Chronic Obstructive Pulmonary Disease (COPD)

Transcription

1 Chronic Obstructive Pulmonary Disease (COPD) Presented by: APS Healthcare Southwestern PA Health Care Quality Unit (APS HCQU) October 2012 pl

2 Disclaimer Information or education provided by the HCQU is not intended to replace medical advice from the consumer s personal care physician, existing facility policy or federal, state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of the topic presented. Certificates for training hours will only be awarded to those who attend a training in its entirety. Attendees are responsible for submitting paperwork to their respective agencies. 2

3 Objectives Define Chronic Obstructive Pulmonary Disease (COPD) Identify risk factors and signs and symptoms of COPD Describe medical and home management techniques used to support individuals with COPD 3

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5 Functions of Air Exchange Purpose of lungs is to bring oxygen into the body and remove carbon dioxide Breathe air in through the nose, mouth or both Air travels down trachea or windpipe Air continues into the lungs through the bronchi Air is then filtered through the alveoli 5

6 Chronic Obstructive Pulmonary Disease (COPD) One of the leading causes of illness and death worldwide Chronic process Can not be reversed No cure Diagnostic Conditions Emphysema Chronic Bronchitis 6

7 Signs and Symptoms Coughing that is not related to cold symptoms Shortness of Breath (SOB) Wheezing Chest tightness Symptoms worsen with time 7

8 Behavioral Signs and Symptoms of COPD Coughing that is not related to cold symptoms Pounding on chest or difficulty swallowing Increased behaviors Decrease in activities 8

9 Causes and Risks for COPD Exposure to tobacco smoke Air pollution / occupational exposure Age 9

10 Diagnosing COPD Physical exam Lung function tests (PFT) Chest X ray CT scan Lab tests 10

11 Treatment Plan for COPD Smoking cessation programs Medications Bronchodilators Inhaled steroids Treatment for respiratory infection Oxygen therapy Pulmonary rehabilitation 11

12 Management of Equipment Oxygen Very FLAMMABLE Notice when traveling Back up supply General use Protect skin Nebulizer Clear instructions for proper use Inhaler Administer measured dose 12

13 Maintain Health to Prevent Exacerbation Emotional well being Reduce stress Exercise Adequate sleep Nutrition Prepare for emergencies 13

14 Emotional Well being Go outside whenever possible. Keep up with activities or hobbies they enjoy. Stay involved with others. Share their feelings with family, friends or staff. Get adequate sleep. Set and follow a realistic daily schedule. 14

15 Manage Stress Identify triggers to stress Practice relaxation exercises 15

16 Exercise Seek approval from doctor before beginning Benefits of regular exercise Help to make breathing easier Improves overall strength and endurance Improves strength of respiratory muscles Be creative Stop if individual becomes short of breath 16

17 Adequate sleep Develop specific bedtime rituals and stick to them, even on weekends. Take a warm shower or bath before bedtime to relax. Encourage the individual to avoid heavy eating, if hungry offer a small light snack alternative. Do not engage in exercise or strenuous activity immediately before bedtime. Avoid caffeine. Do not nap during the day. 17

18 Nutrition Eat healthy foods Weight management Avoid junk foods 18

19 Prepare for Emergencies Know signs and symptoms Seek immediate medical attention Keep phone numbers handy for the doctor and hospital 19

20 Home Environment Avoid: Tobacco smoke Dust Cleaning products with strong chemical odors Fragrant sprays, lotions, and candles Use of humidifier 20

21 Coping and Management of COPD Green zone Yellow zone Red zone 21

22 Getting the Most from Medical Appointments Talk with doctor Make a list of questions to ask Keep a record of changes in condition Use Social Stories or Rehearsal Guides Medical Appointments Guideline 22

23 Suggested Accompanying Trainings Smoking Cessation 23

24 References COPD Flare ups, Spiriva HandiHaler. Retrieved on July 9, 2012 from htm Chronic obstructive pulmonary disease, PubMed Health, U.S. National Library of Medicine. Retrieved on August 1, 2012 from COPD Definition, Mayo Clinic. Retrieved on August 13, 2012 from 24

25 References Chronic Obstructive Pulmonary Disease (COPD, Chronic Obstructive Lung Disease, COLD), MedicineNet.com. Retrieved on August 13, 2012 from /article.htm MY COPD ACTION PLAN, American Lung Association. Retrieved on September 10, 2012 from plan.pdf Breathing with COPD, About.com. Retrieved on September 17, 2012 from The Gray Center for Social Learning and Understanding. (n.d.) What are social stories? Retrieved from are social stories (April 28, 2011) 25

26 To register for future trainings, or for more information on this or any other physical or behavioral health topic, please visit our website at 26

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28 Evaluation Please take a few moments to complete the evaluation form found in the back of your packets. Thank You! 28

29 Test Review There will be a test review after all tests have been completed and turned in to the Instructor. 29

30 PURSED LIP BREATHING EXERCISE Smell the rose Blow out the candle Have the individual sit in a comfortable position and relax. Slowly take a deep breath in through the nose. Draw the lips together as if individual were going to whistle and blow out through pursed lips slowly and evenly. Try to make the time blowing out longer than when it took to take a breath in. Repeat this procedure several times until the individual s shortness of breath disappears. If the individual feels any dizziness, rest until it stops. Practicing pursed lip breathing on a daily basis, 3 to 4 times a day, will allow the individual to use it effectively during times of need, especially when the individuals shortness of breath worsens Source:

31 Relaxation Techniques Visualization Relaxation Visualization can include a variety of ways of using your imagination. Some forms of visualization rely heavily on the imagination, while others are guided so some details are provided, through descriptions, audio, and/or video. Here are some relaxation examples of ways to use visualization: Watch a video of a place you would like to be (on a beach, flying through the clouds, traveling, sitting by a relaxing campfire, watching fish in a tank, etc) and imagine spending time there. Listen to a relaxation script that includes guided visualization. Use your imagination to picture the scenes described. Read a book, and use your imagination to visualize the characters, places, and events. Imagine a safe place, a calming environment, or a relaxing scene. Create all the details in your mind. Picture all the sights, sounds, and smells. Other examples of relaxing visualizations include imagining the following: floating on a cloud watching a burning candle lying on a beach traveling in a canoe sitting by a calm pool or pond walking by the lake strolling on a country road walking in a peaceful forest driving a fast car on a beautiful road playing a sport and doing well gazing at the stars Adapted and used with permission from Candi Raudebaugh, Inner Health Studio, Copyright

32 Creative Expression Relaxation It is possible to use creative activity to relax, even if such activities are unfamiliar or you do not see yourself as a creative person. It is important to focus on the process rather than the end product. Enjoying the process of being creative can be highly therapeutic and very relaxing. Do an activity that allows you to make something. Set aside enough time so you can do the task slowly and enjoy the process. Listen to a creative expression relaxation script that guides you to express yourself through a creative task and relax. Watch an instructional video and follow along with the demonstrated task. Other specific relaxation examples of ways to relax using creativity include: drawing painting pastels dance playing a musical instrument writing a song writing a letter scribbling or doodling singing moving rhythmically drama and acting carpentry or woodwork mechanics building something taking an object apart and putting it back together calligraphy digital illustration photography making videos stamping card-making knitting sewing Adapted and used with permission from Candi Raudebaugh, Inner Health Studio, Copyright

33 Sensory Relaxation The senses (vision, hearing, touch, taste, smell) can be powerful methods of relaxation. For those with sensory sensitivity, it can be necessary to control the levels of exposure to particular sensations. For people who enjoy sensations and find them relaxing, it is important to find ways to experience a variety of calming sensations. Some relaxation examples of how to use sensory techniques include: Determine which senses are the most calming for you, and which kind of sensations may provoke stress. For example, do you enjoy having music in the background while you work, or do you need a quiet environment to perform best? Do you prefer the lighting to be bright or dim? Experiment with different environments and adjust yours accordingly. Use your senses to promote relaxation in daily life. Enjoy participating in activities that use your vision, hearing, sense of touch, smell, or taste. Some specific ways to use sensation to relax: taking a warm bath applying a cool pack to your forehead or neck using scented candles, air fresheners, or cooking food to provide pleasing smells massage manicures brushing your hair wearing soft clothing digging in the mud walking barefoot in grass petting a dog or cat listening to music watching TV using colored lamps to light a room putting up a string of colored lights eating flavorful food adding spice to food rolling dough Adapted and used with permission from Candi Raudebaugh, Inner Health Studio, Copyright

34 Muscle Relaxation Muscle relaxation can involve physical tasks to release stress or engaging in progressive relaxation exercises, where muscles are consciously relaxed, one muscle group at a time. Low relaxation quiz scores in muscle relaxation suggest a lack of familiarity with engaging in muscle relaxation techniques, and the need to explore different kinds of physical muscle relaxation that may be enjoyable. High scores indicate a tendency to react physically to stress (for example, by tensing up) and the ability to use physical strategies to relax. Examples of ways to use muscle relaxation include: Engage in a physical activity to release stress and promote relaxation. Specific relaxation examples of physical strategies include: running walking swimming lifting weights stretching yoga tai chi pilates dance housework playing a sport shake out tension yawn and stretch massage physical work (e.g. mowing the lawn, vacuuming, hammering) Adapted and used with permission from Candi Raudebaugh, Inner Health Studio, Copyright

35 MY COPD ACTION PLAN Actions to take if my symptoms get worse This plan is to be completed by patients with the help of their physician/health care provider. The patient should bring this form to each doctor appointment and update as needed. This symptom list below is comprehensive but you may experience other symptoms. If you are unclear as to the actions you should take, please contact your physician/health care provider. Green Zone: I am doing well today Usual activity and exercise level Usual amounts of cough and phlegm/mucus Sleep well at night Appetite is good Actions Take daily medicines Use oxygen as prescribed Continue regular exercise/diet plan At all times avoid cigarette smoke, inhaled irritants Yellow Zone: I am having a bad day or a COPD flare* More breathless than usual I have less energy for my daily activities Increased or thicker phlegm/mucus Change in color of phlegm/mucus Using quick relief inhaler/nebulizer more often Swelling of ankles more than usual More coughing than usual I feel like I have a chest cold Poor sleep and my symptoms woke me up My appetite is not good My medicine is not helping Actions Continue daily medications Use quick relief inhaler every hours Start Prednisone: Start Antibiotic: Use oxygen as prescribed Get plenty of rest Use pursed lip breathing At all times avoid cigarette smoke, inhaled irritants Call provider if symptoms don t improve * Please call your physician immediately if your symptoms persist (see Red Zone below). Red Zone: I need urgent medical care Severe shortness of breath even at rest Not able to do any activity because of breathing Not able to sleep because of breathing Fever or shaking chills Feeling confused or very drowsy Chest pains Coughing up blood For more information visit or call LUNGUSA ( ) Actions Call 911 or have someone take you to the emergency room Increase oxygen to: Take Prednisone:

36 MY COPD MANAGEMENT PLAN This plan is to be completed by patients with the help of their physician/health care provider. The patient should bring this form to each doctor appointment and update as needed. General Information Name: Emergency Contact: Physician/Health Care Provider Name: Date: Phone Number: Phone Number: Lung Function Measurements Weight: lbs FEV1: L % predicted Oxygen Saturation: % Date: Date: Date: General Lung Health Care Flu vaccine Date: Next Flu Vaccine Due: Pneumonia vaccine Date: Next Pneumonia Vaccine Due: Smoking status Never Past Current Quit Smoking Plan Yes No Exercise plan Yes No Walking Other min/day days/week Diet plan Yes No Goal Weight: Pulmonary Rehabilitation Yes No Inhaled Daily Medicines Quick Relief Long Acting Inhaled Steroid Combination Nebulizer Name of Medicine How Much to Take When to Take It Other Medicines for COPD Quit Smoking Aid Name of Medicine How Much to Take When to Take It Other Oxygen Resting: Increased Activity: Sleeping: Advanced Care and Planning Options Lung Transplant Lung Reduction Transtracheal Oxygen Night-time Ventilator Advanced Directives Other Health Conditions Anemia Anxiety/Panic Arthritis Blood Clots Cancer Depression Diabetes GERD/Acid Refl ux Heart Disease High Blood Pressure Insomnia Kidney/Prostate Osteoporosis Other: For more information visit or call LUNGUSA ( )