Module 10 NP614 COPD Flashcards
What is the definition of sleep apnea
Upper airway narrowing or closure. Cessation of breathing
What classes of meds should not be prescribed for those who c/o sleep apnea
Opiates and benzodiazapenes and Methadone
Who should be screened for OSA?
Those where daytime sleeping is prominent. Screening is not recommended using the unattended home PSG as it is not sufficiently reliable.
What is the best test to order for evaluation of this problem?
polysomnography (Overnight PSG)
What are two common problems that cause patients to discontinue their C-PAP use?
Comfort and acceptance
How can you relieve those problems?
Counsel and make sure client has a good fit.
To get home oxygen
Must be at 88% or below on room air to qualify
COPD
Diagnosed when 3 mos a year for two years of persistant cough and sputum production
O2
Needs to be used 15 hours per day.
1 thing you can do for COPD
Stop smoking
Physical symtoms of COPD
flat diaphragm
darker lung tissue on x-ray
barrel chest AP-diameter
What is used to make the diagnoses
Spirometry is required to make the clnical dx
Beta blockers
Might be helpful in COPD
Air flow in COPD
is only partially reversible
Early diagnosis
is to slow the progression.
Use bronchodilators 1st
Anticholinergic agents (work on the muscarinic receptors located on the smooth muscle (Atrovent and spiriva). Rinse mouth after using!!
Beta 2 agonists
Albuterol- work by relaxing the beta receptors in the muscles around the airways.
Exacerbations
you might do a taper oral steroids for a week. or an antibiotic 1st or 2nd line. Amoxicillin or Zithromycin
COPD
Only start ICS when the FEV1<50%
Start with the long-acting and then add Albuterol.
