Respiratory - COPD

Question 1

What is COPD?

Answer 1

a functional category applied to respiratory disorders that obstruct the pathway of normal aveolar ventilation either by spasm of the airways, mucus secretions, or chnages in airway and/or alveoli

Question 2

What 3 diseases make up COPD?

Answer 2

Chronic bronchitis, emphysema, asthma

Question 3

What is the mechanisms of chronic bronchitis?

Answer 3

injury to the bronchial tree, which causes mucus build-up, which then causes narrowing and air can’t get in

Question 4

What is the mechanism of action for emphysema?

Answer 4

Difficult expiration due to decreased elastic recoil of alveolus and narrowed bronchiole

Question 5

Blue Bloater

Answer 5

chronic bronchitis- problem getting air in, oxygenation compromised

Question 6

Pink Puffer

Answer 6

emphysema- surface area for gas exchange is limited

Question 7

How can you improve ventilation for your COPD patients?

Answer 7

bronchodilators and breathing exercises

Question 8

Describe the type of breathing you would educate your patient on

Answer 8

diaphagmatic and pursed lip breathing: increases expiratory phase to get rid of trapped air

Question 9

What are the 2 “H”s to promote secretion removal?

Answer 9

Hydration and humidification

Question 10

What are possible complications that COPD can lead to if it goes untreated?

Answer 10

pneumonia, status asthmaticus, cor pulmonae, Right sided HF

Question 11

3 types of PO meds for Asthma

Answer 11

H1 antihistamines, leukotriene antagonists, and theophuline

Question 12

3 types of leukotriene antagonists

Answer 12

singulair, accolate, zyflo

Question 13

What are 4 common types of inhalers?

Answer 13

selective B2 agonists, anticholinergic, corticosteroids

Question 14

2 common selective B2 agonists

Answer 14

albuterol and serevent

Question 15

Atrovent belongs to what class of drugs

Answer 15

antocholinergic (sympathomimetic)

Question 16

What is cromolyn used for?

Answer 16

prophylatically for asthma- blocks degranulation of mast cells

Question 17

What are mast cells’ role in the body?

Answer 17

When stimulated, mast cells release its contents into tissue causing increased permeability of blood vessels (inflammation and swelling), contraction of smooth muscle (bronchial muscle) and increased mucus production

Question 18

Acute exacerbation of chronic respiratory conditions can lead to :

Answer 18

respiratory failure, status astmaticus, and acute infections

Question 19

More COPD patients are seen in the __ than ____ centers

Answer 19

ER, Outpatient

Question 20

Which disease has a higher mortality, chronic bronchitis or emphysema

Answer 20

emphysema

Question 21

True or False, more men are diagnosed with COPD and chronic bronchitis.

Answer 21

False, women are diagnosed more with COPD and chronic bronchitis. However, men are more diagnosed with emphysema

Question 22

What are the typical diagnostic tests you’d expect ordered for a COPD patient?

Answer 22

Xray, MRI, Ultrasound, CT, and bronchoscopy, pulmonary function tests, Tb test

Question 23

What should be included in your respiratory assessment?

Answer 23

auscultate lungs, look at symmetry of lung expansion and trach position, RR, use of accessory muscles, O2 Sat, patient’s color, color of nailbeds, mucosa, dyspnea, cough, and sputum

Question 24

Your patient has an O2 sat of 98-100%, what is the paO2?

Answer 24

90-100

Question 25

Your patient has an o2 sat < 90, what is PaO2?

Answer 25

< 60, which is not compatible to life

Question 26

What are some signs that may indicate to you as the nurse that your patient is in respiratory decompensation?

Answer 26

stridor, noisy respirations w/out stethoscope, retractions, flaring naares, labored RR with use of accessory muscles, minimal or absent chest wall movement, cyanosis, decreases or absent breath sounds, anxiety and confusions

Question 27

Why might you correct a UAP that gives your COPD patient 5 L of O2 via Nasal Cannula?

Answer 27

the stimulus to breathe is hypoxia (hypoxic drive). Too much O2 can cause the patient to stop breathing

Question 28

Possible nursing dx for COPD

Answer 28

impaired gas exchange, ineffective breathing pattern, ineefective airway, sleep deprivation, and acute confusion

Question 29

What is the r/t portion of impaired gas exchange

Answer 29

alteration in supply of oxygen or the ability to transport oxygen or changes in the alveolar-capillary membranes

Question 30

Other nursing dx for COPD patients

Answer 30

pain, altered comfort, fluid deficit, hyperthermia, activity intolerance, safety ( transmission of infection)

Question 31

What are your 3 nursing intervention priorities?

Answer 31

maintain O2 delivery, monitor O2 effectiveness, and Bronchial hygiene

Question 32

What is bronchial hygiene?

Answer 32

Turn, cough, deep breath, ICS

Question 33

What are some RT roles you might see your patient receive?

Answer 33

chest percussion, vibration, and postural drainage

Question 34

With oral hygiene, what should you try to avoid? What will you incoporate?

Answer 34

avoid glycerine swabs or mouthwash that contains alcohol. Assess for mouth ulcers, bacterial or fungal growth and infections

Question 35

Other nursing interventions you should incorporate into your care of a COPD patient

Answer 35

collab with RT, evaluate meds, relieve pain, suction prn

Question 36

If you have communication barriers with you patient, what might you do?

Answer 36

get a translator, use pen and paper, speak directly to patient.

Question 37

True or False, you should assess who makes the decisions of the family

Answer 37

TRUE

Question 38

What is a vulnerable population?

Answer 38

at risk populations for health disparities based on race/ethnicity, socio-economic status, geography, gender, age, disability status, risk status

Question 39

While establishing an asthma action plan, what should be in the green portion? What treatments go in this area?

Answer 39

breathing is good, no cough or wheeze, sleep through the night, work and play. Daily preventive anit-inflammatory medicines

Question 40

What goes in the caution zone of an asthma plan?

Answer 40

first signs of a cold, exposure to known trigger, cough, mild wheeze, tight chest, and coughing at night. Daily preventinve anti-inflammatory meds, rescue meds and call primary care provider

Question 41

What are danger signs for asthma patients?What are key interventions you should educate your patient on?

Answer 41

medicine is not helping, breathing is hard and fast, nose wide open, ribs show, and cant talk well. See you doctor right away!

Question 42

Nursing priorities of COPD and asthma patient

Answer 42

maintian patent airway, assist with measures to facilitate gas exchange, enhance nutritional intake, prevent complications, provide info about disease process and treatment plan, control/alleviate pain,

Question 43

What are discharge goals for COPD and asthma patients?

Answer 43

ventilation/oxygenation, good nutrition, prevent infection

Question 44

Inflammation of the lower respiratory tract causing excess fluid in lungs describes what disease?

Answer 44

Pneumonia

Question 45

S/s of pneumonia include:

Answer 45

weakness, fatigue, lethargy, CONFUSION, possible fever or cough

Question 46

Cardiac failure, esspecially cor pulmonale ( right-sided HF caused by pulmonary disease), occures with ____ or _____

Answer 46

bronchitis or ephysema

Question 47

Describe the disease process of cor pulmonale/CHF

Answer 47

Air trapping, airway collapse and stiff alveolar walls increase the lung tissue presssure, making blood flow through the lung vessels more difficult. The increased pressure makes the workload heavy on the right side of the heart.