Chronic Obstructive Pulmonary Disease

ExitCare ImageChronic obstructive pulmonary disease (COPD) is a condition in which airflow from the lungs is restricted. The lungs can never return to normal, but there are measures you can take which will improve them and make you feel better.


  • Smoking.

  • Exposure to secondhand smoke.

  • Breathing in irritants such as air pollution, dust, cigarette smoke, strong odors, aerosol sprays, or paint fumes.

  • History of lung infections.


  • Deep, persistent (chronic) cough with a large amount of thick mucus.

  • Wheezing.

  • Shortness of breath, especially with physical activity.

  • Feeling like you cannot get enough air.

  • Difficulty breathing.

  • Rapid breaths (tachypnea).

  • Gray or bluish discoloration (cyanosis) of the skin, especially in fingers, toes, or lips.

  • Fatigue.

  • Weight loss.

  • Swelling in legs, ankles, or feet.

  • Fast heartbeat (tachycardia).

  • Frequent lung infections.

  • ExitCare Image Chest tightness.


Initial diagnosis may be based on your history, symptoms, and physical examination. Additional tests for COPD may include:

  • Chest X-ray.

  • Computed tomography (CT) scan.

  • Lung (pulmonary) function tests.

  • Blood tests.


Treatment focuses on making you comfortable (supportive care). Your caregiver may prescribe medicines (inhaled or pills) to help improve your breathing. Additional treatment options may include oxygen therapy and pulmonary rehabilitation. Treatment should also include reducing your exposure to known irritants and following a plan to stop smoking.


  • Take all medicines, including antibiotic medicines, as directed by your caregiver.

  • Use inhaled medicines as directed by your caregiver.

  • Avoid medicines or cough syrups that dry up your airway (antihistamines) and slow down the elimination of secretions. This decreases respiratory capacity and may lead to infections.

  • If you smoke, stop smoking.

  • Avoid exposure to smoke, chemicals, and fumes that aggravate your breathing.

  • Avoid contact with individuals that have a contagious illness.

  • Avoid extreme temperature and humidity changes.

  • Use humidifiers at home and at your bedside if they do not make breathing difficult.

  • Drink enough water and fluids to keep your urine clear or pale yellow. This loosens secretions.

  • Eat healthy foods. Eating smaller, more frequent meals and resting before meals may help you maintain your strength.

  • Ask your caregiver about the use of vitamins and mineral supplements.

  • Stay active. Exercise and physical activity will help maintain your ability to do things you want to do.

  • Balance activity with periods of rest.

  • Assume a position of comfort if you become short of breath.

  • Learn and use relaxation techniques.

  • Learn and use controlled breathing techniques as directed by your caregiver. Controlled breathing techniques include:

  • Pursed lip breathing. This breathing technique starts with breathing in (inhaling) through your nose for 1 second. Next, purse your lips as if you were going to whistle. Then breathe out (exhale) through the pursed lips for 2 seconds.

  • Diaphragmatic breathing. Start by putting one hand on your abdomen just above your waist. Inhale slowly through your nose. The hand on your abdomen should move out. Then exhale slowly through pursed lips. You should be able to feel the hand on your abdomen moving in as you exhale.

  • Learn and use controlled coughing to clear mucus from your lungs. Controlled coughing is a series of short, progressive coughs. The steps of controlled coughing are:

  1. Lean your head slightly forward.

  2. Breathe in deeply using diaphragmatic breathing.

  3. Try to hold your breath for 3 seconds.

  4. Keep your mouth slightly open while coughing twice.

  5. Spit any mucus out into a tissue.

  6. Rest and repeat the steps once or twice as needed.

  • Receive all protective vaccines your caregiver suggests, especially pneumococcal and influenza vaccines.

  • Learn to manage stress.

  • Schedule and attend all follow-up appointments as directed by your caregiver. It is important to keep all your appointments.

  • Participate in pulmonary rehabilitation as directed by your caregiver.

  • Use home oxygen as suggested.


  • You are coughing up more mucus than usual.

  • There is a change in the color or thickness of the mucus.

  • Breathing is more labored than usual.

  • Your breathing is faster than usual.

  • Your skin color is more cyanotic than usual.

  • You are running out of the medicine you take for your breathing.

  • You are anxious, apprehensive, or restless.

  • You have a fever.


  • You have a rapid heart rate.

  • You have shortness of breath while you are resting.

  • You have shortness of breath that prevents you from being able to talk.

  • You have shortness of breath that prevents you from performing your usual physical activities.

  • You have chest pain lasting longer than 5 minutes.

  • You have a seizure.

  • Your family or friends notice that you are agitated or confused.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.