COPD: Symptoms and Causes (Nursing)

00:00 Now the symptoms of COPD can be different for each person, but common symptoms are increased shortness of breath that gets progressively worse, they have frequent coughing with and without mucus, and increasingly breathless. They have a wheeze and they have tightness in their chest. These are the very common symptoms of COPD. Now causes of COPD, the most common cause in the United States is long-term exposure to tobacco smoke. So that's the number 1 cause of COPD in the states. In other countries that have some difficult conditions to work with, long-term exposure to indoor air pollution has a greater risk. I got the coolest opportunity to go to Guatemala and in the mountains and we got to do, I didn't do the surgery but I did the recovery of these patients after surgery, and they're lungs were in horrible shape. That's because the majority of these women cooked inside over stoves and they inhaled all these fumes which was like much worse than smoking with the intensity of the smoke in an enclosed space that they dealt with for hours and hours over periods of time. So that in poor countries is one of the risks. Patients are exposed to indoor air pollution and even outdoor air pollution can be a global risk. Now other causes, we talked about outside air pollution, in their jobs they could have occupational exposure to some noxious dust or gases, they might be exposed to fumes from burning fuel (talked about that like my patients in Guatemala), or they might have this genetic factor. Now, alpha-1 antitrypsin deficiency emphysema is a very specialized case. That's not a very common reason, but it is a possible one. Now, COPD has a progressive decline. The damage to the airways from COPD will just worsen over time because they have got chronic inflammation, you got chronic scarring, they have increased numbers of goblet cells. Now goblet cells are these goblet-shaped cells and their main job is to produce mucus. In COPD, they can work overtime so they have mucous gland hyper, meaning elevated, plasia. They also have pulmonary fibrosis, the lungs become real stiff. Now your lungs are fairly elastic, they expand and contract, expand and contract, expand and contract. Fibrotic lungs do not. That lung tissue is stiff and is not as elastic as you need it to be. Now the airways even become smaller, they come narrow and they have fewer airways that are productive. That's another reason it's progressive decline. Finally, the airways collapse, the alveolar walls become destroyed in emphysema so that tissue is no longer functioning and effective when those walls are collapsed. So breathing becomes increasingly difficult for a patient with COPD. Their carbon dioxide, CO2, and oxygen exchange is impaired.

03:03 Their lung tissue just isn't as effective anymore so even though they have a blood supply that's coming up to the lungs, the alveoli are not able to exchange that O2 and CO2. So air gets trapped in those lungs. It's harder for them to exhale than to inhale. So they can take a breath in but it kind of gets stuck or trapped in there. That makes it very difficult for the patient. It also starts to affect their lung tissue. If it stays chronically hyperinflated, that will actually change how your body looks externally. So remember, COPD from this definition is an umbrella term that includes chronic bronchitis and emphysema. Now it's a little bit different than the World Health Organization definition, that's okay. We've educated you to all those definitions.