Chronic Respiratory conditions Flashcards
what is asthma
chronic inflammatory airway disorder
airway obstruction, bronchial irritability, edema of mucous membranes, congestion and spasms of smooth muscles of the bronchi and bronchioles.
pathophysiology of ashtma
hypersensitivity type 1 immune response
IgE mediated
asthma classification system
frequency and severity of symptoms severe persistent moderate persistent mild persistent mild intermittent
levels of control in asthma
controlled
partly controlled
uncontrolled
host risk factors of asthma
age heredity gender obesity ethnicity
environmental factors of asthma
allergens infection tobacco smoke indoor/outdoor air pollution diet
clinical manifestations of asthma
dyspnea excessive coughing expiratory wheezing diaphoresis prolong expiratory phase anxious restless setting position
signs of respiratory distress
nasal flaring
cyanosis
intercostal retractions
pulmonary function tests
forced vital capacity (FVC)
forced expiratory volume (FEV)
forced expiratory flow (FEF)
Peak expiratory flow (PEF)
preventer meds for asthma (controllers)
corticosteroids : QVAR, flovent
Long acting Beta 2: advair, servent
mast cell stabilizers: cromolyn
Leukotriene inhibitors: Singulair
rescue meds for asthma (reliever)
short acting beta 2 agonists/ bronchodilators: proventil, xopenex, albuterol
methylxanthines (not used much b/c of toxicity) theophylline
nursing interventions for asthma exacerbation
high fowlers oxygen teach child to use diaphragm to pull in and expel air control panic administer rescue drugs
exercise induced bronchospasms
it is asthma self-limiting develops after vigorous exercise do not exclude children from sports pre-medicate to prevent exacerbation
symptoms of exercise induced bronchospasm
cough, shortness of breath, chest pain or tightness, wheezing and endurance problems
cystic fibrosis mainly effects which ethnicity?
caucasians
pathophysiology of CF
disrupts the normal functions of the exocrine glands related to sodium and chloride transport via the CFTR protein
multiorgan effects of CF
respiratory
gastrointestinal
reproductive
hepatic
pulmonary effects
repeated episodes of bronchitis and chronic bronchial pneumonia
generalized obstructive emphysema
pulmonary s/s of CF
wheezy cough, increasing dyspnea, thick rattling extremely productive cough, cyanosis, pneumonia, polyps in nose, clubbed digits, chronic sinusitis
GI tract effect of CF
small intestine, intestinal obstruction
pancreatic ducts
what happens to the pancreas during CF
degeneration of pancreas
pancreatic achylia
malabsorption syndrome
diabetes
GI s/s of CF
appetite changes steatorrhea azotorrhea weight loss tissue wasting distended abdomen sallow skin anemia
hepatic effects of CF
biliary fibrosis
biliary cirrhosis
portal hypertension
s/s of hepatic effects of CF
ascites
GI bleeding
jaundice
reproductive effects of CF
sterility
delayed puberty
salivary and sweat glands CF
electrolyte loss salty sweat dehydration hyponatremia heat stroke
diagnostic tests for CF
Prenatal-DNA analysis of chronic villi or amniotic fluid samples
newborn screening
pilocarpine electrophoresis (sweat chloride test) >60 is a positive result
stool for fecal fat
what is considered a positive sweat test result during a pilocarpine electrophoresis test?
greater than 60
prognosis of CF
decreased life expectancy
how do you maximize health potential in CF patients
pulmonary hygiene
nutrition
prevention/early aggressive treatment of infection
types of aggressive airway clearance for CF
manual percussion positive expiratory pressure (PEP Mask) high frequency chest percussion vest airway oscillators like the flutter device postural drainage breathing exercises physical exercise
drugs for CF
bronchodilators
mucolytics; dornase alfa (pulmozyme)
chloride channel activators and sodium channel blockers
antibiotic therapy; therapeutic and prophylactic
medical mgmt of cf
pancreatic enzymes by mouth fat soluble vitamins ( A,D,E,K) stool softeners PRN sodium tablets added to diet in hot water oral iron supplements monitor blood glucose anti-inflammatory agents protease inhibitors immunizations flu shots lung transplant
