish in any order across devices

1. 1

   Introduction

   Chronic obstructive pulmonary disease (COPD) is a group of diseases that are characterized by progressive and incurable airflow restriction.1 It has multiple clinical forms, including chronic bronchitis and emphysema, making breathing difficult.1,2 This preventable multifactorial disease affects 380

   4 min

2. 2

   Lung Anatomy and Physiology

   Before we discuss chronic obstructive pulmonary disease, let’s discuss the lungs’ anatomy and physiology. There are two lungs in the thoracic cavity, divided by the mediastinum into two sections or lobes. The right lung is further divided into three lobes, and the left is divided into two.3 A protec

   4 min

3. 3

   What is Chronic Obstructive Pulmonary Disease (COPD)?

   Chronic obstructive pulmonary disease (COPD) is a chronic lung disease caused by obstruction or airflow restriction.4,5 It is a progressive disease that worsens over time and makes breathing difficult.6 Chronic obstructive pulmonary disease is diagnosed more often in women compared to men, and accor

   4 min

4. 4

   Lung Variations in COPD

   In COPD, three parts of the lungs, such as the bronchi, parenchyma, and pulmonary vessels, undergo morphological changes. Studying the relationship and interaction between these three lung parts can help simplify diagnosing COPD phenotypes and understanding the underlying pathophysiology.8 These lun

   4 min

5. 5

   Causes of COPD

   Prolonged exposure to harmful lung irritants, such as tobacco smoke and chemicals, and damage the lungs and airway can cause chronic obstructive pulmonary disease.7,9 In the United States, cigarette smoking is the most common cause of COPD.7,10 However, 1 in 4 COPD patients have never smoked. The ch

   4 min

6. 6

   Diagnosing COPD

   Diagnosis of COPD is challenging as the symptoms are not apparent and thus cannot be measured. Moreover, each patient does not necessarily experience the same symptoms or intensity. It is important for the healthcare professional to create a customized treatment plan and monitor a patient’s symptoms

   4 min

7. 7

   History and Physical

   Chronic obstructive pulmonary disease is diagnosed through inquiry about a patient’s family history, smoking habits or exposure to second-hand smoke, and exposure to environmental and occupational chemicals.7 The following are considerations when obtaining a history and physical: 7

   4 min

8. 8

   Spirometry

   Spirometry is the main test for confirming a diagnosis of COPD or determining how severe COPD is.12 It is a type of pulmonary function test that is performed before and after administering an inhaled bronchodilator.7 Spirometry assesses how well the lungs work by measuring how much air can be blown

   4 min

9. 9

   Global Initiative for Chronic Obstructive Lung Disease (GOLD)

   The Global Initiative for Chronic Obstructive Lung Disease (GOLD) program is a joint initiative by the World Health Organization (WHO) and the National Heart, Lung, and Blood Institute (NHLBI).7 It provides updated information and recommendations for diagnosing and managing COPD. It is also useful i

   4 min

10. 10

    Laboratory Tests

    Common laboratory tests conducted for COPD include:

    4 min

11. 11

    Lung Imaging

    COPD lung imaging involves the following two scans:

    4 min

12. 12

    Daily Medications

    Evidence shows that pharmacotherapy is effective against COPD and helps dilate the airways, decrease resting lung volumes and severe symptoms, and increase exercise tolerance and quality of life.16 With such benefits, implementation becomes necessary. Medication therapy should be based on the patien

    4 min

13. 13

    Inhaled Medications

    Bronchodilators

    4 min

14. 14

    Oral Medications

    Antibiotics - The antibiotic choice depends on the sputum culture and infection type.16 Macrolides such as azithromycin are most used.16

    4 min

15. 15

    Oxygen Therapy

    Among the many pharmacological treatment options available, long-term oxygen therapy is widely used and recommended.17 COPD treatment is focused on relieving symptoms. In severe cases of COPD, patients suffer from dyspnea, and families often request oxygen therapy as palliative care to offer some se

    4 min

16. 16

    Surgical Interventions

    Surgery for COPD is a last resort and is only considered for patients in the very severe stage.18 The following three types of surgical interventions are considered for advanced COPD:

    4 min

17. 17

    COPD Exacerbation

    There is no single definition used to describe exacerbation. However, the simplest and commonly used definition states it as worsening respiratory symptoms with a variable degree of physiological deterioration.14 It can also be defined as worsening respiratory symptoms which require treatment by cor

    4 min

18. 18

    Corticosteroids for Inflammation

    Corticosteroids are commonly used for systemic and airway inflammation during COPD exacerbation.15 Steroids offer multiple benefits, such as reduced hospital stays and admissions, reduced treatment failure, and quicker improvement in lung function and symptoms during exacerbation.15 However, there a

    4 min

19. 19

    Antibiotics and Antivirals for Infection

    Antibiotic therapy is often recommended for patients hospitalized with COPD exacerbation, as a bacterial infection is the cause in many of the cases.15 Antibiotic therapy reduces hospital stays and treatment failure rates; however, it is not required in all patients.15 Healthcare professionals use t

    4 min

20. 20

    Self-Management of COPD

    COPD patients are often recommended to include physical activity in their daily routine as it has multiple benefits.14 For instance, studies have shown that patients who join a pulmonary rehabilitation program with physical activity and awareness education benefit from shorter hospital stays than pa

    4 min

21. 21

    Nursing Considerations

    The following are some of the nursing interventions effective for COPD patients:

    4 min

22. 22

    Conclusion

    Chronic obstructive pulmonary disease presents major challenges for patients and healthcare professionals. In addition to optimal management of symptoms, the economic burden of direct and indirect costs is considerable.1 Moreover, the prognosis of COPD patients varies based on their adherence to tre

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Iheanacho I, Zhang S, King D, Rizzo M, Ismaila AS. Economic burden of Chronic Obstructive Pulmonary Disease (COPD): A systematic literature review. International Journal of Chronic Obstructive Pulmonary Disease. 2020;Volume 15:439-460. doi:https://doi.org/10.2147/copd.s234942
• CDC. Chronic Obstructive Pulmonary Disease (COPD) | CDC. www.cdc.gov. Published March 29, 2021. https://www.cdc.gov/copd/index.html#:~:text=What%20is%20COPD%3F
• Anatomy of the Lung | SEER Training. training.seer.cancer.gov. https://training.seer.cancer.gov/lung/anatomy/#:~:text=The%20lungs%20are%20the%20major
• Anatomy and Physiology of Breathing | ATrain Education. www.atrainceu.com. https://www.atrainceu.com/content/3-anatomy-and-physiology-breathing#:~:text=COPD%20is%20caused%20by%20a
• American Lung Association. Learn About COPD | American Lung Association. Lung.org. Published 2019. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd
• National Heart, Lung, and Blood Institute. COPD - What Is COPD? | NHLBI, NIH. www.nhlbi.nih.gov. Published March 24, 2022. https://www.nhlbi.nih.gov/health/copd
• Agarwal AK, Raja A, Brown BD. Chronic obstructive pulmonary disease (COPD). PubMed. Published August 8, 2022. https://www.ncbi.nlm.nih.gov/books/NBK559281/
• Benlala I, Laurent F, Dournes G. Structural and functional changes in COPD : What we have learned from imaging. Respirology. Published online April 7, 2021. doi:https://doi.org/10.1111/resp.14047
• ‌American Lung Association. COPD causes and risk factors | American Lung Association. Lung.org. Published 2021. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/what-causes-copd
• COPD - Causes and Risk Factors | NHLBI, NIH. www.nhlbi.nih.gov. Published March 24, 2022. https://www.nhlbi.nih.gov/health/copd/causes
• Association AL. COPD Symptoms. www.lung.org. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/symptoms-diagnosis/symptoms
• COPD - Diagnosis | NHLBI, NIH. www.nhlbi.nih.gov. https://www.nhlbi.nih.gov/health/copd/diagnosis#:~:text=The%20main%20test%20for%20COPD
• Burge S, Wedzicha JA. COPD exacerbations: definitions and classifications. European Respiratory Journal. 2003;21(Supplement 41):46S53s. doi:https://doi.org/10.1183/09031936.03.00078002
• Wedzicha JA, Seemungal TAR. COPD exacerbations: defining their cause and prevention. Lancet (London, England). 2007;370(9589):786-796. doi:https://doi.org/10.1016/S0140-6736(07)61382-8
• MacLeod M, Papi A, Contoli M, et al. Chronic obstructive pulmonary disease exacerbation fundamentals: Diagnosis, treatment, prevention, and disease impact. Respirology. 2021;26(6):532-551. doi:https://doi.org/10.1111/resp.14041
• Celli BR. Pharmacological Therapy of COPD. Chest. 2018;154(6):1404-1415. doi:https://doi.org/10.1016/j.chest.2018.07.005
• Branson RD. Oxygen Therapy in COPD. Respiratory Care. 2018;63(6):734-748. doi:https://doi.org/10.4187/respcare.06312
• Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894. Chronic Obstructive Pulmonary Disease (COPD): Surgical Procedures for the Treatment of COPD. Institute for Quality and Efficiency in Health Care (IQWiG); 2019. https://www.ncbi.nlm.nih.gov/books/NBK543216/
• ‌Baker E, Fatoye F. Clinical and cost effectiveness of nurse-led self-management interventions for patients with copd in primary care: A systematic review. International Journal of Nursing Studies. 2017;71:125-138. doi:https://doi.org/10.1016/j.ijnurstu.2017.03.010
• R.N MVB. 7 Chronic Obstructive Pulmonary Disease (COPD) Nursing Care Plans. Nurseslabs. Published September 28, 2019. Accessed April 19, 2023. https://nurseslabs.com/chronic-obstructive-pulmonary-disease-copd-nursing-care-plans/#h-imbalanced-nutrition-less-than-body-requirements

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