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66 Cards in this Set
- Front
- Back
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What are some concepts related to oxygenation? |
Perfusion Sleep Nutrition Tissue Integrity Motion Metabolism Intracranial Regulation |
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What concept is most closely related to oxygenation? |
Perfusion |
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What concepts are related to gas exchange? |
Perfusion Acid-base balance Anxiety Nutrition Mobility Fatigue |
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Which concept is most closely related to gas exchange? |
Perfusion |
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What does COPD stand for? |
Chronic Obstructive Pulmonary Disease |
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What is COPD characterized by? |
Airflow limitation that is not fully reversible |
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What causes COPD? |
Airflow obstruction in the airways OR Obstruction in the parenchyma of the lung OR Combination of both |
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What is the #1 cause of COPD |
Smoking |
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What is another potential factors for causing COPD? |
Environmental exposures |
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What needs to be monitored carefully in COPD patients? |
Respiratory status |
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What may need to be limited for COPD patients? |
Medications that cause respiratory depression (esp. opioid pain medications) |
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How is asthma characterized? |
Abnormal airways characterized primarily by REVERSIBLE inflammation? |
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What type of disease is COPD? |
Progressive |
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What type of disease is asthma? |
Autoimmune |
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What is parenchyma? |
The functional tissue of an organ as opposed to connective and supporting tissue |
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What two conditions typically make up COPD? |
Chronic bronchitis Emphysema |
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Do airflow limitations typically stay the same in COPD patients |
No they typically get progressively worse |
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What is airflow limitation associated with in COPD patients? |
Abnormal inflammatory response to noxious particular or gases |
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What happens to lung tissue in COPD patients? |
Chronic inflammation damages tissue |
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What happens to airways with chronic inflammation? |
Scar tissue forms and results in narrowing |
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What happens to parenchyma with chronic inflammation? |
Scar tissue forms and decreases elastic recoil/compliance |
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What happens to pulmonary vasculature with chronic inflammation? |
Scar tissue forms and causes thickened vessel lining and hypertrophy of smooth muscle |
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What is hypertrophy of smooth muscle in pulmonary vasculature called? |
Pulmonary hypertension |
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What does GOLD stand for in GOLD Stages of COPD? |
Global Initiative for (chronic) Obstructive Lung Disease |
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What are the GOLD stages of COPD used for? |
To determine the severity of a COPD diagnosis |
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What is COPD Stage 1? |
Mild COPD 80% normal lung function |
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What is COPD Stage 2? |
Moderate COPD 50-80% normal lung function |
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What is COPD Stage 3? |
Severe COPD 30-50% normal lung function |
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What does COPD stage 3 often involve? |
Typically involves severe restraint of respiration, tinniness of breath and frequently COPD exacerbations |
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What is COPD Stage 4? |
Very severe COPD Less than 30% normal lung function |
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What does COPD stage 4 typically involve? |
Very severe and risky Decreases the life quality with vital COPD exacerbations |
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What is chronic bronchitis? |
Cough and sputum production for at least 3 months in each of 2 consecutive years |
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What happens to the lungs in chronic bronchitis? |
Ciliary function is reduced Bronchial walls thicken Bronchial airways narrow Mucus may plug airways Alveoli become damaged/fibrosed Alveolar macrophage function dimishes |
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What is the patient more susceptible to with chronic bronchitis? |
Respiratory infections |
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What do increased respiratory infections lead to in COPD patients? |
Increased antibiotic use and increased antibiotic resistance |
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What are some characteristics of a chronically inflammed bronchus? |
Inflammation/narrowing Increased number of mucus glands Excess mucus causing chronic cough |
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TRUE or FALSE For patients with chronic bronchitis, the nurse expects to see the major clinical symptoms of tachypnea and tachycardia. |
False. For patients with chronic bronchitis, the nurse expects to see the major clinical symptoms of sputum and productive cough. |
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What is emphysema? |
Abnormal distention of air spaces beyond the terminal bronchioles with destruction of the walls of the alveoli |
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What is the result of the destruction of alveolar walls in emphysema? |
Decreased alveolar surface area increases in "dead space" and impaired oxygen diffusion |
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What is the result of decreased alveolar surface area and impaired oxygen diffusion? |
Hypoxemia |
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What can happen if pulmonary artery pressure increases too much? |
Right sided heart failure Cor pulmonale |
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What is cor pulmonale? |
Right sided heart failure |
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What vital signs would you expect in a patient with emphysema? |
Heart rate up O2 sat down Blood pressure up |
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What is a visual cue that the patient might have a COPD type disease? |
Barrel chest |
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Why do COPD type diseases cause barrel chest? |
The chest is chronically overinflated with air, so the rib cage stays partially expanded all the time |
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What is normal AP diameter? |
1 / 2 |
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What posture might COPD patients adopt and why? |
Leaned forward with elbows resting to ease breathing |
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What is the primary clinical symptom of emphysema? A. Chest pain B. Productive cough C. Sputum D. Wheezing |
D. Wheezing The primary symptom of emphysema is wheezing.
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What are some nursing process steps for patients with COPD? |
Health history Inspection and examination findings Review of diagnostic tests MDI patient education Nursing Care Plan Home Care check list |
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What is important to remember about applying high levels of oxygen to COPD patients? |
Applying too high a level of oxygen will reduce their biological drive to breathe, which is bad |
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TRUE or FALSE A commonly prescribed medication for COPD clients is theophylline. |
True Bronchodilator that works by relaxing smooth muscles of the airways |
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What is bronchiectasis? |
Chronic, irreversible dilation of the bronchi and bronchioles |
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What are some causes of bronchiectasis? |
Airway obstruction Pulmonary infections Diffuse airway injury Genetic disorders Abnormal host defenses Idiopathic causes |
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Symptoms / Manifestations of Bronchiectasis |
Chronic cough Purulent sputum in copious amounts Clubbing of the fingers |
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Medical Management for Bronchiectasis |
Postural drainage Chest physiotherapy Smoking cessation Antimicrobial therapy |
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Nursing Management for Bronchiectasis |
Focus on alleviating symptoms and clearing pulmonary secretions Patient teaching (re: smoking cessation) |
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What is asthma? |
Chronic inflammatory disease of the airways that causes hyperresponsiveness, mucosal edema and mucus production |
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What does the inflammation of asthma lead to? |
Cough Chest tightness Wheezing Dyspnea |
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What is peak flow monitoring related to asthma? |
Part of diagnostics Measure of lung capacity |
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What will be important in patient teaching regarding asthma? |
Correct use of inhaler How to identify and avoid triggers How to perform peak flow monitoring How to implement an action plan When and how to seek assistance |
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What are some quick relief medications for asthma? |
Beta2 adrenergic agonists Anticholinergics (suppress reactions) |
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What are some long acting medications for asthma? |
Corticosteroids Long acting beta2 adrenergic agonists Leukotriene modifiers |
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What does it mean for treatment for asthma to be stepwise? |
There is a protocol for medications to be implemented and increased or added only as necessary |
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How long should the patient with asthma hold their medication? |
3-5 seconds |
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What lab tests might a patient with asthma or COPD need? |
Metabolic Panel - electrolyte levels CBC - check for infection X-ray CT or MRI maybe |
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What interventions might an asthma or COPD patient need if an infection is suspected? |
Cultures first Bsx antibiotics - amoxicillin, vancomycin, levaquin (if UTI is suspected) Isotonic or hypotonic fluids |
