CH NESE HOSPITAL 845 JACKSON STREET

Transcription

1 CH NESE HOSPITAL 845 JACKSON STREET - SAN FRANCISCO, CALIFORNIA TELEPHONE (415) CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) Trachea \ \ ) Diaphrcrm

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7 6 CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) *LUNGS AND THEIR FUNCTIONS Lungs are the main organs for breathing. Each time you breathe, air enters through your nose or mouth and passes through your wind pipe, known as trachea, and through the different branches from the trachea, known as bronchi. Finally the air reaches the tiny air sacs, called alveoli, where oxygen(02) enters the blood. When you breathe out, your lungs return to their smaller size and push out carbon dioxide(c02)-a waste product from your body. This exchange of 02 and C02 is very important because every cell in the body needs 02 to function. It takes a constant supply of 02 for the cells of your body to live. The disease which causes the obstruction of air flow in the lungs is called chronic Obstructive nary Disease or COPD which include chronic bronchitis, as, and Emphysema. In each of the three diseases, the flow of air is blocked or obstructed. It may be hard for your body to get enough 02 to meet its needs. Some people may have a combination of chronic bronchitis, asthma and emphysema. *CHRONIC BRONCHITIS Bronchitis is an inflammation of the lining of the bronchial tubes. Airways in your lungs become narrowed because of the swelling and inflammation, causing large amounts of mucus to be produced. This excess mucus/sputum can cause clogging of the airways. Symptoms of chronic bronchitis consist of persistent coughing up sputum/mucus for long periods. These symptoms recur each year, generally lasting longer each time. Causes of chronic bronchitis: Smoking and air pollution, the most common causes. Bronchial tubes irritation by bacteria or other diseases such as flu or infected tonsils. *ASTH MA Asthma is a chronic condition caused by substances or conditions, called triggers, that makes the air passages in the lungs inflamed and swollen. This condition narrows and collapses the small air passages. Inflammation may cause mucus to clog the already narrowed air passages. Frequently, a wheezing or whistling sound can be heard when breathing in or out. The person can often feel chest tightness or have difficulty breathing. Types of Triggers: Allergens are substances that some people are sensitive to, causing the lungs to become swollen and inflamed. Allergens include an is (cats, dogs, and other warm blooded

8 pets), house dust(in curtains, mattresses, and carpets), mold (grows in damp places, like the bathroom, closet, or basement), and pollens (from trees, grasses, and weeds). Air pollutants. Weather (too cold, dry, hot and humid). Infections (colds, flu, sinus infections and bronchitis). Certain food additives(such as sulfites, which are used as preservatives in alcohol and some foods). Certain medications(aspirin, ibuprofen, and some prescription drugs). *EMPHYSEMA Some of the air sacs deep in your lungs may have been damaged-due to smoking or other inhaled irritants. - Emphysema does not develop suddenly. It comes on gradually and may begin wit1~ only a slight increase in breathing effort. Any increase in activity may cause shortness of breath. It may reach a point where every breath requires a major effort. Emphysema can also cause heart problems. Symptoms of emphysema: Cough~ Bringing up mucus Wheezing Shortness of breath Difficulty breathing *MANAGEMENT OF COPD ) a a p p ~ p ~i.a A a a ab~ Shortness of breath is often a major problem for COPD patients. Below are some techniques to control your breathing and clear your lungs of excess mucus/sputum which can help you breathe better. 1. CONTROLLING YOUR BREATHING: Pursed lip breathing and belly breathing are great aids for controlling your breathing any time you are short of breath. These breathing techniques can also help ypu climb stairs, carry out household tasks or other energy exerting activity.

9 PURSED LIP BREATHING Pursed lip breathing can help keep the airways and air sacs open and slow down your breathing: 1. Breathe in through your nose slowly, keep yur mouth closed. 2. Pucker your lips in a whistling position and breathe out slowly, gently tightening your stomach muscles to help. push the air out through your lips. Be sure to use enough pressure, but do not force exhalation. Stay relaxed and exhale at least twice as long as you inhale. DIAPHRAGMATIC BREATHING (belly breathing) Belly breathing is another correct way of breathing and will help you breath better when you are short of breath: 1. Start by placing one hand on your belly just below the ribs and the other hand on the upper part of your chest. 2. Breathe in through your nose so that your belly moves out against your hand as far as it will go. Keep the other hand on your chest which should be as still as possible. 3. As you breathe out slowly and fully through pursed lips, press your belly gently upward and inward with your hand. Concentrate on exhaling at least twice as long as you inhale. Keep your chest still so that it is. your diaphragm and not your neck and chest muscles doing_the work of breathing. 2. CLEARING YOUR LUNGS Difficulty breathing with excess mucus secretions is another problem for COPD patients. Drinking plenty of liquids throughout the day is a good way to help keep secretions thin and easy to bring up. Try to drink at least 6 to 8 glasses of water.or other liquids per day, unless you have a problem with fluid retention. In that case, you need to discuss with your doctor about your fluid intake. Effective coughing is one of the simplest and most productive ways to clear excess mucus from your lungs. The best time to cough effectively is upon rising in the morning. Effective coughing: (1) Get ready: have a glass of water ready to rinse your mouth have a supply of tissues ready to dispose of mucus/sputum Situp (2) Breathe in deeply through your nose (3) Exhale slowly and fully with your lips pursed. Remember to breathe out twice as long as you breathe in. (4). Inhale slowly and deeply again but instead of exhaling this time, bend slightly forward and cough two or three times. Keep your mouth open but covered with a tissue.

10 (5). Do not swallow the mucus. Use tissues or paper towels to dispose of mucus. It is very important to be relaxed and comfortable in order to get maximum benefit from any clearing technique or techniques for controlling your breathing by: wearing loose and comfortable clothing clearing your mouth of all food or chewing gum not practicing on a full stomach. *Note: Try to use this effective cough technique any time you cough or feel the need to cough. 3. USING YOUR BREAThING AIDS Several kinds of devices are used to treat COPD. Most of them help deliver medicines, oxygen, or moist air deep into the lungs and help clear mucus out of your airways. Your doctor will order them for you if needed. NEBUI1IZERS A Nebulizer (inhaler) is a device made to deliver a mist of medicine that you can breathe deeply into your lungs. The medicines comes packaged in a spray container. Other kinds of nebulizers plug into the wall to create a mist. Your doctor may also order a spacer, if needed, to make it easier for you to use a nebulizer. OXYGEN If there is too little oxygen in your blood, your doctor may order oxygen equipment for you. Oxygen is a medicine. You need to take the right amount at the right time. Never use oxygen more than what your doctor ordered. Too much oxygen can damage your lungs and even slow your breathing..1_i ~ - ~ ii ~ If your fluid intake is not adequate, dry air can make the mucus/sputum in your lungs sticky and hard to cough up. When mucus/sputum stays in your lungs, it clogs your airways and allows for bacteria to grow. A humidifier or a vaporizer puts moisture in the air which helps soften and loosen the mucus.

11 10 MEDICATIONS: There are different types of medications that may help you breathe better. Your doctor will decide which medications to use, when and how to use them. MEDICINES I BRONCHODILATOR WHAT DO: THEY Open your airways and allows you to breathe better. STEROIDS *Reduces swelling and inflammation in the airways. *Helps decrease wheezing and eases breathing. ANTIBIOTICS *Fight bacterial infection. *Help prevent severe infections. AVAILABLE FORMS: *Pills, liquids, inhalers, injections. *pills, inhalers, injections. *Pills, liquid, injections. POSSIBLE SIDE EFFECTS: *Increased heart rate, nervousness, shakiness, headaches, nausea or upset stomach, loss of appetite, dizziness. *J4outh sores, sore throat, fatigue, nausea, vomiting,. weight loss, decrease appetite, weakness, dizziness. *S]cin ras~i, itching, hives, upset stomach, nausea or vomiting, diarrhea. ThINGS TO REMEMBER: *Know the names of your medications, keep a list. *Take the medications exactly as directed. do not increase the amount without checking with your doctor. *Know the names of your medications, keep a list. *Do not. stop taking or change the amount on your own. *After using inhalers, rinse mouth with water to avoid irritation or infection. *Complete full course of medications your doctor ordered. *Follow instructions carefully. *Consult your doctor if any side effects occur. *Consult your doctor if any side effects occur. *If you have any other questions, please ask your doctor, nurses, and or pharmacist. ~ 1995, Chinese Hospital, Department of Education. All Rights Reserved.

12 1. Place the mouthpiece into the Opening in the reservoir bag. Twist to lock. ~IIi i~i: 5. Place the mouthpiece in your mouth, Close your lips tightly around it. II~fl~A fl4, ~ 6. Press the top of the medicine dpwi~ once to release one puff into the bag. 8. Breathe out slowly into the bag. ~viill~~. ~ET,~ 2. Gently open the bag. 3. Shake the entire unit. ~~JfL~ ~. 4. Plac~e the inhaler into thi top of the mouthpiece. 7. Inhale deeply and slowly through (he mouthpiece until the bag collapses or you cannot breathe in any longer. I bid your breath for 5 -~ 10 seconds. If you hear a whistling sound, breathe slower until the sound. stops. ~i~th)fl ~ ~ie.~- 1O~, fl~l~j:1n~), ~ j~~ttj~, ~ ~*~ih. 9. Repeat the breathing in and out a second time. to. I 1. ~7~fl8) If your doctor has ordered iiioie than one puff, wait at least 2 to 3 minutes before the next puff. Repeat steps 5 to 9 for each puff. ~~ ~ ~ Do not increase the number or frequency of puffs without asking your doctor. ~

13 This chart shows an empty method for CARE OF YOUR INHALER estimating the contents ofyour inhaler. Simply place your canister in a bowl of ~ water and compare its position with the DRUG DELIVERY SYSTEM FOR chart below. METERED DOSE INHAIERS ~, ~ ~W7J~, ~zflti~: I. Wash your mouthpiece with warm running water at least once a day. ~ H~1~1~ Empty 2. Wait until mouthpiece is completely Instructions for use and care dry before storing. ~ji~ ~;j-~k InspirEase helps inhalers deliver 3. Replace the reservoir bag every 2 to ½ l~ull medication to the kings and makes 3 weeks or if there is a hole or lear. (100 puffs) it easier for you to use them. After you press your inhaler, the 4. Replace the mouthpiece as needed or. medication is released and stored when it breaks. Full in the bag, giving you time to (200 puffs) breathe in the medication. ~ ~, im~n~ H~&A~4~i.