COPD Flashcards

1
Q

Obstructive pulmonary disease is an __ term

A

“umbrella”

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2
Q

Three disease processes covered in “obstructive pulmonary disease”

A

asthma, emphysema, chronic bronchitis

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3
Q

A patient with COPD has __ and/or __

A

emphysema and/or bronchitis

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4
Q

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

A

Emphysema

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5
Q

Excessive secretion production in the lungs

A

Chronic bronchitis

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6
Q

Is COPD preventable?

A

Yes

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7
Q

Is COPD treatable?

A

Yes

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8
Q

What causes a patient with COPD to be hospitalized?

A

A COPD exacerbation

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9
Q

What is the most common cause of a COPD exacerbation?

A

a respiratory infection

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10
Q

How is COPD diagnosed?

A

History, symptoms, and spirometry results (PFTs)

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11
Q

What is a barrel chest?

A

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

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12
Q

Breath sounds of someone with COPD are usually __.

A

decreased

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13
Q

3 adventitious breath sounds you may hear in someone with COPD

A

Wheezing, rales, and/or rhonchi

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14
Q

Exhaling is normally a __ process

A

Passive

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15
Q

People with COPD have prolonged

A

expiration

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16
Q

__ __ breathing is a sign of advanced COPD

A

pursed lip

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17
Q

Prolonged expansion of the lungs will cause __ __

A

pulmonary hypertension

  • Increased resistance: When expiration is prolonged, the airways remain narrowed for a longer period. This increases the resistance to airflow.
  • Increased pressure: As the heart works harder to push air out against increased resistance, the pressure in the pulmonary arteries (the arteries that carry blood from the heart to the lungs) rises.
  • Pulmonary hypertension: Over time, this chronic increase in pulmonary artery pressure can lead to pulmonary hypertension.
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18
Q

Pulmonary hypertension may cause __ __ __ and __ __.

A

neck vein distention and peripheral edema

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19
Q

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

A

Advanced disease

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20
Q

Sign of advanced COPD, means excessively malnourished, extremely thin

A

Cachexia

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21
Q

What is pleural effusion?

A

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

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22
Q

How is pleural effusion treated? (3)

A

Thoracentesis, antibiotics, diuretics

23
Q

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

A

flattened diaphragm

24
Q

Six potential nursing problems for a patient with COPD

A

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

25
Q

What is an ineffective breathing pattern?

A

Too fast, too slow, too shallow, too deep

26
Q

Patients with COPD typically breathe too __

A

fast (tachypnea)

27
Q

Breathing pattern that is too fast and also too deep

A

hyperventilation

28
Q

What does an ineffective airway clearance mean?

A

Congestion in the lungs that cannot be expectorated

29
Q

What does impaired gas exchange mean?

A

Damage at the level of the alveoli

30
Q

Why are patients with COPD anxious?

A

They are having such a hard time breathing

31
Q

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

A

Smoking cessation

32
Q

2 teaching points for patients with COPD

____ and ___ vaccine

early detection of ___ ___

A

1) Teach pneumonia and influenza vaccine adherence

2) Teach early detection of respiratory illness

33
Q

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

A

inhaler therapy

34
Q

3 types of inhaler drugs

___ ___ ___ antagonist
___ ___ ___ antagonist
___ corticosteroids

A

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

35
Q

Steroids are potent __

A

anti-inflammatory

36
Q

The typical o2 saturation goal for a patient with COPD?

A

88-92%

37
Q

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

A

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

38
Q

What position and breathing method should you teach COPD patients?

A

Tripod position and pursed lip breathing

39
Q

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

A

Cough techniques

40
Q

What is an intervention for the nursing problem activity intolerance?

A

Teach energy conservation and relaxation exercises

41
Q

Mainstay of treatment for patient admitted to hospital with hypoxemia

__ %

A

Oxygenation therapy above 90% (SpO2)

42
Q

What stimulates a healthy person to inhale?

A

Increased levels of CO2

43
Q

What stimulates a person with COPD to inhale?

A

Decreased oxygen

44
Q

How is a “CO2 retainer” diagnosed?

A

arterial blood gasses

45
Q

How does a patient with COPD develop CO2 narcosis?

A

When given high oxygenation, they lose their stimulus to breathe

46
Q

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

A

Withhold oxygen therapy

47
Q

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

A

They can die

48
Q

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

A

The patient will be intubated and moved to the ICU

49
Q

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

A

Positive pressure ventilation (Bipap or venturi mask)

50
Q

Hypercapnic means

A

increase in carbon dioxide

51
Q

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

A

metered dose inhalers (MDI) and wet nebulizers

52
Q

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

A

Percussion and postural drainage

53
Q

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

A

antibiotics