When you breathe in, the airways bring air to the air sacs. Slide 3-. Tachypnea Accessory respiratory muscle use, COPD Hallmark symptom - Dyspnea Chronic productive cough Minor hemoptysis pink puffer blue bloater. It is important for you to consume enough calories to produce energy in order to prevent wasting or weakening of the diaphragm and . Retrieved February 07, 2009 from Health Source: Nursing and Academic Edition Database. by espen gavin and zabihulla mirzai. 1.) COPD. Pneumothorax occurs when the parietal or visceral pleura is breached and the pleural . Many in this series of 12- to 20-page easy-to-read booklets feature interactive portions for patients and caregivers to discuss together. , Laboratory Tests Elevated hematocrit suggests chronic hypoxemia. 20-23 June 2023 Dublin, Ireland. COPD - Physical Findings. Both have ingested substantial amounts of barbiturates and diazepam. This flyer will give you helpful tips and tools for staying healthy, avoiding illness, and recognizing early warning signs of an infection or flare-up. We believe everyone should have access to free online first aid information which is up-to-date and accurate. rada jones md 09/12/06. This is an original nursing presentation for PowerPoint. California State University how To Reduce Potential Vulnerabilities Discussio California State University Long Beach IRAC Business Law Discussion.docx, CALUMS Personal Statement for University Application Admission Essay.docx. chronic obstructive pulmonary disease. Now customize the name of a clipboard to store your clips. disease of the airway It appears that you have an ad-blocker running. In the health care provider view, users can access the CAT and mMRC Breathlessness Scale; an evidence-based therapy flowchart; COPD medications lists; inhaler and nebulizer education videos; and much more. The tri-fold card. (Chronic Obstructive Pulmonary Disease) COPD Chronic Bronchitis Emphysema, Definition A disease state characterized by airflow limitation that is not fully reversible Conditions include: Emphysema: (anatomically defined condition characterized by destruction and enlargement of the lung alveoli) Chronic bronchitis: clinically defined condition with chronic cough and phlegm Small-airways disease: condition in which small bronchioles are narrowed. Nursing Times [online]; 116: 4, 27-30. . MORE AMOUNT OF SPUTUM. Typically performed by isoelectric focusing of serum, which reflects the genotype at the PI locus for the common alleles and many of the rare PI alleles Molecular genotyping can be performed for the common PI alleles (M, S, and Z). This one-page fact sheet focuses on preventing pneumonia in individuals with COPD. tintinalli chapter 73. copd definition. 2. Takeaway. possible areas to cover. COPD Foundation Guides for Better Living are comprehensive educational booklets for use by individuals with COPD and their families, pulmonary rehabilitation programs, COPD support groups, and health care facilities. COLD exacerbation Bacterial infections Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis Mycoplasma pneumoniae or Chlamydia pneumoniae (510% of exacerbations) Viral infections (one-third) No specific precipitant identified (2035%), Symptoms & Signs 3 most common: Cough Sputum production Exertional dyspnea, frequently of long duration, signs and symptoms Dyspnea at rest Prolonged expiratory phase and/or expiratory wheezing on lung examination Decreased breath sounds Barrel chest Large lung volumes and poor diaphragmatic excursion, as assessed by percussion Use of accessory muscles of respiration Pursed lip breathing (predominantly emphysema) Characteristic "tripod" sitting position to facilitate the actions of the sternocleidomastoid, scalene, and intercostal muscles Cyanosis, visible in lips and nail beds. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. management of stable copd shyam rao may 2014. objectives . COPD: Conserving Your Energy. A CT scan of your lungs can help detect emphysema and help determine if you might benefit from surgery for COPD. Art of Assertive Commnunication, how to be visible in social media by Shreed UiPath Automation Cloud Robots - Best Practises session 2.pptx, How To Restore Tree From Ancestry To Family Tree Maker, INVERTING BUCK-BOOST DCDC CONVERTER DESIGN CHALLENGES. Comment The calculation reveals a normal gradient, indicating that the etiology for hypoxemia and hypoventilation is extrinsic to the lung itself. Advanced disease: signs of cor pulmonale Elevated jugular venous distention Right ventricular heave Third heart sound Hepatic congestion Ascites Peripheral edema, Differential Diagnosis Congestive heart failure Asthma Bronchiectasis Obliterative bronchiolitis Pneumonia Tuberculosis Atelectasis Pneumothorax Pulmonary embolism. You will also learn useful health and safety tips for managing your COPD. Goal: Develop a PowerPoint presentation on a cardiovascular/pulmonary disorder/disease discussed in the McCance text. And/or 1) suspect copd - prolonged or recurrent cough, dyspnea, or, COPD - . Considerations COLD is present only if chronic airflow obstruction occurs. 2023 Spring Consortium: On-Demand. definition epidemiology risk, COPD - . progressive syndrome expiratory airflow obstruction chronic airway and lung parenchyma inflammation. - PowerPoint PPT presentation. what to expect:. juliana tambellini university of pittsburgh. COPD PowerPoint Presentation. Nurse-driven COPD self-management programs can be influential in an ACO's strategy to decrease avoidable utilization and cost. Use the contact form to get in touch Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. Now customize the name of a clipboard to store your clips. All other trademarks are the property of their respective owners. In review, COPD causes the flow of air out of the lungs to be blocked. Chronic Obstructive Pulmonary Disease or Chronic Obstructive lung disease. Chronic obstructive pulmonary disease by aminu arzet, Copd(chronic obstructive pulmonary disease), Chronic Obstructive Pulmonary Disease (COPD), Chronic obstructive pulmonary disease ppt, chronic obstructive pulmonary disease in equine. mary care nurses can be pivotal in the early identification, assessment and manage-ment of COPD (Hooper et al, 2012). In advanced COPD, a chest X-ray might show lungs that appear much larger than normal. INTRODUCTION Microsoft PowerPoint, Microsoft Word and Microsoft Excel are registered trademarks of Microsoft Corporation in the United States and/or other countries. Chronic Bronchitis Views: 1349, By: JenniferDwayne Join Actively Recruiting Research Studies, Bronchiectasis and NTM Research Registry (BRR), COPD Patient Powered Research Network (COPD PPRN), Patient-Inspired Validation of Outcome Tools (PIVOT), COPD Biomarker Qualification Consortium (CBQC), COPD Assessment Test (CAT) / Chronic Airways Assessment Test (CAAT), Medical and Scientific Advisory Committee. MDA, Interventional Pulmonary Course 2023, 2/23/2023 7:00:00 AM - 2/24/2023 4:45:00 PM, The activity is designed to review the current concepts and recent advances in interventional pulmonology as it pertains to the cancer patient, and to introduce new technologic advances that are poised to revolutionize the diagnosis, staging, and management of lung cancer. Chronic Obstructive Pulmonary Disease (Copd), Copd(chronic obstructive pulmonary disease), treatment Chronic Obstructive Pulmonary Disease. COPD Foundation Information Line: (866) 316-COPD (2673) Call to learn more about COPD and talk to people who understand the effect COPD has on your life. The SlideShare family just got bigger. mr. d has. or chronic bronchitis that was dr bruce davies. Youll also find a list of resources for more help managing your COPD. 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Genetic factors 1 antitrypsin (1AT) deficiency Common M allele: normal levels S allele: slightly reduced levels Z allele: markedly reduced levels Null allele: absence of 1AT (rare) Lowest levels of 1AT are associated with incidence of COLD; 1AT deficiency interacts with cigarette smoking to increase risk. COPD Nursing Diagnosis and Care Plan. PK ! briefly review the gold classification of copd, COPD - . It appears that you have an ad-blocker running. The CRT responds to acute episodes for COPD patients before handing over to the IMPACT team of district nurses who manage chronic cases. A chest X-ray isn't used to diagnose COPD, but it may help rule out conditions that cause similar symptoms, such as pneumonia. Download GOLD Teaching Slide Set. It is important to keep a list of your medications and immunizations handy. To download the free app, please visit the App Store or Google Play. Operating Room Nurse/ Clinical Research Nurse . Activate your 30 day free trialto unlock unlimited reading. a disease state characterized. What is hypertension? dinner was great, coffee is brewing and you are all debating, COPD - . argy teaching resident, feb. 2007. Energy-conserving tips are presented. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. -System-wide nurse referral bonus program - earn up to $6000 per referral. Dr. Kaara Ray B. Calma is a full-time Lecturer in the School of Nursing and Midwifery at Deakin University Australia, and is a Registered Nurse with a PhD completed at the University of Wollongong Australia. View COPD Powerpoint.pptx from NUR 395 at Ameritech College of Healthcare, Draper. diagnosis initial, COPD - . COPD: CHRONIC OBSTRUCTIVE PULMONARY DISEASE Callie Cluf WHAT IS COPD: COPD is a common pulmonary disease that. Asthma Reduced forced expiratory volume in 1 second (FEV1) in COLD seldom shows large responses (>30%) to inhaled bronchodilators, although improvements up to 15% are common. Chronic obstructive chronic slowly progressive disorder characterised by airway obstruction which does not change, COPD - . People with COPD use more energy while breathing than the average person. Pneumothorax, or a collapsed lung, is the collection of air in the spaces around the lungs. View (Order 4698406) Powerpoint Presentation on Obesity (2).pptx from ENG 246 at North Carolina State University. CODP ( Chronic Obstructive Pulmonary Disease ), Chronic Obstructive Pulmonary Disease (COPD), Chronic obstructive pulmonary disease (copd), Approach to Chronic Obstructive Pulmonary Disease, COPD (CHRONIC PULMONARY OBSTRUCTIVE DISEASE) by SUKHERA, Chronic Obstructive Pulmonary Disease - COPD, Chrnonic Obstructive Pulomonary Disease - Pathophysiology, Chronic obstructive airway disease (coad), Chronic obstructive pulmonary disorder (copd), COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam, COPD (Chronic Obstructive Pulmonary Disease), Chronic obstructive pulmonary disorders COPD, Nursing management of the client with increased intracranial pressure, Upper respiratory disorders and nursing mangement, Copd(chronic obstructive pulmonary disease), J. Parker Emphysema Presentation Powerpoint, COPD - Chronic obstructive pulmonary disease - Aby. In addition, laminated versions are available through our online catalogue. Complex Nursing Care- COPD powerpoint.pdf, Where shares in an amalgamated company become the property of the assessee in, WebQuest_Careers_in_Chemistry_Heating_and_Cooling_Specialist_Student_Editable.doc, 30932566-FB7A-475F-AA27-D93F1E447C44.jpeg, Catigory Physiologic Intigrity Pharmacologic ad Parintiral Thirapiis 977 A, In respect of the custody uardianship of the children of the marriage the Act, She held out her hand he kissed it with affectionate gallantry though he hardly, 12 D Boneh and A Silverberg Applications of multilinear forms to cryptogra phy, 686 Answers to Odd Numbered Exercises i k i x i i k x i k i u, Expansion the 2016 the ability to produce tritium Written with of living and, As noted above Kyrgyzstan and Tajikistan both depart somewhat from this norm In, Another way to tackle this problem is to employ dimension reduction for high, Regulatory authorities may amend a service approval to reflect a change to the, Learning Objective 11 04 The concentration of loans loan volume and internal, The default risk premiums on the bonds issued by Amazon and Google respectively, Page 3 Stimulation of the PSN is responsible for airway constriction blood, A 55 year-old male patient presents to your clinic for his initial visit requesting refills of his blood pressure and blood sugar medication. 7pm. The patient and caregiver track contains several helpful tools, including an interactive My COPD Action Plan and activity tracking calendar; inhaler, nebulizer and exercise videos; and a wallet card to track important information such as medications and immunizations. Widescreen (16:9) Presentation Templates. Considerations Problems other than COLD should be suspected when hypoxemia is difficult to correct with modest levels of supplemental oxygen. aims & objectives. . Unlock this template and gain unlimited access, Are you already Premium? Click here to review the details. The diagnosis is confirmed by spirometry.Other tests may include a 6-minute walk test, laboratory testing, and radiographic imaging.. Assessment - A diagnosis of COPD should be considered in patients over the age of 35 who have a risk factor (generally smoking) and who present with exertional breathlessness, chronic . This page was reviewed on January 10, 2023 by the COPD Foundation Content Review and Evaluation Committee. Msc Nursing 1st year Chronic Bronchitis Chronic lower airway inflammation Increased bronchial mucus production Productive cough Urban male smokers > 30 years old, Chronic Bronchitis Mucus, swelling interfere with ventilation Increased CO2, decreased 02 Cyanosis occurs early in disease Lung disease overworks right ventricle Right heart failure occurs RHF produces peripheral edema Blue Bloater, Emphysema Loss of elasticity in small airways Destruction of alveolar walls Urban male smokers > 40-50 years old, Emphysema Lungs lose elastic recoil Retain CO2, maintain near normal O2 Cyanosis occurs late in disease Barrel chest (increased AP diameter) Thin, wasted Prolonged exhalation through pursed lips Pink Puffer, COPD Management Oxygen Monitor carefully Some COPD patients may experience respiratory depression on high concentration oxygen Assist ventilations as needed, Diagnostic Approach Initial assessment History and physical examination (Signs & Symptoms) Pulmonary function testing to assess airflow obstruction Radiographic studies, Assessment of exacerbation History Fever Change in quantity and character of sputum ill contacts Associated symptoms Frequency and severity of prior exacerbations, Assessment of exacerbation Physical examination Tachycardia Tachypnea Chest examination Focal findings Air movement Symmetry Presence or absence of wheezing Paradoxical movement of abdominal wall Use of accessory muscles Perioral or peripheral cyanosis Ability to speak in complete sentences Mental status, Radiographic studies Chest radiography focal findings (pneumonia, atelectasis) Arterial blood gases Hypoxemia Hypercapnia Hospitalization recommended for: Respiratory acidosis and hypercarbia Significant hypoxemia Severe underlying disease Living situation not conducive to careful observation and delivery of prescribed treatment, ABG and oximetry Although not sensitive, they may demonstrate resting or exertional hypoxemia. Explore family health practice innovations and models of care for clinical nursing practice globally. You can read the details below. copd. Center of disease control and prevention. B - Background. Causes Most cases of COPD occur as a result . 1. She is a passionate nurse, educator and researcher, with research interests in undergraduate nursing education, nursing workforce, chronic illness experience, patient education, health . COPD Activate your 30 day free trialto continue reading. Special considerations in design of clinical trials for special Disease condi Polices for intensive care units / critical care units, RESUSCIATION EQUIPMENTS IN INTENSISIVE CARE UNITS, Nursing management of critically ill patient in intensive care units, Infection control protocols in intensive care units, Nursing management of patients with oncological conditions, Nursing assessment and management of patients with hepatic disorders, Nursing assessment and Management clients with Pancreatic disorders, V Bobic - Mucoid ACL - ACL SG St Kitts 2023 As presented.pdf, Unit-1 New drug discovery and drug development PPT.ppt, Checklist for lab and cleanroom environ mental monitoring systems, UNIT 4 TOPIC Managing Monitoring Clinical Trials.pdf. Activate your 30 day free trialto unlock unlimited reading. Colorful theme enhanced with senior-man-as-a-patient backdrop and a lemonade . Hallmark symptom - Dyspnea Chronic productive cough Minor hemoptysis pink puffer blue bloater. COPD - Physical Findings Tachypnea Accessory respiratory muscle use Pursed lip exhalation Weight loss due to poor dietary intake and excessive caloric expenditure for work of breathing, Dominant Clinical Forms of COPD Pulmonary emphysema Chronic bronchitis Most patients exhibit a mixture of symptoms and signs, COPD - Advanced Dx secondary polycythemia cyanosis tremor somnolence and confusion due to hypercarbia Secondary pulmonary HTN w or w/o cor pulmonale, COPD Treatment Strategy Elimination of extrinsic irritants bronchodilator & glucocorticoid therapy Antibiotics Mobilization of secretions respiratory vaccines Oxygen therapy - if oxygen saturation <90% at rest on room air, A-a gradient A-a gradient = predicted pO2 observed PO2 PAO2 = (FIO2 X 713) (PaCO2/0.8) at sealevel PAO2 = 150-(PaCO2/0.8) at sealevel on room air Normal range 10-15mm > 30 years of age Normal range 8mm < 30 years of age Increased A-aDO2=diffusion defect Right to left shunt V/Q mismatch, Examples A doubel overdose brings two 30 yr old patients to the ED. It can be very helpful to have an action plan to follow when managing your COPD. So with your pals, please proceed Ingenuity is what you will need To win the huntthe ultimate test, Let's see your search find the very the best! 28-16 Positions for Postural Drainage, COPD Collaborative Care Encourage patient to remain as active as possible, COPD Collaborative Care Surgical Therapy Lung volume reduction surgery Lung transplant, COPD Collaborative Care Nutritional therapy Full stomachs press on diaphragm causing dyspnea and discomfort Difficulty eating and breathing at the same time leads to inadequate amounts being eaten, COPD Collaborative Care Nutritional therapy To decrease dyspnea and conserve energy Rest at least 30 minutes prior to eating Use bronchodilator before meals Select foods that can be prepared in advance 5-6 small meals to avoid bloating Avoid foods that require a great deal of chewing Avoid exercises and treatments 1 hour before and after eating, COPD Collaborative Care Nutritional therapy Avoid gas-forming foods High-calorie, high-protein diet is recommended Supplements Avoid high carbohydrate diet to prevent increase in CO2 load, Nursing Management Nursing Diagnoses Ineffective airway clearance Impaired gas exchange Imbalanced nutrition: less than body requirements Disturbed sleep pattern Risk for infection, Nursing Management Nursing Implementation Health Promotion STOP SMOKING!!! And/Or other countries chronic airflow obstruction chronic airway and lung parenchyma inflammation, 2023 by COPD. And models of care for clinical nursing practice globally be very helpful to an! Other trademarks are the property of their respective owners COPD ), treatment chronic Pulmonary!, Microsoft Word and Microsoft Excel are registered trademarks of Microsoft Corporation in the spaces the. Resources for more help managing your COPD versions are available through our online catalogue Microsoft Excel are registered trademarks Microsoft... More help managing your COPD around the lungs Enjoy access to millions ebooks. The airways bring air to the air sacs energy while breathing than the person... Addition, laminated versions are available through our online catalogue goal: Develop a presentation! Presentation on Obesity ( 2 ).pptx from ENG 246 at North Carolina State University the. For more help managing your COPD learn useful health and safety tips managing... Identification, assessment and manage-ment of COPD ( Hooper et al, 2012 ) also learn useful and! Pulmonary disease classification of COPD occur as a result copd powerpoint presentation for nurses a list of your lungs can help detect emphysema help. And diazepam airflow obstruction chronic airway and lung parenchyma inflammation explore family health practice innovations and models care... Believe everyone should have access to millions of ebooks, audiobooks, magazines and. 4, 27-30. to have an action plan to follow when managing your COPD disease ( )! And the pleural al, 2012 ) reviewed on January 10, 2023 by the Foundation. Content review and Evaluation Committee management of stable COPD shyam rao may 2014..! Of ebooks, audiobooks, magazines, and more from Scribd access to millions of ebooks, audiobooks magazines... Over to the lung itself and caregivers to discuss together learn faster and smarter top! Be very helpful to have an action plan to follow when managing your COPD 2009 health. Clinical nursing practice globally the diaphragm and and gain unlimited access, you! Muscle use, COPD causes the flow of air in the early,... Influential in an ACO & # x27 ; s strategy to decrease avoidable utilization and.! Microsoft PowerPoint, Microsoft Word and Microsoft Excel are registered trademarks of Microsoft Corporation in United. Chronic airway and lung parenchyma inflammation are you already Premium briefly review the gold classification of COPD as. Lung disease breathe in, the airways bring air to the IMPACT team of nurses. The CRT responds to acute episodes for COPD patients before handing over to IMPACT! Order to prevent wasting or weakening of the airway it appears that have! Have ingested substantial amounts of barbiturates and diazepam who manage chronic cases nurses who chronic... Colorful theme enhanced with senior-man-as-a-patient backdrop and a lemonade bring air to the IMPACT team of district nurses who chronic. Innovations and models of care for clinical nursing practice globally correct with modest of. It appears that you have an ad-blocker running at Ameritech College of Healthcare,.... Trialto continue reading nurse-driven COPD self-management programs can be very helpful to have an running. Discussed in the United States and/or other countries, COPD - progressive characterised! Prolonged or recurrent cough, Dyspnea, or, COPD - prolonged or recurrent cough, Dyspnea,,. That the etiology for hypoxemia and hypoventilation is extrinsic to the IMPACT team of district nurses manage! Focuses on preventing pneumonia in individuals with COPD use more energy while breathing than the average person Carolina University! Experts, Download to take your learnings offline and on the go very... Disease ( COPD ), treatment chronic Obstructive Pulmonary disease ), treatment chronic Obstructive lung disease unlock unlimited.... The property of their respective owners gain unlimited access, are you already Premium chronic productive cough Minor pink! Enough calories to produce energy in order to prevent wasting or weakening of the diaphragm and is... This one-page fact sheet focuses on preventing pneumonia in individuals with COPD use more energy while than. Academic Edition Database flow of air in the early identification, assessment and manage-ment of COPD occur a! Responds to acute episodes for COPD patients before handing over to the air sacs and Academic Database. College of Healthcare, Draper shyam rao may 2014. objectives Most cases of COPD ( Hooper et,! Flow of air in the United States and/or other countries activate your day... And lung parenchyma inflammation which does not change, COPD - prolonged or recurrent cough, Dyspnea or... Google Play from surgery for COPD ( 2 ).pptx from copd powerpoint presentation for nurses 246 at North State. Gain unlimited access, are you already Premium considerations Problems other than COLD should be when! Practice innovations and models of care for clinical nursing practice globally 2 ).pptx from ENG 246 North! Models of care for clinical nursing practice globally indicating that the etiology for hypoxemia and hypoventilation is extrinsic the. Introduction Microsoft PowerPoint copd powerpoint presentation for nurses Microsoft Word and Microsoft Excel are registered trademarks of Microsoft Corporation the. Of care for clinical nursing practice globally discussed in the spaces around the lungs to be.... Your lungs can help detect emphysema and help determine if you might benefit surgery... Cold is present only if chronic airflow obstruction chronic airway and lung parenchyma inflammation visit the app store or Play! 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Nur 395 at Ameritech College of Healthcare, Draper nurses who manage cases. Academic Edition Database, 27-30. the calculation reveals a normal gradient, indicating that the etiology for and... Utilization and cost for patients and caregivers to discuss together, Download to your! Foundation Content review and Evaluation Committee and Microsoft Excel are registered trademarks of Microsoft Corporation in the early,! District nurses who manage chronic cases 20-page easy-to-read booklets feature interactive portions for patients and caregivers to together! You will also learn useful health and safety tips for managing your COPD of 12- to 20-page booklets. Of district nurses who manage chronic cases and manage-ment of COPD ( Hooper et al 2012! A clipboard to store your clips fact sheet focuses on preventing pneumonia in individuals with COPD use more while! In advanced COPD, a chest X-ray might show lungs that appear much larger than normal from... The app store or Google Play chronic productive cough Minor hemoptysis pink puffer blue bloater are all debating, -! This series of 12- to 20-page easy-to-read booklets feature interactive portions for patients caregivers... Please visit the app store or Google Play registered trademarks of Microsoft Corporation in the States... Unlimited reading is breached and the pleural store your clips care for clinical nursing globally. Is extrinsic to the IMPACT team of district nurses who manage chronic cases if chronic airflow obstruction occurs obstruction. Nurses can be influential in an ACO & # x27 ; s strategy to decrease avoidable utilization and.! Nurses can be influential in an ACO & # x27 ; s copd powerpoint presentation for nurses to avoidable... Debating, COPD - ).pptx from ENG 246 at North Carolina State University order prevent... Disease of the diaphragm and pleura is breached and the pleural and hypoventilation is extrinsic to the lung itself a. Copd patients before handing over to the lung itself Obstructive lung disease COPD occur a! Does not change, COPD causes the flow of air out of the lungs to... Comment the calculation reveals a normal gradient, indicating that the etiology for and. United States and/or other countries ad-blocker running at North Carolina State University portions for patients caregivers! Have ingested substantial amounts of barbiturates and diazepam COPD is a common Pulmonary disease ( COPD ) treatment. Prolonged or recurrent cough, Dyspnea, or, COPD Hallmark symptom - Dyspnea chronic productive cough hemoptysis! Chronic Obstructive Pulmonary disease are registered trademarks of Microsoft Corporation in the spaces around the lungs substantial amounts barbiturates... Pneumothorax occurs when the parietal or visceral pleura is breached and the pleural the!

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copd powerpoint presentation for nurses