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Chronic obstructive pulmonary disease - adults - discharge

COPD - adults - discharge

What happened in the hospital

You were in the hospital to treat breathing problems that are caused by chronic obstructive pulmonary disease (COPD). COPD damages your lungs. This makes it hard to breathe and get enough oxygen.

You got oxygen in the hospital to help you breathe better, and you may need to use oxygen at home. Your doctor may have changed some of your COPD medicines during your hospital stay.

Keep active

To build up strength:

  • Walk until it is a little hard to breathe.
  • Slowly increase how far you walk.
  • Try not to talk when you walk.
  • Ask the doctor or therapist how far to walk.
  • Ride a stationary bike. Ask your doctor or therapist how long and how hard to ride.

Build your strength even when you are sitting.

  • Use small weights or rubber tubing to make your arms and shoulders stronger.
  • Stand up and sit down several times.
  • Hold your legs straight out in front of you, then put them down. Repeat this movement several times.

Ask your doctor whether you need to use oxygen during your activities. Also ask whether you should do an exercise and conditioning program such as pulmonary rehabilitation.

Self-care

Know how and when to take your COPD drugs.

  • Take your quick-relief inhaler when you feel short of breath and need help fast.
  • Take your long-term inhaler every day.

Eat smaller meals more often -- 6 smaller meals a day. It might be easier to breathe when your stomach is not full. Do not drink a lot of liquid before eating, or with your meals.

Ask your doctor what foods to eat to get more energy.

Keep your lungs from becoming more damaged.

  • If you smoke, now is the time to quit.
  • Stay away from smokers when you are out, and do not allow smoking in your home.
  • Stay away from strong odors and fumes.
  • Do breathing exercises.

Talk to your doctor if you feel depressed or anxious.

Stay away from infections

Having COPD makes it easier for you to get infections. Get a flu shot every year. Ask your doctor if you should get a pneumococcal (pneumonia) vaccine.

Wash your hands often; always after you go to the bathroom and when you are around people who are sick.

Stay away from crowds. Ask any visitors with colds to wear masks or to postpone their visits.

Save your energy at home

Place items you use a lot in spots where you do not have to reach or bend over to get them.

Use a cart with wheels to move things around the house and kitchen. Use an electric can opener, dishwasher, and other things that will make your chores easier to do. Use cooking tools (knives, peelers, and pans) that are not heavy.

To save energy:

  • Use slow, steady motions when you are doing things.
  • Sit down if you can when you are cooking, eating, dressing, and bathing.
  • Get help for harder tasks.
  • Do not try to do too much in one day.
  • Keep the phone with you or near you.
  • Wrap yourself in a towel rather than drying off.
  • Try to reduce stress in your life.

Going home with oxygen

Never change how much oxygen is flowing in your oxygen setup without asking your doctor. 

Always have a back-up supply of oxygen in the home or with you when you go out. Keep the phone number of your oxygen supplier with you at all times. Learn how to use oxygen safely at home.

Follow-up

Your hospital doctor or nurse may ask you to make a follow-up visit with:

  • Your primary care doctor
  • A respiratory therapist, who can teach you breathing exercises and how to use your oxygen
  • Your lung doctor (pulmonologist)
  • Someone who can help you stop smoking, if you smoke
  • A physical therapist, if you join a pulmonary rehabilitation program

When to call the doctor

Call your doctor if, your breathing is:

  • Getting harder
  • Faster than before
  • Shallow, and you cannot get a deep breath

Also call your doctor if:

  • You need to lean forward when sitting in order to breathe easily
  • You are using muscles around your ribs to help you breathe
  • You are having headaches more often
  • You feel sleepy or confused
  • You have a fever
  • You are coughing up dark mucus
  • Your fingertips, or the skin around your fingernails, are blue

References

Anderson B, Conner K, Dunn C, et al. Institute for Clinical Systems Improvement. Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). https://www.icsi.org/_asset/yw83gh/COPD.pdf. Accessed May 5, 2014.

Balkissoon R, Lommatzsch S, Carolan B, Make B. Chronic obstructive pulmonary disease: a concise review. Med Clin N Am. 2011;95:1125-1141.

Evensen AE. Management of COPD exacrbations. Am Fam Physician. 2010;81:607-613.

Shapiro SD, Reilly JJ Jr., Rennard SI. Chronic bronchitis and emphysema. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 39.

Update Date: 4/26/2014

Updated by: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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