Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
14 Cards in this Set
- Front
- Back
|
COPD is a combination of?
|
Emphysema and Chronic Bronchitis
|
|
|
COPD reversible?
|
No, tissue damage is not reversible. It is treatable and further damage can be prevented in some cases if caught early and smoking/exposure to irritants decreases.
|
|
|
Respiratory Assessment for COPD
Hobbies? Hx of? |
-Woodworking, model airplanes, model cars
-Hx of Resp Illness |
|
|
Respiratory Asessment for COPD
Drug use? Socioeconomic? Travel? Nutrition? Family hx? Current problems? |
-Legal/Illegal (Snorthing can irritate or dry)
-Can they afford medications? Current living conditions: molds, air cond., heat, pets, fumes, pollens -Climates, exacerbations -What types of food? ShOB when eating? Preparing foods? Any allergic reactions? -Genetics? TB in the home or at work? -CP, ShOB, sputum, when do symptoms occur? |
|
|
Chronic Bronchitis
Definition? Caused by? What happens? Nsg Dx? |
-Inflammation of the bronchi and bronchioles
-Chronic exposure to irritants/Cig smoking is the leading cause -Chronic Inflammation w/vasodilation, congestion and edema of the bronchial mucosa, goblet cells increast in amt and size and mucous glands enlarge=excessive amts of thick mucous on the bronchial walls thicken, airflow is impaired b/c less space -Ineffective Airway Clearance, Ineffective Breathing Pattern, Impaired Gas Exchange |
|
|
Emphysema
Describe? Onset? Causes? What happens? Primary Nsg Dx? |
-Loss of lung elasticity and hyperinflation of the lung
-Comes on slowly, increased RR and tired -Smoking is leading cause, Alpa 1 antitrypsin deficiency (protective protein) -Less alveoli for gas exchange, alveolar sacs lose elasticity, bullae (air filled spaces) form, increased amount of air trapped in lungs, collapse of small airways, increased work of breathing, hyperinflated lung weakens the diaphragm, need to use accessory muscles (retraction), increased effort=increased need for o2=work harder, "air hunger" sensation =Impaired Gas Exchange |
|
|
Risk Factors for COPD
|
-Cigarette smoking, Second-hand smoke, Alpha 1 Antitrypsin deficiency, Air pollution, long term exposure to chemical irritants, asthma
|
|
|
Tobacco smoke and air pollution lead to
Those complications lead to Those diseases lead to |
-Continual bronchial irritation and inflammation & breakdown of elastin in connective tissue of lungs
-Chronic bronchitis: bronchial edema, hypersecretion of mucus, chronic cough and bronchospasm, Emphysema: destruction of alveolar septa, airway instability -Airway obstruction, air trapping, dyspnea, frequent infx -Abnormal Vent/Perf Ratio, hypoxemia, hypoventilation, cor pumonale (R sided heart failure) |
|
|
Clinical Manifestations of COPD:
First Four? S/S Bronchitis S/S Emphysema More S/S COPD Psychosocial factors |
-Cough, sputum production (w/color), dyspnea, exercise intolerance
-Chronic cough w/mucous production, dsypnea, tachycardia, narrowed airway passages, wheezing, air trapping -Air trapping, possible wheezing, dyspnea, barrel chest, pursed lip breathing, posturing (tripod) -Cardiac changes, tachycardia, cyanotic, dusky appearance, delayed cap refill, clubbing, dependent edema, distended NC, liver engorgement, enlarge heart -Can't work, anxiety, socialization is affected |
|
|
Treatment options for COPD in order of increasing severity
|
-Self Education & Smoking Cessation
-Bronchodilators -Corticosteroids -Pulomnary Rehabilitiation -Oxygen -Surgery |
|
|
COPD:
Medications ordered when? Oxygen Surgery Types of resp therapy Important Vaccines |
-To the findings of diagnostic tests, meds change as disease progresses
-Low flow O2 (2-4L), may need O2 only at certain times -Bolectomy- lung volume reduction, transplant is the last resort for end stage -Percussion (forceful striking), vibration and postural drainage (by gravity) -Influenza and Pneumococcal vaccination |
|
|
Pharmacology for Asthma or COPD
Bronchodilators: SABA: Uses, Meds LABA: Uses, Meds Cholinergic Antagonist: action, med SABA or LABA first? S/E of Bronchodilators |
-Attack rescue medication, flare ups: Albuterol (Proventil, Ventolin)
-Slower onset, longer, prevention, duration, maintenance: Salmeterol (Serevent) or Asmanex (mometasone furoate) -Long acting: Ipratropium (Atrovent, Apolpravent) -SABA first, then Laba -Tachycardia, jittery, shaky, can't sleep |
|
|
Pharmacology for COPD:
Methylxanthines What types of cases? Meds? Forms? Acts like? Serum level, what effects? |
-Chronic
-Theophylline (Theo-Dur, Elixophyllin, Theolair, Slo-Bid and many others) -PO and IV -Like caffeine 10-20, stopping smoking changes level |
|
|
Anti-Inflammatories:
Corticosteroids: meds S/E steriods NSAIDS: med Leukotrine Antagonist- Effects, Meds |
-Fluticasone (Flovent) Will not relieve or reverse a symptom, only prevent inflamm. response, Prednisone (Deltasone, Predone): less common because extreme s/e suppress immune response
-B/S elevate, wt. gain, ulcers, insomnia, jittery, shaky -Nedocromil (Tilade) inhaler to prevent attacks, does not relieve or reverse symptoms -Prevents inflammatory mediator from stimulating- Montelukast (Singulair)- long acting, daily, Omalizaumab (Xolair)- SC, given every few weeks for rare or severe cases, many allergic reactions to |
