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350-T2 > COPD > Flashcards

COPD Flashcards

1
Q

Clinical Manifestations of COPD

A 
develops slowly
chronic intermittent cough
sputum production
dyspnea with excercise progresses to dyspnea at rest
difficulty exhaling
frequent respiratory infections
chronic fatigue
chest tightness
prolonged expiratory phase
wheezes or crackles - decreased breath sounds
barrel chest (increased A-P diameter)
pursed lip breathing
accessory muscle use
bluish-red skin color (polycythemia and cyanosis)
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2
Q

polycythemia

A

is a disease state in which the hematocrit (the volume percentage of red blood cells in the blood) is elevated

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3
Q

Clinical Manifestations specific to emphysema

A

Pink puffer

permanent enlargement of air spaces distal to the terminal bronchioles with destruction of their walls

underweight with adequate caloric intake

use of accessory muscles

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4
Q

Clinical Manifestations specific to Chronic Bronchitis

A

Blue Bloaters

Presence of chronic productive cough for 3 months in 2 consecutive years in patients without other causes of chronic cough

frequent cough (especially in the winter)

foul smelling sputum

increase in A-P diameter

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5
Q

Complications of COPD

A

Cor pulmonale

COPD exacerbation

Acute respiratory failure

Peptic ulcer disease

Depression / anxiety

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6
Q

Diagnositc Studies for COPD

A

diagnosis confirmed by spirometry (PFT)

CXR

H and P

6 minute walk

ECG can show RV failure

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7
Q

Typical ABG findings in COPD

A

Low PaO2

increased PaCO2

decreased pH

Increased bicarbonate level

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8
Q

Global initiatives for COPD

A

Prevent progression

Relieve symptoms

Prevent/ treat complications

Promote patient participation

Prevent/treat exacerbations

improve quality of life and reduce mortality

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9
Q

Collobarative Care- Drug therapy for COPD

BRONCHODILATORS

A

Bronchodilators

  • relax smooth muscle
  • improve ventilation
  • decrease dyspnea
  • increase FEV1
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10
Q

Bronchodilators used in COPD

A
  1. B2 adrenergic agonists
  2. anticholinergics (atrovent, spiriva)
  3. Methylxanthines - second line therapy
  4. inhaled corticosteroids (mod-severe)
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11
Q

methlxanthines for COPD

A

theophylline

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12
Q

Collaborative care of COPD

A

Surgery-

  • lung volume reduction surgery
  • remove diseased lung to enhance performance of remaining lung

Bullectomy

  • used for emphysema
  • large bullae are resected to improve lung function

Lung Transplantantation

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13
Q

O2 therapy for COPD

A

used to:
decrease WOB
reduce workload on the heart

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14
Q

Long term O2 therapy in COPD improves:

A

Survival and prognosis

Exercise tolerance

Cognitive performance;

Sleep

Hematocrit

Pulmonary hypertension

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15
Q

breathing training for COPD

A

Pursed lip breathing

diaphragmatic breathing

Huff coughing (effective coughing)

Chest physiotherapy

  • percussion
  • vibration
  • postural drainage

Airway clearance

  • acapella
  • flutter

Treat exacerbations promptly

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16
Q

rules of O2 administration

A

add humidification

no smoking with Oxygen

17
Q

1 collaborative care goal for COPD

A

Improve patient’s quality of life

18
Q

Health Promotion/Prevention- COPD

A

Avoid exposure to occupational and environmental pollutants and irritants

Smoking cessation (Most effective intervention)

Awareness of family history of COPD and AAT deficiency

Early diagnosis and treatment of respiratory tract infection
Influenza vaccine and pneumococcal vaccines

19
Q

Nursing Management - Nutritional therapy-COPD

A

Consult Nutritionist

Decrease dyspnea and conserve energy:

  • Rest at least 30 minutes before eating (no exercising 1 hour before and after eating)
  • Use bronchodilator/beta-adrenergic agonists
  • Oxygen
  • Prepare foods in advance
  • Pursed lip breathing
  • Small, frequent meals (she said 6 small meals in class)
  • Avoid foods that require great deal of chewing
  • Avoid gas-forming foods
  • High-calorie, high-protein
  • Fluids (intake of 3 L/day) should be taken between meals
20
Q

Nursing Management–Pulmonary rehabilitation–COPD

A

Increase exercise performance

Reduce dyspnea

Improve quality of life

21
Q

Activity considerations –COPD

A

Rest periods

Modify ADLs to conserve energy

Walk 15 to 20 minutes a day at least 
 3 times/week -

gradual increases

Medication education

22
Q

Sexual activity–COPD

A

Plan when breathing is best

Use slow, pursed lip breathing

Refrain after strenuous activity

Do not assume dominant position or prolong foreplay

23
Q

Promote Sleep–COPD

A

Nasal saline sprays, decongestants, or nasal steroid inhalers

24
Q

Psychosocial considerations of COPD

A

-will need to pull this content from text

25
Q

us supplemental oxygen with COPD to:

SpO2 goals
PaO2 goals

A

maintain ADL

Keep O2 sat 90% or greater (on our test we will use 90%)

PaO2 greater than 60mmHg

26
Q

position for better breathing with COPD

A

tripod position

Exhale with pulling, pushing, tugging

27
Q

Monitor the following with COPD

A

mental status

vital signs

lung sounds

color

28
Q

Nursing Diagnoses- COPD

A

Ineffective airway clearance

Impaired gas exchange

Imbalanced nutrition: Less than body requirements

Activity Intolerance

Risk for infection

Anxiety/Depression
Insomnia

29
Q 
Nursing Interventions associated with:
Ineffective airway clearance
Impaired gas exchange
Imbalanced nutrition: Less than body requirements
Activity Intolerance
Risk for infection
Anxiety/Depression
Insomnia
A

find in textbook???

30
Q

nursing interventions for newly diagnosed COPD –cor pulmonale patient

A

In class discussion of Cor pulmonale case study
we want to:
–diuresis to remove the excess fluid
–educate the patient on smoking cessation, monitor weights, encourage rehab, medication education

look in textbook for a chart relating to this

31
Q

anticholinergics used for copd

A

spiriva, atrovent

“pium”=anticholinergics

350-T2 (2 decks)

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