COPD

Question 1

COPD encompasses

Answer 1

Emphysema & Bronchitis

Question 2

What does smoking do?

Answer 2

hyperplasia (increased number of cells)

ii. Lost or decreased ciliary activity
iii. Abnormal distal dilation and destruction of alveolar walls
iv. Chronic, enhanced inflammation results in remodeling

Question 3

Passive smoking

Answer 3

i. Decreased pulmonary function
ii. Increased respiratory symptoms
iii. Increased risk of lung and nasal sinus cancer

Question 4

COPD risk factors

Answer 4

a. Infection
b. Severe, recurring respiratory infections in childhood
c. HIV
d. Tuberculosis
e. Asthma
f. Air pollution
g. Occupational dusts and chemicals
h. Aging
i. Genetics

Question 5

Defining feature of COPD

Answer 5

airflow limitation not fully reversible during forced exhalation

Question 6

Air flow limitation due to:

Answer 6

i. Loss of elastic recoil

ii. Airflow obstruction due to mucous hypersecretion, mucosal edema, and bronchospasm

Question 7

Main characteristic of COPD

Answer 7

inability to expire air “air trapping” barrel chest

Question 8

COPD patho

Answer 8

Excess mucus production and cough
Pulmonary vascular changes
d. Results in pulmonary hypertension resulting in right ventricular hypertrophy which results in right heart failure

Question 9

Diagnosis is considered with:

Answer 9

i. Chronic cough (intermittent—first symptom)
ii. Sputum production
iii. Dyspnea; occurs with exertion and progressive
iv. Exposure to risk factors
1. Smoke, occupational dust

Question 10

Diagnostics

Answer 10

a. Hypoxemia PaO2 < 60 mmHg; SaO2< 88 %
b. Hypercapnia PaCO2 > 45 mmHg
Increased RBC (body think they need more oxygen)
e. Bluish-red color of skin—polycythemia and cyanosis

Question 11

Complications:

Answer 11

Pulmonary HTN
Cor pulmonale (R sided ♡  failure)

Question 12

Acute exacerbation symptoms

Answer 12

1. Increased dyspnea, increased sputum volume, increased sputum purulence
2. Malaise, insomnia, fatigue, depression, confusion, decreased exercise tolerance, wheezing, fever

Question 13

Hospitalized for complications

Answer 13

i. Acute exacerbations
ii. Acute respiratory failure
iii. Pneumonia
iv. HF

Question 14

1. Removes diseased tissue so healthy tissue works better

2. Diaphragm can return to normal shape

Answer 14

Lung volume reduction surgery (LVRS)

Question 15

COPD therapies

Answer 15

i. Oxygen therapy (considered a medication)

ii. O2 therapy is used to treat hypoxemia

Question 16

Keep O2 sat @

Answer 16

88-92%, during rest/sleep/exertion

PaO2 >60

Question 17

O2 admin what flow?

Answer 17

low flow

Question 18

Complications of O2 therapy

Answer 18

Combustion
CO2 narcosis
O2 toxicity
Infection

Question 19

CO2 narcosis what is it?

Answer 19

1. CO2 no longer stimulus to breathe

2. DEVELOP A TOLERANCE TO HIGHER CO2 LEVELS-TRICKS BRAIN TO NOT TAKE DEEP BREATHES BC BODY THINGS I HAVE ENOUGH OXYGEN

Question 20

Respiratory Care

Answer 20

Breathing retraining
Airway clearance techniques
Effective coughing or huff coughing

Question 21

Short-term O2 therapy

Answer 21

up to 30 days

Question 22

Long-term O2 Therapy (LTOT)

Answer 22

15 or more hours/day

Question 23

Chest physiotherapy (CPT) indicated for

Answer 23

i. Excessive, difficult-to-clear bronchial secretions

ii. Postural drainage, percussion, and vibration

Question 24

Positive expiratory pressure (PEP) to mobilize secretions

Answer 24

1. Flutter
2. Acapella
3. TheraPEP

Question 25

Diet for COPD

Answer 25

v. High-calorie, high-protein, moderate carbohydrates, and moderate fats diet is recommended

Question 26

Avoid foods that:

Answer 26

1. Foods that require a great deal of chewing
2. Exercises and treatments 1 hour before and after eating
3. Gas-forming foods

Question 27

Health Promotion for COPD

Answer 27

i. Abstain from or stop smoking
ii. Early diagnosis and treatment of respiratory tract infections; avoidance measures
iii. Avoid or control exposure to occupational and environmental pollutants and irritants.
iv. Influenza and pneumococcal vaccines
v. Awareness of family history of COPD and AAT deficiency

Question 28

Hospitalization required for acute exacerbations or complications:

Answer 28

Pneumonia
Cor Pulmonale
Acute respiratory failure

Question 29

Pt/caregiver teachings

Answer 29

1. Pulmonary rehabilitation
2. Activity considerations
3. Sexual activity
4. Sleep
5. Psychosocial considerations

Question 30

Interfering factors with sleep

Answer 30

1. Current tobacco use, depression, anxiety, meds, congestion, coughing or wheezing, sleep apnea