COPD Flashcards
broadly describe COPD
- chronic obstructive pulmonary disorder
- progressive disorder that gets worse
- risk is cigarette smoking
- either chronic bronchitis or emphysema
path of COPD
progressive failure of lungs to be able to ventilate/perfuse
end stage is the same for both
what does COPD lead to in both
- abnormal ventilation, perfusion ratio (V/Q)
- hypoxemia
- hypoventilation
- cor pulmonate (R heart failure)
describe chronic bronchitis
- BLUE-bloater
- airway problem (air trapping)
- compromised airway, healthy alveoli but air does NOT reach them
- *V/Q Mismatch
- hypercapnea
what is V/Q mismatch in chronic bronchitis
perfusion is fine but CANNOT ventilate
describe emphysema
- PINK-puffer
- alveolar problem (alveolar hyperinflation)
- ineffective alveoli (bad air trapping, cant push air back out)
- V/Q Matched (perfusion AND ventilation are bad)
what are the COPD stages
0-normalish
to
4-severe
chronic bronchitis s/s
- airway flow problem
- recurrent cough/sputum
- hypoxia
- respiratory acidosis
- increased Hgb
- increased RR
- cardiac enlargement
- blue bloater
emphysema s/s
- alveoli (diffusion) problem
- CO2 retention
- pursed lip breathing
- barrel chest (use muscles not normally used)
- prolonged expiatory time
- THIN (use energy all the time)
- pink puffer
- severe dyspnea at rest
- sit up and lean forward
diagnose COPD
- chest x ray
- pulmonary function test (how well can you force air out of lungs?)
- ABG
what s/s of hypoxemia (lack of oxygen)
restlessness or confusion
assessment indications of COPD or resp problems
- pt with difficulty sleeping (need many pillow or sits up)
- wt loss d/t expenditure of energy to breathe (emphysema)
- ABGs show compensation
- dyspnea
- barrel chest
diagnose chronic bronchitis
s/s and history
diagnose emphysema
physical change in alveoli
treatment goal of COPD
slow progression
smoking cessation
meds for COPD
- mucolytic: break up secretions
- pnumococcal and flu vaccine: decrease risk of resp infection
- bronchodilator: improve airflow and reduce air trapping
- theophylline: stimulates resp drive, strengthens diaphramatic contractions, improves cardiac output
systemic or inhaled agents for COPD
systemic
what are pulmonary hygeine measure
breathing exercise, pursed lip breathing
hydration
coughing, percussion, drainage
nursing interventions for COPD
**high fowlers: easiest position to breathe in
oxygen
encourage exercise but rest when needed: walk 2-3 times per week, expand lung capacity, combat muscle wasting
who should NOT get a flu shot
allergies to eggs
hx of Gullian Barre
acute illness/fever
s/s of flu shot
site soreness, fever, aches
will NOT increase asthma attacks
flu can lead to _____
pneumonia
what is important when helping COPD pt
ensure they maintain adequate perfusion and ventilation
most common indicators of pulmonary embolism
tachypnea (decrease CO2)
hypoxia (decrease O2)
dyspnea
risk for pulmonary embolism
immobility, obesity, DVT, post op, post partum, oral contraceptive
effects of pulmonary embolism
large pulmonary artery occlusion that can result in sudden death
s/s of pulmonary embolism
dyspnea, SOB, chest pain, anxiety, cough, tachycardia, tachypnea, crackles(rales), low grade fever
diagnosis of pulmonary embolism
- *d dimer level
- CT chest with contrast
- lung scans
important to remember about d dimer
specific to clot ANYWHERE in body
does not tell where clot is
meds for pulmonary embolism
anticoagulants (heparin and warfarin) thrombolytic therapy (streptokinase, urokinase)
describe pulmonary HTN
HIGH pressure system in lungs
