Obstructive Lung Diseases (Gas#3) Flashcards
Antitrypsin
patients with obstructive lung diseases lack this which leads to breakdown of protein
Chronic bronchitis
inflammation of the trachea and bronchi. Edema narrows airway& causes hyper-secretion of mucus. Basically, bronchi are narrowed due to increased mucus
How long do you have a cough if you have chronic bronchitis?
3 months or more for 2 years. Cough can go away & come back
When are people generally diagnosed with chronic bronchitis? when does it start?
generally diagnosed ages 40-55 years, starts after 20
Chronic bronchitis s/s
chronic inflammation, cilia damaged, mucous glands enlarged, thick mucus that obstructs bronchi, persistent cough with sputum, SOB, wheezing
Because patient with chronic bronchitis are cyanotic what problems do they have
Polycythemia (too many RBCs) occurs as compensation for hypoxemia, pulmonary infections are common (pneumonia), Pulmonary HTN which leads to cor pulmonale
cor pulmonale
enlargement of the right ventricle due to high pressure in the lungs
Right heart failure/cor pulmonale s/s
cough with or without sputum, dyspnea esp with exertion, S3& tricuspid regurgitation, atypical chest pain, rhonchi & wheezing, hepatomegaly & ascites, cyanosis
blue bloater
has low o2, doesnt struggle to breath, cyanotic, fat
pink puffer
has high co2, struggle to breath, thin
Emphysema
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
Why do patients with emphysema have difficulty with breathing?
lungs lose elasticity in bronchioles and alveoli causing difficulty with exhalation
Centrilobular emphysema
bronchioles are destroyed usually in upper lungs. end alveolar remain the same but bronchioles are destroyed
Panlobular emphysema
destroys bronchioles & alveoli. usually effects lower lungs
Emphysema s/s
marked dyspnea 1st with exertion then dyspnea at rest, thin, tacypnea with prolonged expiration, barrel chest, diminished breath sounds
Bronchiectasis
abnormal dilation of a bronchi & bronchioles from long term obstruction r/t chronic infection d/t mucus accumulation & stasis (cystic fibrosis)
Asthma
inflammation of respiratory track and spasm of bronchiolar smooth muscle, increase mucus, decreased airflow, decreased ventilation of alveoli
Asthma s/s
cough, dyspnea, wheezing, expiratory& or inspiratory wheezes, stridor
Peak flow monitor
used to asses the maximum expiratory flow
during an asthma attack which do you give first, beta agonist or steroid?
beta agonist then steroid
what do you do if your asthma symptoms do not improve after 15-20 minutes
call 911 or dr
Status Asthmaticus & s/s
severe asthma unresponsive to therapy lasting longer than 24 hours, CO2 increases& pH falls, severe obstruction with less wheezing, fatigue
Causes of status asthmaticus
aspirin, respiratory infection, massive exposer to allergens, abrupt discontinuation of drug therapy or overuse, waiting too long to take intervention
Cystic Fibrosis
inherited autosomal recessive disease of exocrine glands, inability to transport chloride by epithelial cells making exocrine secretions very thick & tenacious
effects of cystic fibrosis on the lungs
blocks alveolar ventilation, chronoic inflammation, edema of the capillary-alveolar interface, bronchial scarring & fibrosis destroys bronchial airways, reduced lung compliance, digital clubbing
effects of cystic fibrosis on the pancreas
duct clogs, decreased insulin secretion & diabetes, destroys pancrease, digestive enzymes don’t reach small intestine
Effects of cystic fibrosis on the liver
small bile duct obstruction, billiary cirrhosis, portal HTN, liver failure
effects of cystic fibrosis on the intestine
blocks digestion & absorption, malabsorption of fats, CHO & proteins,
effects of cystic fibrosis on heart
right sided heart failure
effects of cystic fibrosis on reproductive organs
males: obstructed vas deferens, Females: thick musus secretion in cervix
effects of cystic fibrosis on sweat glands
impaired reabsorption of sodium cloride in sweat ducts, salt loss in sweat (hyponatremia), heat exhaustion
effects of cystic fibrosis on dental
gingivits, dental caries
cystic fibrosis s/s
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
management of cystic fibrosis
cool mist, hydration, chest PT, give pancreatic enzymes with meals & snacks, vitamins, antibiotics (prophylactic bactrium DS), mucolytics
Cystic fibrosis diet
high in calories & protein, moderate in fat, extra fluids if warm outside,
Why do we want to decrease carbs with a patient with COPD?
because carb metabolism produces CO2