respiratory Flashcards
asthma
chronic disease, airflow obstruction, inflammation, hyper-responsiveness
chronic airflow limitation (CAL)
asthma incidence, etiology, risks
5 million under age 18
allergy, esophageal reflux, male, genetics, elderly, urban areas, ethnicity
asthma clinical manifestations
wheezing, chest tightness, dyspnea, SOB, no wheezing if blocked, cough, tachycardia, diaphoresis, anxiety, panic, mood changes, hyperventilation
bronchodilators
short acting= albuterol
long acting= salmeterol
increases smooth muscle relaxation, no effect on inflammation, increase fluid intake, take 5 minutes before other inhaled drugs
monitor HR
methylxanthines
long acting
theophylline= most common med
dilates bronchi, used when other drugs are ineffective, can build up and cause toxicity
cholinergic antagonists
intermediate acting
ipratropium= most common
adverse reactions= increased HR
anti inflammatory drugs
corticosteroids
long acting, local or systemic
pulmicort/flovent/azmacort= most common
significant S/E= delayed wound healing, personality changes, fluid retention
taper doses, rinse mouth
asthma complications
pneumonia, atelectasis, hypoxemia, respiratory acidosis, respiratory failure, emphysema, chronic hypoxia, chronic bronchitis, asthmaticus
COPD
emphysema and chronic bronchitis
Symptoms: worsening breathlessness upon exertion, leads to breathlessness at rest
COPD etiology/ risk factors
smoking, alpha 1-antitrypsin deficiency, air pollution, occupational exposure, infection
3 million deaths each year
clinical manifestations of COPD
distended neck veins, right ventricular enlargement, lower sternal pulsations, GI disturbance, weight loss, dependent edema, metabolic and resp acidosis, pulmonary hypertension, hypoxia, fatigue, weak, enlarged/tender liver, bounding pulse, warm cyanotic extremities, cough
oxygen therapy for COPD
heated, humidified system
clear secretions
monitor liter flow and effectiveness with pulse ox., oxygen toxicity and oxygen induced hypoventilation, skin breakdown, anxiety
teach at home use
COPD complications
pulmonary hypertension, cardiac dysrhythmias, pneumonia, atelectasis, pneumothorax, bronchospasm, RF
emphysema
increased ventilatory “dead space”, hyperinflation of the lung, loss of elasticity, increased mucus, destruction of alveolar walls, alveoli collapse, spontaneous pneumothorax, chest tube for re-expansion of lung
caused by smoking, genetics, pollution
emphysema clinical manifestations
severe SOB at rest
O2 level below 40mmHg
chronic productive cough
barrel chest
wheezing, crackles, rhonchi
diminished breath sounds
tachypnea
hypoxia
hypoxemia
hypercapnia
fatigue
anorexia