Exam 2, Ch 31 (Week 4): Obstructive Pulmonary Diseases Flashcards
What are the 4 main OPD’s covered in this class?
-Bronchiectasis
-Asthma
-Cystic Fibrosis
-COPD
In general, what is an Obstructive Pulmonary Disorder.
An obstructive pulmonary disorder is any disorder that causes an Increased resistance to airflow because of an airway obstruction or airway narrowing.
In an Obstructive Pulmonary Disorder, patients find it hard to breath because of some kind of airflow resistance. Speaking generally, what are the two main reasons for their difficulty breathing?
An airway obstruction or an airway narrowing.
What kind of bodily response could lead to the narrowing of the airways in an OPD?
Acute or Chronic inflammation
A patient is suffering from Airflow restrictions due to chronic inflammation. What are two possible reasons for the chronic inflammation??
-Cystic Fibrosis
-The presence of Scar tissue
What can the Alveoli in the lungs lose that can cause airflow resistance in OPD patents?
Alveoli can lose their elasticity and recoil
In an obstructive pulmonary disease, the pulmonary arteries and veins can thicken, causing what effect on the smooth muscle in the lungs?
Hypertrophy. This makes it harder for O2 and CO2 to diffuse because of the enlarged smooth muscle membranes.
What are the 3 main things you would assess for in a patient with an OPD?
-Cyanosis
-Abnormal ABG’s
-Adventitious lung sounds
What are some factors involving a patient’s history that you might assess for when screening for an OPD?
-Do they smoke?
-What are their allergies?
-Have they ever been exposed to pollutants?
-Does anyone in their family have n OPD?
A chronic, irreversible dilation of the bronchi and the bronchioles is which type of OPD?
Bronchiectasis
Bronchiectasis is the irreversible dilation of what?
The bronchi and the bronchioles
True or False:
Bronchiectasis is the irreversible constriction of the bronchi and the bronchioles.
False
Bronchiectasis is the irreversible dilation of the bronchi and the bronchioles.
Bronchiectasis is a condition that FOLLOWS another disease/Infection. What are some diseases that can lead to bronchiectasis?
-Cystic Fibrosis
-The flu
-Tuberculosis
Cystic Fibrosis causes dehydrated mucus to build up in the bronchi and bronchioles, causing increased airway resistance. How would this effect lead to Bronchiectasis?
This could cause in inflammatory reaction to counteract the narrowing of the airways, as well as the addition of neutrophiles in the lung walls to aid in the inflammatory response from bacterial mucus buildup.
Cystic Fibrosis is typically chronic, and so there would be a chronic cycle of airway constriction, then inflammation to dilate, repeated over and over. Eventually, the airways of the bronchi would lose their elasticity from so much constriction/dilation, along with mucus and bacterial built up in pockets of the bronchial wall, damaging it.
Thus, the bronchi remain permanently open.
CT scans are the gold standard to help to visualize the dilation effect of bronchiectasis, but it is often misdiagnosed as chronic bronchitis.
What is another way to diagnose bronchiectasis that would be combined with CT scan results?
A Sputum culture.
Look for an excessive amount of purulent, and blood streaks in the sputum.
Blood streaks mean Bronchiectasis.
What lab values would you assess in a patient suspected of bronchiectasis?
-WBC
-AAT levels above 150mg/dl (From the book, not the PowerPoint, so take it or leave it.)
What is the main pathophysiological marker for bronchiectasis?
Chronic dilation of the bronchi/bronchioles
Which would be advisable in treatment for Bronchiectasis?
a.) Pneumonia vaccine
b.) Sputum drainage
c.) Surgery to remove the effected lung.
d.) Antibiotics
e.) All of the above
f.) None of the above
e.) All of the above.
What would be a priority act for the nurse to engage in for a patient with bronchiectasis?
Postural drainage
What is Cor pulmonale?
Right sided heart failure, due to long-term high blood pressure.
True or False:
Cystic Fibrosis is a genetically linked OPD
True
Cystic Fibrosis causes the altered transport of what ions?
Sodium and Chloride ions in Epithelial cells
Due to the failure of specific transported ions, what effect does Cystic Fibrosis cause on mucus?
It causes thick mucus secretions with low water content.
Due to the thickened mucus caused by Cystic Fibrosis, glands become plugged up. What effect does this have on bodily organs?
Dysfunction and atrophy.