Chronic Respiratory Conditions Flashcards
What are chronic respiratory conditions
Long lasting conditions that affect the airway
What is COPD?
- Progressive lung diseases characterised by inflammation that intensifies as disease progresses
- Includes chronic bronchitis (excessive bronchial mucous secretions) and emphysema (destruction of alveoli and enlargement of airspaces)
- Decreased lung compliance, scarring and obstruction, impaired gas exchange
Causes of COPD
- Active smoking or exposure to smoking
- Expoure to smoke from burning plant and animal foods
- Outdoor air pollution
- Fumes and dust in workplace
- Childhood respiratory infections
COPD management
- Control risk factors eg. smoking (5A strategy)
- Health and education and promotion of self management
- PURSED LIP BREATHING:
- improves ventilation and releases trapped air, keeps airways open longer and reduces work of breathing
- Prolongs exhalation to slow RR
- Relieves SOB
- Creates general relaxation
- MOBILISING SECRETIONS
- Postural drainage - trendelenerg position
- Chest percussion - to loosen secretions
- Vibration - fine shaking pressure from hands to chest wall while pt is exhaling
- HYDRATION - adequate fluid intake to keep secretions moist
CLEARING AIRWAY
- Depends on pt coughing ability
- Promotes more effective breathing pattern (better air entry, better gas exchange)
- Deep breathing, controlled coughing, incentive spirometry (pt needs adequate pain relief)
- Forced exhalation (huffing)
- Suctioning (oropharyngeal, nasopharyngeal)
SUPPLEMENTAL O2
- End stage COPD
- Changes in hypoxic drive
- o2 dependence
NUTRITION
- Increased resting energy expenditure (REE) by 10-15% due to work of breathing
- High calorie, high protein, healthy diet
- Frequent snacking and small meals
What is asthma?
- Chronic inflammatory condition of airways causing narrowing
- Airways in constant state of infalmmation, can be triggered to become more inflamed (asthma attack / flare up)
- Characterised by episodes of wheezing, breathlessness, chest tightness
Asthma management
- Bronchodilators and corticosteroids / relievers and preventers, which may be delivered via MDI, dry powder inhaler, nebs
- Vaccinations to prevent viral infections
- PEFR - measures greatest flow velocity produced during forced respiration (after fully expanding lungs during inspiration)
- Asthma action plan - to help recognise deterioration, start treatment and reach medical attention
- Trigger avoidance (eg. b blockers, NSAIDS, aspirin, inhaled allergens, smoke, food additives and colourants, URTI, exercise and sport)
What is sleep apnoea
- Cessation of breathing during sleep - decreased airflow through nose and mouth, causing intermittent dips in amount of o2 in blood
- Most common in obese individuals or those with large neck circumference
Types of sleep apnoea
- OBSTRUCTIVE (OSA)
- Repetitive pauses in breathing during sleep due to obstruction / collapse of upper airway (throat), usually with decreased o2 sats and followed by awakening to breathe - CENTRAL
- Loss of neuro inspiratory drive and as OSA (rare) - MIXED
- Treatment same as obstructive
Sleep apnoea management
Can be treated with devices that help open up airways such as a continuous positive airway pressure (CPAP) machine. A CPAP machine delivers air pressure through a mask placed over a person’s nose and/or mouth while they sleep
What is cystic fibrosis
Hereditary disorder causing secretions to become thick, viscous and sticky
Management of cystic fibrosis
- Physiotherapy to clear secretions
- Inhalations via nebs (mucolytics, bronchodilators, antibiotics, antiinflammatory)
- Na+ supplements to prevent dehydration
- High calorie, high salt, high fat diet
- Exercise to clear secretions
- Pancreatic enzyme deficiency prevents absorption and digestion of nutrients –> enzyme replacement
What are the non-modifiable and modifiable risk factors of chronic respiratory conditions?
Non-modifiable
- Age
- Heredity
Modifiable
- Smoking
- Unhealthy diet
- Being inactive
Education for respiratory patients
SELF- ASSESSMENT
identifying/avoiding triggers; using pulmonary function tests such as peak expiratory flow meters
MANAGING EXACERBATIONS
use of an asthma action plan; use of appropriate medications
MEDICATION MANAGEMENT
storage and use of inhalers; care and use of devices such as spacers/CPAP machine
NUTRITION
weight management and healthy diet choices
EXERCISE
maintaining appropriate level of physical activity
OTHER NON- PHARMACOLOGICAL TECHNIQUES
effective coughing and breathing techniques
SUPPORT
connecting to organisations such as Lung Foundation Australia, Asthma Australia, etc. which provide support programs for clients and families