Identifying Exacerbations
COPD Exacerbations tend to be characterized by patients reports of increased symptom severity rather than by the onset of new symptoms. Symptoms that commonly worsen during exacerbation include.
-dyspnea and cough, with or without sputum production.
-chest congestion.
-chest discomfort.
-sleep disturbance.
-feelings of weakness, fatigue, fear, or worry.
Almost half of patients experiencing a COPD exacerbation report a significant decline in physical activity.
Hallmark clinical features of exacerbation include inflamed, narrowed airways, leading to tachypnea and accessory muscle use. Pursed-lip breathing may be more pronounced,as patients try to prevent airway collapse and increase oxygenation. Reduced distance between the cricoid cartilage and suprasternal notch, Hoover's sign (paradoxical retraction of the lower rib cage margin with inspiration), and resonant percussion over the heart reflect pulmonary hyperinflation. Tachycardia and cyanosis may occur in patients with hypoxia. In severe cases, patients may exhibit hypotension, flapping tremor (an involuntary trembling of the hand when the wrist is extended), and mental status changes.
No single test can help NPs and other clinicians establish that a patients is experiencing an exacerbation. Early recognition is critical in initiating prompt treatment, thereby reducing risk of hospitalization, future exacerbations, and impaired quality of life
Identifying Exacerbations COPD Exacerbations tend to be characterized by patients reports of increased symptom severity rather than by the onset of new symptoms. Symptoms that commonly worsen during exacerbation include.-dyspnea and cough, with or without sputum production.-chest congestion.-chest discomfort.-sleep disturbance.-feelings of weakness, fatigue, fear, or worry.Almost half of patients experiencing a COPD exacerbation report a significant decline in physical activity.Hallmark clinical features of exacerbation include inflamed, narrowed airways, leading to tachypnea and accessory muscle use. Pursed-lip breathing may be more pronounced,as patients try to prevent airway collapse and increase oxygenation. Reduced distance between the cricoid cartilage and suprasternal notch, Hoover's sign (paradoxical retraction of the lower rib cage margin with inspiration), and resonant percussion over the heart reflect pulmonary hyperinflation. Tachycardia and cyanosis may occur in patients with hypoxia. In severe cases, patients may exhibit hypotension, flapping tremor (an involuntary trembling of the hand when the wrist is extended), and mental status changes.No single test can help NPs and other clinicians establish that a patients is experiencing an exacerbation. Early recognition is critical in initiating prompt treatment, thereby reducing risk of hospitalization, future exacerbations, and impaired quality of life
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