Chronic obstructive pulmonary disease - adults - discharge

In the hospital you received oxygen to help you breathe better. You may also need to use oxygen at home. Your health care provider may have changed some of your COPD medicines during your hospital stay.

To build strength:

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

Build your strength even when you are sitting.

• Use small weights or an exercise band to strengthen your arms and shoulders.
• 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 provider whether you need to use oxygen during your activities, and if so, how much. You may be told to keep your oxygen above 90%. You can measure this with an oximeter. This is a small device that measures your body's oxygen level. Talk with your provider about how much oxygen is safe to use and what oxygen saturation to aim for.

Talk to your provider about whether you should do an exercise and conditioning program such as pulmonary rehabilitation.

Know how and when to take your COPD medicines.

• Take your quick-relief inhaler when you feel short of breath and need help fast, but always according to your provider's instructions so you don't take too much.
• Take your long-term medicines every day.

Eat smaller meals more often, such as 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 provider 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 provider if you feel depressed or anxious.

Having COPD makes it easier for you to get infections. Get a flu shot every year. Ask your provider if you should get a pneumococcal (pneumonia) vaccine, respiratory syncytial virus (RSV) vaccine, a Tdap (tetanus, diphtheria and pertussis) vaccine, a Zoster vaccine and a COVID-19 vaccine.

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

Stay away from crowds. Ask visitors who have colds to wear masks or to visit when they're all better.

Place items you use often 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.
• Minimize going up and down the stairs.
• Get help for harder tasks.
• Do not try to do too much in one day.
• Keep your phone with you or near you.
• After bathing, wrap yourself in a towel rather than drying off.
• Try to reduce stress in your life.

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

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 provider may ask you to make a follow-up visit with:

• Your primary care provider
• 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

Contact your provider if your breathing is:

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

Also contact your provider if:

• You need to lean forward when sitting in order to breathe easily
• It is difficult to speak even a few words without being short of breath
• 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

COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; Chronic bronchitis - adults - discharge; Emphysema - adults - discharge; Bronchitis - chronic - adults - discharge; Chronic respiratory failure - adults - discharge

Global Initiative for Chronic Obstructive Lung Disease (GOLD) website. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. goldcopd.org/2024-gold-report/. Accessed May 16, 2024.

Han MK, Lazarus SC. COPD: clinical diagnosis and management. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 64.

National Heart, Lung, and Blood Institute website. COPD. www.nhlbi.nih.gov/health/copd. Updated October 25, 2023. Accessed May 16, 2024.

Reilly J. Chronic obstructive pulmonary disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 76.

US Department of Veterans Affairs website. VA/DoD Clinical Practice Guideline for The Management Of Chronic Obstructive Pulmonary Disease, Version 3.0. www.healthquality.va.gov/guidelines/CD/copd/VADoDCOPDCPGFinal508.pdf. Updated April 2021. Accessed May 16, 2024.

Updated by: Allen J. Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant Professor, Rutgers New Jersey Medical School, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.