Class 7: Respiratory system Flashcards
dyspnea
bad breathing
apnea
a suspension of breathing
sputum
matter coughed/spit up from the respiratory system and especially the lungs in diseased states that is mucus that sometimes contains pus, blood, fibrin or bacteria
expectorate
to discharge matter from the throat or lungs by coughing or spitting
wheezing
a whistling noise in the chest when breathing
acute bronchitis
inflammation of breathing tubes within the lungs as a result of an infection or chemical irritant
chronic bronchitis
inflammation and swelling of the lining of the airways, leading to narrowing and obstruction generally resulting in a daily cough. the inflammation stimulates production of mucus, which can cause further blockage of the airways
emphysema
lung condition featuring an abnormal accumulation of air due to enlargement and destruction of the lungs many tiny air sacs resulting in the formation of scar tissue
COPD
a common lung disease that makes it hard to breathe. two main forms of COPD is chronic bronchitis and emphysema. shortness of breath, persistent airflow, limitation, and is primarily caused by smoking
acute asthma
severe asthma that does not respond to repeated courses of the treatment. some patient may need emergency treatment in a facility.
chronic asthma
long term condition that intermittently inflames and narrows the airways in the lungs. airways swell, causes periods of wheezing, chest tightness, shortness of breath and coughing
assessment of asthma
- hx and physical examination
- pulmonary function studies
- chest radiograph
- allergy skin testing
- oximetry and measurement of ABG’s during acute episodes when patient is in emergency department of hospital
nursing management of asthma
- control through the use of environmental control measures (reduce exposures to triggers)
- teaching self management for condition
- write action plan for treatment
- pharmacotherapy individualized for the client (types of inhalers
- continued assessment
obstructive sleep apnea
characterized by partial or complete obstruction of the upper airway during sleep (2-3 mins). frequent periodic cessation of breathing during sleep. occurring during REM and NREM sleep. frequency ranges up to 400 periods per night. occurs when the structure of the pharynx or oral cavity block off the the air.
assessment of obstructive sleep apnea
ask client If they snore, have excessive daytime sleepiness, headaches, muscle pain, mood changes, etc.
nursing management of obstructive sleep apnea
healthy body weight, lower alcohol intake, change sleep position (raise head of bed, pillows, side sleep), surgical interventions, medications, CPAP machines
assessment of COPD
ask about smoking or exposure to second hand smoke, swelling or edema, O2 saturation shortness of breath, dyspnea scale. hypooxemia, hypercapnia
nursing management of COPD
stop smoking, reduce frequency or severity of exacerbations, O2 therapy, medications, bronchodilators.
hypoxemia
low level of oxygen in the blood
hypercapnia
excessive amount of CO2 in the blood
causes and risks of obstructive sleep apnea
-obseity, age, gender, smoking, enlarged tonsils, deviated septum, nasal polyps, reduced muscle tones
assessment of obstructive sleep apnea
- sleep/rest hx
- physical appearance
- weight
- posture
- energy level
- sleep hygiene
- polysomnography (sleep studies - HR, breathing)
treatment with CPAP
continuous positive airway pressure.
- mild, continuous flow of room air into nose, inflating airway
- patients must initiate their own breaths
- very effective
- compliance poor
asthma
narrowed bronchioles, chronic inflammatory disorder of airways
- recurrent episodes of airway obstruction
- reversible (spontaneously or with treatment)
triggers of asthma
- allergens
- exercise
- resp infections
- drugs/food additives
- gastroesophageal reflex disease
- air pollutants
- emotional stress
mast cells
responsible for responding to information to an allergen “master cells”
clinical manifestations of asthma
-wheezing, coughing, dyspnea, chest tightness, prolonged expiration, abrupt or gradual onset
diagnosis of asthma
- symptoms (frequency and duration)
- variable airflow obstruction
- spirometry the preferred test (non invasive- to determine vital capacity- determine what’s left over) how much you can breath in and out
- allergy assessment
general management approach for asthma
- limit exposure to triggers
- patient education
- appropriate Pharmacotherapy
- continuous assessment and monitoring of control and severity
- regular follow up
acute asthma episode
- emergent situation
- assess degree of severity
- appropriate pharmacotherapy
- supplemental oxygen PRN
pharmacological interventions
-most patients require daily use of inhaled corticosteroids in addition to a short acting
controllers for asthma
long acting, anti inflammatory and bronchodilators.
relievers for asthma
quick relief, inhaled beta
problems with the use of metered dose inhalers
activating it in the mouth while breathing through the nose, inspiring to rapidly, not holding the breath for 10 seconds
COPD
a disease characterized by progressive, partially reversible airflow obstruction, systemic manifestations, and increasing frequency
-includes diseases that cause airflow obstruction
COPD risk factors
smoking, expose to chemicals and pollutants, infection, aging
pathophysiology of COPD
abnormal inflammatory response of lungs to noxious partials or gases
- chronic inflammation causes narrowing in small peripheral airways
- injury-repair process causes scar tissue formation and narrowing of airway
- inflammation results in thickening of pulmonary vasculature
chronic bronchitis
presence of cough and sputum production for at least 3 months in each of 2 consecutive years.
- smoke or environmental pollutants irritate airways which leads to hyper secretion of mucus and inflammation
- bronchial walls become thickened, bronchial lumen is narrowed, and mucus may plug airway, alveoli may become damaged
emphysema
an abnormal distension of the air spaces beyond the terminal bronchioles, with destruction of the walls of the alveoli
panlobular emphysema
destruction of the respiratory bronchioles, alveolar ducts and alveoli. all airspace is enlarged, but little inflammation.
-hyperextended (barrel chest), dyspnea on exertion, weight loss
centrilobular emphysema
changes to the centre of the secondary lobule
leads to chronic hypoxemia, hypercapnia, polycythemia, right sided heart failure
complications of emphysema
pulmonary heart disease, acute respiratory failure, acute exacerbations, depression/anxiety/panic
management of COPD goals
prevent disease progression, reduce frequency and severity of exacerbations, alleviate breathlessness and other respiratory symptoms, improve exercise tolerance and daily activity, treat exacerbation and complication of the disease, improve health status and quality of life, reduce risk of mortality
respiratory assessment
- medical dx and hx
- vital signs
- pulse oximetry
- inspection
- palpation
- auscultation
- blood tests
- spirometry
