Health Encyclopedia - Discharge Instructions
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 drugs during your hospital stay.
Walk to build up strength:
- Ask the doctor or therapist how far to walk.
- Slowly increase how far you walk.
- Try not to talk when you walk.
Walk until it is a little hard to breathe. Ride a stationary bike. Ask your doctor or therapist how long and how hard to ride. Make yourself stronger 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.
Ask your doctor whether you need to use oxygen during your activities.
Know how and when to take your COPD drugs:
- Quick-relief inhalers when you feel short of breath and need help fast.
- Long-term inhalers to take every day.
Eat smaller meals more often. It might be easier to breathe when your stomach isn't full. Try to eat 6 small meals a day. Do not drink a lot of liquid before eating, or with your meals.
Ask your doctor what foods to eat to get more energy.
If you smoke, STOP. 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, and always after you go to the bathroom and when you are around people who are sick.
Stay away from crowds. Ask a visitor with a cold to wear a mask or to postpone their visit.
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.
Tips 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.
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.
Anthonisen N. Chronic Obstructive Pulmonary Disease. In: Goldman L, Auseillo D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 88.
Wilt TJ, Niewoehner D, MacDonald R, Kane RL. Management of stable chronic obstructive pulmonary disease: a systematic review for a clinical practice guideline. Ann Intern Med. 2007;147:141.
Xu W, Collet JP, Shapiro S, Lin Y, Yang T, Platt RW, et al. Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations. Am J Respir Crit Care Med. 2008;178:913-920.
Rodrigo G, Castro-Rodriguez JA, Plaza V. Safety and efficacy of combined long-acting beta-agonists and inhaled corticosteroids vs. long-acting beta-agonists monotherapy for stable COPD: a systematic review. Chest. 2009; 136(4):1029-1038.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.