All respiratory diseases characterized by chronic obstruction to airflow fall under the broad classification of COPD, also known as chronic airflow limitations (CAL). COPD is a condition of chronic dyspnea with expiratory airflow limitation that does not significantly fluctuate. Within that broad category, the primary cause of the obstruction may vary; examples include airway inflammation, mucous plugging, narrowed airway lumina, or airway destruction. The term COPD includes chronic bronchitis and emphysema. Although asthma also involves airway inflammation and periodic narrowing of the airway lumina (hyperreactivity), the condition is the result of individual response to a wide variety of stimuli/triggers and is therefore episodic in nature with fluctuations/exacerbations of symptoms. Because client response and therapy needs can be similar, asthma has been included in this plan of care.
Asthma: Sometimes called chronic reactive airway disease, asthma is a chronic inflammatory disorder characterized by episodic exacerbations of reversible inflammation and constriction of bronchial smooth muscle, hypersecretion of mucus, and edema. Precipitating factors include allergens (e.g., foods, animals, latex, plants, molds), emotional upheaval, air pollution, cold weather, exercise, chemicals, medications, and viral infections. The prevalence of asthma is rising, accounting for the sixth most common chronic disease in the United States.
Chronic bronchitis: Widespread inflammation of airways with narrowing or blocking of airways, increased production of mucous/sputum (productive cough), and marked cyanosis.
Emphysema: Most severe form of COPD characterized by recurrent inflammation that damages and eventually destroys alveolar walls to create large blebs or bullae (air spaces) and collapsed bronchioles on expiration (air-trapping). Clinically, emphysema typically presents with nonproductive or minimally productive cough and progressive dyspnea.
Note: Chronic bronchitis and emphysema coexist in many clients and are most commonly seen in hospitalized COPD clients when acute exacerbations occur. Chronic bronchitis and emphysema are usually irreversible, although some effects can be mediated.
CARE SETTING
Primarily community level; however, severe exacerbations may necessitate emergency and/or inpatient hospital stay.
Primarily community level; however, severe exacerbations may necessitate emergency and/or inpatient hospital stay.
RELATED CONCERNS
Heart failure: chronic, Pneumonia, Psychosocial aspects of care, Ventilatory assistance (mechanical), Surgical intervention
Heart failure: chronic, Pneumonia, Psychosocial aspects of care, Ventilatory assistance (mechanical), Surgical intervention
