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MY NUR 326 > Obstructive pulmonary diseases > Flashcards

Obstructive pulmonary diseases Flashcards

1
Q

obstructive pathophysiology

A

THINK AIR TRAPPING

person is not able to fully EXHALE –> air cannot get out = HIGH CO2
air is TRAPPED in the alveoli –> person works harder to breathe, lungs are HYPERINFLATED
therefore normal exhalation is obstructed
chronic HIGH CO2 AND LOW O2

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2
Q

asthma

A

chronic inflammation of the bronchial airways (NOT alveoli)
chronic inflammation causes brochial HYPERRESPONSIVENESS, constriction of airways and variable airflow obstruction that is reversible

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3
Q

Risk factors for asthma

A

usually starts in childhood –> associated with ALLERGIES

  • familial link
  • levels of allergen exposure
  • urban residency
  • exposure to indoor and outdoor air pollution
  • tobacco exposure/smoke
  • recurrent respiratory tract viral infections and GERD
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4
Q

pathophysiology of asthma

A

exposure to antigen (trigger) –> airway inflammation –> narrow breathing passages –> wheezing, cough, SOB, tightness in chest

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5
Q

what are the two responses of asthma

A

bronchoconstriction (#1 symptom of asthma attack) and inflammation

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6
Q

how is asthma diagnosed

A

History: allergies, recurrent episodes of wheezing, dyspnea, and course/exercise intolerance
pulmonary function tests: measures lung function with respect to time
FEV1: force expiratory volume in 1 sec

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7
Q

classic symptoms associated with asthma

A

wheezing, shortness of air, cough, tight chest

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8
Q

severe attack asthma symptoms

A

use of accessory muscles
distant breath sounds
diaphoresis
inability to speak one or two words before taking breath
respiratory failure: inaudible breath sounds and repetitive hacking cough

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9
Q

how to manage asthma

A

avoidance of asthma/irritant
use of peak flow meter
low dose corticosteroids
immunotherapy

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10
Q

status asthmaticus

A

respiratory failure that comes with the worst form of acute severe asthma attack

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11
Q

Symptoms of status asthmaticus

A

SEVERE
SILENT CHEST
pCO2 > 70 mmhg

LIFE THREATENING

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12
Q

treatment of status asthmaticus

A

avoidance of precipitating factors and prophylactic

drug therapy: bronchodilators, corticosteroids, and oxygen therapy

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13
Q

what is chronic bronchitis

A

hypersecretion of mucus and chronic productive cough for at least 3 months for at least 2 consecutive years

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14
Q

what is simple (acute) bronchitis

A

inflammation of the bronchi and bronchioles

  • bacterial or viral
  • no airflow obstruction
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15
Q

how does someone with acute bronchitis present

A

usually mild and self-limiting, requiring supportive care

usually gets better 3-4 weeks

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16
Q

what is chronic bronchitis

A 
bronchitis for 3 months out of the year for at least 2 years 
airflow obstruction (form of COPD)
17
Q

clinical manifestations of chronic bronchitis

A

persistent productive cough !!!
purulent if super imposed respiratory infection

as disease progresses increase cough, increase congestion, increase shortness of air

may have acute exacerbation of chronic bronchitis

18
Q

how to diagnose chronic bronchitis

A

history of symptoms, physical exam, chest imaging, pulmonary function tests

19
Q

who gets chronic bronchitis

A

smokers

20
Q

pathophysiology of chronic bronchitis

A

inhaled irritants result in airway inflammation –> infiltration occurs with neutrophils, macrophages, lymphocytes into bronchial walls

continual bronchial inflammation –> bronchial edema, increase number and size and goblet cell and mucus glands

thick, tenacious mucus produced and cannot be cleared because of impaired ciliary function

21
Q

late clinical manifestations of chronic bronchitis

A

pulmonary hypertension - advanced disease

22
Q

treatment for chronic bronchitis

A

irreversible
prevention:
-stoping smoking
-bronchodilators
-expectorants/prophylactic antibiotic therapy
-chest physiotherapy
-steroids late in disease (with acute exacerbations)

23
Q

what is emphysema

A

abnormal permanent enlargement of gas exchange airways, accompanied by DESTRUCTION of alveolar walls

loss of elastic recoil
lung hyperinflation
destruction results from tissue changes and not mucus production

24
Q

causes of emphysema

A

SMOKING!!!!!
air pollution
childhood respiratory infections
genetic emphysema

25
Q

CM for emphysema

A 
gradual increase in breathlessness 
-particularly with exertion 
eventually shortness of air at rest 
-prolonged expiratory phase 
-may become oxygen dependent 
wheezing 
malnourished 
decreased muscle mass
barrel chest 
pursed lip breathing 
decreased breath sounds
26
Q

how to diagnose emphysema

A

Pulmonary function tests
FEV1 - DECREASED
Chest X-Ray - hyperinflation
ABG - respiratory acidosis

27
Q

treatment of emphysema

A 
smoking cessation 
bronchodilators and anti inflammatory agents 
O2 supplementation 
breathing retraining 
relaxation techniques 
antibiotics for acute infections

MY NUR 326 (12 decks)

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