《COPD level3》.pptx

Chronic obstructive pulmonary disease (COPD);Scenario;On examination:;Laboratory tests at admission ;Medication on admission;Clinical sighs and symptoms of COPD;Interpretation of this pt’s pulse oximetry and arterial gases, which considered to be type II respiratory falure.;Clinical difference between asthma and COPD;Comments on the current drug therapy;The role of O2 in this patient;Describe the care plan for this pt;Review the use of nebulisers: – review the need for nebulisation, check inspiratory flow rate – consider use of tiotropium. Review of changes in treatment: discuss with GP the changes in medicines, especially the warfarin and pain control. Check the plan for acute exacerbations: discuss with patient and GP what plan is in place. Review the need for bone protection: osteoporosis is present, need to check why no bone protection medication has been given, therefore start if no contraindications. Check understanding of anticoagulation: careful monitoring of INR.;What are the key aims for this pt and the professional;Explain how spirometry can be used to monitor this pt;Normal FEV1 excludes COPD as a diagnosis, a normal peak flow does not. The patient inhales maximally and then exhales as forcefully as possible. The volumes recorded are compared with predicted values based on age, sex and height. The ratio of FEV1/FVC airflow obstruction is diagnosed, as well as the severity. The VC in COPD may be greater than the FVC, because of floppy airways. Spirometry does not distinguish between airflow obstruction due to asthma and COPD, but in conjunction with reversibility testing it can do so. FEV1 can therefore be diagnostic, assess severity and prognosis and monitor progression of disease. ;What are the social issues in treating this patient at home?