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Concepts 2 FINAL > Pneumonia, COPD, Asthma > Flashcards

Pneumonia, COPD, Asthma Flashcards

1
Q
  1. What is COPD?
A

Chronic obstructive pulmonary disease, or COPD, refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema and chronic bronchitis.

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2
Q
  1. What can COPD Lead to?
A

Respiratory infections, lung cancer, high blood pressure in lung arteries, depression, more prone to catching colds, the flu and pneumonia.

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3
Q
  1. What are Causes of COPD?
A

Exposure to tobacco smoke/long term cigarette smoking. Asthma, occupational exposure to dusts, fumes and chemicals, and genetics.

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4
Q
  1. What is Polycythemia?
A

Also called erythrocytosis, means having a high concentration of red blood cells in your blood. This makes the blood thicker and less able to travel through blood vessels and organs. Many of the symptoms of polycythemia are caused by this sluggish flow of blood.

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5
Q
  1. What are Signs and Symptoms of COPD?
A
  • mild cough that produces clear sputum (usually in morning)
    • or phlegm
  • SOB on exertion then increases to SOB
  • A persistent chesty cough with phlegm that does not go away
  • frequent pneumonia & other lung infections
  • severe weight loss in 1/3 people
  • cough up blood (inflammation of bronchi)
  • morning headaches
  • pursed lip breathing
  • barrel chest
  • cyanosis (low O2 levels in blood)
  • pneumothorax (air in pleural space)
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6
Q
  1. How is COPD diagnosed?
A
  • The main test for COPD is spirometry. Spirometry can detect COPD before symptoms are recognized. Spirometry is a type of lung function test that measures how much air you breathe out.
  • chronic bronchitis= prolonged productive cough
  • chronic obstructive bronchitis= evidence of airflow obstruction on pulmonary function tests
  • emphysema= basis of findings observed during physical exam & pulmonary function tests
  • blood test may show polycythemia (high levels of RBC)
  • pulse oximetry show low levels of O2
  • chest movement diminished during breathing & resp accessory muscles may occur
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7
Q
  1. How is COPD treated?
A

-stop smoking
- group counselling & support sessions
-NRT
-varenicline (champix) bupropion (Zyban) decrease tobacco craving
-avoid airborne irritant exposure
-yearly influenza vaccine & pneumococcal vaccine every 5-6yrs

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8
Q

How are symptoms of COPD treated?

A
  • short-acting bronchodilator inhalers are the first treatment used (anticholinergic & beta-adrenergic agonist drugs)
  • corticosteroids
  • avoiding dehydration may prevent thickening of secretions
  • resp therapy
  • arterial blood gas measurements
  • treatment of flare ups
  • long term O2 therapy
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9
Q
  1. What is Pneumonia?
A
  • Pneumonia is an inflammatory process in lung parenchyma (functional tissue) that is usually associated with a marked increase in interstitial & alveolar fluid
  • Pneumonia is the 2nd most common nosocomial (hospital acquired) infection, but has the highest mortality
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10
Q
  1. What are causes of Pneumonia?
A

Noninfectious:
*inhale toxic gases,
*chemicals,
*smoke → irritates lung tissue;

Infectious:
* Bacteria
* Viruses
* Fungi (spore-producing organisms)

  • Mycoplasmas (parasitic bacteria)
  • Protozoa (single-celled microscopic animals)
  • Aspiration of food, fluids, or vomit
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11
Q
  1. What are the risk factors of pneumonia?
A
  • Advanced age
  • History of smoking
  • Upper respiratory tract infection
  • Tracheal intubation
  • Prolonged immobility
  • Immunosuppressive therapy
  • A nonfunctional immune system
  • Malnutrition
  • Dehydration
  • Homelessness
  • Chronic disease state
  • Being hospitalized
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12
Q

Types of Pneumonia

A
  • COMMUNITY-ACQUIRED PNEUMONIA: Bacterial pneumonia (streptococcus pneumoniae)
  • HOSPITAL-ACQUIRED PNEUMONIA: Bacterial pneumonia (Staphylococcus aureus or a gram-negative bacteruim.)
  • FUNGAL PNEUMONIA
  • ASPIRATION PNEUMONIA
  • OPPORTUNISTIC PNEUMONIA
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13
Q
  1. What are the signs and symptoms of Pneumonia?
A
  • Fever
  • Headache
  • Chills
  • Sweats
  • Fatigue
  • Cough
  • Producing Sputum
  • Dyspnea (difficulty breathing)
  • Hemoptysis (coughing up blood)
  • Pleuritic chest pain (sharp chest pain when breathing [inflamed pleura rubbing together])
  • Crackles heard on chest auscultation
  • May see unequal chest wall expansion
  • Older adults: delirium (acute confusion) & may not have a fever or respiratory manifestations
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14
Q
  1. What tests are used to diagnose pneumonia?
A
  • history & physical exam,
  • chest xray (shows lung tissue solidification= consolidation),
  • sputum C&S (culture & sensitivity)
  • complete blood count & differential
  • O2 SAT levels and arterial blood gas measurements to determine need for supplemental O2
  • blood and urine cultures if indicated to check for systemic spread (sepsis)
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15
Q
  1. How is Pneumonia treated? (collaborative therapy for pneumonia)
A
  • specific antibiotic therapy,
  • increased fluid intake (atleast 3L/day),
  • O2 therapy,
  • antipyretics,
  • analgesics,
  • nutritional support,
  • bronchodilator medications
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16
Q
  1. How to prevent Pneumonia
A

Getting the flu and pneumococcal vaccines, hand hygiene, not smoking, living a healthy lifestyle, avoiding sick people.

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17
Q

what is asthma

A

inflammatory disorder of the airways. inflammation caused varying degrees of obstruction in the airways leading to recurrent episodes of wheezing, breathlessness, chest tightness, cough

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18
Q

2 main receptors of the bronchi

A

beta-adrenergic and cholinergic

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19
Q

beta-adrenergic and cholinergic receptors

A

sense the presence of specific substances and stimulate the underlying muscles to contract and relax, regulating the flow of air

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20
Q

allergens that trigger narrowing airways

A

inhaled allergens such as pollens, particles from dust mites, particles from feathers and animal dander

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21
Q

what happens when allergens are inhaled in asthma

A

allergens combine with immunoglobulin E (antibody) on the surface of mast cells to trigger the release of asthma-causing chemicals from these cells (allergic asthma)

22
Q

what cells are thought to be responsible for initiating muscles of the airway to contract when they should not in asthma?

A

mast cells

23
Q

what do mast cells throughout the bronchi release

A

substances such as histamine & leukotrienes which cause smooth muscle muscle to contract, mucus secretion to increase and certain WBC to migrate to the area

24
Q

eosinophils role in asthma

A

type of WBC found in airways of people with asthma, release additional substances contributing to airway narrowing

25
Q

what happens during an asthma attack

A

smooth muscle layer goes into spasm, narrowing the airway. the middle layer swells b/c of inflammation & more mucus produced. In some segments of the airway, mucus forms plugs that nearly or completely block the airway

26
Q

stress & anxiety role in asthma

A

trigger mast cells to release histamine and leukotrienes and stimulate vagus nerve (which connects to airway smooth muscle) which then contracts and narrows the bronchi

27
Q

symptoms of asthma

A

attacks vary in frequency & severity, some ppl symptom free with occasional brief, mild episode of SOB, others cough, wheeze most of the time, can have severe attacks after viral infections, exercise, or exposure to allergens or irritants, including cig smoke

28
Q

When do asthma attacks usually occur?

A

in early morning hours when the effects of protective drugs wear off and the body is least able to prevent bronchoconstriction

29
Q

severe asthma attack

A

person is able to say only a few words without stopping to take a breath
- Confusion
- lethargy
- cyanosis

30
Q

status asthmaticus

A

-most severe form of asthma
- lungs are no longer able to provide the body with adequate oxygen or adequately remove carbon dioxide
- without O2 the organs may begin to malfunction
- CO2 buildup leads to acidosis= affects function of most organs

31
Q

medical intervention for status asthmaticus

A
  • artificial airways passed through throat (intubation) & mechanical ventilator used to assist breathing
32
Q

diagnosis for asthma

A

pulmonary function test, challenge test

33
Q

pulmonary function test

A

done before and after giving pt inhaled drug (betaadrenergic agonist) that reverses bronchoconstriction. if results improved after drug = asthma present

34
Q

challenge test

A

pulmonary function is measured before & after pt inhales chemical (usually methacholine but histamine may be used) that can narrow the airways. Chemical given in doses that are too low to affect healthy lungs but cause harm in asthma

35
Q

treatment of asthma

A

based on 2 classes of drugs:
- anti-inflammatory drugs (suppress inflammation that narrows airways)
- bronchodilators (relax & dilate airways)

36
Q

bronchodilators

A

beta-adrenergic agonists, drugs with anticholinergic effects and methylxanthines

37
Q

bronchodilators

A

beta-adrenergic agonists, drugs with anticholinergic effects and methylxanthines

38
Q

anti-inflammatory drugs

A

corticosteroids, leukotriene modifiers, mast cell stabilizers

39
Q

complications of COPD

A
  • in early stages O2 levels in blood may be decreased but CO2 remain normal
  • later stages CO2 levels increase & O2 falls
  • decrease in O2= blood stimulates bone marrow to send more RBC to bloodstream (polycythemia)
  • decrease O2 =increases pressure in pulmonary artery
40
Q

community acquired pneumonia

A
  • onset in community or during first 2 days of hospital stay
  • can be caused by number of agents but is often caused by bacterium streptococcus pneumoniae
41
Q

hospital-acquired pneumonia

A
  • 48 hours or longer after admission
  • can be caused by a number of agents but often caused by s. aureus or a gram negative bacterium
  • require different antibiotics depending on causative agent
42
Q

Fungal pneumonia

A

Fungi causes the pneumonia

43
Q

aspiration pneumonia

A
  • abnormal entry of secretions or substances into the into the lower airway
  • usually aspiration of material from the mouth or stomach
44
Q

opportunistic pneumonia

A

people with an altered immune response are susceptible to respiratory infections (immunosuppressive drugs, radiation therapy, chemo, HIV)

45
Q

chronic bronchitis

A
  • presence of a chronic productive cough for 3 months in 2 successive years when other caused have been excluded
  • when involves airflow obstruction = chronic obstructive bronchitis
  • glands lining the bronchi (larger airways) of the lungs enlarge & increase their secretion of mucus
46
Q

Emphysema

A
  • widespread & irreversible destruction of the alveolar walls (cells that support the lung alveoli) & enlargement of many of the alveoli.
  • results in collapse of bronchioles= permanent airflow obstruction
  • inflammation of bronchioles develops & causes smooth muscle spasm further obstructing the airflow. This also causes airflow to be blocked by secretions
47
Q

airflow obstruction of COPD causes:

A

air to become trapped in the lungs after full exhalation which increases the effort required to breathe

48
Q

abnormalities in COPD

A

number of capillaries in walls of alveoli decreases which impairs the exchange of O2 & CO2 between alveoli and blood

49
Q

Pulmonary Rehabilitation Programs

A
  • Can help people improve lung function.
  • Programs provide education about the disease, exercise, nutritional & psychological counseling
50
Q

Single lung transplantation

A

A treatment option for people who are usually younger than 60 & have severe airflow obstruction

51
Q

Lung volume reduction surgery

A
  • can be carried out in people with severe emphysema in the upper portions of their lungs
  • In this operation, the most severely diseased portions of the lungs are removed, permitting the remaining portions of the lungs & the diaphragm to function better

Concepts 2 FINAL (7 decks)

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