Management of Patients with Chronic Pulmonary Disease

Question 1

is a slowly progressive respiratory
disease of airflow obstruction

• Emphysema, chronic bronchitis
• Preventable and treatable but not fully
  reversible
• Involving the airways, pulmonary parenchyma,
  or both

Answer 1

COPD

Question 2

3 Associated Respiratory Diseases

Answer 2

• Cystic fibrosis
• Bronchiectasis
• Asthma

Question 2

Pathophysiology

• Airflow limitation is progressive, associated with
  abnormal inflammatory response to noxious
  particles or gases
• Chronic inflammation damages tissue
• Scar tissue in airways results in narrowing
• Scar tissue in the parenchyma decreases elastic
  recoil (compliance)
• Scar tissue in pulmonary vasculature causes
  thickened vessel lining and hypertrophy of smooth
  muscle (pulmonary hypertension)

Answer 2

__

Question 2

• Cough and sputum production
  for at least 3 months in each of
  2 consecutive years
• Ciliary function is reduced,
  bronchial walls thicken,
  bronchial airways narrow, and
  mucous may plug airways
• Alveoli become damaged,
  fibrosed, and alveolar
  macrophage function diminishes
• The patient is more susceptible
  to respiratory infections

Answer 2

Chronic Bronchitis

Question 3

For patients with chronic bronchitis, the
nurse expects to see the major clinical symptoms of ___

Answer 3

SPUTUM AND PRODUCTIVE
COUGH

Question 4

• Abnormal distention of air spaces beyond the
  terminal bronchioles with destruction of the
  walls of the alveoli
• Decreased alveolar surface area increases in
  “dead space,” impaired oxygen diffusion
• Hypoxemia results
• Increased pulmonary artery pressure may cause
  right-sided heart failure (cor pulmonale)

Answer 4

Emphysema

Question 5

• Three primary symptoms
• Chronic cough
• Sputum production
• Dyspnea
• Weight loss due to dyspnea
• “Barrel chest”

Answer 5

Emphysema

Question 6

Typical Posture of a Person With COPD

The person tends to lean forward and uses the accessory
muscles of respiration to
breathe, forcing the
shoulder girdle upward
and causing the
supraclavicular fossae to
retract on inspiration.

Answer 6

EMPHYSEMA

Question 6

normal adult chest diameter

Answer 6

ap diameter 1: 2 transverse diameter

Question 7

is a chronic, irreversible dilation of
the bronchi and bronchioles

Answer 7

Bronchiectasis

Question 8

• Chronic inflammatory disease of
  the airways that causes
  hyperresponsiveness, mucosal
  edema, and mucus production
• Inflammation leads to cough,
  chest tightness, wheezing, and
  dyspnea
  *is largely
  reversible; spontaneously
  or with treatment
• Allergy is the strongest
  predisposing factor

Answer 8

Asthma

Question 9

• Most common autosomal recessive disease
  among the Caucasian population
  *Genetic screening to detect carriers
  *Genetic counseling for couples at risk
  *Genetic mutation changes [chloride transport] which
  leads to thick, viscous secretions in the lungs,
  pancreas, liver, intestines, and reproductive tract
• Respiratory infections are the leading cause of
  morbidity and mortality

Answer 9

Cystic Fibrosis