COPD Flashcards
What are the 2 disease related to COPD?
- Emphysema
- Chronic Bronchitis
COPD is reversible or Irreversible?
Irreversible
3 things that happens on a patient with emphysema
- Gas Exchange Impairment
- CO2 retention
- Respiratory Acidosis
Describe the difference between EMPHYSEMA and CHRONIC BRONCHITIS
Emphysema - destruction of the alveoli
Chronic Bronchitis - inflammation of the bronchi and bronchioles
3 Health promotion for patient with COPD
- Smoking Cessation
- Influenza and Pneumonia Immunizations
- Avoid Second Hand Smoke
4 RF for patient with COPD
-Older Adults
-Smoking (PRIMARY RF)
-Alpha Antitrypsin Deficiency (AAT Deficiency)
-Air pollution
Expected Findings for patient during acute exacerbation
40 - 50/ min RR
What other findings can be seen for patient with COPD? (both Emphysema and COPD)
H CRIEED
-Hypoxemia
C - crackles
R - rapid/shallow breathing
I - irregular breathing patter
E - edema
E - enlarged neck muscle
D - decreased 02 sat
What 2 clinical manifestation can be seen for patient with late stages of COPD?
- Clubbing of finger and toes
- Pallor + Cyanosis of NAIL BEDS and MUCOUS MEMBRANE
What should you remember for COPD patients that are adult or patients with dark colored skin?
Their 02 sat can be slightly lower
What lab test result would you see on a patient with COPD?
-Hypoxemia
-Increased HCT Level (due to low 02 level)
-Hypercabia
FEV1 and FVC usually decreases with COPD patients. How much do they decrease for MILD COPD vs MODERATE-SEVERE COPD?
Mild - 70% less
Moderate-Severe - 50%
What is the correlation of AAT to COPD
Alpha Antitrypsin is an enzyme produced by the LIVER to help regulate other enzymes from attacking LUNG TISSUE
COPD patients have AAT Deficiency
What are the top 4 interventions for patient with COPD?
- High Fowlers
- TCDB
- Remove Secretions
- Incentive Spirometer
What 02 sat level should be maintained for patient with COPD?
88% - 92%
What should be the flow rate of patient with nasal cannula?
WHAT IS THE EXCEPTION?
2L- 4L
Exceptions: For patient with CHRONICALLY INCREASED PaCO2. required amount is 1L - 2L
What should you look out for patient using oxygen device?
Skin breakdown around the nose and the mouth
Why do patients with COPD needs adequate nutrition?
Their increase WOB increased their caloric demand
Proper nutrition also prevents INFECTION
What is the rationale for patients that needs exercising conditioning
This strengthen the condition of their lungs
Client education for “WALKING” as an exercise
walk until dyspnea occurs and then stop to rest. Once the dyspnea resolves, resume walking
Why should you increase the fluid intake for client?
2L - 3L of water helps to liquefy the mucus
What is the use of the Incentive Spirometer?
-monitors the lung expansion
How do you use the incentive spirometer?
- Tight mouth seal around mouthpiece
- Inhale and HOLD BREATH FOR 3-5 SECONDS
What are the adverse effect of patient taking Corticosteroid?
- Immunosuppression
- Fluid retention + WT gain
- Hyperglycemia
- Hypokalemia
- Poor wound healing
- Black Tarry Stool
What is the purpose of mucolytic agents such as NEBULIZER?
helps thin secretions
What are the 3 THERAPEUTIC PROCEDURES for patients with COPD?
- Chest Physiotherapy
(percuss and vibrate to mobilize secretion)
- Raising foot of the bed slightly
(facilitates optimal drainage and removal of secretion by gravity)
- Humidifier
(useful for patients in dry climate)
What are the 2 complication for patient with COPD?
- Respiratory Failure
- Cor Pulmonale
What is the cause of Respiratory Failure?
-Poor Oxygenation level
-Increased mucus production
what is an indication of Respiratory Infection?
-Increased WBC, CRP
-Decreased 02 say
-Change in Temperature
What are the nursing actions for respiratory infection?
- Monitor 02 level
- 02 therapy
- Administer antibiotics
What is the CM of RHF?
-Low 02 level
-Cyanosis
DHAWN P
What are the nursing actions for RHF
-monitor lungs and heart rate and rhythm
-monitor GI disturbances (anorexia + nausea)
-administer IV fluids and diuretics to maintain fluid balance
What is the side effect of ALBUTEROL?
Tachycardia
Steps in doing Pursed Lip Breathing?
- Relax your neck and shoulder muscle
- Breathe in for 2 SECONDS through your nose KEEPING YOUR MOUTH CLOSE
- Breathe out for 4 SECONDS through your pursed lips
—> if this is too long, breathe twioce as long
what is the purpose of pursed lip breathing?
It PROLONGS THE EXPIRATORY PRESSURE
explain the cause of RHF
High blood pressure in the pulmonary blood vessel caused by chronic lung dx
What are the 2 breathing techniques you can teach to a patient?
- Pursed Lip Breathing
- Diaphragmatic Breathing
Steps in doing Diaphragmatic Breathing?
- Take a deep breath from the diaphragm
- Lie on back with knees bent
- Rest hand over the abdomen to create resistance
- Client’s hand must rise and lower upon inhalation and expiration
