COPD Part 4

Question 1

Surgical Management

Answer 1

Bullectomy
Lung Volume Reduction Surgery
Lung Transplantation

Question 2

is a surgical option for select patients with bullous emphysema

Answer 2

bullectomy

Question 3

are enlarged airspaces that do not contribute to ventilation but occupy space in the thorax; these areas may be surgically excised.

Answer 3

Bullae

Question 4

compress areas of the lung and may impair gas exchange

Answer 4

Bullae

Question 5

Bullectomy help

Answer 5

reduce dyspnea and improve lung function

Question 6

Bullectomy can be performed via

Answer 6

video-assisted thoracoscope
limited thoracotomy incision

Question 7

Treatment options for patients with advanced or end-stage COPD (grade IV) with a primary emphysematous component are limited

Answer 7

Lung Volume Reduction Surgery

Question 8

What surgical option is Lung Volume Reduction Surgery

Answer 8

Palliative

Question 9

LVRS helps to

Answer 9

reduces hyperinflation
functional tissue to expand resulting
improved elastic recoil and
diaphragmatic mechanics

Question 10

involves the removal of a portion (homogenous) of the diseased lung parenchyma.

Answer 10

Lung volume reduction surgery

Question 11

These bronchoscopic procedures were developed to collapse areas of emphysematous lung and thus improve aeration of the functional lung tissue.

Answer 11

Bronchoscopic lung volume reduction therapies

Question 12

Bronchoscopic lung volume reduction techniques include

Answer 12

endobronchial placement of one way valve
bronchoscopic instillation of nitinol coils

Question 13

allows air and mucus to exit the treated area but does not allow air to reenter

Answer 13

endobronchial placement

Question 14

Installation into the airway of the hyperinflated lung tissue of patients with advanced emphysema

Answer 14

bronchoscopic instillation of nitinol coils

Question 15

is a viable option for definitive surgical treatment of severe COPD in select patients

Answer 15

Lung transplantation

Question 16

Limited not only by the shortage of donor organs, it is also a costly procedure with financial implications for months to years because of complications and the need for costly immunosuppressive medication regimens

Answer 16

Lung transplantation

Question 17

one of the most cost-effective treatment strategies, is a holistic intervention aimed at improving physical and psychological health of patients with COPD

Answer 17

Pulmonary rehabilitation

Question 18

The primary goals of rehabilitation are to

Answer 18

reduce symptoms, improve quality of life, and increase physical and emotional participation in everyday activities

Question 19

The benefits of this therapy include

Answer 19

improvement of exercise capacity, reduction in the perceived intensity of breathlessness, improvement in health-related quality of life, reduction in hospitalization days, reduction in thw anxiety and depression

Question 20

is reflected in severity of symptoms, degree of disability, and prognosis.

Answer 20

Nutritional status

Question 21

is often not considered until the disease is far advanced. to manage symptoms and improve the quality of life for patients and families with advanced disease

Answer 21

Palliative care

Question 22

are fundamental components of treatment for patients with advanced COPD

Answer 22

Palliative, hospice care, and end-of-life care

Question 23

Nursing mgt

Answer 23

Assessing the Patient
Achieving Airway Clearance
Improving Breathing Patterns
Promoting Self-Care
Improving Activity Tolerance
Encouraging Effective Coping
Monitoring and Managing Potential Complications
Promoting Home, Community-Based, and Transitional

Question 24

Bronchospasm can sometimes be detected on

Answer 24

Auscultation
Wheezing and diminished breath sounds

Question 25

consists of a slow, maximal inspiration followed by breath-holding for several seconds and then two or three coughs

Answer 25

Directed coughing or huff coughing

Question 25

consistent with improved airway clearance as they are to remove bronchial secretions, improve ventilation, and increase the efficiency of the respiratory muscles.

Answer 25

Chest Physiotherapy

Question 25

CPT includes

Answer 25

postural drainage, chest percussion and vibration, and breathing retraining

Question 25

allows the force of gravity to assist in the removal of bronchial secretion

Answer 25

Postural drainage

Question 25

The secretions drain from the affected bronchioles into the bronchi and trachea and are removed by

Answer 25

Coughing and suctioning

Question 25

are used so that the force of gravity helps move secretions from the smaller bronchial airways to the main bronchi and trachea

Answer 25

Postural drainage

Question 25

lower and middle lobe bronchi drain more effectively when the

Answer 25

Head is down

Question 25

the upper lobe bronchi drain more effectively when the

Answer 25

Head is up

Question 25

used to identify the areas that need drainage and assess the effectiveness of treatment

Answer 25

Auscultation of the chest before and after the procedure

Question 25

Postural drainage is usually performed when

Answer 25

two to four times daily, before meals
(to prevent nausea, vomiting, and aspiration) and at bedtime

Question 25

The nurse instructs the patient to remain in each position in PD for

Answer 25

10 to 15 minutes with pursed lip breathing

Question 25

is carried out by cupping the hands and lightly striking the chest wall in a rhythmic fashion over the lung segment to be drained

Answer 25

Chest percussion

Question 25

Percussion, alternating with vibration, is performed for …. In each position

Answer 25

3-5 minutes

Question 25

Avoid percussion on

Answer 25

over chest drainage tubes and the sternum, spine, liver, kidneys, spleen, or breasts

Question 25

is the technique of applying manual compression and tremor to the chest wall during the exhalation phase of respiration

Answer 25

Vibration

Question 25

The vest uses air pulses to compress the chest wall 8 to 18 times/sec, causing secretions to detach from the airway wall and enabling the patient to expel them by coughing

Answer 25

inflatable HFCWO vest

Question 25

Help improve breathing pattern

Answer 25

Breath retraining

Question 26

reduces the respiratory rate, increases alveolar ventilation, and sometimes helps expel as much air as possible during expiration.

Answer 26

Diaphragmatic breathing

Question 27

helps slow expiration, prevent collapse of small airways, and control the rate and depth of respiration

Answer 27

Pursed-lip breathing

Question 28

consists of exercises and breathing practices that are designed to achieve more efficient and controlled ventilation and to decrease the work of breathing.

Answer 28

Breathing Retraining