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Older Adults Exam 2 > Oxygenation: COPD > Flashcards

Oxygenation: COPD Flashcards

1
Q

Kyphosis

A

hunching over

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2
Q

Pulmonary Changes in OA

A
  • reduced pulmonary reserve
  • decreased cough reflex with risk of aspiration pneumonia
  • increased risk of infection and bronchospasm with ariway obstruction
  • thinning of alveoli
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3
Q

COPD

A

chronic, progressive, lung disease

  • # 1 cause: smoking
  • irreversible
  • developes over many years
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4
Q

Small Airway Disease

A
  • airway inflammation
  • airway fibrosis, luminal plugs
  • increased airway resistance
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5
Q

Parenchymal Destruction

A
  • loss of alveolar attachments

- decrease of elastic recoil

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6
Q

COPD: Prevention

A
  • decrease exposure to second hand smoke
  • decrease occupational respiratory irritants
  • decrease air pollutants
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7
Q

which population has increased risk of COPD

A

hispanics

  • education levels
  • alcohol and substance abuse
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8
Q

Pulmonary Functional Testing

A

FEV, FVC

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9
Q

FVC

A

forced vital capacity

-the maximal amount of air that can be rapidly and forcefully exhaled from the lungs after maximal inspiration

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10
Q

FEV

A

forced expired volume

-achieved in one second, the volume of air expired in the first second of FVC

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11
Q

Proof of Obstruction

A

FVC is less than 70%, normal is more than 70%

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12
Q

Serum Alpha1

A

antitrypsin levels

-protects lungs from injury

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13
Q

Polycythemia

A

increased number of RBC’s

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14
Q

Bacterial Infection normally shows….

A

increased WBC count and higher % immature WBCs

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15
Q

ABG’s

A

arterial blood gas

-evaluates gas exchange especially during COPD exacerbations

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16
Q

Chronic Bronchitis

A

marked hypoxemia and hypercapnia with respiratory acidosis

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17
Q

Emphysema

A

mild obstruction

-normal or low carbon dioxide tension

18
Q

Chest X-Rays: bronchitis

A

larger white areas: secretions are present or fluid retention

19
Q

Chest X-Rays: emphysema

A
  • small white patches: hyper-inflated alveolar sacs filled with secretions
  • flattening of the diaphragm: hyperventilation and evidence of pulmonary infection
20
Q

Pulse O2 for COPD

A

less than 95%, severe is less than 90%

21
Q

Main Goal for COPD

A

promote oxygen

22
Q

Bronchodilators (4)

A
  • albuterol
  • ipratropium bromide
  • salmeterol
  • theophylline
23
Q

Albuterol

A

most used, short acting

24
Q

Ipratropium Bromide

A

anticholinergic agent by MDI, longer duration

25
Q

Salmeterol

A

long acting beta2 agonist, can be given with corticosteriod to reduce risks of cardiac side effects

26
Q

Theophylline

A

weak bronchodialator, not used often, narrow therapeutic range

27
Q

Cough Suppressants

A

usually ineffective

28
Q

Sedatives

A

generally avoided, may cause retention of secretions, decreased respirations

29
Q

Vasodilators and Mucosurpressant and COPD….

A

not recommended

30
Q

Pulmonary Rehabilitation

A
  • exercise training

- aerobic exercise, walking 20min at least 3 times a week

31
Q

Oxygen Therapy

A

CAUTION!! too much oxygen will have reverse effect, monitor closely, only use in later stages
-MAX 2L/min

32
Q

Surgery

A

LAST RESORT

  • bullectomy
  • lung reduction surgery
  • lung transplant
33
Q

Bullectomy

A

removing enlarged alveolar air spaces, compress lung tissues

34
Q

Lung Reduction Surgery

A

removes non functional lung areas, improves survival for more than 50 months

35
Q

Lung Transplant

A

single/bilateral transplants, increases survival rate of 75% to 2 years (NOT OFTEN)

36
Q

Dietary Measures: COPD

A
  • reduce diary products and salt
  • need protein, high fat, low carbs
  • hot herbal teas with peppermint RELIEVE chest congestion
37
Q

Need for Protein

A

patients burn a lot of calories trying to breath, thats why the need for high protein is important

38
Q

Promote Airway Clearence

A

fowlers, high fowlers, encourage coughing and deep breathing at least q2hrs

39
Q

Enhance Breathing Pattern

A

pursed lip breathing, abdominal breathing/diaphragmatic breathing, relaxation techniques

40
Q

5 R’s

A
  • Relevance to quit smoking
  • Risks of using tobacco
  • Rewards of quitting
  • Roadblocks to quitting
  • Repetition with each new encounter with the patient
41
Q

STAR quit plan

A
  • Set a quit date (2 weeks from decision)
  • Tell family
  • Anticipate challenges
  • Remove all tobacco products
42
Q

What do you give first?

A

Bronchodilator to open airway, then give broad spectrum antibiotic for infection

Older Adults Exam 2 (6 decks)

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