COPD: NCLEX Priorities
COPD: barrel chest, pursed-lip breathing, low-flow O2 (CO2 retainer), tripod position, inhaler ladder.
COPD is one of the most-tested chronic respiratory diseases. NCLEX hammers low-flow O2 and patient teaching.
Recognition
Chronic dyspnea, productive cough, history of smoking. Barrel chest. Pursed-lip breathing. Tripod position. Decreased breath sounds, possible wheezing.
Low-flow O2
Start at 1-2 L/min via NC. Higher flows can suppress hypoxic drive in CO2 retainers. Target SpO2 88-92%.
Inhaler ladder
SABA prn → add LAMA → add LABA → add ICS in severe with exacerbations.
Exacerbation
Steroids + antibiotics if increased sputum purulence. Bronchodilators. Consider BiPAP for hypercapnic respiratory failure.
Teaching
Smoking cessation (#1 intervention). Pneumococcal + annual flu + COVID vaccines. Pulmonary rehab. Energy conservation.
Frequently asked
Why not high-flow O2 in COPD?
Some patients rely on hypoxic respiratory drive. High O2 can blunt drive → CO2 retention → respiratory failure.
Tripod position, why?
Uses accessory muscles to expand chest. Reduces work of breathing.
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