FINAL EXAM - All Conditions of the Respiratory System Flashcards
nasal cavity Fn
sticky mucous membrane lining the nasal cavity traps dust particles, and tiny hairs called cilia help move them to the nose to be sneezed or blown out
sinuses Fn
these air-filled spaces along side the nose help make the skull lighter
pharynx fn
both food and air pass through the pharynx before reaching their appropriate destinations. the pharynx also plays a role in speech.
larynx
essential to human speech
traches fn
located just below the larynx, the trachea is the main airway to the lungs.
lungs Fn
together the lungs form on of the body’s largest organs. they’re responsible for providing oxygen to capillaries and exhaling co2
bronchi fn
for the trachea into each lung and create the network of intricate passages that supply the lungs with air
diaphragm fn
the diaphragm is the main respiratory muscle that contracts and relaxes to allow air into the lungs
normal Respiratory rate (RR)
12-15 minute
Heart Rate (P) (4)1. rate2. feel for how long3. if irregular count for how long4. if it’s low ask client what?
- 60-1002. feel for 15sec. x43. if irregular count for 1 min. 4. low rate - ask if client feels light headed
Metabolic Equivalent of task (MET)
amount of energy used by the body to perform a physical activity or daily task
at rest what is the average oxygen consumption MET?
1 MET
With more activity MET values
increase
tachycardia(3)1. what is the heart rate2. what is it not always?3. what do you ask the client?
- heart rate > 100 bpm2. not always pathological (side effect)3. Ask if they’re light headed/ dizzy and if they sit down does it go away
tachypnea (2)1. what is the RR2. What is a normal RR
respiratory rate > 20/minutenormal rate is 8-12/minute
wheeze
airway is constrictedcontinuous, coarse, whistling sound produced in the airways during breathing
If there is no sound when listening to lungs it means
air is not moving around; not good
rales
sounds like bubble wrap; avioli popping due to filled with secretions; clicking, rattling, or crackling noises that may be made by one or both lungs during inalation
Rhonchi
wheezing then cough and sound is gone; due to mucous moving around.coarse rattling sound somewhat like snoring, usually caused by secretion in bronchial airways
Signs of CAP (3)
- tachycardia/tachypnea2. dullness to percussion with consolidation/effusion3. exam alone cannot confirm/exclude diagnosis
Symptoms of CAP (5)
- altered breath sounds/rales2. rigor/sweats3. fever/hypothermia4. dyspnea5. new cough (+/- sputum)
rigor
shaking chills
CAP prognosis
can take weeks to return to baseline functioning
Signs of Nosocomial pneumonia (HCAP) (2)
- altered breath sounds/rales2. dullness to percussion with effusion
Symptoms of HCAP (4)
- fever/hypothermia2. rigor/sweats3. dyspnea4. new cough (+/- sputum)
OT intervention recommendations (4)
- encourage coughing2. sitting/walking is good and can speed recovery3. walking prevents blood clots4. recovery can take several weeks
Atropy
tendency to be hypoallergic is the strongest identifiable factor
Atopic “triad” (3)
- wheeze2. eczema3. seasonal rhinitis
Asthma’s impact on structure of the respiratory system (4)
- narrowed airway (limited airflow)2. tightened muscles- constrict airway3. inflamed/thickened airway wall 4. mucus
Asthma symptoms (5)
- breathlessness2. cough3. wheeze prolonged expiration4. episodic/chronic symptoms of airway obstruction5. 1/3 of children have no wheeze
asthma general management (4)
- remove irritants2. peak flow measurements3. desensitization4. oxygen
Asthma pharmacological management (3)
- quick relief meds (beta 2 agonists - albuterol)2. long term control - steroid3. medication side effects-Tachycardia or increased RR
asthma OT activity recommendation (3)
- avoid triggers such as cold air2. control symptoms first before activity3. activities with short bursts are better tolerated to build up conditioning
emphysema clinical findings (8)
- exertional dyspnea (activity)2. cough is rare3. quiet lungs4. no peripheral edema5. thin; recent weight loss6. barrel chest7. pursed lips breathing8. hyperventilation
Emphysema CXR (5)
- decreased lung markings at apices2. flattened diaphragms3. hyperinflation4. parenchymal bullae and blebs - small thin appearing heart
bronchitis clinical findings (5)
- mild dyspnea2. chronic productive cough3. noisy lungs; rhonchi and wheeze4. peripheral edema5. overweight and cyanotic
bronchitis CXR (2)
- increased interstitial markings at bases2. diaphragms not flattened
treatment options for COPD - increase in severity as you go down the list (7)
- no cure; once developed never goes away2. self-management education and smoking cessation3. bronchodilators4. inhaled corticosteroids5. pulmonary rehabilitation6. oxygen7. surgery
vital signs (7)
- temperature - T2. pulse - P3. respirations - R4. blood pressure - BP5. height - Ht6. weight - Wt7. pain
Alveoli
small air sacs that perform gas exchange
epiglottis
protects the lungs from foreign objects by covering the trachea during swallowing
tachycardia - define
heart is pumping too quickly or thready; impacts circulation
Due to the close relationship between the lungs and the heart; conditions that
impact one organ can cause impairment in the other
HTN
increase in the amount of force that is pushing against the walls of the arteries as the heart pumps blood
HTN is usually
asymptomatic; can go years unnoticed and untreated; but still causing damage to the heart, kidneys, and other body structures
Prehypertensive is considered between what 2 numbers?
120/80 and 139/89
HTN Preventions include (2)
- regular exercise2. eating a healthy diet
Treatment of HTN
- follow physician recommended health care plan2. adhering to exercise and healthy eating plans3. monitoring BP levels4. taking medications
atherosclerosis
condition where plaque made of cholesterol, fat, calcium, and other substances sticks to the inner lining of arteries; over time hardening and narrowing the opening of blood vessels, thus reducing the rate of oxygenated blood being delivered.
Causes of CAD(6)
smokingobesitydiabeteshigh cholesterolgeneticsage
Treatment of CAD
- healthy lifestyle choices2. medications3. surgical procedures
Surgical procedures for CAD include
- angioplasty 2. CABG3. Carotid endartrerectomy
Angioplasty
small mesh tube is inserted into the coronary artery to widen the opening, thus increasing the blood flow
CABG
artery or veins are harvested from the leg usually and then surgically attached to bypass the blocked arteries near the heart
Carotid Endarterectomy
surgery where the carotid artery in the neck is opened in order to remove some of the plaque that has formed thus allowing better blood flow to the brain
pneumonia
inflammation of the lung tissue caused by infection, usually from bacterial, viral, or fungal sources
Community-acquired pneumonia
exposure to the bacteria or virus in the community
Those at risk for hospital-acquired pneumonia (3)
- post surgery (especially abdominal or chest surgery)2. patients in intensive care unit3. patients with weakened immune system
Those at risk for aspiration pneumonia are
- TBI or CVA pts. that have impacted the swallowing sequence or gag reflexes2. when food or foreign substance enters the lungs and causes an infection
Early signs and symptoms of pneumonia are often confused with the
flu
Symptoms for pneumonia include (8)
- cough2. fever3. dyspnea4. sweating5. chills6. chest pain or tightness7. headache8. fatigue
diagnosing pneumonia(3)
listening to the chest for rales or rumblingchest xrayblood and mucus tests (less common)
Course of pneumonia
- signs of the flu2. severity of symptoms depend on the infecting organism3. caught early enough avoid hospitalization4. If hospitalized, usually 3-4days5. Older adults over 85 may have other health complications
if left untreated pneumonia can lead to
severe respiratory distress and even death b/c organs are no longer getting the O2 that they need and begin to fail
Prevention of pneumonia (2)
vaccinationflu shot
Standard treatment plan for pneumonia
- antibiotics2.. rest3. fluids
Cough is not totally stopped in pneumonia with medications because
it is an important mechanism for removing excess mucus from the airways
COPD is an overarching term that also includes (2)
emphysema and chronic bronchitis
Physically, a COPD lung is more
floppy and somewhat deflated or damaged
emphysema
the alveoli walls may become deflated or damaged which reduces the amount of gas exchange that can occur
chronic bronchitis
the bronchial tubes become inflamed and thickened making it difficult to breathe
Symptoms of COPD (4)
smoker’s cough (persistent mucus producer)wheezing or whistling while inhalingchest tightnessdyspnea with exertion
As COPD progresses other symptoms may include (2)
swollen ankles and feet lips and fingernails may be bluish due to decreased oxygen levels
What is the main test for lung Fn for those with COPD?
spirometry
Course of COPD
- breathing becomes more difficult and less O2 get to the body2. heart becomes enlarged due to strain3. BP increases4. Cognitive deficits due to lack of O25. Organ failure6. Death
Medical management of COPD includes
- Oxygen2. Inhaled medications3. oral medications4. Lung reduction surgery or replacement.
What are the first two things an OT practitioner should determine?
1.determine the occupational needs of the client 2.determine the effects of their symptoms on occupational performance
Common symptoms that impact occupational performance in cardiopulmonary disorders
- dyspnea2. fatigue3. depression4. difficulty focusing5. anxiety6. light-headed
Dyspnea’s impact on occupational performance
may need frequent breaks and may need chairs placed in various positions around their house to provide a place to sit
Fatigues impact on occupational performance
may need to have tasks broken down into smaller parts and to do them over a longer period of time. Work simplification and energy conservation
Depressions impact on occupational performance
encouragement to participate, support in successes, and empathy
Difficulty focusing and it’s impact on occupational performance
visual reminders and verbal cues. Processing time may be lengthened, so a slower pace may be helpful when problem-solving more complex tasks.
Anxiety’s impact on occupational performance
more time, encouragement, and pleasant distractions can help them move forward with the small day-to-day tasks. May become a larger issue that keeps clients from doing what they need to do.
Light-headedness: impact on occupational performance
allow the client to sit whenever possible to complete a task. have seats close and encourage them to stand near a stable counter or table, or use a grab bar is standing is needed.
It is important for OT’s to consider how precautions impact a clients
ability to safely complete all areas of occupations
Common Precautions for Cardiopulmonary disorders(6)
- No heavy lifting2. heart rate less than or equal to 110 beats/minute3. O2 at all times4. Maintain low-salt diet5. Record daily weight6. Follow recommended oral and inhaled medication schedule7. No activities at a MET rate of higher than 6
No heavy lifting - impact on occupational performance
any task that would require lifting would need to be modified or completed by someone else. lifting precautions also limit wheelchair self-propulsion as this too, puts too much strain on the upper body
heart rate less than or equal to 110 beats/minute - impact on occupational performance
clients will need to be taught to take their own heart rate and be reminded to take it if more exertion is attempted. Written cues may be needed for reminders.
O2 at all times - impact on occupational performance
Clients will need to be connected to an oxygen source; tank and long hose must be manipulated to ensure safety with mobility