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NURS4036 - complex health > COPD > Flashcards

COPD Flashcards

1
Q

what is COPD

A

abnormal chronic inflammatory response of airways to noxious particles or gases

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2
Q

past definitions of COPD

A
  • chronic bronchitis
  • emphysema
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3
Q

cardinal symptoms of COPD

A
  • dyspnea
  • difficulty breathing
  • SOB
  • limitations in activity
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4
Q

COPD significance

A
  • 9.4% Canadians >35
  • comparable gender prevalence
  • higher among first nations
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5
Q

risk factors of COPD

A
  • smoking
  • occupational chemicals or dust
  • air pollution
  • infection
  • aging
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6
Q

tobacco smoke and sympathetic nervous system

A
  • increases HR
  • peripheral vasoconstriction
  • increases BP
  • increases cardiac workload
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7
Q

tobacco smoke and the respiratory tract

A
  • increased mucus production
  • hyperplasia of goblet cells
  • decreased ciliary activity
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8
Q

tobacco smoke and carbon monoxide

A
  • decreased O2 carrying capacity
  • increase HR
  • impair psychomotor performance and judgement
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9
Q

passive smoking (environmental tobacco smoke or secondhand smoke)

A
  • decrease pulmonary function
  • increase risk of lung cancer
  • increase rate of mortality fro ischemic heart disease
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10
Q

respiratory tract infections

A
  • recurring infections impair normal defence mechanisms
  • reduce lung function
  • pathological destruction of lung tissue
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11
Q

alpha - antitrypsin (AAT) deficiency

A
  • genetic risk factor for COPD
  • occurs in 1 and 5000
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12
Q

aging and emphysema

A
  • loss of elastic recoil in lungs
  • lungs are rounded and smaller
  • number of functional alveoli decreases
  • peripheral airways lose support
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13
Q

COPD defining features

A
  • airflow limitations during forced exhalation due to loss of elastic recoil
  • airflow obstruction due to mucus hyper secretion, mucosal edema and bronchospasm
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14
Q

process of respiratory inflammation

A
  • inhalation of noxious particles
  • mediators released cause damage to lung tissue
  • airways inflamed
  • parenchyma destroyed
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15
Q

COPD and supporting structures

A
  • air goes in easy but remains in lungs
  • bronchioles tend to collapse
  • causes barrel-chest look
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16
Q

lung changes in COPD

A
  • bronchioles lose their shape and become clogged with mucus
  • alveoli walls are destroyed forming fewer larger ones
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17
Q

common characteristics of COPD

A
  • mucus hypersecretion
  • cilia dysfunction
  • hyperinflation of lungs
  • gas exchange abnormalities
18
Q

CM of COPD

A
  • develops slowly
  • cough with sputum
  • dyspnea
  • underweight with adequate caloric intake
  • anorexia
  • chronic fatigue
  • use of accessory muscle for breathing
  • bluish-red skin colour
19
Q

physical findings of COPD

A
  • prolonged expiratory phase
  • wheezes
  • decreased breath sounds
  • increased anterior-posterior diameter
20
Q

COPD complications

A
  • car pulmonale
  • acute exacerbations
  • acute respiratory failure
  • peptic ulcer disease
  • depression
  • anxiety
21
Q

car pulmonale

A
  • hypertrophy of the right side of the heart
  • results in pulmonary hypertension
  • causes right sided HF
22
Q

acute exacerbations

A
  • worsening symptoms
  • change signaled by; dyspnea, cough, sputum
  • purulent (require antibiotics) or nonpurulent
  • associated with poorer outcomes
  • causes: infections, air pollution, cold air
23
Q

acute respiratory failiure

A
  • causes: exacerbations, cor pulmonale, discontinuing bronchodilator or corticosteroid meds
24
Q

COPD spirometry findings

A
  • reduced FEV1/FVC ratio
  • increased residual volume
25
Q

COPD arterial blood bas findings

A
  • low PaO2
  • high PaCO2
  • low pH
  • high bicarbonate
26
Q

walk test

A
  • 6 minutes
  • determines O2 desaturation in the blood with exercise
27
Q

MRC dyspnea scale

A
  • grades 1 to 5
  • assess SOB and disability in chronic COPD
28
Q

primary care goals for COPD

A
  • prevent progression
  • reduce exacerbations
  • alleviate breathlessness
  • improve exercise tolerance
  • treat exacerbations
  • improve health status
  • reduce mortality
  • smoking cessation
29
Q

COPD medications (bronchodilators)

A
  • relax smooth muscle in the airway
  • reduce airway resistance and dynamic hyperinflation of the lungs
  • improve lung ventilation
  • decrease dyspnea
  • increase FEV1
30
Q

commonly used bronchodilators

A
  • beta 2 adrenergic agonists (salbutamol, albuterol)
  • muscarinic medications (ipratropium bromide)
  • long acting (salmerotol)
  • inhaled corticosteroids (fluticasone)
31
Q

O2 delivery for COPD

A
  • used to maintain PaO2 and reduce heart workload
  • low flow
  • humidify d/t drying effect
32
Q

complications of O2 therapy

A
  • combustion
  • CO2 narcosis
  • O2 toxicity
  • absorption atelectasis
  • infection
33
Q

chronic O2 therapy at home

A
  • reduce hematocrit and pulmonary hypertension
  • re-evaluate every 30-90 days
34
Q

COPD pulmonary rehabilitation

A
  • pursed lip breathing
  • diaphragmatic breathing
  • forced expiratory technique
  • huff coughing
35
Q

pursed lip breathing

A

prolongs exhalation and prevents bronchiolar collapse and air trapping

36
Q

diaphragmatic breathing

A

use of diaphragm instead of accessory muscles to achieve max inhalation and slow respiratory rate

37
Q

nutritional therapy for COPD

A
  • BMI between 21 and 25
  • rest 30 min before eating
  • bronchodilator before meals
  • 5 to 6 small meals a day
    -1.2/1.3 times normal kilocalorie intake
  • 2/3 L fluids a day
38
Q

nursing assessment COPD

A
  • health history
  • physical assessment
39
Q

nursing diagnosis COPD

A
  • inadequate breathing pattern
  • inadequate airway clearance
  • reduced gas exchange
  • ineffective breathing pattern
  • inadequate nutrition: less than body requirements
  • disturbed sleep pattern
  • potential for infection
40
Q

nursing planning COPD

A
  • prevent progression
  • ability to perform ADLs
  • relief of symptoms
  • prevent exacerbations
  • improved QOL
41
Q

nursing implementation COPD

A
  • smoking cessation
  • avoid pollutants and irritants
  • early detection and diagnosis of infection
  • energy conserving strategies (tripod position when shaving, sit when performing activities)

NURS4036 - complex health (10 decks)

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