Obstructive Pulmonary Flashcards
How are obstructive lung diseases diagnosed?
by outcomes on static PFTs
What are the risk factors for COPD?
secondhand smoke and smoking
hereditary and hx of respiratory infectios
environmental factors
Emphysema is a disease of:
exhalation
Emphysema will cause an increase in:
TLC and Residual volume
emphysema will cause a decrease in:
FVC1/ FVC ratio
What enzyme is thought to be a genetic cause of emphysema?
A-1AT
A-1AT deficiencies can not only cause emphysema but:
liver disease
If a pt has an FEV1/FEV <.5, is this good or bad for emphysema?
it is very bad
What is the first complaint of someone w emphysema?
Shortness of breath
A - 1AT deficiency and cigarette smoking are associated with:
- destruction of individual alveoli
- development of super alveoli
- destruction of connective tissue supports for the very smallest airways allowing them to collapse during expiration.
What are the characteristics of someone with emphysema?
anxious, addicted to O2
thin
deformed chest
absent cough
What typical cardiac problem accompanies emphysema?
cor pulmonale!
with disease progression of emphysema, what 3 things will occur?
- structural damage to the lungs increases
- hypoxemia worsens
- CO2 is retaine
What are 7 frequent complications of emphysema?
- pneumonia
- pneumothorax
- chronic atelectasis
- cor pulmonale
- pulmonary interstitial emphysema
- recurrent respiratory tract infections
- respiratory acidosis
What are the 4 gold level criteria we have for emphysema?
Mild = FEV1 is 80 or above
Moderate = FEV1 is between 50 - 79
Severe = FEV1 is 30 - 50
Very severe = FEV1 is below 30
How do we treat emphysema?
- Reducing airway edema
- Facilitating the elimination of bronchial secretions
- Prevent & treat respiratory infection
- Increase exercise tolerance
- avoid airway irritants
- relieve airway anxiety
What medication thins and loosens mucus?
expectorants and mucolytics
what medication will manage respiratory tract infections?
antibiotics
What medication will result in the dilation of bronchial smooth muscles?
anticholinergics and B2 Agonists
What medications will limit the occurrence of an inflammatory reaction?
mast cell membrane stabilizers, glucocorticoids, and antihistamines
What pt would get long-term oxygen therapy?
- PaO2 of 55 or less
- resting oxygen saturation of 88% or less
What are the implications for the PT?
- pulse oximeter
- monitor HR and BP
- take first heart distal sternal area
- can modulate the nasal cannula O2
- monitor respiratory rate and O2 saturation
What is used to deliver drugs to lungs for emphysema?
a metered dose inhaler
what are the diagnostic criteria for being diagnosed with chronic bronchitis?
- productive cough lasting at least 3 months per year for 2 consecutive years
- FEV/FEV1 < 75% (suggests obstruction) plus chronic cough suggests bronchitis
