Lower Respiratory Tract Conditions Flashcards
What do I need to know about the lower respiratory context?
In this session we are aiming to:
* Consider the role of smoking and vaping in chronic respiratory disease
* Explore the implications for a patients life of living with a chronic respiratory condition
* Review social prescribing and it’s place in respiratory disease care
What are the risks to health from smoking?
Health risks of cigarette smoking extend far beyond the respiratory system, with cardiovascular risks playing a large role in morbidity and mortality in relation to smoking.
Key respiratory risks include the following:
* Predisposition to infection as you’re causing inflammation and breaking down lung lining
* Predisposition to acute lung injury
* Increased risk of developing adult asthma
* Poorer asthma control, more asthma exacerbations
* Increased risk of developing chronic bronchitis
* Increased risk of developing COPD
Stopping smoking reduces mortality regardless of age of cessation - it’s never too late to quit.
Is vaping safer?
Vaping – the safer option?
It is fairly logical to assume that, as the respiratory system is designed to minimise as far as possible inhaled contaminants, deliberate inhalation of chemicals is likely to cause some damage.
What damage to respiratory tissues could be caused by vaping?
* Direct lung exposure to chemicals including nitrosamines and carbon monoxide contained in the vapour may cause increased oxidative stress at a cellular level
* Potential acute endothelial cell dysfunction
Compares better than normal smoking, so a good bridge, BUT its not completely safe. A stopgap with smoking cessation.
What impact might respiratory issues have on someone’s life?
- Mobility – if you’ve smoked for a long time, impairment may extend from a slight reduction in respiratory capacity, leading to having to allow more time for journeys and tasks, to being a wheelchair user. Pathophysiology: this then might in turn lead to issues of circulatory stasis, reduced aerobic capacity and respiratory movement increasing risks of stagnation and thus infection in the lungs.
- Sleep – you might need to use a device to address sleep apnoea, and consider positioning of bed and bedding. Pathophysiology: – psychological impacts of potential impaired sleep, increased risk of hypertension, stroke and right-sided heart failure due to impaired oxygen delivery and chronic inflammation in the body
- Health administration – people may require extra time off work to attend multiple appointments, and keep track of prescription requirements and facilities for prescription collection and delivery. Pathophysiology: physical effects of increased stress possibly associated with extra time off work, potential gaps in medication if there is a complex array of prescribed medicines to keep track of.
What are the social factors of living with chronic respiratory disease?
Social implications of chronic respiratory disease such as COPD:
Physically stuck
* Mobility difficulties
* Inaccessible social spaces
Shame/stigma attached to condition
* Blaming self
* Perceived blame from others - ‘you’ve brought it on yourself’
Deteriorating self image
* Having to use oxygen devices
* Looking ‘ill’
What are the wider occupational factors of living with chronic respiratory disease?
Occupational implications of chronic respiratory disease
Reduction/loss of employment:
- Reduced self-esteem
- Lack of mental/physical stimulation - Missing colleague interactions
Occupational therapy intervention can help:
- Increased independence
- Improved psychological wellbeing
- Reduction in isolation due to interaction with therapist team
What reasonable adjustments might someone with COPD be able to ask for?
What is social prescribing?
Social prescribing is good to consider across many conditions but particularly COPD:
* Non-clinical – this is pertinent to COPD patients who contend with significant levels of medical intervention and medication
* Multi-agency – social prescribers can refer to a wide range of beneficial
activities such as arts groups, cookery, gardening and befriending/companionship arrangements: offering a COPD patient scope for therapeutic intervention in an enjoyable format offers psychological benefits and potential reduction in social isolation
* Individualised – social prescribers form an individual plan with patients tailored to what matters to them and what they enjoy; recognition and respect for a patients interests and values may help to reduce the negative
impacts of stigma associated with COPD
