Chronic obstructive pulmonary disease (COPD) nursing NCLEX lecture on the pathophysiology, signs and symptoms, types (chronic bronchitis and emphysema), complications, and how it is diagnosed. COPD is a pulmonary disease that causes chronic obstruction of airflow from the lungs. The cause of the limited airflow is due to chronic inflammation and narrowing of the bronchioles which becomes deformed over time and produces excessive mucous (mainly in chronic bronchitis) and the loss of elasticity of the alevoli sacs (mainly found in emphysema). These problems lead to limited gas exchange such as respiratory acidosis due to extreme retention of carbon dioxide (CO2) and low availability of oxygen. COPD is a "catch all" term used to describe diseases that limit airflow which now includes diseases such as chronic bronchitis and emphysema. Patients with chronic bronchitis are sometimes referred to as "blue bloaters". This is because of the cyanosis and edema (hence the bloating) experienced with this disease. Patients with emphysema are sometimes referred to as "pink puffers". These patients do not experience cyanosis, although they have low oxygen levels but maintain a "pink" appearance due to the compensatory state of hyperventilation keeping the oxygen level sufficient enough. The hyperventilation leads to the increased usage of the accessory muscles which leads to a barrel chest look (increased anteroposterior diameter noted on inspection). Signs and symptoms of COPD include: chronic dry or productive cough, lack of energy, extreme dyspnea, abnormal blood gases, abnormal lung sounds (coarse crackles or wheezing), barrel chest, tripod position for breathing, poor nutrition, recurrent lung infection etc. Complications of COPD include: heart disease such as right-sided heart failure, pulmonary hypertension, pneumothorax, pneumonia, increase risk of lung cancer. Chronic obstructive pulmonary disease is diagnosed with spirometry. Don't forget to watch Part 2 which includes the nursing interventions and medication regime for COPD.

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