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NURS 347 EXAM 2 > COPD part 2 > Flashcards

COPD part 2 Flashcards

1
Q

What’s are the most common used of anticholinergic inhaler (2)?

A

Ipratropium (Atrovent)
Trutropium (Spiriva)

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2
Q

What is the non pharmacy therapy for COPD? (4)

A

Stop smoking
Avoid exposure
Covid & Flu & pneumonia vaccine
Pulmonary rehab
- PTOT ( vest that vibrates that break that mucus )

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3
Q

Can you get surgery for COPD? But is it really recommend for them or more so are they good candidates? And why?

A

Yes
But they aren’t good candidates due to the fact that they have other underlying problems

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4
Q

What are the 4 type of surgery that go into surgical therapy for COPD?

A

LVRS ( lung volume reduction surgery )
bronchoscopic lung volume reduction surgery
Bullectomy
Lung transplant

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5
Q

How does LVRS ( lung volume reduction surgery ) work?

A

Removed diseased tissue so healthy tissue works better

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6
Q

What is bronchoscopic lung volume reduction surgery?

A

Place 1 way valve in airways to diseased lung leads to collapse

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7
Q

What is bullectomy?

A

Removal of one more Bullae to decrease work of breathing

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8
Q

What is lung transplant?

A

Removing and replacing one or both lung

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9
Q

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?

A

Eligible for lung transplant

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10
Q

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)

A

Yes
In order to help hypoxemia
Humidified
To avoid nosebleeds & inflammation

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11
Q

Keeping O2 saturation above ___? During rest sleep and exertion or
PaO2 > ____?

A

90
60

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12
Q

What are the complications of oxygen therapy? (4)

A

Combustion - if they smoke
Infection - humidity supports bacterial growth
CO2 narcosis - no longer stimulus to breathe
O2 Toxicity - prolonged high O2 - inflammation

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13
Q

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?

A

They live at a low oxygen
We can keep them at 88%

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14
Q

Oxygen is a prescribed what??

A

Medication !!
We need a doctor order

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15
Q

Nasal cannula can put you at risk of infection and you can get what?
So we do what with the equipment?

A

Pneumonia
Dispose equipment

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16
Q

What are some breathing techniques we can teach a patient? (4)

A

Pursed lip breathing
Diaphragmatic breathing
Airway clearance techniques
Effective cough or huff coughing

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17
Q

What is pursed lip breathing?

A

Like breathing into a paper bag
Prolonges expiration to reduce bronchial collapse and air trapping

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18
Q

What is diaphragmatic breathing?

A

Teaching to breath anatomically better than using accessory muscles

Like sitting up
No tripod

19
Q

What is an airway clearance techinique?

A

Giving them medication
Bronchodilator

20
Q

What’s effective coughing or huff coughing?

A

Conserves energy
Reducing fatigue
Facilitate removal of secretion

21
Q

What are 3 other treatments for breathing? And meaning ?

A

Percussion - patting their back
Vibration - machine to break mucus
CPT
Chest physiotherapy
- pulmonary rehab, break up muscus

22
Q

What is cheat therapy ?
High frequency Chest wall oscillation

A

Inflatable vest connect to high frequency pulse generator that vibrates the chest

23
Q

Can the patient use the chest wall vibration of their own? And is it portable?

A

Yes

24
Q

What is the function of the chest wall vibration?

A

Dislodges and mobilizes mucus to larger airways

25
Q

Due to malnutrition in COPD patients we want to provide what type of therapy?

A

Nutritional therapy

26
Q

Since COPD patients are malnourished we will see what? (3)

A

Increase in inflammatory mediators
Increase metabolic rate
Lack of appetite

27
Q

In the advance stages of COPD, weight loss is a predictor of what?

A

Poor prognosis

28
Q

In order to decrease dyspnea and converse energy we will teach patients to? (3)

A

Rest at least 30mins before eating
Avoid exercise for 1 hour before eating and after eating
Use bronchodilator before meals

29
Q

We want to give what type of food for COPD patients? (5)

A

High calorie
High protein
Moderate carbohydrates
Moderate fats
5-6 small meals

30
Q

What do we want to avoid for COPD nutritional therapy? (3)

A

Avoid a lot of chewing
Exercise and treatments 1 hour before
Gas forming food

31
Q

COPD has a great risk of choking, you want them to what? And they should be on a what diet?

A

Chewing meals completely
Soft diet

32
Q

Gerontologic considerations
How do you treat COPD elderly different than younger?
They have what (4)?

A

Reduce lean body mass
Decrease respiratory muscle strength at base line
Increase dyspnea
Increase lower exercise
Tolerances leads to higher incidence of acute exacerbations

33
Q

Gerontologic considerations have more complications like what? (3)
And why?

A

Increase complications, stress and drug interactions

Because these patients are on other medications

34
Q

Gerontologic considerations
Adherence may be an issue? (3)
Reason for each

A

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

35
Q

Gerontologic considerations
Quality of life issues (2)
And reason for each

A

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

36
Q

What are the 4 nursing diagnosis?

A

Impaired breathing
Activity intolerance
Impaired nutritional status
Difficulty coping

37
Q

What’s the nursing plan? (3)

A

Goals
relief from symptoms
Perform ALDS
educating they have it for life but you give tools to make it manageable

38
Q

What is the health promption for COPD? (5)

A

No smoking
Early diagnosis & treatment
Avoid exposure
Flu & pneumonia vaccine
Awareness of family history
( AAT genetic )

39
Q

Nurses will normally see the acute care for COPD what does that mean?
We’ll see what? And what type of complications?

A

Acute exacerbations
Pneumonia
Cor pulmonare ( right heart failure )
Acute Respiratory failure

40
Q

What’s the nursing implementation upon discharge?

A

Pulmonary rehab
- exercise
- smoking cessation
- nutrition

41
Q

How do we help with activity with COPD?
Like how will we help them?

A

How to comb their hair
Shaving
Showering
15-20mins walking
Break during excerise 5mins

42
Q

How to help sleep COPD?

A

They won’t sleep because of the increase of CO2
Teach them how to sleep or using oxygen to sleep

43
Q

Symptoms can be managed but COPD cannot be what?

A

Cured

44
Q

Teaching COPD of palliative care, end of life decision, and hospice care we are what?

A

Doing our job as a nurse

NURS 347 EXAM 2 (7 decks)

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