Late Stage Complications of Emphysema (Nursing)

00:00 Now, here's another really important point. I want you to have these 4 complications in mind.

00:08 When we talk about the worst case scenario when a patient has COPD, these are 4 of the worst case scenarios that you'll see. With chronic obstructive pulmonary disease, the patient is going to have pulmonary hypertension. That means the arterial blood pressure in the pulmonary arteries is going to be extra high. So remember arteries take blood away from the heart so those pulmonary arteries are coming from the right atrium, tricuspid valve, right ventricle. Then those pulmonary arteries are taking blood over to the lungs. When that is elevated, that's going to really mess up the rest of the system. Cor pulmonale means cor means heart, pulmonale means lungs so that means the heart's in trouble and it's the lungs' fault. Remember that pulmonary hypertension we just talked about. Well, when that is elevated arterial pressures, now the right side of the heart is having to work extra extra hard because all the blood pressure in the lungs is elevated. So it's having to really overcompensate to take that blood that comes from right atrium, tricuspid, right ventricle over to the lungs. Now this workload is significantly increased. So the right ventricle will do the same thing that the left ventricle does when the systemic blood pressure is high. Now the right ventricle, because the blood pressure in the lung is high, it will start to get bigger to try to compensate. Initially, that's helpful but if this goes on too long that right wall is going to get thick and just as ineffective as the left ventricle does when you have systemic high blood pressure. So, cor pulmonale means right-sided heart failure because of the lung, meaning the lung pressures were elevated. Now when I have right-sided pressure, everything is going to back up. Right? So right ventricle, up to the tricuspid, right atrium out through the rest of the body. So if a patient has specifically right-sided congestive heart failure, they're going to feel like their liver is going to get kind of bloaty and yucky and they're not going to feel good when they eat, you're going to have issues with jugular vein distension. This one will look really big and bounding. You're also going to have edema, peripheral edema will be noted. So, think of everything backing up on the right side, jugular vein distension, liver is going to get kind of full, you're going to end up with feeling not good afterwards and we have some real issues with the blood supply and the liver and you're going to have pulmonary edema. Those are all signs of cor pulmonale. So make sure you pause for just a second and if I ask you the question "Why does COPD cause right-sided heart failure?" See if you can talk through the answer.

03:13 Okay, welcome back. Good job thinking through that answer on your own. Now the last 2, a little bit similar, they're going to have recurrent respiratory infections and they are at increased risk for chronic respiratory failure. Remember respiratory failure is you're not able to supply the body with enough oxygen that it needs or even get rid of enough carbon dioxide.

03:36 So, neither one is a good deal. So, all excellent nurses know these are 4 possible late stage complications of COPD. Be on the lookout for the signs and symptoms of these late stage complications.