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Acute Care Module 3 > Pulm Management > Flashcards

Pulm Management Flashcards

1
Q

what is obstructive lung disease

A

decreased airway lumen thus increasing resistance to expiratory airflow

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2
Q

what is the result of obstructive lung disease

A

increased dead space and decreased surface area for gas exchange

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3
Q

how does lung function change in obstructive disease (2)

A
  1. hyperinflation

2. decreased oxygenation

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4
Q

how do lung volume values change in obstructive disease

A
  1. TLC elevated
  2. FRC elevated
  3. RV elevated
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5
Q

what are the five obstructive lung pathologies

A

asthma, chronic bronchitis, emphysema, CF, bronchiectasis

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6
Q

what is the primary symptom of obstructive lung disease

A

dyspnea on exertion

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7
Q

how does FEV1 change in obstructive lung

A

> 2 L = little/no obstruction
1-2 L = mild/mod obstruction
< 1 L = severe obstruction

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8
Q

how does FVC change in obstructive lung

A

reduced

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9
Q

how does FEV1/FVC change in obstructive lung

A

ratio decreases as severity increases (normal is 75%)

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10
Q

what is the pathophys of COPD

A

destruction of lung parenchyma due to inflammatory processes leading to loss of alveolar attachments and decreased elasticity

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11
Q

describe a COPD’s patients drive to breathe

A

normal people are CO2 driven, but chronically elevated CO2 levels in COPD patients create an O2 drive. Therefore if O2 gets too low, pts are stimulated to breathe

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12
Q

what happens if you give long term oxygen to a COPD patient?

A

since they are O2 driven, when they receive enough O2 their brain will tell them to stop breathing

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13
Q

what is emphysema

A

abnormal and permanent enlargement of the airspaces distal to the terminal bronchiole accompanied by destruction of the alveolar walls

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14
Q

what is chronic bronchitis

A

presense of productive cough most days for 3 months during 2 consecutive years when other causes of chronic mucus have been ruled out

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15
Q

what are 6 clinical manifestations of pulmonary disease

A
  1. chronic cough
  2. excess sputum
  3. dyspnea on exertion
  4. increased accessory muscle use
  5. early AM headaches
  6. postural deficits
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16
Q

how can a cxr determine copd

A

depressed diaphragm and hyperinflation

17
Q

what does an ABG say about copd

A

dec PO2 and inc PCO2

18
Q

____ is indicative of significant obstruction during auscultation of lungs

A

> 4s

19
Q

what are three bronchodilators

A

anticholinergics, beta2agonists, and methyxanthines

20
Q

what is a type of anti-inflammatory used for lungs

A

inhaled corticosteroids

21
Q

long term admin of O2 (>15 hours per day) to pts with chronic respiratory failure has been shown to increase survival, but only if they fit what criteria?

A

PO2 < 55 (SaO2 < 88%)

22
Q

T/F: a patient should use a bronchodilator before initiating PT

A

true: for patients who need it, it may enhance exercise tolerance

23
Q

T/F: patients should exercise on less oxygen than they use at rest

A

false

24
Q

on a borg 10 dyspnea scale, how should you aerobically exercise your COPD patients?

A

3 max for inpatient, 6 max for outpatient

25
Q

what is CF

A

complex multisystem disorder that affects exocrine glands to produce abnormally thick and sticky mucus

26
Q

what are the clinical manifestations of CF

A
  1. chronic cough
  2. excess sputum
  3. dyspnea on exertion
  4. decreased exercise tolerance
27
Q

T/F: pts with CF should do aerobic exercise

A

true: start with short duration low intensity exercise

28
Q

what are four extrapulmonary restrictions

A
  1. chest wall injury
  2. postural deformities
  3. respiratory muscle weakness
  4. obesity/ascites
29
Q

what is the pathogenesis of restrictive lung pathologies

A

decreased pulmonary compliance (stiffer lungs) requires increase in pressure to maintain expansion

30
Q

how are lung volumes affected in restrictive lung pathos?

A

all volumes and capacities are decreased

31
Q

what are the unique clinical manifestations of restrictive lung pathos (3)

A
  1. difficult to take a deep breath
  2. tachypnea
  3. irritating, dry, and NPC
32
Q

what does a restrictive lung patho lung sound like

A

decrease in breath sounds and dry crackles

33
Q

what is atelectasis

A

partial collapse of lung parenchyma

34
Q

what can cause atelectasis

A

breathing too shallow, respiratory muscle weakness, and long term mechanical ventilation

35
Q

T/F: pneumonia is an URT infection

A

false: LRT

36
Q

what is unique clinical manifestations of pneumonia

A

fever, tachypnea, CXR increased density, wheezes or rales

37
Q

what are common complaints in those with lung cancer

A

dyspnea, cough/hemoptysis, and decreased activity tolerance

38
Q

what biochemically happens during respiratory failure

A

hypoxia and hypercapnia thus causing acidosis

39
Q

how are patients with respiratory failure on mechanical ventilation managed?

A

varying body positions including 12-16 hours proned

Acute Care Module 3 (11 decks)

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