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22 Cards in this Set

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<Chronic obstructive pulmonary disease (COPD) is made up of two different problems which are?
<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
<COPD causes damage that is?
irreversible (as opposed to asthma which causes damage that IS reversible>
<The anatomical and functional changes with emphysema...
<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>
<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?
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>
<What symptoms are consistent with chronic bronchitis?
cough
wheezing
<Chronic bronchitis only affects which part of the airway?
bronchi
bronchiole
<Pulmonary emphysema only affects the?
alveoli
<What is the pathology behind the client's manifestations...what's making him cough and wheeze?
smoking inflames the bronchi and bronchioles
<When the cells of the bronchial lining tissue are irritated beyond a certain point...
the cilia that normally trap and eliminate fluids stop functioning>
<What is the pathology behind the client's manifestation?
<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>
There is actually an enzyme called AAT (alpha 1 antitrypsin) and it's dependent on?
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
What is the probable cause of a patient's chronic bronchitis?
smoking for a long time...smoking is the highest risk factor
What are other clinical manifestations of chronic bronchitis?
If there's a lot of mucus, what might happen...good medium for bacterial growth so the patient might get other respiratory infections
How might chronic bronchitis affect the heart?
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
What is cor pulmonale?
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
What is the advantage of Ventimask over nasal cannula?
delivers more accurate dosage of oxygen
<Medications prescribed for chronic bronchitis?
albuterol
cefuroxime (Zinacef
prednisone
theophylline (Theo-Dur)

(these are some of the same drugs used to treat asthma)>
<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
corticosteroid...used as an antiinflammatory...what are some of the side effects?
<What should be taught to a patient taking antiinflammatory steroids?

hypotension
shock
death
<don't stop med abruptly because they may go into an adrenal crisis and that can lead to?
<What classification of drug is Zinacef?
<antibiotic...side effects may include:
GI symptoms
allergic reactions (rash,
edema)
<What classification of drug is theophylline?

GI symptoms:
nausea and vomiting
anorexia
GERD
<xanthine derivative and bronchodilator...what are it's side effects?
<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)>
<beta2 adrenergic agonist
bronchodilator....what are its side effects?>