Exam 2 pulmonary part 2 Flashcards
Pathophysiology of Asthma
Intermittent and reversible airflow obstruction affecting airways only, not alveoli
Etiology of Asthma
- Inflammation:
Caused by cold air, dry air, specific allergens, general irritants, microorganisms, aspirin - Hyper-responsiveness:
caused by exercise, URI, GERD, unknown reasons
Asthma severity: Mild Intermittent- Class I
- Sx less than twice a week
Asthma severity: Mild Persistent- Class II
Sx more than twice a week, but not daily
Asthma severity: Moderate Persistent- Class III
Daily sx, with exacerbations twice a week
Asthma severity: Severe Persistent- Class IV
Sx occur continually with frequent exacerbations
Drug therapy for Asthma (Not the specific names): Preventive therapy (controller drugs)
- Change airway responsiveness to prevent asthma attacks
- Used every day, regardless of symptoms
Drug therapy for Asthma (Not the specific names): Rescue Drugs
Actually stop attack once it has started
Albuterol; Salmetrol
- Short- and long-acting beta2 agonists
- Bronchodilator
- Main rescue inhaler (Albuterol)
Ipratroprium bromide
- Cholinergic antagonists
- Bronchodilator
theophylline
- Methylxanthines
- Bronchodilator
Fluticasone, prednisone
- Corticosteroids
- Anti-inflammatory agents
nedocromil
- Cromones
- Anti-inflammatory agents
montelukast
- Leukotriene modifiers
- Anti-inflammatory agents
Status Asthmaticus
Severe, life-threatening, acute episode of airway obstruction
Intensifies once it begins, often does not respond to common therapy
Patient can develop pneumothorax and cardiac/respiratory arrest
Chronic Obstructive Pulmonary Disease (COPD)
- Characterized by bronchospasm and dyspnea
- Tissue damage not reversible; increases in severity, eventually leads to respiratory failure
Emphysema
- Loss of lung elasticity and hyperinflation of lung
- Dyspnea
need for increased respiratory rate - Air trapping
caused by loss of elastic recoil in alveolar walls, overstretching and enlargement of alveoli into bullae, collapse of small airways (bronchioles)
Chronic Bronchitis
Inflammation of bronchi and bronchioles caused by chronic exposure to irritants, especially cigarette smoke
Chronic Bronchitis symptoms
- Inflammation, vasodilation, congestion, mucosal edema, bronchospasm
- Affects only airways, not alveoli
- Production of large amounts of thick mucus
Chronic Obstructive Pulmonary Disease (COPD) etiology
- Cigarette Smoke
First, second & third hand smoke - Advanced Age
- Alpha1-antitrypsin (AAT) deficiency (important)
- Exposure to air pollution
Chronic Obstructive Pulmonary Disease (COPD) complications
- Hypoxemia/tissue anoxia
- Acidosis
- Respiratory infections
- Cardiac failure, especially cor pulmonale
- Cardiac dysrhythmias
Laboratory Assessment of COPD
- ABG values for abnormal oxygenation, ventilation, acid-base status
- Sputum samples
- CBC
- Hemoglobin and hematocrit (up)
- Serum electrolytes
- Serum AAT
- Chest x-ray
- Pulmonary function test
COPD interventions
- Improve oxygenation and reduce carbon dioxide retention
- Prevent weight loss
- Minimize anxiety
- Improve activity tolerance
- Prevent respiratory infection
COPD drug therapy
- Beta-adenergic agents
- Cholinergic antagonists
- Methylxanthines
- Corticosteroids
- NSAIDs
- Mucolytics
Chest tube Chambers: Chamber 1
collects fluid draining from patient
Chest tube Chambers: Chamber 2
water seal prevents air from re-entering patient’s pleural space
Chest tube Chambers: Chamber 3
suction control of system
