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COPD
pn 141 test 2 book: burke: pg 556
| Question | Answer |
|---|---|
| what is it | itis charecterized by chronic and progressive obstruction of airflow in the lungs |
| who does it usually effect | middle and older adults, whites, WM |
| what is the most common cause of it | smoking |
| what are risk factors | smoking, second hand smoke, air pollution, occupational pollutants, and family hx of COPD |
| it is the leading cause of what | death |
| what happens to the airways | they are narrowed, and obstructed |
| what causes the narrowing and obstruction of the airways | inflammation, excess mucous production, loss of elastic tissue and alveoli |
| what two different things cause airway and lung tissue changes | chronic bronchitis and emphysema |
| what happens to alveolar ventilation and gas exchange | it is impaired, between alveoli and blood |
| by the time COPD is Dx what s/s do pt have; how long have they had those s/s | productive cough, dyspnea, exercise intolerance; 10 years |
| when does the cough normally occur | in the mornings (smokers cough) |
| what causes increased sputum and difficulty breathign | respiratory tract infections |
| chronic bronchitis: what is it; s/s | a chronic inflammatory airway disorder; that causes excessive, secretion of thick tenacious mucus and a productive cough |
| chronic bronchitis: how long does the cough last | > 3 mo |
| chronic bronchitis: what leads to the chronic inflammatory process in the bronchial mucosa | inhaled irritants (cig. smoke) |
| chronic bronchitis: what are the narrowed airways do to | mucosal edema, and excess secretions obstruct airflow |
| chronic bronchitis: is expiratory or inspiratory affected first | expiratory airflow |
| chronic bronchitis: what happens to ciliary function; what does this do to body's defense system | it is impaired, normal defense mechanisms cannot clear mucus and inhaled pathogens |
| chronic bronchitis: what is very common b/c of decreased ciliary function | recurrent infections |
| chronic bronchitis: what sided heart failure does client usually develop | right sided heart failure (distended neck veins, edema, enlarged heart) |
| emphysema: what is it | destruction of alveolar walls leading to large adnormal spaces in the lungs |
| emphysema: what is the major cause | cig. smoke, also dificiency of alpha-antitrypsin enzyme |
| emphysema: alpha-antitrypsin enzyme- what does it normally do | prevent lung tissue destruction |
| emphysema: what happens when alveolar walls are dstroyed | air spaces enlarge and the surface area for gas exchange decreases |
| emphysema: what happens to the alveoli; this causes what | they become less elastic; and airways tend to collapse during exhalation |
| emphysema: when the airways collapse, what happens to the air | it becomes trapped in the lungs |
| emphysema: what happens to the AP chest diameter over time; what is this called | it increases, barrel chest |
| emphysema: what happens w/ expiration | it is prolonged |
| emphysema: what muscles are being used for respiration | accessory |
| emphysema: how do they often sit | sitting and leaning forward |
| emphysema: s/s- onset and s/s at onset | after age 50 w/ progressive SOB |
| emphysema: s/s- cough charecter | absent or mild, nonproductive |
| emphysema: s/s- appearance of pt | thin and cachectic (malnurished), barrel chest, use of accesory muscle for respiration |
| emphysema: s/s- Lung sounds | distant or diminsed breath sounds |
| chronic bronchitis: s/s- onset and s/s at onset | after age 35 w/ recurrent resp. infections |
| chronic bronchitis: s/s- cough charecter | persistant, productive of copious,thick sputum |
| chronic bronchitis: s/s- appearance of pt | often obese, edema and cyanosis, distended meck veins |
| chronic bronchitis: s/s- Lung sounds | wheezing and rhonchi |
| what is a way to prevent COPD | avoid smoking |
| what is COPD tx focused on | reducign s/s and maintaining optimal function |
| diagnostic tests: pulmonary functions test- what is it used for | to evaluate mung ventilation and function |
| diagnostic tests: serum alpha1 antitrypsin- what is it used for | levels and drwam to screen for a deficiency of this enzyme |
| diagnostic tests: ABGs- what is it used for | drawn to eval the effect of COPD on gas exchange |
| diagnostic tests: ABGs- during an acute episode what will PO2, PCo2 pH be | Po2 will be low, pco2 will be high, and pH will be low |
| diagnostic tests: ABGs- name for low po2 | hypoxemia |
| diagnostic tests: ABGs- name for high pco2 | hypercapnia |
| diagnostic tests: ABGs- name for low pH | respiratory acidosis |
| diagnostic tests: ABGs- chronic hypercapnia will reduce the effects of pco2 and pH on what | the respiratory drive |
| diagnostic tests: ABGs-what is breathing driven by with chronic hypercapnia | a drop in arterial oxygen levels |
| diagnostic tests: ABGs- chronic hypercapnia: pt will develop what with o2 administeration; why? | sleep apnea, respiratory arrest; b/c their drive to breath is suppressed |
| meds: what immunizations are recommended | PNA and flu shots |
| med: whatis ordered for infection | broad spectrum antibiotic |
| meds: why are corticosteroids given | to reduce inflammation and edema of the airways |
| meds: what ones should be avoided | cough suppressents and sedatives, beta blockers |
| other therapies: what can help clear the secretions | increased fluid intake, effective cough, percussion, postural drainage |
| tx for end stage COPD | lung reduction or lung transplant |
| surgery: what does lung reduction do | reduces to volume of the lung, reshapes it and improves elastic recoil |
| surgery: what does lung reduction improve | pulmonary lung function and exercise intolerance, reduces dyspnea |
| how does coughing help | it mobilizes secretions and maintains open airways |
| meds: what ones should be used before coughing percussion ect; why? | expectorants and bronchodilators; they improve airway clearance |
| breathing and coughing techniques: guidlines for pursed lip breathing | inhale through nose w/ mouth closed; wxhale slowly though pursed lips and though whistleing or blowing out a candle, exhale twice as long as inhale |
| breathing and coughing techniques: guidlines for diaphramatic or abdominal breathing | one hand on abdomen and other on chest, inhale concetrating on pushing abdominal hand out ward while chest hand will remain still; exhale slowly while abdominal hand moves inward and chest hand remains still |
| breathing and coughing techniques: guidlines for controlled cough technique | after use of bronchodilator, inhale deeply and hold breath briefly, cough twice (1st to loosening mucus, then to expel sectretions), inhale bysmiffing to prevent mucus from moving back into deep airways, rest |
| breathing and coughing techniques: guidlines for hiff cough technique | inhale deeply, leaning forward, exhale sharply w/ a huff sound, helps to keep the airways open while mobilizing secretions |
| what is the 31 trigger of it | smoking |
| it increases the susceptibility to what | infections |
| chronic bronchitis: what airways does it effect | both large and small |
| who is the blue bloater | the chronic bronchitis |
| who is the pink puffer | emphysema |
| what age does chronic bronchitis occur | after 35 |
| what age does emphysema occur | after 50 |
| emphysema: what happens to the lungs | they hyperinflate |
| what happens when pt is sleeping | orthopnea |
| Nx Dx: impaired gas exchange- nursing considerations | assess rsp, lungs, LOC, Vitals, 02 sats, lobs, skin cap refill, clubbing, Hi fowlers, administer 02 and humidity |
| meds that are good | bronchodilaters, corticosteroids |
| Nx Dx: nutrition imblanace- nursing considerations | increase calories, bronchodilators, small frequent meals, snacks, easily digested foods, mouth care before and after |
Created by:
jmkettel
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