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20 Cards in this Set
- Front
- Back
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DEFINED COPD?
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inflammation of airway due to noxious particle and gases mainly smoking
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What also associate in COPD or coexist with COPD?
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Chronic bronchitis
emphysema |
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What happen when patient smoke?
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cause hyperplasia
which cause airway diamater get smaller and alveolar become thicker which pt have hard time removing mucus out. Lead to increase in mucus production or accumulation |
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What other contribution to cause COPD?
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Occupational and environmental: dust, vapor, fume, air polluntion, fume indoor cooking and heat
Infection: recur infection lead to impair defense mechanism intensify lung damage Bacteria: Haemophilu influenza; Strep. pneumonia, Moraxella catarrhalis, Rhinovirus Genetic - AAT deficiency Aging |
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What happen when the airway is limited and not fully reversible
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cause mucus hypersecretion, mucosal edema, bronchospasm because they can't secret out due to airway obstruction and reduce elastic recoil
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What happen when the inflammation of the central airway in COPD pt?
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1. Activate inflammotary mediator: lympholyte, macrophage and neutrophile... which active other inflammatory mediator = stimulate tumor necrosis and growth factor = change in structure of the lungs
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What happen when OXIDANT release by the inflammatory mediator?
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Oxidant inhibit antiprotease (prevent breakdown connective tissue in alveoli) - the imbalance of antiprotease and protease cause obstruction of the airway and reduce elastic recoil of the lung.
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What happen when to the patient if obstruction of the airway and reduce elastic recoil to the lung?
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The lung have to work hard which mean the functional residual capacity increase because patient trying to breath when the lung is overinflated
cause patient to be tired (Dyspnea) and can't do exercise |
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What happen when the airway exchange is being abnormal or interferes?
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cause hypoxemia and hypercarbia which lead to destroy the alveoli and fromation of bullae and bulbe lead to V/Q mismatch and hypoxemia
Pulmoary airway obstruction also lead to V/Q mismatch and respiratory muscle impair = CO2 retension = severe disease |
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what happen when patient have chronic cough in COPD?
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mucus production increase because there is an increase in globet cell and enlargement of submucosal gland
cause dysfunctional cilia |
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What when pulmonary vascular change in COPD pt?
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cause Hypertension due to hypoxia the pulmonary artery constriction
structural change cause further vasoconstriction which lead to hypertrophy R. ventricular (Cor Pulmonary |
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what are the clinical manifestation of COPD PT?
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Develop slowly
Dyspnea, cough w/ sputum Physical exame: prolong exhale; crackle and wheeze/ decrease breath sound, anterior and posterior ratio increase Bluish red - cyanosis/ polycythemia tripod position and pursed lip breathing |
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what are the four class of COPD and treatment?
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Mild: FEV>80%: Vaccine + short bronchodilator
Moderate: 50%<FEV<80%: vaccine +short+long bronchodilator + rehabilitation Severe: 30<FEV<50%: vaccine +short+long bronchodilator + rehabilitation + Corticosteroids VERY SEVERES: FEV<30%: vaccine +short+long bronchodilator + rehabilitation + Corticosteroids + Oxygen therapy or surgical therapy |
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What are the complication in COPD?
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1. Cor Pulmonary
s/s: dyspnea, Jugular venous distension, pulmonary edema, hepatomegaly, weight gain, crackles sound 2. COPD exacerbation s/s: Dyspnea, Cough, Sputum 3. Depression/ Anxiety s/s: Dyspnea - pursed lip breathing |
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what test will you order for COPD PT?
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1. Pulmonary functional test
Chest X-Ray, Spirometery: FEV/FVC<70%; Increase residual volume 2. ABG test pH low, low O2, high CO2 and HCO3 3. 6 Minutes walk determine O2 saturation |
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What are the goal in collaboration of COPD?
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Prevent complication and progression
Reduce symptom and mortality Promote Pt praticipation |
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What is the drug therapy for COPD?
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Bronchodilators
Function: Relax smooth muscle, increase ventilation and FEV; decrease dyspnea Type: Beta adrenergic agonist Anticholinergic Methylxanthines Admin: Inhaled combine ICS + beta = more effective for stage 3 and 4 Long acting anticholinergic is Tiotropium/ Spiriva |
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What is the function of oxygen therapy?
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Benefit:
reduce heart work and lung maintain O2 exercise, sleep, cognitive performance (mental), prognosis BAD: HTN and hemotocrit |
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How do you delivery oxygen for oxygen therapy?
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Low flow delivery: nasal cannula, simple mask, non-partial mask
High flow delivery: tracheostomy, venturi mask, conseru maks |
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What are the respiratory therapy for COPD?
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Breathing retrain - pursed lip or diaphargmatic
effective cough - huff cough Chest physiotherapy: percussion, vibration, drainage postural Airway Clearing: flutter, acapella, thera peptherapy High freq chest oscillation: vest inflate |
