COPD

Question 1

Obstructive pulmonary disease is an __ term

Answer 1

“umbrella”

Question 2

Three disease processes covered in “obstructive pulmonary disease”

Answer 2

asthma, emphysema, chronic bronchitis

Question 3

A patient with COPD has __ and/or __

Answer 3

emphysema and/or bronchitis

Question 4

Alveoli are overinflated, they are stretched and damaged. There is impaired gas exchange

Answer 4

Emphysema

Question 5

Excessive secretion production in the lungs

Answer 5

Chronic bronchitis

Question 6

Is COPD preventable?

Answer 6

Yes

Question 7

Is COPD treatable?

Answer 7

Yes

Question 8

What causes a patient with COPD to be hospitalized?

Answer 8

A COPD exacerbation

Question 9

What is the most common cause of a COPD exacerbation?

Answer 9

a respiratory infection

Question 10

How is COPD diagnosed?

Answer 10

History, symptoms, and spirometry results (PFTs)

Question 11

What is a barrel chest?

Answer 11

Increased anteroposterior diameter of chest due to hyperinflation (1:1)

Question 12

Breath sounds of someone with COPD are usually __.

Answer 12

decreased

Question 13

3 adventitious breath sounds you may hear in someone with COPD

Answer 13

Wheezing, rales, and/or rhonchi

Question 14

Exhaling is normally a __ process

Answer 14

Passive

Question 15

People with COPD have prolonged

Answer 15

expiration

Question 16

__ __ breathing is a sign of advanced COPD

Answer 16

pursed lip

Question 17

Prolonged expansion of the lungs will cause __ __

Answer 17

pulmonary hypertension

Question 18

Pulmonary hypertension may cause __ __ __ and __ __.

Answer 18

neck vein distention and peripheral edema

Question 19

Neck vein distention and peripheral edema are signs of __ __.

Answer 19

Advanced disease

Question 20

Sign of advanced COPD, means excessively malnourished, extremely thin

Answer 20

Cachexia

Question 21

What is pleural effusion?

Answer 21

Build up of excess fluid between the layers of the pleura outside the lungs

Question 22

How is pleural effusion treated?

Answer 22

Thoracentesis, antibiotics, diuretics

Question 23

In addition to barrel chest, a patient may have a __ __ due to hyperinflation.

Answer 23

flattened diaphragm

Question 24

Six potential nursing problems for a patient with COPD

Answer 24

1) Activity intolerance
2) Ineffective breathing pattern
3) Ineffective airway clearance
4) Impaired gas exchange
5) Anxiety
6) Poor nutritional status

Question 25

What is an ineffective breathing pattern?

Answer 25

Too fast, too slow, too shallow, too deep

Question 26

Patients with COPD typically breathe too __

Answer 26

fast (tachypnea)

Question 27

Breathing pattern that is too fast and also too deep

Answer 27

hyperventilation

Question 28

What does an ineffective airway clearance mean?

Answer 28

Congestion in the lungs that cannot be expectorated

Question 29

What does impaired gas exchange mean?

Answer 29

Damage at the level of the alveoli

Question 30

Why are patients with COPD anxious?

Answer 30

They are having such a hard time breathing

Question 31

Single most effective and cost-effective intervention to reduce the risk for COPD and disease progression

Answer 31

Smoking cessation

Question 32

2 teaching points for patients with COPD

Answer 32

1) Teach pneumonia and influenza vaccine adherence

2) Teach early detection of respiratory illness

Question 33

Mainstay of COPD self-management and adherence to this is critical

Answer 33

inhaler therapy

Question 34

3 types of inhaler drugs

Answer 34

Long acting beta antagonist, long acting muscarinic antagonist, inhaled corticosteroids

Question 35

Steroids are potent __

Answer 35

anti-inflammatory

Question 36

The typical o2 saturation goal for a patient with COPD?

Answer 36

88-92%

Question 37

Why is the O2 saturation goal for patients with COPD lower than the healthy individual?

Answer 37

Because their body has adjusted to a lower oxygenation level due to the obstructive nature of the disease

Question 38

What position and breathing method should you teach COPD patients?

Answer 38

Tripod position and pursed lip breathing

Question 39

What is an intervention for the nursing problem ineffective airway clearance?

Answer 39

Cough techniques

Question 40

What is an intervention for the nursing problem activity intolerance?

Answer 40

Teach energy conservation and relaxation exercises

Question 41

Mainstay of treatment for patient admitted to hospital with hypoxemia

Answer 41

Oxygenation therapy above 90% (SpO2)

Question 42

What stimulates a healthy person to inhale?

Answer 42

Increased levels of CO2

Question 43

What stimulates a person with COPD to inhale?

Answer 43

Decreased oxygen

Question 44

How is a “CO2 retainer” diagnosed?

Answer 44

arterial blood gasses

Question 45

How does a patient with COPD develop CO2 narcosis?

Answer 45

When given high oxygenation, they lose their stimulus to breathe

Question 46

If a patient with a COPD exacerbation is hypoxemic and develops CO2 narcosis due to high oxygenation, what should you never do?

Answer 46

Withhold oxygen therapy

Question 47

What can happen if you withhold oxygen therapy for a COPD patient with hypoxemia?

Answer 47

They can die

Question 48

If a patient with COPD exacerbation and hypoxemia stops breathing due to C02 narcosis, what are the next steps?

Answer 48

The patient will be intubated and moved to the ICU

Question 49

A patient who is hypercapnic may be put on what type of ventilation?

Answer 49

Positive pressure ventilation (Bipap or venturi mask)

Question 50

Hypercapnic means

Answer 50

increase in carbon dioxide

Question 51

A patient with COPD exacerbation may be on bronchodilators such as…

Answer 51

metered dose inhalers (MDI) and wet nebulizers

Question 52

Two types of chest physiotherapy a patient with a COPD exacerbation may do…

Answer 52

Percussion and postural drainage

Question 53

A COPD patient experiencing an exacerbation in the hospital may be on __ if it is bacterial in nature

Answer 53

antibiotics