ATI: Chapter 22: Chronic Obstructive Pulmonary Disease Flashcards
Chronic obstructive pulmonary disease (COPD) encompasses two diseases ________ and _______.
emphysema and chronic bronchitis
Most clients who have emphysema also have ______.
chronic bronchitis
______ is irreversible.
COPD
Emphesema is characterized by the loss of lung elasticity and _______ of lung tissue.
hyperinflation
Emphysema causes destruction of the _______, leading to a decreased surface area for gas exchange, carbon dioxide retention, and respiratory acidosis.
alveoli
Chronic bronchitis is an inflammation of the bronchi and bronchioles due to chronic exposure to ________.
irritants
COPD typically affects middle age to ______.
older adults
With COPD patients promote smoking ________.
cessation.
With COPD patients avoid _______ smoke.
secondhand
With COPD patients use protective equipment, such as a mask, and ensure proper ventilation while working in environments that contain _________ or particles in the air.
carcinogens
With COPD patients influenza and _______ vaccinations are important for all clients who have COPD, but especially older adults.
pneumonia
A risk factor for COPD is _____ age: older adult clients have a decreased pulmonary reserve due to normal lung changes.
advanced
________ is the primary risk factor for the development of COPD.
cigarette smoking
________ deficiency is a risk factor of COPD.
Alpha1-antitrypsin (AAT)
Exposure to ________ is a risk factor for COPD. (air pollution)
environmental factors
Chronic _______ is an expected finding of COPD.
dyspnea
With COPD a physical assessment finding is dyspnea upon _____.
exertion
With COPD a physical assessment finding is a ______ cough that is most severe upon rising in the morning.
productive
With COPD a physical assessment finding is crackles and _______.
wheezes
Hypoexemia is a common finding of _____.
COPD
With COPD a physical assessment finding is rapid and ______ respirations.
shallow
With COPD a physical assessment finding is the use of ________ muscles.
accessory
With COPD a physical assessment finding is a _____ chest or increased chest diameter (with emphysema).
barrel
With COPD a physical assessment finding is _______ on perscussion due to “trapped air” (with emphysema).
hyperresonance
With COPD a physical assessment finding is irregular _______.
breathing pattern
With COPD a physical assessment finding is thin extremities and _______ muscles.
enlarged neck
With COPD a physical assessment finding is dependent edema secondary to _________ failure.
right sided heart
With COPD a physical assessment finding is ______ of fingers and toes (late stages of disease).
clubbing
With COPD a physical assessment finding is pallor and ______ of nail beds and mucous membranes (later stages of the disease).
cyanosis
With COPD a physical assessment finding is decreased ______ saturation levels (expected reference range is 95% to 100%)
oxygen
With COPD a physical assessment finding is in older adults or clients who have dark colored skin, ______ levels can be slightly lower.
oxygen saturation levels
With COPD increased ______ will show on lab tests due to low oxygenation levels.
hematocrit
With COPD use sputum cultures and ______ counts to diagnose acute respiratory infections.
WBC
Arterial blood gases will display hypoxemia (decreased PaO2 less than 80 mm Hg) and _______ (increased PaCO2 greater than 45 mm Hg)
hypercarbia
Serum ______ tests are used to identify COPD.
electrolytes
________ are used for diagnosis, as well as determining the effectiveness of therapy in COPD patients.
Pulmonary Function Tests (PFTs)
Comparisons of forced expiratory volume (FEV) to _______ are used to classify COPD as mild to very severe.
forced vital capacity (FVC)
As COPD advances, the FEV to FVC ratio ________.
decreases
The expected reference range is _____% for FEV to FVC ratio.
100%
For mild COPD, the FEV/FVC ratio is decreased to less than ______%.
70%
As the disease progresses to moderate and severe, the FEV/FVC ratio decreases to less than ______.
50%
A chest x-ray reveals hyperinflation of the ______ and flattened diaphragm in the late stages of emphysema.
alveoli
_______ are often not useful for the diagnosis of early or moderate disease.
chest x-rays
Clients who have COPD usually have oxygen levels less than the expected reference range of ____% to ____%
95% to 100%
Used to assess for deficiency in ____, an enzyme produced by the liver that helps regulate other enzymes (which help break down pollutants) from attacking lung tissue.
AAT (alpha, antitrypsin levels)
Position the client to maximize ventilation for COPD patients in ________.
high Fowlers
Encourage the effective coughing or ______ to remove secretions.
suction
Encourage deep breathing and the use of an ______.
incentive spirometer
Administer breathing treatments and _____ to COPD patients.
meds
Administer _____ as prescribed to COPD patients.
oxygen
Monitor for ______ around the nose and mouth from the oxygen device.
skin breakdown
Promote adequate nutrition because the increased work of breathing increasing the _____ demand.
caloric
Proper nutrition aids in the prevention of ______.
infection
Encourage fluids to promote adequate _____.
hydration
______ decreases energy available for eating, so soft, high-calorie foods should be encouraged.
dyspnea
Monitor _____ and note any changes.
weight
