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Stack #38867
RRC Maintenance - COPD
| Question | Answer |
|---|---|
| Emphysema | hyperinflation of alveoli, destruction of alveolar walls, destruction alveolar capillary walls, narrowed/torturous small airways, loss of lung elasticity |
| Chronic bronchitis | hyperplasia of mucous glands, hypersecretion of mucus, loss of cilia, chronic inflammatory changes and narrowing of small airways, altered function of macrophages |
| hyperplasia + hypersecretion of mucus + inflammatory response = | narrowing of airway lumen and diminished airflow resulting in increased WOB |
| hypoxemia | deficient O2 in blood |
| hypercapnia | excessive CO2 in blood |
| Why does hypoxemia and hypercapnia develop in those with COPD? | contricted bronchiole acts as physical barrier |
| What happens when there is an exacerbation of COPD | inflammation! |
| Clinical manifestation of emphysema | progressively worse dyspnea, minimal coughing, barrel chest, use of accessory and intercostal muscles to breathe, characteristically underweight, decreased breath sounds, limited diaphragmatic excursion |
| clinical manifestions of chronic bronchitis | frequent productive cough/frequent clearing of throat, SOB, wheezing on forced expiration, frequent respiratory infections, normal weight or heavy-set |
| diagnostic tests for COPD | Chest x-ray, pulmonary function tests, arterial blood gases, sputum analysis, CBC |
| Risk factors for COPD | exposure to cigarette smoke, occupational exposure to dust, asbestos, silica, coal, gas fumes; chronic marijuana, pipe and cigar smoke, age |
| What s+sx of heart failure need to be taught to client | increased dyspnea, fatigue, increased coughing, changes in amount and consistency of sputum, peripheral edema, fever or sudden weight gain |
| bronchodilators | opens airway by relaxing smooth muscle of airways - resulting in increased airflow which may help loosen mucus |
| inhaled steroids | to decrease inflammation and thereby increase airflow -- should only be used short-term to relieve symptoms during exacerbations |
| antibiotics | given based on C&S results of sputum sent to treat underlying pneumonia |
| diuretics | to reduce fluid overload in presence of cardiac complications: cor pulmonale |
| Give rationale for elevating HOB in semi-Fowlers during exacerbation | maximizes ventilation and prolongs expiratory phase; also facilitates coughing and prevents aspirations |
| Give rationale for hydration during exacerbation of COPD | liquifies secretions for easier expectoration |
| Give rationale for administering O2 and why we only give 1-2L/min via NP | treat hypoxia --> use cautiously as those with chronic CO2 retention as hypoxemia stimulates respiratory drive, not hypercapnia |
| Give rationale for teaching pursed-lip breathing to a client with COPD | may prevent airway collapse during expiration |
Created by:
bella83
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