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Directions Caring for the Patient with  COPD Directions Caring for the Patient with  COPD

Directions Caring for the Patient with COPD - PowerPoint Presentation

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Directions Caring for the Patient with COPD - PPT Presentation

Nursing Program 15 CE 1 This program is best viewed as Slide Show 2 Before proceeding to the posttest be sure you have completed the entire PowerPoint 3 Exit the program and ID: 682638

amp copd pulmonary patient copd amp patient pulmonary patients lungs air care lung spirometry chronic oxygen smoking education program

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Slide1

Directions

Caring for the Patient with COPD Nursing Program1.5 CE1. This program is best viewed as “Slide Show”. 2. Before proceeding to the posttest, be sure you have completed the entire PowerPoint©.3. Exit the program and complete the posttest which is final step of this education.  “Take Test” is a posttest.  Remember, no attendance record is needed.  Completion of the posttest will be sent electronically to your EduTracker record once a 100% is achieved.  Print the CE Certificate of Completion for your records. Comments, questions, or suggestions can be directed to Maureen Cope or Ina Nechita in the COPD Care Coordination Office at 484-526-4227

This program is required for RNs on P5 & P6 and it is recommended for all RNs! Slide2

Caring for the Patient with Chronic Obstructive Pulmonary Disease

December, 2014Slide3

Objectives

At the conclusion of this program the learner will be able to:Identify COPD risk factors and the conditions that comprise it.Discuss diagnosis and staging of COPD.Differentiate between rescue and maintenance inhalers & proper technique of each. Identify non-pharmacological options for COPD treatment.Provide education to the patient on the COPD Zone Tool usage, which includes proper treatments for each zone. Describe the role of Pulmonary PALS Program in the care of the COPD patient.Slide4

Purpose

The purpose of the program is to provide RNs with information to enhance their knowledge for caring more effectively for patients with COPD and to provide guidelines and strategies for teaching patients to care for themselves.Slide5

What is

Chronic Obstructive Pulmonary Disease? COPD is a common preventable and treatable disease, characterized by

persistent airflow

limitation

.

It is

usually progressive and associated with an

enhanced chronic inflammatory response in the airways and lungs

due to

noxious particles or gases

.

Exacerbations

and comorbidities contribute to the overall severity in individual patients

.

Chronic

Bronchitis

&

Emphysema

are grouped under the generalized term COPD.

COPD

affects an estimated 24 million Americans

in all

fifty states.

Pennsylvania

ranks in the top third (#16)

for

COPD prevalence at 6.1%.

New Jersey has a lower prevalence rate of 4.3%.

Kentucky

has the highest COPD prevalence with a rate of 9.3%. Slide6

Risk Factors for Developing COPD

Smoking: COPD most often occurs in people age 40 and older with a history of smoking (either current or former smokers). As many as one out of six people with COPD have never smoked. Harmful pollutants: long-term contact with occupational chemicals, dust or fumes as well as household factors such as organic fuels from cooking and second hand smoke. Genetic factors: Alpha-1 Anti-trypsin deficiency (AATD) is the most commonly known genetic risk factor for emphysema. It is

caused by a deficiency of the

Alpha-1

Antitrypsin

protein.

- Without this protein

,

leukocytes begin

to harm the

lungs, causing lung deterioration. Because not all individuals with COPD have AATD, and because some individuals with COPD have never smoked, it is believed that there are other genetic predispositions to developing COPD. Slide7

A & P ReviewSlide8

Air

enters through the mouth or nose. After air passes through the trachea it branches off into the two bronchi. The entire airway is coated with hair-like structures called cilia. Combined with mucus, they sweep foreign particles from the lungs (with a cough or sneeze).

Within the lungs the bronchi split into

smaller tubules called bronchioles

. These tubes end in tiny round air sacs called

alveoli.

Image

from

:

http://www.nhlbi.nih.gov/health/health-topics/topics/hlw/system.html

Normal Lungs Slide9

Capillaries are the blood vessels that surround the alveoli. Oxygen from the alveoli enter into the capillaries to be disbursed into the circulatory system. The alveoli also give off carbon dioxide through the capillary wall

to be exhaled out of the lungs. The diaphragm is a large muscle that lies under the lungs and separates them from the organs below. As it moves down or flattens, the lungs expand and air is drawn in (inspiration). As the diaphragm relaxes, air leaves the lungs and they spring back to their original position (expiration).

http://www.bing.com/images/search?q=lungs+and+diaphragm&qs=IM&form=QBIR&pq=lungs&sc=8-5&sp=6&sk=IM5#view=detail&id=42C02D712C72E1EAF59699D3D064619BEE34509E&selectedIndex=22Slide10

Emphysema

Damage to the collagen and elastin fibers of the alveoli prevent them from expanding, causing air trapping. The alveoli weaken and eventually rupture causing reduced surface area for oxygen/carbon dioxide gas exchange. Normal patient presentation:

Barrel chested/flattened diaphragm due to hyperinflation of the lungs from air trapping

Nail clubbing and cyanosis due to chronic oxygen deprivation in advanced

stages

Decreased breath sounds due to air trapping

Typically thin physical appearance

Image from

http://gudhealth.com/emphysema.htmSlide11

Chronic Bronchitis

Irritation due to environmental triggers or infections causes the bronchial linings to become inflamed. The healthy cells are replaced by mucus-secreting cells. Irritants can also damage the cilia (hair like projections within the bronchioles) preventing the movement of excess mucus and irritants out of the lungs. The increased mucus causes bronchial and alveolar destruction leading to air trapping and

CO2 retention

.

Normal patient presentation:

Chronic productive cough of thick sputum for > 3 months x 2 consecutive years

Rhonchi

and

wheezing

Peripheral edema

Cyanotic

Usually overweight

Image

from:

http://www.thinkcopdifferently.com/en/About-COPD/What-is-COPD/Pathophysiology-of-COPDSlide12

DiagnosisSlide13

Diagnosis by Signs

& Symptoms Symptoms can vary from mild to severe: Chronic intermittent coughChronic sputum productionDyspnea - progressive and characteristically worsens with exercise.

Family

history of COPD Slide14

How is Spirometry used to diagnose COPD?

COPD causes air in the lungs to be exhaled at a slower rate and in smaller amounts compared to a normal healthy person. Measuring the ability to forcibly exhale air, called spirometry, can help determine the presence and severity of COPD. Spirometry can be done as part of a full pulmonary function test or by itself. FEV1 (forced expiratory volume in 1 second): measures how quickly the lungs can empty in one second. FEV1 naturally declines with age, but occurs at a must faster and more severe rate in those with COPD. FVC (forced vital capacity): amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible.Spirometry

SHOULD NOT

to be confused with

Incentive Spirometry

, a tool used to help keep lungs inflated. Incentive Spirometry is NOT recommended for COPD patients due to potential “air-trapping” in

hyper-inflated

lungs.Slide15

Diagnosis of COPD by Spirometry

“Spirometry is a method of assessing lung function by measuring the volume of air that the patient can expel from the lungs after a maximal inspiration.” ---Global Initiative for Chronic Obstructive Lung Disease (GOLD)Along with symptoms, spirometry helps to stage COPD severity and can be a guide to specific treatment steps.Spirometry is used to monitor disease progression. Intervals between measurements should be at least 12 months to be most reliable. It is not recommended to perform spirometry on a patient during an acute exacerbation of COPD. Slide16

Spirometry

Per GOLD guidelines, Spirometry is needed to make a firm COPD diagnosis. Slide17

TreatmentSlide18

COPD

Rescue Medications(Relievers)Short acting bronchodilators (SABAS)Provide quick relief of symptoms (wheezing, SOB) and should only be used when neededBronchodilator effects usually wear off within 4-6 hoursAdverse effects : tachycardia, tremors, hypokalemia ProAir HFA,

Ventolin HFA Proventil

HFA

Xopenex

HFA (Levalbuterol)

(

Albuterol) Slide19

Medications for COPD

Maintenance(Controllers) Long acting bronchodilators (LABAS): effect lasts 12 or more hoursconvenient and more effective at controlling symptomsAdverse effects: dry mouth, dysuria, constipation, headache, cold symptoms, cough, rapid heartbeat, nervousnessShould be taken every day in order to prevent exacerbations!

Spiriva

(

TiotropiuM)

Foradil

(formoterol

)

Combivent

Respimat

(

ipratropium/albuterol)

TudrzA

(

aclidinium)

Serevent

(salmeterol

)

Anoro Ellipta

(

umrclidinium/vilanterol

)Slide20

Medications for COPD

Maintenance Inhaled Corticosteroids (anti-inflammatory) - regular treatment improves symptoms, lung function & quality of life and reduces the frequency of COPD exacerbationsAdverse effects:associated

with higher prevalence of oral candidiasis

(thrush

), hoarse

voice,

and skin bruising

i

ncreased

risk of pneumonia

Flovent Discus

(Fluticasone)

Flovent HFA

(Fluticasone)

Pulmicort nebulizer

(Budesonide)

Should be used every day to prevent exacerbations! Slide21

Medications for COPD

Maintenance Combination Inhaled Corticosteroids/BronchodilatorAn inhaled corticosteroid combined with a long acting Bronchodilator is more effective than the individual components in improving lung function and health status and reducing exacerbations in patients with moderate to severe COPD.

Advair Diskus OR HFA

(Fluticasone/salmeterol

)

Symbicort

(Budesonide

/

Formoterol

)

Breo

Ellipta

(fluticasone and vilanterol)Slide22

Key Point

It is vital to teach patients the correct way to use their inhalers!Slide23

Metered

Dose Inhalers (MDIs)ShakeBreathe out, then hold

inhaler to lips

Spray 1 puff as you

b

reathe

in deeply for

5

seconds

.

Hold

for

count

of

10…

Breathe out

slowly…

Rinse mouthSlide24

Using MDIs with Spacers

Spacer:Device placed on the mouthpiece of an MDI (metered dose inhaler)Creates “space” between the mouth and the inhaler, allowing the medication to break into smaller droplets.Smaller droplets travel deeper into the bronchioles and do not require the patient to time his/her inhalation. Valved holding

chamber:

A specific type

of spacer

with a

one-way valve

close to the

mouthpiece

, holding the medication within the chamber to allow for a longer, deeper inspiration. Slide25

Proper Use of Inhalers

http://use-inhalers.com/The above link** will allow you to view short instructive videos on the proper use of various types of respiratory medication delivery devices. ** This link requires you to use an email address.** Please review the videos on the following devices (using the link above) so you can coach patients in their efforts to utilize them

effectively

!

Inhalers

with &

without use of spacers

Discus

devices (Advair, Serevent

)

Handihaler (Spiriva)

Ellipta

devices (Breo, Anoro)

Respimat (Combivent)Slide26

Nebulized Treatments

A nebulizer is a drug delivery device used to administer medication in the form of a mist inhaled into the lungs.Often used for patients with impaired cognitive abilities with poor inhaler technique, or for those with low inspiratory effort due to advanced pulmonary disease Medications used in the nebulizer may include inhaled bronchodilators, corticosteroids, & combination short acting bronchodilators Slide27

Nebulizer vs. Inhaler

Nebulizer Benefits:Easy to use No special technique requiredGood particle depositionMore effective for patients with low inspiratory effort. Challenges:Requires powerCan be noisyTakes time to completeRequires assembly and cleaningInhalerBenefits:Easy to carryPortable, lightweightQuick delivery of medicationChallenges:Requires coordination and proper technique for best resultsCommonly used incorrectlyMisuse can cause thrush

The benefit of each should be judged symptomatically and needs to be patient specific. A combination of the two methods can be used at different times throughout the

day.Slide28

Vaccinations

Influenza vaccination is recommended for patients with any chronic condition. Can reduce serious illness and death in COPD patients.Strains are adjusted every year for appropriate effectiveness and should be received annually. Pneumococcal polysaccharide vaccine has been shown to reduce the incidence of community-acquired pneumonia in COPD patients <65 years of age that have a low FEV1 of < 40%.COPD patients should be counseled to receive the pneumococcal vaccine at any age. Slide29

COPD: Therapeutic Mucous Clearance

DevicesFlutter ValvesRecommended for patients with COPD and Cystic Fibrosis who have dyspnea due to excessive mucus production.Assists the patient with mobilizing their secretions.Uses positive end pressure (PEP) therapy to create airway vibrations. This regulates the movement of mucus and transfers

it from

peripheral (small) airways

to

central (bigger) airways

where it can be easily coughed

out.Slide30

Coaching the Patient on Use of the Flutter Valve

Breathe in from the diaphragm through the mouthpiece, taking a larger than normal breathHold breath for 2-3 seconds Exhale actively, not forcefully through the device (exhalation should be 3-4 times longer than inhalation)Adjust dial to assure exhalation is 3-4 times longer than inhalationPerform 10-20 breathsRemove mouthpiece and perform 2-3 “huff” coughs to raise

secretions

Repeat 4 times

daily

Note: The Flutter can be used in conjunction with a nebulizer treatment. See package instructions for proper setup.Slide31

COPD Management: Putting it all together!Slide32

COPD: Stages

Stage I: Mild Rescue inhaler as neededSmoking cessationFlu and pneumonia vaccinationHealthy nutrition/Exercise

Stage

II: Moderate

Rescue

inhaler as needed or timed

basis

Controller

medication (Long acting

bronchodilator/corticosteriod)

Pulmonary

Rehab

Stage III:

Severe

Continue

same treatment as stage

II

Add supplemental

oxygen

Stage

IV: Very Severe

Bronchodilators/inhaled steroid

BiPAP/supplemental oxygen

Pulmonary Rehab

Lung

volume reduction

surgery

Psychological &

social

support

Nutritional counseling

OpiatesSlide33

COPD

Care ContinuumSlide34

Patient EducationSlide35

Education for the COPD Patient

COPD definition and diagnosisCOPD ZONE TOOLMedications: schedule, purpose, & side effectsInhalers: maintenance vs rescue, proper technique Smoking

cessation

Mucus clearance

Energy conservation/Pulmonary

Rehab

Nutrition therapy

Purse lipped breathing

Preventing respiratory infections

Oxygen

t

herapy & safety

Better Breathers

support

g

roupSlide36

Patient Education Using

Teach BackExample: have the patient SHOW the proper inhaler technique and TELL the purpose of the inhalerTake the opportunity to provide gentle correction, review, and/or praise for the concepts.For more information about Teach-back, see the education program called “

Patient

Education using

the Teach-Back Method

MyNET > Learning tab > Tracker Trainer linkSlide37

Documenting COPD Education

Assure completion, take credit for your work!Slide38

Have an Action Plan!!

Green Zone: Good to Go!Yellow Zone: Take Action! (prescribed medications, call your doctor)Avoid the Red Zone: call for an emergent appointment or go to the

Emergency

Room!

Warning signs of a problem

:

increased shortness of breath,

wheezing or coughing; increased

mucus or mucus that has an odor,

has changed color or

is bloody;

chest tightness that

does not go away with normal medications;

sore

throat or hoarseness;

fatigue

(more than

usual).

It is important for COPD patients to recognize their own usual signs of an exacerbation and

to follow

the action plan designed for them by their COPD

provider!Slide39

Preventing Infections

Influenza and pneumococcal pneumonia vaccinations are recommended by GOLD.Wash hands frequently with soap, water, and friction for 15 seconds, then rinse. Hand sanitizer may be used as an alternative to soap & water.Avoid touching your face with your hands -- this keeps bacteria away from the warm moist environment of the nose.Avoid people with colds and other respiratory infections. Avoid large crowds and air travel during flu season.Slide40

IMPACT of Smoking

Effects of smoking:COPDHeart diseaseStrokeCancersPneumoniaInfluenzaDamage to major organsDamages lung tissue and irritates airways: direct correlation to COPD Damages cilia to render them ineffective for clearing mucus, bacteria and dirt from the airways.

The effects of smoking

.

1992

2002

Smoking one

large cigar is the equivalent of smoking an entire pack of cigarettes!! Slide41

Chemicals Found in Tobacco Smoke

Ammonia: poisonous gas, cleaning agentFormaldehyde: preservativeCarbon monoxide: auto exhaust poisonHydrogen cyanide: in chemical weaponsAcetone: poisonous solventPolonium 210: radioactive

element

Benzoic Acid

Angelica root extract

:

causes

cancer in animals

Arsenic

:

used

in rat poison

Benzene

:

makes

dyes, synthetic rubber

Butane

:

gas

found in lighter fluid

Cadmium

:

used in car batteriesCyanide: deadly poisonDDT: banned insecticideLead: poisonous in high dosesMethanol: rocket fuelMethoprene: insecticide

Nicotine

:

addictive

drug, pesticide Slide42

Smoking Cessation=Abstinence

Pharmacotherapy DOUBLES quit rateNicotine Replacement Therapy (NRT)Reduces cravings/withdrawal symptomsProvides same positive effects of nicotineVery safe - same drug in a lower dose in a less addictive form over shorter period of timeFirst line medications:Nicotine GumNicotine PatchNicotine Lozenge

Nicotine Nasal Spray

Nicotine Inhaler

St. Luke’s Smoking

Cessation

484-526-2100Slide43

Smoking Cessation

=AbstinencePharmacotherapy DOUBLES quit rate Non-nicotine Replacement Therapy (NNRT) Bupropion (Zyban/Wellbutrin)Stimulates dopamine release from the brain, causing a “feel good” effectDoes NOT contain nicotineNot addictive but will reduce cravings and withdrawal symptomsVarenicline (Chantix)Blocks nicotine’s ability to bind to receptors

Lowers amount of dopamine into the brain

Adverse effects of NNRT include:

Headache

Nausea

Dry mouth

Insomnia

Slide44

Nutrition - Weight

Loss and COPDWeight loss can be common in people with COPD.Causes: Loss of appetite: “food does not taste good” Chewing, swallowing and breathing adds to dyspneaDrugs can interfere with nutrient absorptionBloating sensation due to swallowing air during acute dyspneaSlide45

Nutrition

The work of breathing consumes many calories in a COPD patient.Coughing, excessive mucus, chest discomfort can make it difficult for patients to eat. Balanced meals are important.

Many

patients require extra calories/protein to combat weight and muscle loss.Slide46

Optimal Nutrition for the COPD Patient

The following are some strategies to help COPD patients get optimal nutrition:Eat smaller, more frequent meals whenever hungryGet plenty of fluids: water, high calorie/high nutrient beveragesHomemade milk shakesMilk or cream based soups in moderationAvoid carbonated beverages (increases bloating)

High

calorie, nutritious foods

:

Healthy oils, cream cheese, margarine, butter, nut butters

Regular cheeses, salad dressings, dips, sour cream, ice cream

Yogurt, cottage cheese

Foods high in

protein: eggs

, milk, meats, poultry, fish, nuts, beans

Milk

has

calcium, protein, vitamins A

, D

,

& B

12

Foods with fiber:

whole

grains,

fruits, vegetables

Foods with nutrients: colorful fresh vegetables, enriched grainsSlide47

Suggestions to improve

food intake:Cook food until soft (to decrease work of chewing)Mince meatsDip harder/crunchier foods in liquidsChoose softer foods like pasta, mashed potatoes, thick or creamed soups, casserolesDrink milk shakes/eggnogsEat frequent, nutritious snacks instead of 3 large mealsSlide48

Dealing with Dyspnea

SOB makes everyday tasks take longer Encourage patients to maximize energy by planning activities in advance Important activities completed earlier with 20 – 30 min rest periods in betweenDo not wait until overtired to stop and restAllow plenty of time to do

activities

Encourage

patients to find ways to conserve energy:

Appliances to make work lighter

Using assistive devices to dress, shop

Wheeled carts to move things in the house and in

stores

Keep the items used most at waist level to avoid reaching and

bending

Pursed lip breathing (PLB):

p

ositive internal pressure can maintain higher airway pressures in the larger airways, preventing airway collapse

caused by emphysema

Avoid encouraging deep breathing, as this contributes to greater air trappingSlide49

Patient Education

for Pursed Lip BreathingRelax neck and shoulder musclesBreathe in for two (2) seconds through the nose, keeping the mouth closedBreathe out for four (4) seconds through pursed lips…if this is too long,

simply breathe out twice as long as you breathe

inSlide50

Increasing

Endurance & StrengthExercises Shoulder pressBiceps curl Side lift Leg raises Wand work Roller coaster waveStationary bicycle TreadmillSlide51

Oxygen Therapy & Safety

DO NOT smoke when oxygen in useKeep oxygen at least 10 feet away from open flames (includes gas range)Hang oxygen signs in clearly visible locations in the home settingDO NOT use petroleum based products on face and upper chest. Water based products

(i.e.: Aquaphor®) are acceptable for

lubrication of dry nasal

membranes

Use

electrical appliances with

caution

Avoid tripping/entanglement on tubing

Do

not store oxygen canisters

in closed spaces

Maintain working smoke detectors & monitor battery life

Keep

f

ire extinguishers nearbySlide52

Pulmonary Rehab

Pulmonary rehabilitation is a non-pharmacologic therapy that has emerged as a standard of care for patients with COPD & other chronic lung diseases.Pulmonary rehabilitation is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, self-management education, and psychosocial support. Pulmonary rehabilitation is usually performed in outpatient, hospital-based settings lasting 6 to 12 weeks.Pulmonary rehabilitation should be considered in all COPD/chronic pulmonary patients who remain symptomatic or have decreased functional status despite optimal medical management.

Demonstrable improvement in lung function (spirometry results)

may not improve, however pulmonary rehabilitation allows the COPD patient

to

have:

-increased

exercise

tolerance

-reduced

dyspnea and

anxiety

-increased self-worth

-improvement

in health-related quality of

life

-reduced

hospital

admissionsSlide53

St. Luke’s Pulmonary Rehab Facilities:

Fountain HillBethlehemCoaldaleQuakertown Phillipsburg, NJ Slide54

Pulmonary PALS

Pulmonary PALS* is a program designed by the COPD & palliative care teams to help patients & significant others deal with the long term effects of symptomatic, advanced lung disease.* This is not Hospice*Goals are patient-centered to relieve suffering & manage symptoms while maintaining the best quality of life.

Patients

receive usual medical care enhanced by a team of healthcare providers with specialized knowledge in COPD & palliative care.Slide55

1) Chronic pulmonary conditions including COPD & ILD (Interstitial Lung

Disease)/pulmonary fibrosis confirmed via spirometry within the past 2 years.2) For patients with COPD: BODE index score of 6-10. (BODE predicts all cause mortality and

respiratory

related mortality with better accuracy than FEV1

alone) BODE index explanation in upcoming slide.

3)

Two or more hospitalizations in one year for respiratory related

diagnoses.

4

) Need

for continuous oxygen

therapy.

5) Pulmonary care: must be under the care of a pulmonologist

OR

have an evaluation by

a pulmonologist prior to enrollment.

Secondary

criteria:

6) Decline

in quality of

life – the patient is unable

to carry out

activities

of

personal value

due

to

impaired respiratory

status.

7)

Persistent respiratory functional

decline.

Pulmonary PALS Enrollment CriteriaSlide56

Pulmonary PALS

Team members include: Palliative medicinePulmonary medicine COPD Care Team coordinatorsHome Health Services (nursing, PT,OT, personal care aides & hospice liaison)

The

PALS Team collectively reviews each case individually to see if the patient with advanced COPD/lung disease & a high symptom burden would benefit from the program

. Slide57

What is the BODE index?

Body mass index - Airflow Obstruction - Level of Dyspnea - Exercise capacityVariable Points on BODE 012

3

FEV1 (%

predicted)

>=65

50-64

36-49

<=35

6 minute walk test

>=350 m

250-349 m

150-249 m

<=149

MMRC dyspnea scale

0-1

2

3

4

BMI

>21

<21

The BODE index is a predictor of COPD mortality by measurement of the following:Degree of pulmonary impairment (

FEV

1

)

Patient’s perception

of

dyspnea (MMRC

dyspnea scale

)

Distance walked

in six

minutes with responding SpO2 levels

BMI

BODE

predicts all cause mortality and

respiratory

related mortality with better accuracy than

FEV1 alone. Slide58

Patient

SupportSt. Luke’s COPD Care Team (484-526-4227) SLB, SLW, SLA - soon to be network-wide Maureen Cope, BSN, RN & Ina Nechita, BA, RRT St. Luke’s Better Breathers Club3rd Thursday of the month 6-7:30pmMOB, Anderson CampusInfo Link 1-866-STLUKES (785-8537)

St. Luke’s Pulmonary Rehab

Info Link 1-866-STLUKES (785-8537)

St. Luke’s Smoking Cessation

484-526-2100

COPD Foundation

www.copdfoundation.org Slide59

St.

Luke’s Better Breathers Support Group Offers patients the opportunity to learn ways to better cope with chronic pulmonary disease while getting the support of others who share in their struggles. Led by a certified Better Breathers facilitatorSupported by the American Lung Association

Provides education on various topics pertinent to lung health:

How COPD affects the lungs

Breathing techniques

Exercise

Talking with your physician

Medications and other treatment options

Medical tests

Supplemental

oxygen

Home health care

Lung transplants

Air pollutionSlide60

References

www.copdfoundation.orgwww.medline.govhttp://use-inhalers.comwww.goldcopd.comSlide61

Questions about this educational presentation ?

Maureen Cope, BSN, RN Ina Nechita, BA, RRT Nancy Leitgeb, RN, OCN Terrance Hill MPA, BS, RRT Terry Nemeth, MS, RN Clinical EducationSpecialist - SLUHRespiratory Therapy Dept.

St Luke’s Quakertown

COPD Care Coordination

Education Coordinator

St Luke’s Home Health

& Hospice Slide62

Thank You!

Close the PowerPoint© programTake Test This program awards 1.5 CEPrint a copy of the certificate for your filesQuestions about this educational program or COPD Care Coordination should be directed to Maureen Cope or Ina Nechita at 484-526-4227.