CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
PROBLEM
Chronic obstructive pulmonary disease (COPD) is a chronic, progressive, debilitating disease of the lungs that does not have a cure. Most people have a combination of emphysema and chronic bronchitis. Persons with COPD usually have some of the following symptoms: cough (usually productive), shortness of breath at rest or with exertion, wheezing, decreased energy level, and weight loss.
CAUSE
COPD is most commonly associated with cigarette smoking. COPD is also caused by long-term exposure to pulmonary irritants in the environment (e.g., coal dust). Repeated respiratory infections may also contribute to the development of COPD.
PREVENTION
A.Avoid smoking and exposure to secondhand smoke.
B.Avoid exposure to environmental irritants, including pollution, household cleaning products, and smoke from fires.
TREATMENT PLAN
A.Stopping smoking is the most important treatment. Talk to your healthcare provider about support for stopping. It is never too late to stop smoking. 
Patient Teaching Guide Nicotine Dependence.
B.Get the flu vaccine every year.
C.There are two pneumococcal vaccines; you may need to be given both vaccines.
D.You may be given one of the pneumonia vaccines at the same time as you get the flu vaccine.
E.Reduce your exposure to lung irritants and extremely hot and cold air temperatures.
F.Begin an exercise program with your healthcare provider’s approval. Walking is a good aerobic exercise. Begin with a pace that is tolerable and easy to maintain, then increase the duration and intensity of the exercise as tolerated. Stop if you experience shortness of breath or chest pain. A realistic goal may be 5 to 10 minutes a day, eventually increasing to 30 to 40 minutes a day.
Patient Teaching Guide How to Use a Metered Dose Inhaler.
H.Use slow, deep breathing or pursed-lip breathing when you are short of breath. Breathe out like you are blowing out a candle.
I.Ask your health care provider if you are a candidate for low-flow oxygen treatment when shortness of breath occurs at night and causes insomnia and restlessness.
J.If you are prescribed theophylline to help control your respiratory systems, your blood level needs to be monitored.
Activity: Group activities together, such as planning shopping with going to the post office. Schedule rest periods throughout the day. Exercise programs should help increase activity tolerance.
Diet: Good nutrition is important. Six small, high-calorie meals a day are suggested. Avoid excessive intake of carbohydrates, especially simple carbohydrates like candy, soda, and potato chips. Milk and milk products increase the production of mucus. Ask your healthcare provider to refer you to a dietitian if nutritional problems persist.
Medications:
You Have Been Prescribed: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Need to Notify the Office If:
A.Your mucus changes color or increases in amount, or if the consistency is becoming thicker.
B.Your wheezing or shortness of breath is getting worse after you start your medication.
C.You are having trouble walking or talking because of your shortness of breath.
D.Other: ___________________________________________________________
Phone: ____________________________
You should have a follow-up appointment in 3 months unless you worsen before then.
If you are prescribed theophylline, your blood level needs to be monitored whenever you have a new illness, worsening chronic illness, or change in medications that may alter theophylline clearance (e.g., fever >102°F sustained for >24 hours, hepatitis). Call 911 and get emergency medical help for severe headache, high blood sugars, severe vomiting, irregular heartbeats, seizures, or confusion.
RESOURCE
A Patient’s Guide to Aerosol Drug Delivery is available at http://www.copd-alert.com/AerosolDrug.pdf
PATIENT TEACHING GUIDE