Exam 2 - COPD Flashcards
collection of lower airway disorders that interfere with airflow and gas exchange
COPD
destructive problem of lung elastic tissue that reduces its ability to recoil after stretching, leading to hyperinflation of the lung
emphysema
what are the 3 causes of air trapping?
(1) loss of elastic recoil in the alveolar walls
(2) overstretching and enlargement of the alveoli into air-filled spaces (bullae)
(3) collapse of small bronchioles
gas exchange is affected by ____ and the loss of alveolar tissue
the increased work of breathing
inflammation of the bronchi and bronchioles, thick mucus
chronic bronchitis
____ leads to mucus plugs and inflammation
chronic bronchitis
emphysema leads to what two things in the lungs?
hyperinflation and air trapping
chronic bronchitis leads to what two conditions?
hypoxemia and respiratory acidosis
name at least 3 complications of COPD
(1) COPD exacerbation
(2) hypoxemia
(3) acidosis
(4) respiratory infections
(5) heart failure
(6) dysrhythmias
(7) weight loss
s/s of early hypoxia
(1) confusion, irritability, restlessness
(2) tachypnea
(3) tachycardia
(4) elevated BP
(5) pale skin
(6) O2 <90%
s/s of late hypoxia
(1) stupor - lethargic, difficult to arouse
(2) cyanosis
(3) bradypnea (<12)
(4) bradycardia
(5) hypotension
(6) cardiac dysrhythmias
s/s of chronic hypoxia
(1) nail clubbing
(2) cyanosis
(3) delayed cap refill
(4) barrel chest
(5) pursed lip breathing
s/s of COPD exacerbation
(1) RR 40-50
(2) Low SpO2 (80-85%)
(3) accessory muscle use
(4) abnormal lung sounds
what is the target O2 level for COPD patients?
88-92%
what is the #1 nursing priority for COPD patients?
impaired gas exchange
the key action related to impaired gas exchange for the nurse is to perform ___
a focused respiratory assessment
if SpO2 is 80%, nurse should ____
raise HOB and give O2 to get them to 88-92%
why is hydration important in COPD?
to thin secretions
name the 5 common meds for COPD
(1) rapid-acting beta2 agonist
(2) inhaled anticholinergics
(3) long-acting beta2 agonist
(4) inhaled corticosteroid
(5) mucolytics
which med is the rescue inhaler?
rapid-acting beta2 agonist (Albuterol)
what is the action of the inhaled anticholinergic?
bronchodilation - slow onset / prevention
_____ is an example of an inhaled anticholinergic
tiotropium
_____ is a side effect of tiotropium
dry mouth
what is the purpose of the long-acting beta2 agonist?
bronchodilation - slow onset / prevention
____ is an example of a LABA
Salmeterol
____ is an example of an inhaled corticosteroid
Fluticasone
what is the action of an inhaled corticosteroid?
reduce airway inflammation
which medication should you rinse your mouth with to avoid thrush?
Fluticasone
Why do we give a lot of IV and inhaled corticosteroids for COPD?
slower-onset inflammation reduction
the action of mucolytics is ____
to thin secretions and make them easier to expel
side effect of mucolytics
hepatotoxicity
what is an example medication of mucolytics?
Acetylcysteine
____ can smell like rotten eggs
Acetylcysteine
name the proper steps of MDIs
(1) shake for 5 seconds
(2) take a deep breath and exhale completely
(3) inhale slowly and deeply while depressing inhaler for 3-5 seconds
(4) hold breath for 10 seconds
(5) wait 5 minutes between medications
(6) rinse mouth (especially after corticosteroids)
which meds should be administered first
bronchodilators before corticosteroids
