Emphysema

1. Anatomy and physiology of the lung.

1. The lungs are two sac-like organs located in the chest cavity.

2. The main function of the lungs is to supply oxygen to the blood and to remove carbon dioxide from the blood.

3. The airways are similar to an upside down tree; the trachea, or windpipe, is like the main trunk, which divides into smaller branches.

4. At the end of the small branches are small air sacs called alveoli, where gas exchange takes place.

2. Definition of "emphysema."

1. It is a chronic, irreversible lung disease caused by recurrent inflammation resulting in destruction of lung tissue.

2. There is an enlargement and loss of elasticity of the alveoli resulting in decreased air exchange and air trapping.

3. The lungs are in a chronic state of hyper-expansion, causing expiration to be more difficult.

3. Factors that may increase the risk of emphysema.

1. Recurrent respiratory infections.

2. Continual exposure to harmful irritants.

1. Occupational hazards.

2. Air pollution.

3. Cigarette smoking.

3. Heredity.

4. Allergies.

5. Advanced age.

4. Signs and symptoms of emphysema.

1. Shortness of breath.

2. Barrel chest.

3. Loss of appetite.

4. Weight loss.

5. Cough.

6. Wheezing.

7. Weakness.

5. Measures to manage emphysema.

1. Avoid irritants such as smoking, pollution, aerosol sprays, cold air, strong wind, etc.

2. Avoid fatigue by using energy-conserving techniques.

3. Avoid excessive heat, which increases oxygen requirements, and avoid excessive cold, which increases possibility of bronchospasm.

4. Eat a well-balanced diet high in protein, fat, and calories. (Provide "Increase Calories," "Daily Food Guide," and "Protein in Diet" handouts.)

1. Eat small, frequent meals.

2. Chew slowly.

5. To maintain patent airways, perform measures to thin or remove secretions.

1. Drink large amounts of liquids to thin secretions.

2. Use a humidifier to moisten air.

3. Use effective coughing methods. (Provide "Effective Coughing Techniques" handout.)

4. Take medication as prescribed.

5. Do chest percussion and postural drainage as ordered.

6. Get regular exercise with adequate rest periods.

1. Obtain physician's approval.

2. Stop exercise if any side effects occur.

3. Use warm-up and cool-down exercises.

4. Gradually increase exercise.

7. Use oxygen as ordered. (Refer to Oxygen Therapy Teaching Guide.)

8. Contact local support groups or American Lung Association for more information.

9. Report any symptoms of respiratory infection.

1. Fever.

2. Change in amount or color of sputum.

3. Increased shortness of breath.

10. Avoid or control stress, which can exacerbate disease.

6. Possible complications of emphysema.

1. Respiratory infection.

2. Peptic ulcer disease.

3. Right-sided heart failure.

4. Hypoxia (lack of oxygen).