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NCM118 > COPD Part 2 > Flashcards

COPD Part 2 Flashcards

1
Q

Diagnostic Findings

A

Pulmonary function studies:
*Spirometry
*Arterial blood gas measurements
*chest x-ray
*Screening for alpha1-antitrypsin deficiency

SACS

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2
Q

are used to help confirm the diagnosis of COPD, determine disease severity, and monitor disease progression

A

Pulmonary function studies

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3
Q

is used to evaluate airflow obstruction, which is determined by the ratio of FEV1 to forced vital capacity (FVC).

A

Spirometry

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4
Q

used to determine reversibility of obstruction after the use of bronchodilator

A

Spirometry

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5
Q

How to do spirometry

A

Spirometry is initially performed, the patient is given an inhaled bronchodilator treatment according to a standard protocol, and then spirometry is repeated. The patient demonstrates a degree of reversibility if the pulmonary function values improve after administration of the bronchodilator

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6
Q

obtained to assess baseline oxygenation and gas exchange and are especially important in advanced COPD.

A

Arterial blood gas measurements

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7
Q

obtained to exclude alternative diagnoses

A

Chest xray

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8
Q

is suggested for all adults who are symptomatic, especially for patients younger than 45 years

A

Screening for alpha1-antitrypsin deficiency

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9
Q

Factors that determine the clinical course and survival of patients with COPD include history of

A

cigarette smoking, exposure to secondhand smoke, age, rate of decline of FEV1, hypoxemia, pulmonary artery pressure, resting heart rate, weight loss, reversibility of airflow obstruction, and comorbidities.

ARCHER PWRC

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10
Q

primary differential diagnosis of COPD is

A

Asthma

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11
Q

may help in the differential diagnosis.

A

high-resolution CT scan

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12
Q

Key factors to diagnose

A

Pt. history, severity of symptoms and reactions to bronchodilator

PSR

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13
Q

Grade I

A

Mild
FEV1/FVC <70%
FEV1 ≥80% predicted

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14
Q

Grade II

A

Moderate
FEV1/FVC <70%
FEV1 50–79% predicted

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15
Q

Grade III

A

Severe
FEV1/FVC <70%
FEV1 30–49% predicted

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16
Q

Grade IV

A

Very severe
FEV1/FVC <70%
FEV1 <30% predicted

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17
Q

Complications

A

Acute/chronic Respiratory insufficiency and failure
pneumonia, chronic atelectasis, pneumothorax, and pulmonary arterial hypertension (cor pulmonale)

A Parrot Can Play Piano

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18
Q

are major life-threatening complications of COPD.

A

Respiratory insufficiency and failure

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19
Q

The acuity of the onset and the severity of respiratory failure depend on

A

baseline pulmonary function, pulse oximetry or arterial blood gas values, comorbid conditions, and the severity of other complications

Big Pandas Climb Sticks

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20
Q

Severe copd

A

Chronic Resp. Insufficiency and failure

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21
Q

severe bronchospasm or pneumonia in a patient with severe COPD

A

Acute Resp. Insufficiency and failure

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22
Q

Medical mgt

A

Therapeutic strategies
*promoting smoking cessation as appropriate, providing supplemental oxygen therapy as indicated, prescribing medications, and managing exacerbations.

Some: surgical interventions
Advance copd: palliative care

Superman Saves People, Makes Super Plans

23
Q

Risk Reduction

A

Modify environmental exposures
*Smoking cessation

24
Q

the single most cost-effective intervention to reduce the risk of developing COPD and to stop its progression

A

Smoking cessation

25
Q

Factors associated with continued smoking

A

strength of the nicotine addiction, continued exposure to smoking associated stimuli (at work or in social settings), stress, depression, and habit

26
Q

promote cessation by

A

“at-risk” message
set a definite “quit date.”
smoking cessation program
Continued reinforcement
Relapses should be analyzed
identify possible solutions

27
Q

a first-line pharmacotherapy that reliably increases long-term smoking abstinence rates—comes in a variety of forms (gum, inhaler, nasal spray, transdermal patch, sublingual tablet, or lozenge

A

Nicotine replacement

28
Q

both antidepressants, may also increase longterm quit rates of smoking

A

Bupropion SR and nortriptyline

29
Q

antihypertensive agent but limited use

A

Clonidine

30
Q

a nicotinic acetylcholine receptor partial agonist, may assist in smoking cessation

A

Varenicline

31
Q

Patients who are not appropriate candidates for pharmacotherapy

A

medical contraindications, light smokers (fewer than 10 cigarettes per day), pregnant women, and adolescent smokers

MAPL

32
Q

is the administration of oxygen at a concentration greater than that found in the environmental atmosphere

A

Oxygen therapy

33
Q

the concentration of oxygen in room air is

A

21%

34
Q

to provide adequate transport of oxygen in the blood while decreasing the work of breathing and reducing stress on the myocardium

A

Oxygen therapy

35
Q

Oxygen transport to tissues depends on factors

A

cardiac output, arterial oxygen content, concentration of hemoglobin, and metabolic requirements

CARM

36
Q

Indications for oxygen therapy

A

change in the patient’s respiratory rate or pattern
*Hypoxia & Hypoxemia

37
Q

a decrease in the arterial oxygen tension in the blood

A

Hypoxemia

38
Q

How Hypoxemia is manifested

A

by changes in mental status, dyspnea, increase in blood pressure, changes in heart rate, arrhythmias, central cyanosis (late sign), diaphoresis, and cool extremities

39
Q

a decrease in oxygen supply to the tissues and cells that can also be caused by problems outside the respiratory system, can be life-threatening.

A

Hypoxia

40
Q

changes occur in the central nervous system because the neurologic centers are very sensitive to oxygen deprivation

A

rapidly developing hypoxia

41
Q

Signs and symptoms of oxygen deprivation

A

depend on how suddenly
resemble that of alcohol intoxication, lack of coordination and impaired judgment.

42
Q

fatigue, drowsiness, apathy, inattentiveness, and delayed reaction time may occur with this kind of hypoxia

A

long-standing hypoxia

43
Q

need for oxygen is assessed by

A

arterial blood gas analysis, pulse oximetry, and clinical evaluation

CAP

44
Q

Complications of oxygen therapy

A

*Oxygen toxicity effects on the lungs and central nervous system or may depress ventilation (lethal adverse effect)
*absorption atelectasis
*Combustion
*Bacterial contamination

CABO

45
Q

is a medication, and except in emergency situations it is given only when prescribed by a health care provider.

A

Oxygen

46
Q

a patient with any type of respiratory disorder is given oxygen therapy only to increase the

A

partial pressure of arterial oxygen (PaO2)
Normal: 60 to 95 mm Hg

47
Q

oxyhemoglobin dissociation curve arterial hemoglobin at these levels is

A

80% to 98% saturated with oxygen

48
Q

higher fraction of inspired oxygen (FiO2) may produce toxic effects on

A

lungs and central nervous system or may depress ventilation (lethal adverse effect)

49
Q

is used to monitor oxygen levels

A

Intermittent or continuous pulse oximetry

50
Q

may occur when too high concentration of oxygen is given for an extended period (generally longer than 24 hours)

A

Oxygen toxicity

51
Q

caused by overproduction of oxygen free radicals, which are by-products of cell metabolism.

A

Oxygen toxicity

52
Q

An additional adverse effect of the administration of high concentrations of
oxygen (greater than 50%) to patients who are sedated and breathing small tidal volumes of air

A

absorption atelectasis

53
Q

It is important to post when oxygen is in use.

A

“No Smoking” signs

NCM118 (22 decks)

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