COPD part 2 Flashcards
What’s are the most common used of anticholinergic inhaler (2)?
Ipratropium (Atrovent)
Trutropium (Spiriva)
What is the non pharmacy therapy for COPD? (4)
Stop smoking
Avoid exposure
Covid & Flu & pneumonia vaccine
Pulmonary rehab
- PTOT ( vest that vibrates that break that mucus )
Can you get surgery for COPD? But is it really recommend for them or more so are they good candidates? And why?
Yes
But they aren’t good candidates due to the fact that they have other underlying problems
What are the 4 type of surgery that go into surgical therapy for COPD?
LVRS ( lung volume reduction surgery )
bronchoscopic lung volume reduction surgery
Bullectomy
Lung transplant
How does LVRS ( lung volume reduction surgery ) work?
Removed diseased tissue so healthy tissue works better
What is bronchoscopic lung volume reduction surgery?
Place 1 way valve in airways to diseased lung leads to collapse
What is bullectomy?
Removal of one more Bullae to decrease work of breathing
What is lung transplant?
Removing and replacing one or both lung
COPD is not a curable disease, it’s a progressive disease for your lungs, though if you’re young with COPD you may be what?
Eligible for lung transplant
Can we give oxygen to COPD ? Why? And what does it treat?
And we want to make sure there room is what?
In order to what?^ (4)
Yes
In order to help hypoxemia
Humidified
To avoid nosebleeds & inflammation
Keeping O2 saturation above ___? During rest sleep and exertion or
PaO2 > ____?
90
60
What are the complications of oxygen therapy? (4)
Combustion - if they smoke
Infection - humidity supports bacterial growth
CO2 narcosis - no longer stimulus to breathe
O2 Toxicity - prolonged high O2 - inflammation
These COPD patients live at a low what?
These patients will come in for a broken leg and they are breathing just fine, their pulse ox says 88% but they live at that level. So it’s important to say what? And if they are breathing fine, what do we do?
They live at a low oxygen
We can keep them at 88%
Oxygen is a prescribed what??
Medication !!
We need a doctor order
Nasal cannula can put you at risk of infection and you can get what?
So we do what with the equipment?
Pneumonia
Dispose equipment
What are some breathing techniques we can teach a patient? (4)
Pursed lip breathing
Diaphragmatic breathing
Airway clearance techniques
Effective cough or huff coughing
What is pursed lip breathing?
Like breathing into a paper bag
Prolonges expiration to reduce bronchial collapse and air trapping
What is diaphragmatic breathing?
Teaching to breath anatomically better than using accessory muscles
Like sitting up
No tripod
What is an airway clearance techinique?
Giving them medication
Bronchodilator
What’s effective coughing or huff coughing?
Conserves energy
Reducing fatigue
Facilitate removal of secretion
What are 3 other treatments for breathing? And meaning ?
Percussion - patting their back
Vibration - machine to break mucus
CPT
Chest physiotherapy
- pulmonary rehab, break up muscus
What is cheat therapy ?
High frequency Chest wall oscillation
Inflatable vest connect to high frequency pulse generator that vibrates the chest
Can the patient use the chest wall vibration of their own? And is it portable?
Yes
What is the function of the chest wall vibration?
Dislodges and mobilizes mucus to larger airways
Due to malnutrition in COPD patients we want to provide what type of therapy?
Nutritional therapy
Since COPD patients are malnourished we will see what? (3)
Increase in inflammatory mediators
Increase metabolic rate
Lack of appetite
In the advance stages of COPD, weight loss is a predictor of what?
Poor prognosis
In order to decrease dyspnea and converse energy we will teach patients to? (3)
Rest at least 30mins before eating
Avoid exercise for 1 hour before eating and after eating
Use bronchodilator before meals
We want to give what type of food for COPD patients? (5)
High calorie
High protein
Moderate carbohydrates
Moderate fats
5-6 small meals
What do we want to avoid for COPD nutritional therapy? (3)
Avoid a lot of chewing
Exercise and treatments 1 hour before
Gas forming food
COPD has a great risk of choking, you want them to what? And they should be on a what diet?
Chewing meals completely
Soft diet
Gerontologic considerations
How do you treat COPD elderly different than younger?
They have what (4)?
Reduce lean body mass
Decrease respiratory muscle strength at base line
Increase dyspnea
Increase lower exercise
Tolerances leads to higher incidence of acute exacerbations
Gerontologic considerations have more complications like what? (3)
And why?
Increase complications, stress and drug interactions
Because these patients are on other medications
Gerontologic considerations
Adherence may be an issue? (3)
Reason for each
Cognitive impariment : memory
- they have a lot of other things to worry about
- as well teaching them
Complex medication regimens
- taking a lot of patients
Physical issues : arthritis, vision, side of effects of medications ( ICS )
- make sure they even have the strength to even use an inhaler
Gerontologic considerations
Quality of life issues (2)
And reason for each
Psychological and emotional
- supporting them
Palliative care and hospice
- later stages
- how to keep up with change
COPD is a hard diagnosis to live and be diagnosed with, we want to make sure they are prepared and how they can live with it
What are the 4 nursing diagnosis?
Impaired breathing
Activity intolerance
Impaired nutritional status
Difficulty coping
What’s the nursing plan? (3)
Goals
relief from symptoms
Perform ALDS
educating they have it for life but you give tools to make it manageable
What is the health promption for COPD? (5)
No smoking
Early diagnosis & treatment
Avoid exposure
Flu & pneumonia vaccine
Awareness of family history
( AAT genetic )
Nurses will normally see the acute care for COPD what does that mean?
We’ll see what? And what type of complications?
Acute exacerbations
Pneumonia
Cor pulmonare ( right heart failure )
Acute Respiratory failure
What’s the nursing implementation upon discharge?
Pulmonary rehab
- exercise
- smoking cessation
- nutrition
How do we help with activity with COPD?
Like how will we help them?
How to comb their hair
Shaving
Showering
15-20mins walking
Break during excerise 5mins
How to help sleep COPD?
They won’t sleep because of the increase of CO2
Teach them how to sleep or using oxygen to sleep
Symptoms can be managed but COPD cannot be what?
Cured
Teaching COPD of palliative care, end of life decision, and hospice care we are what?
Doing our job as a nurse
