COPD Case Study
Breathing new life into
COPD management
16 Nursing made Incredibly Easy! July/August 2011
www.NursingMadeIncrediblyEasy.com
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) promotes awareness, education, and care for patients with chronic obstructive pulmonary disease (COPD). The committee annually reviews evidence-based guidelines for prevention, diagnosis, and treatment of COPD. We give you an overview of these guidelines.
By Brenda L. Smith, MSN, RN, CMSRN Nursing Instructor • UPMC Shadyside School of Nursing • Pittsburgh, Pa. Frederick J. Tasota, MSN, RN Critical Care Clinical Specialist • UPMC Presbyterian Hospital • Pittsburgh, Pa. …show more content…
Possible physical assessment findings include decreased breath sounds, a barrel-shaped chest, and pursed-lip breathing (see Picturing a barrel-shaped chest). The healthcare provider will confirm a diagnosis of COPD with spirometry. Considered the gold standard for diagnosing and monitoring disease progression, spirometry is the most accurate and objective means to measure airflow limitation. It also helps to differentiate COPD from other pulmonary diseases. Spirometry includes measurement of forced vital capacity (FVC), the maximal amount of air that can be rapidly and forcefully exhaled from the lungs after maximal inspiration, and forced expired volume achieved in 1 second (FEV1), the volume of air expired in the first second of FVC. The ratio of FEV1/FVC is then calculated. A normal FEV1/FVC ratio is greater than or equal to 70% of the predicted value based on height, age, and gender. A calculated ratio of less than 70% confirms airflow obstruction. COPD severity is classified as stages I through IV based on spirometry measurements (see Using GOLD staging for
COPD management
16 Nursing made Incredibly Easy! July/August 2011
www.NursingMadeIncrediblyEasy.com
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) promotes awareness, education, and care for patients with chronic obstructive pulmonary disease (COPD). The committee annually reviews evidence-based guidelines for prevention, diagnosis, and treatment of COPD. We give you an overview of these guidelines.
By Brenda L. Smith, MSN, RN, CMSRN Nursing Instructor • UPMC Shadyside School of Nursing • Pittsburgh, Pa. Frederick J. Tasota, MSN, RN Critical Care Clinical Specialist • UPMC Presbyterian Hospital • Pittsburgh, Pa. …show more content…
Possible physical assessment findings include decreased breath sounds, a barrel-shaped chest, and pursed-lip breathing (see Picturing a barrel-shaped chest). The healthcare provider will confirm a diagnosis of COPD with spirometry. Considered the gold standard for diagnosing and monitoring disease progression, spirometry is the most accurate and objective means to measure airflow limitation. It also helps to differentiate COPD from other pulmonary diseases. Spirometry includes measurement of forced vital capacity (FVC), the maximal amount of air that can be rapidly and forcefully exhaled from the lungs after maximal inspiration, and forced expired volume achieved in 1 second (FEV1), the volume of air expired in the first second of FVC. The ratio of FEV1/FVC is then calculated. A normal FEV1/FVC ratio is greater than or equal to 70% of the predicted value based on height, age, and gender. A calculated ratio of less than 70% confirms airflow obstruction. COPD severity is classified as stages I through IV based on spirometry measurements (see Using GOLD staging for