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NURS 347 EXAM 2 > COPD > Flashcards

COPD Flashcards

1
Q

What does COPD mean?

A

Chronic obstructive pulmonary disease

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2
Q

Who has the most death/COPD causes ?

A

White people

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3
Q

Who has the least amount of COPD cases?

A

Hispanics

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4
Q

Over how many people have COPD?

A

16 million

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5
Q

COPD is the what leading cause of death?

A

Third

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6
Q

Gender differences of COPD

A

More men have it
More woman die from it

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7
Q

What is exacerbation mean?

A

Worsen of a condition

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8
Q

What’s the number reason of getting COPD?

A

Smoking

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9
Q

COPD is what? (3)
Characizteried by?

A

Preventable, treatable, often progressive diseases
Characterized by persistent airflow limitation

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10
Q

Chronic inflammatory response in airways and lungs primarily caused by what?

A

Cigarettes smoking & other noxious particles/gases

Noxious particles - toxins

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11
Q

Someone can have COPD for years
But if they come to the hospital with respiratory distress what do they have?

A

Acute exacerbations

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12
Q

What does dyspnea mean?

A

Trouble breathing

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13
Q

Is there a cure for COPD?

A

No

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14
Q

What other things contribute to severity of the disease (2)? Examples too

A

Exacerbations ( good days & bad days )
Other illnesses, asthma, pneumonia

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15
Q

COPD puts you at risk of developing what

A

Developing other respiratory illness

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16
Q

What is the primary function of the lung? & function

A

Alveoli
Gas exchange

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17
Q

What does COPD Alveoli sacs look like? (3)

A

Sacs become in enlarged, saggy & lose elastic recoil

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18
Q

COPD does not include what? (2)

A

Chronic bronchitis & emphysema

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19
Q

What does chronic bronchitis mean?
( BLUER )

A

The presence of cough & sputum production for at least 3 months in each of 2 consecutive years

B - big and blue skin
L - long term chronic cough
U - Unsual lung sounds
E - edema peripherally ( heart failure )
( pulmonary hypertension & big feet )
R - right side heart failure
Cor pulmonae

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20
Q

What does emphysema mean?
( PINK )

A

Destruction of alveoli without fibrosis
P - pink & pursed lip breathing ( hugging and puffing )
I - increase chest ( barrel chest )
N - no chronic cough
K - keep on tripoding

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21
Q

What’s are risk factors of COPD? (11)

A

Infection
Severe respiratory Infections in childhood
HIV
TB
Cigarette smoking
Asthma
Air pollution
Occupation
Aging
Genetics
AATD

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22
Q

Smoking is the number one cause of COPD
Develops ___ of smokers
Anyone over __
With a smoking history of ____ more pack years

A

20%
40
10 pack years

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23
Q

What is pack years mean?
1 pack a day for 30 years how many pack years?

A

30 pack years

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24
Q

2 packs a day for 15 years ??

A

30 pack years

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25
Q

What is examples of occupational dust and chemicals? (4)

A

Dusts
Vapors
Irritants
Fumes

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26
Q

When you have asthma, how does that effect you for COPD?

A

They overlap each other from pathologic & functional

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27
Q

What does ATTD mean?

A

Antitrypsin deficiency

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28
Q

COPD pathophysiology is characterized by?
(3 ex)

A

Chronic inflammation of airways, lung parenchyma, pulmonary blood vessels

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29
Q

What’s the defining feature of COPD?

A

Airflow limitation not fully reversible during forced exhalation

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30
Q

Airflow limitation not fully reversible during forced exhalation are due to what (2?)

A

Loss of elastic recoil
Airflow obstruction due to mucosal hypersecretion, mucosal edema, and bronchospams

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31
Q

COPD pathophysiology
Disease progression marked by worsening due to ? (3) (AAG)

A

Abnormliaties in airflow limitation
Air trapping
Gas exchange

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32
Q

COPD pathophysiology
Severe disease (2)

A

Pulmonary hypertension
Systemic manifestations

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33
Q

COPD pathophysiology
Primary process is inflammation
What is inhaled that causes inflammation and result to what?

A

Inhale noxious particles and gases results inflammation
Results in Damage to lung tissue

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34
Q

What are the inflammatory cells of COPD? (3)

A

Neutrophils
Macrophages
Lymphocytes

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35
Q

What’s the main characteristic of COPD?

A

Inability to expire air

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36
Q

Peripheral airways are obstructed and trap air during expirations and results in what?

A

Increase residual volume which results in barrel shape chest

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37
Q

What’s the biggest characteristic of COPD, inflammation of what?

A

Inflammation of the small alveoli sacs

38
Q

Barrel chest happens when the lungs become what?

A

Overfilled with air

39
Q

Whats the diameter of barrel chest ?

A

1:1

40
Q

What’s the reason for a barrel chest?

A

In order to expand the lungs to get more air but it doesn’t help at all

But since it doesn’t have the alveoli sac
So air exchange doesn’t happen

41
Q

As air trapping increases, alveolar walls are destroyed resulting in formation of what? (2?

A

Bullae and blebs

42
Q

What is Bullae and blebs?

A

No surrounding capillary bed resulting in VQ perfusion mis match

43
Q

What is VQ perfusion mix match? (2)

A

Low oxygen in blood (hypoxemia)
High CO2 In blood ( hypercapnia )

44
Q

What’s the driving force of breathing?

A

CO2

45
Q

Excess mucus production and cough
(4) causes what?

A

Increase mucus goblet cells
Enlarged submucosal gland
Dysfunction of cilia
( hair doesn’t push chemicals out )
Inflammatory mediators

46
Q

COPD is a systemic disease as result of ?
What does systemic mean

A

Systemic - blood stream & all parts of body
Chronic inflammation

47
Q

What are other diseases common for COPD? (4)

A

Cardiovascular
Osteoporosis
Diabetes
Metabolic syndrome

48
Q

Your heart and lungs are right next to each other, so that means?

A

If you have heart problems
You’ll have lung problems
Vice versus

49
Q

Pulmonary vascular change means for COPD? (2)

A

Vasoconstriction of small pulmonary arteries due to hypoxia

Hypertrophy
Pulmonary arteries Thicken

50
Q

Results in pulmonary hypertension resulting in _____ & ______?

A

Right ventricular hypertrophy
Right heart failure

51
Q

Left side of the heart means ?
Right side if the heart failure mean?

A

Cardiovascular problems
Respiratory problems

52
Q

What does pulmonary hypertension mean?

A

Can’t breathe even though your blood pressure is fine

53
Q

When you have right heart failure, what is happening and results what?

A

Not enough blood pumping
Backing into your lungs
Resulting in pulmonary edema

54
Q

What’s the diagnosis of COPD?

A

FEV1/FEV < 70%

55
Q

How do you test FEV1/FEV?
And what’s the normal range for those who have have COPD?

A

Forced expiratory volume in a machine in the first one second to the forced vital capacity of the lungs

0.75-85

56
Q

What’s an abnormal FEV1/FEV ratio, or to see who has COPD?

A

Below 70

57
Q

Since COPD is a progressive disease there are what to categorize it?

A

Stages

58
Q

What are the 4 stages of COPD?

A

Gold 1 - mild
Gold 2 - moderate
Gold 3 - severe
Gold 4 - very severe

59
Q

What are clinical manifestations of COPD? (20)
Chad spits dying rice chowder chips why?
Chunky fat weed ants put badly triad

Purge right hypo sex cap increases CYAN

A

Chronic cough
Sputum production
Dyspnea
Risk factors exposure
Chest heaviness
Chest breather
Wheezing
Chest tightness
Fatigue
Weight loss
Anorexia
Prolonged expiratory phase
Barrel chest
Tripod position
Pursed lip breathing
Peripheral edema ( ankles ) right heart failure
Hypoxemia - < 60
Sa < 88
Hypercapnia > 45
Increase RBC
( polycythemia/erythrocytosis)
Cyanosis

60
Q

Not all COPD will produce sputum? True or false

A

True

61
Q

What does chest heaviness mean for COPD? (4)

A

Can’t take a deep breath
Gasping
Increased effort to breathe
Air hungry

62
Q

What’s a chest breather mean?

A

Use Accessory and intercostal muscle
Inefficient breathing

63
Q

What is the tripod position?

A

2 hands on knees bend down

64
Q

What does polycythemia/erythrocytosis mean?

A

Increase RBC

65
Q

What are the complications of COPD?
_____examples?
Common cause ? (2)
You’ll also have increase what?

A

Acute exacerbations
Increased dyspnea
Increased sputum volume
Increased sputum purulent ( infection)
Malaise - tiredness
Fatigue
Insomnia
Confusion

Bacterial or viral infections

Frequency with disease progression

66
Q

Complications COPD
they will have increase what
Decrease what

And how do we test for this? Or measure it

A

Increase CO2
Decrease OXYGEN

ABG ( aertial blood gas )

67
Q

What are some treatments for COPD?
Short term?
Examples (3) 1 ex of eah

A

Saba - albuterol, anticholinergic, antibiotics, diuretics

Oral corticosteroids
- premidosone

Oxygen - nasal cannula

68
Q

As a nurse you want to education a patient on acute exacerbations why?

A

In order for a patient to understand and prepare/avoid it

69
Q

Inter professional care
COPD patients live where?

A

Outside the hospitals

70
Q

Though when COPD patients come into the hospital they are there for what (2?)

A

Acute exacerbations
Acute respiratory failure

71
Q

How is do we stage COPD? Like how do we put them in the 1-4 category?

A

How many times they come into the hospital for acute exacerbations & acute respiratory failure

72
Q

If you have COPD, you want avoid what?

A

Occupational or environmental triggers

73
Q

We want to make sure COPD patients have what two vaccines?
And how many times?

A

Flu and pneumococcal vaccine
Yearly

74
Q

Number 1 goal for COPD patients is to do what?

A

Stop smoking !!!
Smoking cessation

75
Q

What’s the first nursing intervention of COPD?

A

Stop smoking
Educating on smoking

76
Q

What are asthma medication ?? (5)

A

Saba
LABA
Anticholinergic drug
corticosteroids
LTMA

77
Q

What are 4 COPD medication?

A

Bronchodilators
LABA
ICS
Anticholinergic drug

78
Q

What’s anticholinergic drugs mean?
COPD

A

Promote bronchodilation by preventing muscles around bronchi from tightening

79
Q

What’s example of corticosteroids for COPD? (2)

A

Beclomethasone
Budesonide

80
Q

If you are giving a patient a inhaled corticosteroids, you want to make sure a patient what?

Why?

A

Gargles and spits it out
To avoid oral thrush & organisms

81
Q

You will never LTMA for emegereny? True or false?

A

True

82
Q

What does MDI stand for and mean?

A

Metered dose inhaler

Small hand held pressure devices

83
Q

You always want to start what with a brand new inhaler?

A

1 or 2 puffs

84
Q

Inhalers Can be used with a spacer or holding chamber to what (3)?

A

Reduce oropharyngeal medication
Increase delivery to lungs
Reduce problems with hand breath coordination

85
Q

For an inhaler you always want to teach what?

A

Correct technique

86
Q

If bronchodilator use of great than 2 canisters/month should prompt what?

A

Visit to HCP

87
Q

Some inhalers can come as what?

A

DPI
Dry power inhaler

88
Q

What are some advantages of DPI? (2)

A

Less manual dexterity
No spacer needed

89
Q

What are some disadvantages of DPI? (3)

A

Low FEV1 - inadequate inspiration
Not all common meds
Power may clump

90
Q

What’s a nebulizer?

A

Machine converts drug solutions into fine mist for inhalation via mask or mouthpiece
: easy to use

91
Q

Neblukizer needs what? (2)

A

O2 generator
Air compressor
Patient education

92
Q

What’s the best way to teach a patient an inhaler? What method?

A

Teach back

NURS 347 EXAM 2 (7 decks)

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