Pines City Colleges

(Owned and operated by THORNTONS INTERNATIONAL STUDIES, INC.)

COLLEGE OF NURSING

A Written Output on Case Presentation of

Chronic Obstructive Pulmonary Disease
(COPD)

In partial completion of

NCM 118 Lec

Submitted by:
GROUP 11
DULAY, Denver
LUYUN, Trisha ML
MACAUYAM, Amia Danice
MANAOIS, Rosane
MANGANGEY, Keisha
MATIAS, Leizl Ojares
MOTIO, Roselle
MUNAR, Hannah Desiree
PALSAEN, Shanaiah
PAYABYAB, Anjielyn

BSN3- 03

Submitted to:
Alma Bucang, RN

August 27, 2024

 Pines City Colleges
(Owned and operated by THORNTONS INTERNATIONAL STUDIES, INC.)
COLLEGE OF NURSING

Chronic Obstructive Pulmunary

Disease (COPD)

 Also known as the “Smoker’s Disease”

 Chronic obstructive pulmonary disease, or COPD, describes a group of lung conditions

that make it difficult to empty air out of the lungs because the airways have become
narrowed.

 Two of these lung conditions are long-term (or chronic) bronchitis and emphysema,
which can often occur together.
• Bronchitis means the airways are inflamed and narrowed. People with bronchitis
often produce sputum, or phlegm
• Emphysema affects the tiny air sacs at the end of the airways in your lungs, where
oxygen is taken up into your bloodstream. They break down and the lungs become
baggy and full of bigger holes which trap air These conditions narrow the airways.
This makes it harder to move air in and out as you breathe, and your lungs are less
able to take in oxygen and get rid of carbon dioxide.

 The airways are lined by muscle and elastic tissue. In a healthy lung, the springy tissue
between the airways acts as packing and pulls on the airways to keep them open. With
COPD, the airways are narrowed because:
• the lung tissue is damaged so there is less pull on the airways
• mucus blocks part of the airway
• the airway lining becomes inflamed and swollen
 Pines City Colleges
(Owned and operated by THORNTONS INTERNATIONAL STUDIES, INC.)
COLLEGE OF NURSING

 CAUSES:
• COPD usually develops because of long-term damage to your lungs from breathing in
a harmful substance, usually cigarette smoke, as well as smoke from other sources
and air pollution.
• Jobs where people are exposed to dust, fumes and chemicals can also contribute to
developing COPD.
• You’re most likely to develop COPD if you’re over 35 and are, or have been, a smoker
or had chest problems as a child.
• Some people are more affected than others by breathing in noxious materials.
• COPD does seem to run in families, so if your parents had chest problems then your
own risk is higher. A rare genetic condition called alpha-1-antitrypsin deficiency
makes people very susceptible to developing COPD at a young age.

 SYMPTOMS:
• getting short of breath easily when you do everyday things such as going for a walk
or doing housework
• having a cough that lasts a long time
• wheezing in cold weather
• producing more sputum or phlegm than usual
• If you have COPD that has a severe impact on your breathing, you can also lose your
appetite, lose weight and find that your ankles swell

 DIAGNOSTIC TESTS:
• Spirometry
✓ To get an accurate diagnosis, you should have a simple test called spirometry.
✓ This involves blowing hard into a machine that measures the total amount of air
you can breathe out, called your lung capacity, and also how quickly you can
empty your lungs. The measure used is called the forced expiratory volume in
one second, often shortened to FEV1.
✓ Healthy people can empty at least 70% of the air from their lungs in the first
second of a hard blow out. Spirometry only covers one aspect of your lung
function.
✓ People with the same spirometry result may be more or less breathless
depending on their level of fitness, any other medical problems and the exact
way COPD has damaged their lungs.

• Chest X-ray and blood test

✓ For the vast majority of people, a firm diagnosis of COPD can only be confirmed
by spirometry. It will not be made on a chest X-ray finding on its own. Your health
care professional should arrange for you to have a chest X-ray or scan and blood
test to rule out other causes of your symptoms.

• CT Scan
✓ A CT scan may show the type of COPD like emphysema or chronic bronchitis,
progression of the disease or severity
 Pines City Colleges
(Owned and operated by THORNTONS INTERNATIONAL STUDIES, INC.)
COLLEGE OF NURSING

• Oximetry or Arterial Blood Gas

✓ Oximetry or ABG measures the oxygen level in your blood. This test can show
how well your lungs move oxygen in the blood and remove carbon dioxide from
your blood.

• Other Tests
✓ lung volume test—measures the volume of air in the lungs including the air that
remains at the end of a normal breath
✓ diffusing capacity test—shows how easily oxygen enters the blood stream
✓ exercise testing—such as 6-minute walk test may be used to evaluate shortness
of breath during exercise.

 MANAGEMENT:
• The core care for COPD is:
✓ having treatment and support to stop smoking (smoking cessation programs)
✓ having a flu jab every year and a one-off pneumonia vaccination
✓ an exercise program called pulmonary rehabilitation, if your breathlessness
stops you doing things
✓ having your own self-management plan
✓ identifying and managing your other health problems, because most people with
COPD also have other long-term conditions
✓ taking medicine or combinations of medications to improve breathlessness and
help prevent flare-ups

• Pulmonary rehabilitation Pulmonary rehabilitation or PR

✓ is a program of exercise and education designed for people living with COPD. It’s
one of the best treatments available for COPD
✓ A course lasts about six to eight weeks and you’ll be part of a group. At each
session, you’ll spend about half the time on physical exercise. This will be
carefully designed to provide the right level of activity for you. You’ll also get
information and tips about things like:
− breathing techniques and positions to help you when you’re out of breath
− how to manage stress
− healthy eating
− how to use your inhalers and other medicines
− what to do when you’re unwell PR is about helping you manage your
COPD better.
✓ It’s a treatment not a cure, but you’ll feel better- more confident and in control.
After you’ve completed your course, it’s important to carry on exercising
regularly, stay active and use the techniques you’ve learned.
 Pines City Colleges
(Owned and operated by THORNTONS INTERNATIONAL STUDIES, INC.)
COLLEGE OF NURSING

 MEDICATIONS:
• Bronchodilators
✓ Bronchodilators are a type of medicine you inhale that open up your airways to
help you breathe more easily.
a) Short-acting bronchodilator
− If you only get short of breath when you’re active, your doctor will give
you a short-acting bronchodilator. This will help your breathing
quickly and the effects last for 4 to 6 hours.

b) Long-acting bronchodilator
− If you’re breathless daily, you’ll be prescribed a long-acting
bronchodilator. This may take longer to have an effect, but the effects
last longer – 12 to 24 hours.
− There are two main types of long-acting drugs. They are called
long-acting anti-muscarinic (LAMA) and long-acting beta agonist
(LABA). Most people with COPD who are breathless will benefit from
taking both kinds. Sometimes they come in separate inhalers and
sometimes in combinations.

✓ Taking your inhalers

− If you are given inhaled medicine to take regularly make sure that you use it
every day as prescribed, even if you feel well. This can also reduce the risks of
a flare-up.
− You can take your inhaled medicine in different ways. These include different
sorts of inhalers:
a) dry powder inhalers – suck in as hard as you can then hold your breath
for ten seconds

b) pressurized metered dose inhalers – they produce a puff of medication

like an aerosol – use a slow deep breath in and hold your breath for up to
ten seconds
c) spacers– these attach to pressurized metered dose inhalers to help you
breathe in the drug more effectively

d) nebulizers– these devices turn the medicine into a mist that you can
breathe in. They’re used in an emergency when you need large doses of
inhaled medicine, such as during a flare-up. Most people don’t need such
a big dose and get as much benefit from normal inhalers as long as they
use them correctly with a spacer device

• Mucolytic
✓ If you cough up a lot of sputum, you may be given a drug called a mucolytic as a
tablet or syrup. This may make your sputum thinner and easier to cough up.
 Pines City Colleges
(Owned and operated by THORNTONS INTERNATIONAL STUDIES, INC.)
COLLEGE OF NURSING

 ADDITIONAL MANAGEMENT:
• Oxygen
✓ Your health care team may send you to a specialist to see if oxygen therapy can
help you.
✓ Oxygen is only useful as a treatment for people with a low oxygen level. It doesn’t
help breathlessness in people whose oxygen level is not low. It’s not a treatment
for breathlessness, which in COPD, is usually caused by difficulty moving air in
and out as you breathe, rather than by a low oxygen level.

• Non-invasive ventilation
✓ If you’re admitted to hospital with a severe flare-up of your condition, you may
be offered non-invasive ventilation. This involves wearing a snug-fitting mask
over your nose, or over your nose and mouth, connected to a machine that
pushes air into your lungs.
✓ Non-invasive ventilation supports your breathing to give your muscles a rest and
gently helps with each breathe you take. This increases your oxygen level and
helps you breathe out more carbon dioxide.
✓ If you regularly wake up with a headache, tell your doctor. It can be a sign your
breathing is shallow at night and you might benefit from non-invasive ventilation
at home.

• Eating well and keeping a healthy weight

✓ It’s important to eat a balanced diet and maintain a healthy weight. Your doctor
or nurse can help you to work out what your healthy weight should be and can
refer you to a dietician or local scheme to help you if necessary.
✓ If you’re overweight, it will be harder for you to breathe and move around.
✓ If you’re losing too much weight because eating makes you feel breathless, or you
find it difficult to shop and prepare meals, try to eat little and often.
✓ Ask your doctor or nurse about nutritional supplements

• Take care of your emotional wellbeing

✓ Living with a long-term condition can affect many aspects of your life. Physical
symptoms such as breathlessness and coughing, feeling more tired and being
less active can mean you feel stressed, anxious or depressed.
✓ The risk of anxiety and depression is greater in people with more severe COPD,
people who have been admitted to hospital, and those with low oxygen levels.
✓ Treatment is available to support you. Many other people have experienced
anxiety and depression and have recovered. They are both very normal reactions
to living with COPD. Talk to your health care professional about medications and
counselling.
✓ Don’t bottle things up – talking to someone you trust, including your health care
professional, can help. It’s very important to stay active and sociable, and to learn
more about COPD. This will help you to understand and cope better with your
condition.
 Pines City Colleges
(Owned and operated by THORNTONS INTERNATIONAL STUDIES, INC.)
COLLEGE OF NURSING

PRESENTATION FLOW
CASE:
Seo P. Dee is a 35 years old female who was rushed to the Emergency Room of DGHMC due
to difficulty of breathing. She was later admitted to respiratory ward, with an initial diagnosis
of Chronic Obstructive Pulmonary Disease (COPD)secondary to Emphysema. Assessment of
history revealed that the patient is a heavy smoker and was exposed to cigarette smoke both
from home and work for the past 10 years. No consultations were made prior to this
admission.

PATIENT’S PROFILE:
Name: Seo P. Dee
Age: 35 years old
Sex: Female
Address: NA
Occupation: Call Center Agent
Civil Status: Single
Religion: Roman Catholic
Nationality: Filipino
Chief Complaint: Difficulty of Breathing

ROLES:
Patient: Amia Danice Macauyam
Family members: Leizl Ojares Matias, Trisha Luyun
Coworkers: Roselle Motio, Shanaiah Palsaen
Nurses: Rosane Manaois
Other Nurses (Extra): Trisha Luyun, Keisha Mangangey
Narrator: Anjielyn Payabyab
Doctor: Hannah Desiree Munar
Respiratory Therapist: Denver Dulay