Medical 5-Ms33-Copd

Front 1

<Chronic obstructive pulmonary disease (COPD) is made up of two different problems which are?

Back 1

<chronic bronchitis
an airway problem
pulmonary emphysema
alveolar problem

(these two conditions are almost always together>

most clients with emphysema have chronic bronchitis at the same time, but each condition has its own pathophysiologic process

Front 2

<COPD causes damage that is?

Back 2

irreversible (as opposed to asthma which causes damage that IS reversible>

Front 3

<The anatomical and functional changes with emphysema...

Back 3

<there is loss of lung elasticity and so alveolar sacks lose elasticity...narrow...causingdecreased area for gas exchange in the lungs...these changes result in DYSPNEA and the need for increased respiratory rate>

Front 4

<Hyperinflation of the lungs...when the alveoli are overstretched, the air is trapped in the lungs and the hyperinflation of the lungs as I mentioned earlier flattens and weakens the diaphragm...this is why emphysemic clients need to use which muscles?

Back 4

accessory muscles in neck and abdomen, chest wall in order to ventilate...the diaphram is the strongest muscle that helps to ventilate...if it's damaged or not able to be flattened out, then accessory muscles are used causing a barrel chest effect...sometimes inhalation will actually start before exhalation has been completed and this results in an uncoordinated pattern of breathing and it also causes carbon dioxide to accumulate faster because they're not able to completely expire the air that they need to get rid of...this results in chronic respiratory acidosis...that's why it's so important to teach patient the pursed lip expiration...this puts more pressure on the alveoli to force air out of there and get gas exchange going>

Front 5

<What symptoms are consistent with chronic bronchitis?

Back 5

cough
wheezing

Front 6

<Chronic bronchitis only affects which part of the airway?

Back 6

bronchi
bronchiole

Front 7

<Pulmonary emphysema only affects the?

Back 7

alveoli

Front 8

<What is the pathology behind the client's manifestations...what's making him cough and wheeze?

Back 8

smoking inflames the bronchi and bronchioles

Front 9

<When the cells of the bronchial lining tissue are irritated beyond a certain point...

Back 9

the cilia that normally trap and eliminate fluids stop functioning>

Front 10

<What is the pathology behind the client's manifestation?

Back 10

<the air passages become clogged with debris and irritation increases and in response to this irritation, heavy secretions of mucus and there is a characteristic bronchial cough>

Front 11

There is actually an enzyme called AAT (alpha 1 antitrypsin) and it's dependent on?

Back 11

inheritance of two certain types of genes.
If a person inherits both of these genes, they make enough AAT, to prevent COPD unless there's significant exposure to cigarette smoking or other pollutants...but if both genes are faulty, COPD can develop at a fairly young age even if they don't smoke cigarettes...so there's another genetic quality with bronchitis as well

Front 12

What is the probable cause of a patient's chronic bronchitis?

Back 12

smoking for a long time...smoking is the highest risk factor

Front 13

What are other clinical manifestations of chronic bronchitis?

Back 13

If there's a lot of mucus, what might happen...good medium for bacterial growth so the patient might get other respiratory infections

Front 14

How might chronic bronchitis affect the heart?

Back 14

stroke volume might go up
heart rate might go up...right sided heart failure might occur because the heart has to work hard....this is called COR PULMONALE...due to the decreased oxygen in the blood causing major blood vessels to constrict and so the right side of the heart has to generate more pressure to pump the blood through the lungs and this causes the right chamber of the heart to enlarge and thicken... there can also be cardiac dysrhythmias because of the hypoxic conditions or it can also be due to the meds or acidosis which can cause cardiac dysrhythmias...the HALLMARK sign is EXCESSIVE SPUTUM PRODUCTION

Front 15

What is cor pulmonale?

Back 15

hypertrophy or failure of orders of the right ventricle resulting from disorders of the lungs, pulmonary vessels, or chest wall...may occur with chronic bronchitis...respiratory acidosis occurs...HYPERCAPNIA

Front 16

What is the advantage of Ventimask over nasal cannula?

Back 16

delivers more accurate dosage of oxygen

Front 17

<Medications prescribed for chronic bronchitis?

Back 17

albuterol
cefuroxime (Zinacef
prednisone
theophylline (Theo-Dur)

(these are some of the same drugs used to treat asthma)>

Front 18

<Prednisone is what type of drug and is used for what?

Cushing syndrome (moon face)
truncal obesity...this is
because the steroids
interfere with nitrogen,
carbohydrate and mineral
metabolism in the body..
fragile skin
electrolyte imbalance
mood swings
weight gain

Back 18

corticosteroid...used as an antiinflammatory...what are some of the side effects?

Front 19

<What should be taught to a patient taking antiinflammatory steroids?

hypotension
shock
death

Back 19

<don't stop med abruptly because they may go into an adrenal crisis and that can lead to?

Front 20

<What classification of drug is Zinacef?

Back 20

<antibiotic...side effects may include:
GI symptoms
allergic reactions (rash,
edema)

Front 21

<What classification of drug is theophylline?

GI symptoms:
nausea and vomiting
anorexia
GERD

Back 21

<xanthine derivative and bronchodilator...what are it's side effects?

Front 22

<Explain the main actions and common side effects of albuterol?

headaches
tremors
nervousness
dizziness
diaphoresis
nausea and vomiting
muscle cramps

(they work to produce relaxation and dilatation of the bronchii)>

Back 22

<beta2 adrenergic agonist
bronchodilator....what are its side effects?>