Chronic Obstructive Pulmonary Disease in Primary Care looks at the treatment of COPD in primary care: in the GP surgery, in outpatient clinics, and through district and community nursing.

Features:

• Helps nurses and other healthcare professionals to support these patients
• Details how much can be done to help these patients from a psychological, social and holistic perspective to cope with their everyday activities

Contents

The Background to COPD

• The prevalence of COPD
• Definition of COPD
• Pathophysiology of COPD
• Chronic bronchitis
• Emphysema
• Chronic asthma
• Comparison of infl ammation in COPD and asthma
• The risk factors for COPD
• Primary risk factors
• Associated risk factors

Presentation of COPD

• Progression of COPD
• Clinical symptoms
• Breathlessness.
• Scales to measure breathlessness
• Cough and sputum production
• Wheeze
• Chest pain
• Frequent chest infections
• Ankle oedema
• Anorexia
• Weight loss
• Fatigue and depression
• Disability
• Complications of COPD
• Corpulmonale
• Anaemia
• Polycythaemia
• Pneumothorax
• Respiratory failure

Diagnosis and Patient Assessment

• Clinical history
• Patient assessment
• Patient history
• Risk factors
• Medical history
• Family history
• Drug history
• Known allergies/drug reactions
• Social history
• Impact of the disease on daily living
• Respiratory examination of the patient
• General examination – fi rst impressions
• Physical examination of the chest

Investigations to Diagnose COPD

• Lung function testing
• What is spirometry
• Types of spirometers
• Volume displacement spirometers
• Flow-sensing spirometers
• Spirometry measurements used to diagnose COPD
• Complications and contraindications to performing spirometry
• Preparation of the patient for spirometry
• Procedure for spirometry
• Common reasons for inconsistent spirometry results
• Interpreting the results of spirometry
• Normal spirometry
• Obstructive pattern
• Restrictive pattern
• Mixed pattern
• Reversibility testing
• Other useful investigations
• Chest X-ray
• Computerised tomography scan
• Haematology
• Electrocardiogram
• Sputum culture
• Alpha-1 antitrypsin defi ciency screening
• Pulse oximetry
• Arterial blood gas analysis

Nonpharmacological Management of Patients with COPD

• Smoking cessation
• Cigarette smoking and COPD
• Role of the health professional in helping smokers quit
• Intervention steps for health professionals to take
• Withdrawal symptoms
• Nicotine replacement products
• Other nonpharmacological management
• The importance of exercise
• Management of breathlessness
• Nutrition in COPD
• Dietary requirements for patients with COPD
• Dietary advice for patients

Pharmacological Management of Patients with Stable COPD

• Inhaled bronchodilator therapy
• Short-acting beta-2 agonists
• Long-acting beta-2 agonists
• Short-acting anticholinergics
• Long-acting anticholinergics
• Combined short-acting inhaled therapy
• Theophylline
• Inhaled corticosteroid therapy
• Long-term clinical trials of inhaled corticosteroids in COPD
• NICE guidelines advice on inhaled corticosteroids in COPD
• Oral steroids
• Inhaler devices
• Pressurised metered-dose inhalers
• Breath-actuated inhalers
• Dry powder inhalers
• Nebuliser therapy
• Indications for nebuliser therapy
• Nebuliser trials
• Miscellaneous COPD therapy
• Influenza vaccination
• Pneumococcus vaccination
• Mucolytic therapy
• Prophylactic antibiotic therapy
• Short-burst oxygen therapy

Management of Acute Exacerbations of COPD

• Definition of an exacerbation
• Causes of an exacerbation
• Management of an acute exacerbation
• Treatment of an exacerbation at home
• Antibiotics
• Oral corticosteroids
• Bronchodilators
• Diuretics
• Nursing interventions
• Management of an exacerbation in hospital
• Investigations
• Treatment
• Discharge planning from hospital
• Self-management education

Other Treatments in the Management of COPD

• Pulmonary rehabilitation
• Programme content
• Patient selection
• Long-term oxygen therapy
• Domiciliary oxygen concentrators
• Indications for LTOT
• Methods of oxygen delivery
• Care and management of patients using LTOT
• Travel and fl ying for patients using LTOT
• Noninvasive ventilation
• Care and management of patients with NIV
• Lung surgical interventions
• Bullectomy
• Lung volume reduction surgery
• Lung transplant

COPD and Its Effects on Activities of Living

• Difficulties with daily living
• Assessing quality-of-life issues
• Coping strategies
• Cognitive behavioural therapy
• Adapting daily activities of living
• What is palliative care
• When to implement palliative care
• Patient choice
• Advance directives
• Strategies for improving symptom control
• Breathlessness
• Cough
• Fatigue
• Carers
• Complementary therapies

Specialist Support within Primary Care for Patients with COPD

• The role of the specialist nurse
• The role of the consultant respiratory nurse
• The role the community matron
• The role of the practice nurse
• The role of the physiotherapist
• The role of the occupational therapis

Index

click here to see books • videos • cd-roms of related interest