(^108) Medical-Surgical Nursing Demystified
- Decreased oxygen and increased carbon dioxide in arterial blood gas as gas
exchange is impaired due to air trapping; more pronounced as disease pro-
gresses. - Chest x-ray shows overinflation of lungs and flattening of the diaphragm.
TREATMENT
Treatment will vary depending on the stage of the emphysema. As the disease pro-
gresses the treatment will change. Medications to control symptoms and keep air-
ways open, use of supplemental oxygen, and smoking cessation are the mainstays
of treatment.- Administer beta 2 -agonists to bronchodilate by inhaler or nebulizer:
- terbutaline, albuterol, levalbuterol
- Administer long-acting bronchodilating medications by metered dose inhaler
or dry powder inhaler:- formoterol, salmeterol
- Administer anticholinergics which allow for relaxation of bronchial smooth
muscle:- ipratropium, tiotropium inhaler
- Administer methylxanthines to dilate the bronchi. These are typically used
in conjunction with other medications, not for acute effect:- aminophylline
- theophylline
- Administer steroids to decrease inflammation within the airways:
- hydrocortisone, methylprednisolone systemically
- beclomethasone, triamcinolone, fluticasone, budesonide, flunisolide in-
halers - prednisolone, prednisone orally
- Administer antacid, H2 blocker, or proton pump inhibitor to decrease the
amount of acid in stomach, reducing possible ulcer formation due to stress
of the disease or medication effects:- antacids: aluminum hydroxide/magnesium hydroxide, calcium carbonate
- H2 blockers: ranitidine, famotidine, nizatidine, cimetidine
- Proton pump inhibitors: omeprazole, lansoprazole, esomeprazole, rabepra-
zole, pantoprazole