chronic obstructive pulmonary disease Flashcards
what is COPD?
- narrowed bronchioles blocked with mucus
- causes disruptions to the airway and breathing difficulties
what does COPD result in?
- emphysema
what are the 4 problems of breathing in COPD?
- hypoxia
- increased WOB
- ineffective airway clearance
- increased sputum production
what are the 3 main symptoms of COPD?
- dyspnoea
- wheeze, recurrent cough and LRTI
- history of risk factors
what is dyspnoea?
- shortness of breath
what is the time frame of dyspnoea? when it is worse?
- progressive over time
- persistent
- worse on exercise
what does LRTI stand for?
- lower respiratory tract infection
what is the wheeze and recurrent cough described as?
- intermittent
- unproductive
what are the risk factors of COPD?
- smoke (tobacco or home cooking/ heated fuels)
- occupational dusts/ fumes
- host factors e.g., genetic, developmental abnormalities, low birthweight, prematurity, childhood RI
what is exacerbation?
- event characterised by dyspnoea and/ or cough and sputum that worsens over 14 days
what may the dyspnoea and/ or cough and sputum be accompanied by in exacerbation?
- tachypnoea and/ or tachycardia
what is tachypnoea?
- abnormally rapid breathing
what is tachycardia?
- increased heart rate
what is exacerbation associated with regarding inflammation?
- increased local and systemic inflammation
- caused by airway infection, pollution or other insult to the airways
how do you measure exacerbation?
- VAS scale used
0-10
how is exacerbation categorised?
- mild
- moderate
- severe
what are the key signs of COPD?
- sputum volume and colour
- respiratory distress (accessory muscle use)
how do you evaluate severity of COPD symptoms?
- use appropriate additional investigations e.g., pulse oximetry, laboratory assessment, and CRP and/ or arterial blood gases
what should you establish lastly in the diagnostic approach of COPD?
- establish cause of event
what are the main three cause of events of COPD?
- viral
- bacterial
- environmental
what should you give a hypoxic patient?
- immediately give them oxygen
- as they can die from lack of oxygen
what is a humidified circuit?
- delivers water so the regulatory system isn’t dry and hence mucus is less likely to get stuck
what is the purpose of the nebuliser attachment?
- can deliver liquid form of drugs
what do different adaptors on the oxygen machine represent? what group of people is this especially important for?
- represent different percentages of oxygen
- ensures we can control the flow
- important specific flow rate for stroke patients
how much oxygen does a normal breath bag deliver?
- delivers 15litres of oxygen per minute
what percentage of oxygen does a normal oxygen bag give patients?
- 98% of oxygen
what is the problem with the normal breath bag? what does this mean?
- dry circuit
- important to move acute patients on
what are COPD patients more prone to obtaining? what does this cause the body to do?
- high carbon dioxide
- prolonged period of high C02 concentration means the body adapts
what happens if a COPD patient is given too much oxygen?
- might knock off respiratory drive
what type of oxygen is given to COPD patients?
- dry air
what is the respiratory management for increased secretion load/ ineffective airway clearance? what does it do?
- active cycle of breathing technique
- moves the secretions from the lower airway to the higher airway
what are the active cycle of breathing steps?
- breathing control for 20-30 seconds
- 3/4 deep breaths
- breathing control
- 3/4 deep breaths
- breathing control
- huffing followed by cough if needed
what are the four types of respiratory managements?
- suction
- airobika
- acapella
- nasopharyngeal suction
what type of devices are acapella and airobika?
- oscillatory devices
what do acapella and airobika help split?
- help split the airways open
- send vibrations into the airways to help move secretions up
what is an example of a suction machine?
- endotracheal tube
what are the two different ways a nasopharyngeal suction can be used?
- orally
- nasally
what is a barrel chest?
- ribs up and stiff
- flattened diaphragm (hasn’t got far to go to increase volume so want to make more dome shape)
what is the respiratory management of increased work of breathing?
- forward lean position
- abdominal contents push up on diaphragm to aid dome shape
- more movement produced and bigger change in volume
what should you fixate in the forward lean position? what does this prevent?
- fixate the arms to help the accessory muscles
- prevents the muscles becoming fatigued
