Pulmonary Flashcards
t/f: mild COPD has a favorable prognosis
true!
what makes the prognosis for COPD worse and mortality high?
severe airflow restriction–> 95% of patients will die within 10 years :(
what are the 4 most common complications of COPD that are what actually lead to death/
- infections
- lung collapse(pneumothorax)
- arrhythmia
- cor pulmonale
what is cor pulmonale
enlargement and failure of the R heart due to pulmonary hypertension
what are the two “stereotypes” of emphysema patients?
pink puffers and blue bloaters
what is the main difference between blue bloaters and pink puffers? how does this manifest in the blood?
pink puffers compensate for decreased alveolar gas exchange by hyperventilating–> Hgb oxygenation remains ok(getting enough O2)
blue bloaters do not compensate for decreased gas exchange and therefore are hypoxic/cyanotic
typically pink puffers are (thin/obese) while blue bloaters are (thin/obese). Which tends to have a barrel chest?
pink puffers=barrel chested and thin
blue bloaters=obese
t/f: both blue bloaters and pink puffers experience chronic bronchitis
true!
who retains more CO2? blue bloaters or pink puffers?
blue bloaters
what are 3 food-focused interventions for COPD patients that have difficulty eating due to SOB? what are 3 lifestyle interventions focused on meals?
food: nutrient-dense, softer, limit gas-forming veg
meals: rest before, have someone else help with prep, make them small and more frequent
t/f: COPD patients have increased energy needs
true! due to increased work of breathing
what is the protein req for COPD patients?
1.2-1.7 g protein
t/f: the % of total calories from fat should be higher for COPD patients
true… need more dense foods b/c difficult to eat a large volume
t/f: pink puffer COPD patients should be given enough calories to gain weight and create a weight “cushion” to prevent the inevitable weight loss
false. patients should be repleted, but not overfed
typically, COPD patients experience what symptom in the mornings? why?
headaches/confusion b/c retention of CO2
what are the typical gas-producing foods? (4)
cruciferous veg, legumes, alliums, carbonated bevs
how should TF be modified for COPD patients?
should be lower CHO
in addition to increased labor of breathing, why else might a COPD patient have increased energy needs?
metabolic effect of corticosteriods
cystic fibrosis is caused by what? what does it cause?(2 things)
genetics–> pancreatic insufficiency and lung infection
a characteristic symptom of cystic fibrosis that used to be used for “diagnosis” was what?
increased NaCl in sweat(docs used to “lick babies”)
what demographic is CF more common in?
Caucasians
t/f: CF is eventually lethal
true
Due to abnormal Cl channels in mucus glands, mucus in CF lungs is __________
dehydrated
besides nutrition, what are the 3 treatments for the lung complications in CF? what is the 1 for pancreatic complications?
lungs: antibiotics, chest PT, “clean outs”
pancreas: enzyme replacement therapy (PERT)
what are the 3 components of PERT?
amylase, lipase, protease
why must PERT tablets be packaged in an acidic medium?
do not want to activate until it hits the basic duodenum
how fast do PERT enzymes start working
within 1 hr
unlike many other conditions, why should CF patients NOT consume small frequent meals?
because grazing all day makes dosing of PERT difficult
if a CF patient eats a high fat meal, what should be done?
increase dose of PERT to accomodate
when is PERT NOT needed for CF patients?
if they only consume a simple CHO meal (candy, tea, popsicles, fruit juice, etc.)
besides a MVM, what other supplement might CF patients need?
Na tabs… losing more in sweat
what are the calorie guidelines for adult and child CF patients? why?
adults: multiply REE by 1.4-1.5
children: multiply by 1.1.-2
**coughing is exhausting and sometimes experience vomiting(need to replete)
if CF patients cannot meet increased calorie needs, how can we help?
might provide nocturnal TF
t/f: calories from fat in CF patients should be greater than a normal population
true! need 35-40% cal from fat
_______________ is a restrictive lung condition caused by a variety of factors but is always characterized by widespread inflammation in the lungs
Acute Respiratory distress syndrome(ARDS)
complete the ARDS pathway: inflammatory response–> ____________—> ________________–> _________ and ____________
inflammation–> damaged alveoli–> lung cell necrosis and edema–> decreased gas exchange AND decreased oxygenation of blood
what are the hallmark symptoms of ARDS?
acute-onset dyspnea and fluid seen in lungs on an x-ray
where will you always find an ARDS patient?
in the ICU
