COPD

Chronic Obstructive Pulmonary Disease (COPD)



Chronic Obstructive Pulmonary Disease (COPD)

Introduction

This condition is likely in any current or ex-smoker aged over 35 who has any combination of breathlessness, wheeze, chest tightness, reduced ability to exercise cough, and frequent chest infections sputum production. Many patients with COPD also have asthma, but the pure form of the latter is different because it is reversible - that is it gets better and worse with time (asthma attacks) or can be reversed by bronchodilators. In particular, in COPD the cough tends to be persistent and productive of sputum, the shortness of breath gets steadily worse over years and - unlike asthma - patients do not feel worse at night. This paper discusses the condition and care of a male adult with COPD (pseudonym: John) at the emergency department in an Irish hospital in Ireland.

Discussion

John was admitted in the emergency department in the hospital. He was having Chronic Obstructive Pulmonary Disease (COPD). The current nursing contributions to health outcomes for patients like John is discussed here. COPD is a lung disease that involves increased resistance to air flow in the bronchial airways and decreased tissue elasticity, leading to decreased ventilation. COPD can be the long-term result of chronic bronchitis, emphysema, asthma or chronic bronchiolitis. Since these health effects may, in some cases, result from exposure to chemicals, COPD can, in those cases, be considered a chronic toxic endpoint. (Van 2010, 73-85)

The incidence of COPD has been increasing, as has the death rate. In the UK around 30,000 people with COPD die annually and the disorder makes up 10 per cent of all admissions to hospital medical wards, making it a serious cause of illness and disability. The occurrence, mortality and incidence rates increase with age, and more men than women have the disorder, which is also more common in those who are socially disadvantaged. Chronic obstructive pulmonary disease (COPD) is a complex chronic inflammatory disease of the lungs with significant extrapulmonary effects that may contribute to its severity in individual patients. Growing evidence suggests that markers of systemic inflammation, such as C-reactive protein (CRP) and serum amyloid A (SAA), are increased in patients with COPD compared with control subjects without COPD . For this reason, low-grade systemic inflammation is currently considered to be a hallmark of COPD and one of the key mechanisms that may be responsible for the increased rate of co-morbidity. (Bowling 2001, 12)

CRP is the prototypic acute-phase reactant that belongs to the highly conserved pentraxin family of plasma proteins. Current evidence indicates that increased CRP levels can be used to identify subjects who have an increased risk of developing myocardial infarction, stroke, unstable angina, or sudden cardiac death . Elevated levels of CRP in patients with COPD were demonstrated to predict adverse outcomes and the development of cardiovascular complications . In recent years, CRP has emerged as a biochemical marker of systemic involvement in COPD , a prognostic factor , and a marker for diagnosis and prognosis during acute exacerbations ...