Both narrow the airways and cause wheezing and shortness of breath. Asthma comes and goes and can be reversed. COPD is permanent and slowly gets worse.
Side by side
| Asthma | COPD | |
|---|---|---|
| Main cause | Airway inflammation from triggers: allergens, exercise, cold air, infection | Usually smoking |
| Reversible? | Yes, mostly | No |
| Pattern | Attacks with normal breathing in between | Constant symptoms with flare-ups |
| Classic signs | Wheezing, chest tightness, cough at night | Barrel chest, pursed-lip breathing, tripod position, chronic cough |
Red flags
- Asthma: a "silent chest," where wheezing stops because almost no air is moving. This is an emergency.
- COPD: new confusion or drowsiness can mean rising CO2.
Oxygen in COPD
Never withhold oxygen from a patient who needs it. For patients who retain CO2, the usual goal is an SpO2 of 88% to 92%, or as ordered.
Medications
- Rescue: albuterol, a short-acting bronchodilator, for quick relief.
- Daily controllers: inhaled steroids, long-acting bronchodilators like tiotropium, and montelukast for asthma.
- Flares: steroids, and antibiotics if there is an infection.
Teaching
- Use the rescue inhaler first when using two inhalers.
- Rinse your mouth after inhaled steroids to prevent thrush.
- Pursed-lip breathing: in through the nose, out slowly through pursed lips.
- Quit smoking and stay up to date on vaccines.
Practice this in Head-to-Toe
Listen for wheezes and diminished breath sounds in real-feeling patients.
Play Head-to-ToeFree account to start. Every game free for 14 days.
Quick answers
What oxygen saturation is the goal for COPD?
For patients who retain CO2, the usual goal is 88% to 92%, or as ordered by the provider.
What is a silent chest in asthma?
When wheezing stops because very little air is moving. It is a sign of a severe, life-threatening attack.
Evidence & Clinical Sources
- GOLD report (COPD)
- National Human Genome Research Institute: Genetic Discrimination and GINA
- Hinkle & Cheever, Brunner & Suddarth's Textbook of Medical-Surgical Nursing, Wolters Kluwer
Reviewed against current guidelines and drug labels. Always follow your program, a current drug reference, and facility policy. Our sources policy
For learning only. Lab ranges and policies vary. Always follow your nursing program, a current drug reference, and your facility's policies.