Final Exam: Week 4 Pulmonary

Question 1

Pulmonary disease prevalence

Answer 1

• Third highest cause of mortality in the U.S
• 15% of U.S adults have chronic lung disease such as asthma or COPD
• 10% report mild symptoms
• > 33% report persistent moderate to severe symptoms that impact quality of life

Question 2

Bronchitis and emphysema

Answer 2

• Chronic airflow limitation
• Most commonly associated with a history of smoking

Question 3

How is asthma characterized?

Answer 3

Hyper-excitability of bronchial smooth muscle
- May occur on its own or as a component of chronic airflow limitation

Question 4

Restrictive lung disease

Answer 4

Common in older age groups as a result of prolonged exposure to pulmonary irritants over the life span

Question 5

Factors that affect pulmonary health in elders

Answer 5

Impaired oxygen transport (physical inactivity, sarcopenia, cardiovascular abnormalities) and lifestyle factors

Question 6

COPD lung diseases

Answer 6

Emphysema and chronic bronchitis

Question 7

Is COPD preventable?

Answer 7

Yes, but it is also progressive

Question 8

Risk factors for COPD

Answer 8

• Smoking
• Environmental pollutants
• History of asthma

Question 9

Characterization of COPD

Answer 9

-Airflow obstruction impacting gas exchange causing dyspnea - Limited reserve lung capacity with greater risk of hypoxemia

Question 10

CO2 retention

Answer 10

Patients struggle to exhale enough CO2 when they breathe out, excess carbon dioxide builds up in patient’s blood which can cause serious symptoms making it difficult to breathe
- Trapped CO2 takes up space that is needed to hold oxygen rich air when breathing in

Question 11

Alveoli damage with COPD

Answer 11

Damage to alveoli and lung tissue prevents patients from pushing all of the CO2 out of their lungs → airway narrowing, blockage, and other changes in the lungs

Question 12

CO2 build up in the blood

Answer 12

• Fewer healthy alveoli making it difficult to get enough oxygen into the blood
• Imbalance between blood oxygen and carbon dioxide levels, leads to oxygen deprivation
• CO2 gets reabsorbed back into the blood, leaving fewer healthy red blood cells to pick up oxygen

Question 13

Ventilation-perfusion mismatch

Answer 13

When the body gets confused about which parts of the lungs to prioritize, reducing the efficiency of gas exchange in the lungs

Question 14

Hypercapnia

Answer 14

Blood CO2 gets too high→leads to serious breathing problems and dangerously low levels of oxygen in your blood

Question 15

Clavicular breathing

Answer 15

Too shallow to be effective, diaphragmatic breathing should be practiced

Question 16

Symptoms of CO2 retention

Answer 16

• Mild headaches
• Feelings of drowsiness
• Lack of energy
• Inability to focus
• Feeling dizzy
• Shortness of breath

Question 17

More severe symptoms of hypercapnia

Answer 17

• Unexplained confusion
• Abnormal muscle twitching
• Abnormal depression or paranoia
• Irregular heartbeat
• Bluish tint to skin and lips
• Swollen hands and feet
• Hyperventilation
• Seizures
• Loss of consciousness

Question 18

Causes of CO2 retention

Answer 18

Supplemental oxygen at too high rate and severe emphysema

Question 19

OT role with COPD and CO2 retention/hypercapnia

Answer 19

Pursed-lips breathing and diaphragmatic breathing to help patients train themselves how to empty the lungs more completely during exhalation

Question 20

Acute respiratory distress syndrome (ARDS) definition

Answer 20

Acute life-threatening inflammatory reaction to illness or trauma

Question 21

ARDS complications

Answer 21

Severe pneumonia, sepsis, major trauma
- Severity influenced by age, comorbidities, and alcohol consumption

Question 22

Lung inflammation

Answer 22

Causes injury to lungs→ fluid build up in alveoli, compromising gas exchange, difficulty breathing, and increased risk of respiratory failure

Question 23

What % of ARDS cases are fatal?

Answer 23

40%

Question 24

Interstitial lung disease (ILD)

Answer 24

Group of disorders that share similar clinical profiles

Question 25

ILD characteristic

Answer 25

Scarring of pulmonary interstitium including walls of alveoli and spaces around blood vessels

Question 26

T/F: Lung scarring is reversible

Answer 26

False

Question 27

Treatment for lung scarring

Answer 27

• Disease management
• Lung transplant is possible but mortality risk is high

Question 28

ADL impairment from pulmonary disease

Answer 28

Leads to gradual loss of independence and downward spiral in confidence based on understanding that quality of life has been permanently compromised

Question 29

In what way do ADLs become more difficult for patients with pulmonary disease?

Answer 29

Shortness of breath and inability to increase ventilation and physiological demand can impact function

Question 30

Evaluation and intervention for pulmonary disease

Answer 30

• Education and lifestyle recommendations
• Improved activity tolerance
• Enhanced psychosocial aspects
  Client centered care increases functional capacity

Question 31

OT role in acute care settings with pulmonary disease

Answer 31

• Early mobilization
• Monitoring vitals with activity
• Education
• Restoration of function
• Evaluations that assist with coordination of care

Question 32

Client education plans

Answer 32

• Self care retraining
• Energy conservation
• Use of DME
• Medication management
• Lifestyle balance
• Community resources
• Smoking cessation