Obstructive Lung Diseases (Gas#3)

Question 1

Antitrypsin

Answer 1

patients with obstructive lung diseases lack this which leads to breakdown of protein

Question 2

Chronic bronchitis

Answer 2

inflammation of the trachea and bronchi. Edema narrows airway& causes hyper-secretion of mucus. Basically, bronchi are narrowed due to increased mucus

Question 3

How long do you have a cough if you have chronic bronchitis?

Answer 3

3 months or more for 2 years. Cough can go away & come back

Question 4

When are people generally diagnosed with chronic bronchitis? when does it start?

Answer 4

generally diagnosed ages 40-55 years, starts after 20

Question 5

Chronic bronchitis s/s

Answer 5

chronic inflammation, cilia damaged, mucous glands enlarged, thick mucus that obstructs bronchi, persistent cough with sputum, SOB, wheezing

Question 6

Because patient with chronic bronchitis are cyanotic what problems do they have

Answer 6

Polycythemia (too many RBCs) occurs as compensation for hypoxemia, pulmonary infections are common (pneumonia), Pulmonary HTN which leads to cor pulmonale

Question 7

cor pulmonale

Answer 7

enlargement of the right ventricle due to high pressure in the lungs

Question 8

Right heart failure/cor pulmonale s/s

Answer 8

cough with or without sputum, dyspnea esp with exertion, S3& tricuspid regurgitation, atypical chest pain, rhonchi & wheezing, hepatomegaly & ascites, cyanosis

Question 9

blue bloater

Answer 9

has low o2, doesnt struggle to breath, cyanotic, fat

Question 10

pink puffer

Answer 10

has high co2, struggle to breath, thin

Question 11

Emphysema

Answer 11

permanent enlargement of terminal bronchioles & enlargement and destruction of alveoli which reduces available area for gas exchange. Basically, alveoli lose their flexibility making it hard to expand & contract and alveoli are destroyed

Question 12

Why do patients with emphysema have difficulty with breathing?

Answer 12

lungs lose elasticity in bronchioles and alveoli causing difficulty with exhalation

Question 13

Centrilobular emphysema

Answer 13

bronchioles are destroyed usually in upper lungs. end alveolar remain the same but bronchioles are destroyed

Question 14

Panlobular emphysema

Answer 14

destroys bronchioles & alveoli. usually effects lower lungs

Question 15

Emphysema s/s

Answer 15

marked dyspnea 1st with exertion then dyspnea at rest, thin, tacypnea with prolonged expiration, barrel chest, diminished breath sounds

Question 16

Bronchiectasis

Answer 16

abnormal dilation of a bronchi & bronchioles from long term obstruction r/t chronic infection d/t mucus accumulation & stasis (cystic fibrosis)

Question 17

Asthma

Answer 17

inflammation of respiratory track and spasm of bronchiolar smooth muscle, increase mucus, decreased airflow, decreased ventilation of alveoli

Question 18

Asthma s/s

Answer 18

cough, dyspnea, wheezing, expiratory& or inspiratory wheezes, stridor

Question 19

Peak flow monitor

Answer 19

used to asses the maximum expiratory flow

Question 20

during an asthma attack which do you give first, beta agonist or steroid?

Answer 20

beta agonist then steroid

Question 21

what do you do if your asthma symptoms do not improve after 15-20 minutes

Answer 21

call 911 or dr

Question 22

Status Asthmaticus & s/s

Answer 22

severe asthma unresponsive to therapy lasting longer than 24 hours, CO2 increases& pH falls, severe obstruction with less wheezing, fatigue

Question 23

Causes of status asthmaticus

Answer 23

aspirin, respiratory infection, massive exposer to allergens, abrupt discontinuation of drug therapy or overuse, waiting too long to take intervention

Question 24

Cystic Fibrosis

Answer 24

inherited autosomal recessive disease of exocrine glands, inability to transport chloride by epithelial cells making exocrine secretions very thick & tenacious

Question 25

effects of cystic fibrosis on the lungs

Answer 25

blocks alveolar ventilation, chronoic inflammation, edema of the capillary-alveolar interface, bronchial scarring & fibrosis destroys bronchial airways, reduced lung compliance, digital clubbing

Question 26

effects of cystic fibrosis on the pancreas

Answer 26

duct clogs, decreased insulin secretion & diabetes, destroys pancrease, digestive enzymes don’t reach small intestine

Question 27

Effects of cystic fibrosis on the liver

Answer 27

small bile duct obstruction, billiary cirrhosis, portal HTN, liver failure

Question 28

effects of cystic fibrosis on the intestine

Answer 28

blocks digestion & absorption, malabsorption of fats, CHO & proteins,

Question 29

effects of cystic fibrosis on heart

Answer 29

right sided heart failure

Question 30

effects of cystic fibrosis on reproductive organs

Answer 30

males: obstructed vas deferens, Females: thick musus secretion in cervix

Question 31

effects of cystic fibrosis on sweat glands

Answer 31

impaired reabsorption of sodium cloride in sweat ducts, salt loss in sweat (hyponatremia), heat exhaustion

Question 32

effects of cystic fibrosis on dental

Answer 32

gingivits, dental caries

Question 33

cystic fibrosis s/s

Answer 33

adventitious breath sounds, frequent respiratory infections, atelectasis r/t blockage of bronchioles, bronchiectasis with pockets of infection, cyanosis & hemoptysis (spitting of blood) at near terminal stage, cor pulmonale, barrel chest/nail clubbing at early stage

Question 34

management of cystic fibrosis

Answer 34

cool mist, hydration, chest PT, give pancreatic enzymes with meals & snacks, vitamins, antibiotics (prophylactic bactrium DS), mucolytics

Question 35

Cystic fibrosis diet

Answer 35

high in calories & protein, moderate in fat, extra fluids if warm outside,

Question 36

Why do we want to decrease carbs with a patient with COPD?

Answer 36

because carb metabolism produces CO2