COPD & FEV1 (Bronchitis & Emphysema) Flashcards
What 3 disease states make up COPD?
Chronic Bronchitis, Emphysema, Asthma
COPD can be divided into what two disease pathology?
Obstructive & Restrictive
What is the primary metric for diagnosis for Obstructive Disease?
What are some examples of Obstructive Disease?
What are the primary 2 symptoms displayed by patients with of Obstructive Disease?
Dyspnea & Trouble Exhaling
What is the diagnoses for Restrictive Disease?
What are some metrics of Restrictive Disease?
What is the primary symptom(s) of Restrictive Disease?
Dyspnea & Coughing
FEV1 (Forced Expiratory Volume in 1 sec) = what?
The amount of air exhaled during the 1st sec of FVC
What is a healthy FEV1%?
> 70%
What are some metrics associated with obstructive disorders?
FEV1 Reduced
FVC Normal
FEV1/FVC Ratio Reduced
What are some metrics of restrictive disorders?
FEV1 and FVC Reduced
FEV1/FVC Ratio Normal or Increased
How is COPD characterized?
Characterized by the presence of airflow obstruction attributable to either chronic bronchitis or emphysema.
Does COPD have a cure?
Progressive Disease for which there is no cure.
What is chronic bronchitis?
Productive cough (most days) lasting longer than 3 months
What is Emphysema?
Abnormal permanent enlargement of the respiratory bronchioles and alveoli
What is the primary causes of Chronic Bronchitis?
Smoking 80-90% of cases
Urban pollution
What is the primary causes of Emphysema?
Cigarette Smoking
What are the common signs & symptoms of COPD?
- Shortness of Breath
- Dyspnea (especially w/ exertion)
- Orthopnea (upright breathing only)
- Wheezing
- Chest Tightness
- Increased VR
- Peripheral Cyanosis / Digital Clubbing
- Ongoing or Productive Cough
- Barrel Chest
- Accessory Muscles during Respiration
- Weight Loss
- Decreased FEV1/FVC Ratio
How is COPD Diagnosed?
- Signs & Symptoms
- Medical & Family History
- Test Results:
- Spirometry
- Arterial Blood Gases
- Chest X-Ray
- Chest CT Scan
What is a Mild COPD Classification?
< 0.70 (FEV1/FVC)
FEV1 > 80% of predicted
What is a Moderate COPD Classification?
< 0.70 (FEV1 / FVC)
50% < FEV1 > 80% of predicted
What is a Severe COPD Classification?
< 0.70 (FEV1 / FVC)
30% < FEV1 > 50% of predicted
What is a Very Severe COPD Classification?
< 0.70 (FEV1 / FVC)
FEV1 < 30% of predicted
FEV1 < 50% of predicted in presence of chronic respiratory failure
What measurement tool is considered essential for COPD diagnoses?
Spirometry
In order to minimize variability with bronchodilator values in spirometry, what is an adequate does (of what) to minimize variability?
400 ug Salbutamol
In stage 1 of COPD, what are some subjective patient identifiers associated with the symptoms?
Patient is usually unaware that his/her lung function is abnormal
In stage 2 of COPD, what are some subjective patient identifiers associated with the symptoms?
Patients typically seek medical attention b/c of chronic respiratory symptoms or an exacerbation of their disease.
In stage 3 of COPD, what are some subjective patient identifiers associated with the symptoms?
Symptoms almost have an impact on the patients quality of life.
In stage 4 of COPD, what are some subjective patient identifiers associated with the symptoms?
Quality of life is significantly impaired and exacerbations may be life threatening.
What are some COPD Treatment Goals (x5)?
What are 4 Primary COPD Treatment Goals?
1.) Improve Exercise Tolerance
2.) Advise Self-Management (ADLs)
3.) Increase Knowledge
4.) Airway Clearance
What are some COPD Lifestyle Changes & Treatments?
Smoking Cessation, Proper Nutrition, Pharmacological Therapy (Bronchodilators, Corticosteroids, Vaccines)
In Exercise Testing for COPD Patients what are some physiological function assessments?
GXT (cardiorespiratory) & Spirometry (pulmonary)
Patient Shortness of Breath ratings for exercise testing in COPD Patients should be measured how?
Borg (1-10) Scale
What is an exercise test termination indicator in exercise testing with COPD patients?
low SPO2 (< 90%) or a drop of 3-4%
What forms of exercise are the best modalities for COPD patients?
Walking or Stationary Bicycle
What are the FITT guidelines for COPD patients?
F: > 3-5 days/wk
I: SOB: < 3 (30-40% light / 60-80% vigorous)
T: Small Interval bouts
T: Walking and/or cycling
When can supplemental O2 be provided to a COPD patient?
Can only be provided with a prescription from a physician & with patients with low SpO2
