ILP 2: Respiratory Conditions Flashcards

1
Q

What is the summary of respiratory conditions?

A
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2
Q

What is medication for Asthma?

A

Nebulised salbutamol (4hr)

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3
Q

What are 3 treatments (acute care for mild, moderate and severe tx) for Asthma?

A

Acute Care

Mild

  • Nebulised salbutamol

Moderate

  • O2 Therapy
  • Nebulised salbutamol
  • Oral steroids

Severe

  • O2 Therapy
  • Nebulised salbutamol
  • IV steroids +/- adrenalin
  • Mechanical ventilation

NB. Long-term management.

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4
Q

What is treatment (mild acute care) for Asthma?

A
  • Nebulised salbutamol
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5
Q

What are 3 treatments (moderate acute care) for Asthma?

A
  1. O2 Therapy
  2. Nebulised salbutamol
  3. Oral steroids
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6
Q

What are 4 treatments (severe acute care) for Asthma?

A
  1. O2 Therapy
  2. Nebulised salbutamol
  3. IV steroids +/- adrenalin
  4. Mechanical ventilation
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7
Q

What is medication for COPD?

A

Medications

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8
Q

What are 5 treatments for COPD?

A
  1. Position (treatment)
    • < 60° upright sitting
  2. Breathing control
    • Emphasize S-L-F during expiration
  3. Airway clearance (ACBT)
    • Secretion mobilisation:
      • TEE (caution)
  4. Secretion clearance:
    • Low-mod huff
    • Cough
  5. +/- PEP Device
    • PEP Mouthpiece
      • Consider presence of bullae (CXR)
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9
Q

What is medication for Bronchiectasis?

A

Antibiotics

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10
Q

What are 5 treatments for Bronchiectasis?

A
  1. Education
    • Understand pathology and why Rx is vital
    • Effective PT reduces episodes of infection
  2. Exercise
    • Improve/maintain general fitness
    • Assist mobilisation of respiratory secretions (before, during, or after therapy)
  3. Airway Clearance
    • Goal to self-treat
    • ­­Frequency during infection
    • ACBT + PD positions
    • PEP devices (standard or oscillating)
    • * Precautions with HDT (GOR)
  4. Breathing Control Strategies
    • Education to ¯ WOB and relieve SOB during exercise and Rx or at rest
  5. Musculoskeletal
    • Stiff kyphotic TxSx, neck, shoulder and chest (chronic adaptive changes to the chest wall and muscles)
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11
Q

What are 2 treatments (education) for Bronchiectasis?

A
  1. Understand pathology and why Rx is vital
  2. Effective PT reduces episodes of infection
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12
Q

What are 2 treatments (exercise) for Bronchiectasis?

A
  1. Improve/maintain general fitness
  2. Assist mobilisation of respiratory secretions (before, during, or after therapy)
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13
Q

What are 2 treatments (airway clearance) for Bronchiectasis?

A
  1. Goal to self-treat
  2. ­­ Increase frequency during infection
  3. ACBT + PD positions
  4. PEP devices (standard or oscillating)
  5. * Precautions with HDT (GOR)
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14
Q

What is treatment (breathing control strategies) for Bronchiectasis?

A
  • Education to ¯ WOB and relieve SOB during exercise and Rx or at rest
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15
Q

What is treatment (MSK) for Bronchiectasis?

A
  • Stiff kyphotic TxSx, neck, shoulder and chest (chronic adaptive changes to the chest wall and muscles)
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16
Q

What are 4 medications for Cystic Fibrosis?

A
  1. Bronchodilators
  2. Inhaled antibiotics
  3. Mucolytics –> mucus
  4. Steroids –> inflammation
17
Q

What are 3 treatments for Cystic Fibrosis?

A
  1. Airway Clearance Techniques
    1. Mobilise and clear secretions
    2. Intensive airway clearance (2 sessions/day, 30-60 min)
    3. Inhalation therapy (A/E)
  2. Exercise
    1. Adjunct, not replacement for ACT’s
    2. Includes: aerobic, anaerobic, interval, strength
    3. *Pre-exercise bronchodilators required before
  3. Musculoskeletal
    1. Posture education (altered respiratory mechanics and flexed posture due to chronic coughing)
    2. Maintain flexibility (thorax/axillary region)
    3. Maintain strength (peripheral and core stabilising muscles)
    4. Maintain mobility to decrease joint pain and stiffness (TxSx)
    5. Bone mineral density (may be impaired due to multifactorial causes)
18
Q

What are 3 treatments (airway clearance techniques) for Cystic Fibrosis?

A
  1. Mobilise and clear secretions
  2. Intensive airway clearance (2 sessions/day, 30-60 min)
  3. Inhalation therapy (A/E)
19
Q

What are 3 treatments (exercise) for Cystic Fibrosis?

A
  1. Adjunct, not replacement for ACT’s
  2. Includes: aerobic, anaerobic, interval, strength
  3. *Pre-exercise bronchodilators required before
20
Q

What are 5 treatments (MSK) for Cystic Fibrosis?

A
  1. Posture education (altered respiratory mechanics and flexed posture due to chronic coughing)
  2. Maintain flexibility (thorax/axillary region)
  3. Maintain strength (peripheral and core stabilising muscles)
  4. Maintain mobility to decrease joint pain and stiffness (TxSx)
  5. Bone mineral density (may be impaired due to multifactorial causes)
21
Q

What are 4 medications for LRTI?

A
  1. Antibiotics
  2. O2 Therapy
  3. +/- Ventilation
  4. +/- IV for Cardiac drugs
22
Q

What are 2 main treatments for LRTI?

A
  1. Community Acquired Pneum.
    1. Acute Phase
      1. Pain relief
      2. Improve respiration (encourage to breathe deeply)
      3. Improve cough to prevent secondary atelectasis and deterioration
    2. Resolution Stage
      1. Airway clearance techniques
  2. Hospital Acquired Pneum.
    1. Antibiotics (IV)
    2. Airway clearance techniques
    3. Ventilation strategies
    4. Mobilisation
    5. Exercise prescription
    6. Non-invasive ventilation
    7. Bronchodilator therapy
    8. Oxygen therapy
    9. Fluid support
    10. Assisted ventilation if patient deteriorates
23
Q

What are 2 stages of treatment (community acquired pneumonia) for LRTI?

A
  1. Acute Phase
    1. Pain relief
    2. Improve respiration (encourage to breathe deeply)
    3. Improve cough to prevent secondary atelectasis and deterioration
  2. Resolution Stage
    1. Airway clearance techniques
24
Q

What are 10 treatments (hospital acquired pneumonia) for LRTI?

A
  1. Antibiotics (IV)
  2. Airway clearance techniques
  3. Ventilation strategies
  4. Mobilisation
  5. Exercise prescription
  6. Non-invasive ventilation
  7. Bronchodilator therapy
  8. Oxygen therapy
  9. Fluid support
  10. Assisted ventilation if patient deteriorates
25
Q

What is Type I respiratory failure?

A

Hypoxaemia without hypercapnia

PaO2 <60mmHg; <8kPa

26
Q

What are 10 evidences for Type I respiratory failure?

A
  1. Restlessness
  2. “Plucking”
  3. ­Increase RR, HR, BP
  4. ECG Changes
  5. Blurred vision
  6. Pallor
  7. Confusion
  8. Aggression
  9. Sweating
  10. Fitting

​Increase PaO2 <–> PaCO2

27
Q

What are 2 managements for Type I respiratory failure?

A
  1. Improve ventilation
    1. Breathing exercises
    2. Positioning
    3. Demand ventilation
  2. Mobilise & Remove Secretions
    1. ACT’s
    2. Suction
    3. NIV = IPPB or CPAP

NB. Will depend on level of co-operation.

28
Q

What are 3 outcome measures for Type I respiratory failure?

A
  1. ABG’s
  2. Oximetry
  3. Transcutaneous measures of PaCO2
29
Q

What is Type II respiratory failure?

A

Hypoxaemia with hypercapnia

PaO2 < 60mmHg; <8kPa

PaCO2 > 50mmHg; >6.7kPa

30
Q

What are 7 evidences of Type II respiratory failure?

A
  1. Flushed skin
  2. Drowsiness
  3. Warm peripheries
  4. Bounding pulse
  5. Headache
  6. Convulsions
  7. Coma

Increase PaO2 ­Decreased PaCO2

31
Q

What are 2 managements of Type II respiratory failure?

A
  1. Controlled O2 therapy administered via fixed device
  2. Improve ventilation
    1. Intubation and SIMV, or
    2. NIV = BiPAP
32
Q

What are 3 outcome measures of Type II respiratory failure?

A
  1. ABG’s
  2. Oximetry
  3. Transcutaneous measures of PaCO2