COPD

Question 1

What are the 2 disease related to COPD?

Answer 1

1. Emphysema
2. Chronic Bronchitis

Question 2

COPD is reversible or Irreversible?

Answer 2

Irreversible

Question 3

3 things that happens on a patient with emphysema

Answer 3

1. Gas Exchange Impairment
2. CO2 retention
3. Respiratory Acidosis

Question 4

Describe the difference between EMPHYSEMA and CHRONIC BRONCHITIS

Answer 4

Emphysema - destruction of the alveoli

Chronic Bronchitis - inflammation of the bronchi and bronchioles

Question 5

3 Health promotion for patient with COPD

Answer 5

1. Smoking Cessation
2. Influenza and Pneumonia Immunizations
3. Avoid Second Hand Smoke

Question 6

4 RF for patient with COPD

Answer 6

-Older Adults
-Smoking (PRIMARY RF)
-Alpha Antitrypsin Deficiency (AAT Deficiency)
-Air pollution

Question 7

Expected Findings for patient during acute exacerbation

Answer 7

40 - 50/ min RR

Question 8

What other findings can be seen for patient with COPD? (both Emphysema and COPD)

Answer 8

H CRIEED

-Hypoxemia

C - crackles
R - rapid/shallow breathing
I - irregular breathing patter
E - edema
E - enlarged neck muscle
D - decreased 02 sat

Question 9

What 2 clinical manifestation can be seen for patient with late stages of COPD?

Answer 9

1. Clubbing of finger and toes
2. Pallor + Cyanosis of NAIL BEDS and MUCOUS MEMBRANE

Question 10

What should you remember for COPD patients that are adult or patients with dark colored skin?

Answer 10

Their 02 sat can be slightly lower

Question 11

What lab test result would you see on a patient with COPD?

Answer 11

-Hypoxemia

-Increased HCT Level (due to low 02 level)

-Hypercabia

Question 12

FEV1 and FVC usually decreases with COPD patients. How much do they decrease for MILD COPD vs MODERATE-SEVERE COPD?

Answer 12

Mild - 70% less

Moderate-Severe - 50%

Question 13

What is the correlation of AAT to COPD

Answer 13

Alpha Antitrypsin is an enzyme produced by the LIVER to help regulate other enzymes from attacking LUNG TISSUE

COPD patients have AAT Deficiency

Question 14

What are the top 4 interventions for patient with COPD?

Answer 14

1. High Fowlers
2. TCDB
3. Remove Secretions
4. Incentive Spirometer

Question 15

What 02 sat level should be maintained for patient with COPD?

Answer 15

88% - 92%

Question 16

What should be the flow rate of patient with nasal cannula?

WHAT IS THE EXCEPTION?

Answer 16

2L- 4L

Exceptions: For patient with CHRONICALLY INCREASED PaCO2. required amount is 1L - 2L

Question 17

What should you look out for patient using oxygen device?

Answer 17

Skin breakdown around the nose and the mouth

Question 18

Why do patients with COPD needs adequate nutrition?

Answer 18

Their increase WOB increased their caloric demand

Proper nutrition also prevents INFECTION

Question 19

What is the rationale for patients that needs exercising conditioning

Answer 19

This strengthen the condition of their lungs

Question 20

Client education for “WALKING” as an exercise

Answer 20

walk until dyspnea occurs and then stop to rest. Once the dyspnea resolves, resume walking

Question 21

Why should you increase the fluid intake for client?

Answer 21

2L - 3L of water helps to liquefy the mucus

Question 22

What is the use of the Incentive Spirometer?

Answer 22

-monitors the lung expansion

Question 23

How do you use the incentive spirometer?

Answer 23

1. Tight mouth seal around mouthpiece
2. Inhale and HOLD BREATH FOR 3-5 SECONDS

Question 24

What are the adverse effect of patient taking Corticosteroid?

Answer 24

1. Immunosuppression
2. Fluid retention + WT gain
3. Hyperglycemia
4. Hypokalemia
5. Poor wound healing
6. Black Tarry Stool

Question 25

What is the purpose of mucolytic agents such as NEBULIZER?

Answer 25

helps thin secretions

Question 26

What are the 3 THERAPEUTIC PROCEDURES for patients with COPD?

Answer 26

1. Chest Physiotherapy

(percuss and vibrate to mobilize secretion)

2. Raising foot of the bed slightly

(facilitates optimal drainage and removal of secretion by gravity)

3. Humidifier

(useful for patients in dry climate)

Question 27

What are the 2 complication for patient with COPD?

Answer 27

1. Respiratory Failure
2. Cor Pulmonale

Question 28

What is the cause of Respiratory Failure?

Answer 28

-Poor Oxygenation level

-Increased mucus production

Question 29

what is an indication of Respiratory Infection?

Answer 29

-Increased WBC, CRP
-Decreased 02 say
-Change in Temperature

Question 30

What are the nursing actions for respiratory infection?

Answer 30

1. Monitor 02 level
2. 02 therapy
3. Administer antibiotics

Question 31

What is the CM of RHF?

Answer 31

-Low 02 level
-Cyanosis

DHAWN P

Question 32

What are the nursing actions for RHF

Answer 32

-monitor lungs and heart rate and rhythm

-monitor GI disturbances (anorexia + nausea)

-administer IV fluids and diuretics to maintain fluid balance

Question 33

What is the side effect of ALBUTEROL?

Answer 33

Tachycardia

Question 34

Steps in doing Pursed Lip Breathing?

Answer 34

1. Relax your neck and shoulder muscle
2. Breathe in for 2 SECONDS through your nose KEEPING YOUR MOUTH CLOSE
3. Breathe out for 4 SECONDS through your pursed lips

—> if this is too long, breathe twioce as long

Question 35

what is the purpose of pursed lip breathing?

Answer 35

It PROLONGS THE EXPIRATORY PRESSURE

Question 36

explain the cause of RHF

Answer 36

High blood pressure in the pulmonary blood vessel caused by chronic lung dx

Question 37

What are the 2 breathing techniques you can teach to a patient?

Answer 37

1. Pursed Lip Breathing
2. Diaphragmatic Breathing

Question 38

Steps in doing Diaphragmatic Breathing?

Answer 38

1. Take a deep breath from the diaphragm
2. Lie on back with knees bent
3. Rest hand over the abdomen to create resistance
4. Client’s hand must rise and lower upon inhalation and expiration