Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 195 > Respiratory COPD > Flashcards

Respiratory COPD Flashcards

1
Q

COPD is?

A

emphysema and/or bronchitis (most patients have both)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

COPD obstructs?

A

expiratory airflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are these signs and symptoms of?

feelings of not having enough air to breathe, progressive dyspnea and fatigue.

A

COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are pathologic changes that occur to the airways of patients with COPD?

A

lung parenchyma & the vasculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

COPD: inflammation and narrowing of the airways leads to?

A

loss of pulmonary function, lung destruction, and impaired gas exchange. (increased mucus-producing cells, chronic inflammation in varying parts of the lungs, structural changes that result in a cycle of destruction and repair - airflow limitation, more susceptible to infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

COPD: respiratory infections is the leading cause of?

A

exacerbations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

___________ is when air sacs or alveoli become enlarged with lack of structure in the lung when breathing occurs.

A

emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are emphysema breath sounds?

A

Diminished.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

areas of destroyed alveoli are called?

A

bullae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the blebs which make up the bullae are fragile and susceptible to injury, possible _________, which is one of the complications for ______________.

A

pneumothorax,

end-stage emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

___________ is the presence of cough and sputum production for at least 3 months in each of two consecutive years.

A

bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bronchitis: b/c of chronic inflammation and mucus hyper secretion lung function?

A

declines with repeated infections and exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bronchitis causes __________ of the airways, which causes the airway lumen to become smaller, which predisposes the patient to have repeated episodes of ____________.

A

remodeling,

bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Major modifiable risk factor for COPD?

A

exposure to smoke!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the three categories of risk assessment for smokers?

A

smokers, non-smokers(quit), and never smokers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

20 - 30 % of smokers have?

A

COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What irritates the airways and results in mucus hyper secretion and airway inflammation?

A

smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Smoking paralyzes the mucociliary escalator, which inhibits?

A

expectoration of mucus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is an example of COPD that is a non modifiable risk factor?

A

Alpha 1 Antitrypsin Deficiency - genetic leads to liver and lung disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

_______ inhibits/protects the lungs from injury?

A

A1AT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Alpha 1 Antitrypsin can be?

A

treated if diagnosed (only 5% have been ID’ed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment for alpha 1 antitrypsin?

A

Reducing risk and aggressive treatment of URI; Augmentation therapy, infusions of the human protein from donors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Other non-modifiable factors of COPD:

A

prematurity, age-related changes to the respiratory system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

comorbid conditions, co-existing disorders of COPD:

A

asthma, OSA, pulmonary fibrosis, bronchiectasis, HF, CVD, PVD, stroke, anxiety, and depression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

_____________ is abnormal widened bronchioles related to infection.

A

bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

COPD: Systemic functions affected are r/t?

A

hypoxemia and lack of tissue perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

COPD: Skeletal functions affected?

A

muscle weakness, anorexia, cachexia(wasting), decreased muscle mass, barrel chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

COPD: Cardiovascular functions affected?

A

cor pulmonale, arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

COPD: Neurologic functions affected?

A

changes in cognitive function r/t brains affinity for oxygen, insomnia, sleep disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

COPD: Psychiatric functions affected?

A

anxiety, depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

COPD: Endocrine functions affected?

A

side effects from medications, Cushing’s syndrome r/t corticosteroid treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

COPD: End-stage lead to problems with gas exchange which can lead to?

A

respiratory failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Two predictors of disease progression for COPD?

A

increased frequency of exacerbations and weight loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Leaning forward, arms braced, maximizing pulmonary expansion is called?

A

tripod position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

End-stage COPD:

A
  • impaired gas exchange
  • chronic hypoxemia
  • hypercapnia
  • respiratory failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

_________ _________ is suspected in patients with extreme dyspnea and fatigue.

A

pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Chronic hypoxia leads to?

A

pulmonary arterial narrowing of the vessels and remodeling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pulmonary artery constriction, resistance to blood flow leads to

A

increased workload on right ventricle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When the right ventricle is compensating for pulmonary artery constriction; over time it will ________ and ________ causing _____ ___________ ____________.
This type of side sided heart failure is called?

A

enlarge and dilate.
right ventricular hypertrophy
cor pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are these S/S related to:

  • fluid is evident, systemically.
  • JVD
  • abdominal distention (ascites)
  • hepatomegaly and peripheral edema
  • pulmonary embolus
A

cor pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

COPD: diagnostic tests

A
  • pulmonary function tests
  • spirometry
  • chest x-ray
  • CT
  • EKG
  • CBC
  • BNP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Pulmonary function tests are used to?

A

help confirm the diagnosis, determine severity, and monitor progression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

PFTs are not performed in the acute setting, or on admission with?

A

exacerbation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Spirometry is used to evaluate _________ __________, and compared to normal values for age, gender, race, weight, and height.

A

airflow obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

With obstruction the patient has difficulty ________ or cannot forcibly ______ ____ from lungs.

A
  • exhaling

- exhale air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Obstruction reduces?

A

forced expired volume in one second (FEV1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Lung obstructive disease is defined as?

A

FEV1 of less than 80% OR a ratio of FEV1/FVC of <70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

When lung function declines and the FEV1 is less than 50%, the COPD is classified as?

A

severe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

ABG measurements obtained to assess?

A

baseline oxygenation and gas exchange

50
Q

ABG measurements on admission with?

A

exacerbation to determine severity

51
Q

ABG’s are not usually repeated if?

A

the patient responds clinically with improvement to the treatment.

52
Q

ABG’s will be drawn to evaluate treatment if?

A

intubated and on a ventilator

53
Q

A PaO2 < and PaCO2 > indicates respiratory failure.

For a COPD patient this can be acute or chronic

A

PaO2 < 60%

PaCO2 > 50%

54
Q

A chest x-ray is obtained to establish?

A

patients baseline and to exclude alternative diagnosis.

55
Q

A chest x-ray is seldom diagnostic in COPD unless?

A

obvious bullous emphysema disease

56
Q

bullous are?

A

large, air filled “blisters”

57
Q

With severe hyperinflation what is present?

A

a flat diaphragm

58
Q

Chest x-rays a more commonly used in? why?

A

exacerbations, to determine if the patient has abnormalities such as infiltrate, pneumothorax or a concomitant lung mass.

59
Q

CT scan of the chest may be done to rule out?

A

a differential diagnosis of PE.

60
Q

1 in 5 patient with COPD exacerbation have a?

A

PE

61
Q

EKG is useful to evaluate any ________ or __ ___________.

A
  • ischemia
  • RV hypertrophy
    (P Pulmonale - p wave depression inferior leads)
62
Q

Telemetry is used to monitor for?

A

arrhythmias

63
Q

CBC/diff to r/o?

A

infection

64
Q

BNP levels increase from?

A

FVO cardiac ventricles: HF r/t PHTN and RVH

65
Q

COPD patients live with?

A

hypoxia

66
Q

Key symptoms for COPD?

A

dyspnea, cough and sputum production

67
Q

WOB means

A

work or breathing

68
Q

Nursing process to determine the plan of care for the COPD patient ID and prioritize these problems:

A
  • impaired gas exchange
  • ineffective breathing pattern
  • ineffective airway clearance
  • activity tolerance
  • nutrition (less than body requirement)
69
Q

Impaired gas exchange intervention:

A

oxygen therapy - goal to maintain tissue oxygenation and decrease the work of the cardiopulmonary system

70
Q

Impaired gas exchange s/s:

A

SOB, tachypnea, tachycardia, or increased B/P

71
Q

O2 parameters for a COPD patient?

A

greater than or equal to 90%

72
Q

Ventri mask is?

A

precise and controlled delivery.

73
Q

Higher levels of oxygenation than needed can lead to?

A

hyperoxia and risk of increasing hypercapnia and respiratory acidosis.

74
Q

COPD patients drive to breathe is?

A

hypoxia

75
Q

Ineffective breathing pattern intervention:

A
  • Positioning - allow patient to find the most comfortable position to move the air in and out of the lungs.
    Ex: semi-fowlers w/arms support by pillows, or tripod.
  • Pursed-lip breathing (PLB)
  • Fans and relaxation techniques.
76
Q

What helps slow exhalation and is thought to prevent the collapse of the small airways, effectively allowing more air to be exhaled, decreasing hyperinflation and CO2 retention?

A

pursed-lip breathing

77
Q

Ineffective airway clearance intervention:

A

managing coughing and secretions

78
Q

Managing coughing and secretions can be accomplished by?

A
  • teaching techniques such as controlled cough, HUFF cough x 3
  • adequate fluid intake
  • nebulizer bronchodilators and monolytics (mucomyst or pulmozyme)
  • acapella and CPT
79
Q

Activity Intolerance intervention:

A

Exercises - to do in bed or in a chair (while exhaling through pursed lips) to improve exercise tolerance and conserve energy

80
Q

Corticosteroid treatment side effects:

A

muscle weakness, osteoporosis and thromboembolism! (contributes to condition of activity intolerance)

81
Q

Nutrition intervention:

A

adequate PO intake and calories. Dietician will be needed for COPD patients.

82
Q

BMI should be between:

A

20 - 25

83
Q

end-stage COPD patients experience weight loss and anorexia due to?

A

fatigue, increased work of breathing and hypermetabolism. **Weight gain improves exercise capacity.

84
Q

strategies for COPD patients needing more nutrients for a high metabolism:

A
  • nutritional supplements
  • administer bronchodilators before meals or wear oxygen during meal
  • eat small frequent meals
  • intake of fluids should be outside of meal time
  • choose calorie rich foods.
85
Q

Theobromine is a bronchdilator and is found in?

A

dark chocolate

86
Q

Goals for nursing management of COPD:

A

manage symptoms, maximize function and teach patient skills of self-care

87
Q

Vaccinations:

A

Flu, Pneumococcal

88
Q

obstruction of the airways leads to alveolar collapse: the result of infections, viral or bacterial, with increased production of mucus and congestion is called?

A

atelectasis

89
Q

what is often the presenting problem with COPD exacerbation?

A

Pneumonia (which is a complication of atelectasis)

90
Q

Pulmonary hypertension and chronic hypoxia lead to?

A

cor pulmonale

91
Q

With severe emphysematous changes, bullae may rupture requiring a chest tube this is a?

A

pneumothorax (less common complication)

92
Q

short term acting medications are used as?

A

preventative when anticipating SOB with activities, meal, etc.

93
Q

long term acting medications are?

A

preferred they are around the clock like COPD!

94
Q

bronchodilators are mostly delivered via?

A

inhalation route its faster.

95
Q

corticosteroids need to be weaned off to prevent?

A

adrenal suppression.

96
Q

inhaled corticosteroids steroids require rinsing are use to decrease?

A

oral thrush

97
Q

medications primarily used for patients with COPD?

A

aerolizer - formoterol (Foradil) LABA

Handihaler - tiotropium (Spiriva) long term acting anticholinergic.

98
Q

Adverse effects on the body from e-cig:

A
  • immunosuppression
  • popcorn lung
  • MRSA infections
99
Q

Smoking history is usually expressed in?

A

packs/years

100
Q

Pulmonary rehab goals:

A
  • to reduce symptoms
  • optimize functional ability
  • improve quality of life
101
Q

long-term oxygen therapy decreases?

A

breathlessness

102
Q

long-term oxygen therapy improves?

A
  • exercise capacity and endurance
  • cognitive performance
  • sleep quality
  • preserve organ function: brain, heart, lungs
103
Q

A bullectomy may be necessary if bullae is?

A

compressing against healthier lung sacs resulting in impaired gas exchange.

104
Q

lung volume reduction surgery is usually for patients with?

A

severe emphysema.

105
Q

thoracic lung surgery that involves removal of a portion of the diseased lung parenchyma improvement %?

A

10%

106
Q

what is an alternative for end-stage COPD?

A

lung transplant surgery

107
Q

what is is the specific criteria for referral for lung surgery?

A
  • based on age and prognosis.
  • limited organ availability
  • single lung transplants
  • < 65 yrs, no major organ dysfunction, substance free, no obesity or malignancy
108
Q

Grade dyspnea:

Not troubled by breathlessness except with strenuous exercise.

A

Grade 0

109
Q

Grade dyspnea:

Troubled by SOB when hurrying on a level path or walking up a slight will.

A

Grade 1

110
Q

Grade dyspnea:
Walks more slowly on a level path because of breathlessness than do people of the same age or has to stop to breathe when walking on a level path at his own pace.

A

Grade 2

111
Q

Grade dyspnea:

Stops to breathe after walking about 100 yards (91m) on a level path.

A

Grade 3

112
Q

Grade dyspnea:

Too breathless to leave the house or breathless when dressing or undressing.

A

Grade 4

113
Q

Name this disorder:
Tactile fremitus: Increased
Percussion: Dull
Auscultation: Bronchial breath sounds, crackles, bronchophony, egophony, whispered pectoriloquy

A

consolidation (ex: pneumonia)

114
Q

Name this disorder:
Tactile fremitus: Normal
Percussion: Resonant
Auscultation: Normal to decreased breath sounds wheezes

A

Bronchitis

115
Q

Name this disorder:
Tactile fremitus: Decreased
Percussion: Hyperresonant
Auscultation: Decreased intensity of breath sounds, usually prolonged with expiration

A

emphysema

116
Q

Name this disorder:
Tactile fremitus: Normal to decreased
Percussion: Resonant
Auscultation: Wheezes

A

Asthma (SEVERE ATTACK)

117
Q

Name this disorder:
Tactile fremitus: Normal
Percussion: Resonant
Auscultation: Crackles at lung bases, possibly wheezes

A

Pulmonary edema

118
Q

Name this disorder:
Tactile fremitus: Absent
Percussion: Dull
Auscultation: Decreased to absent breath sounds, bronchial breath sounds and bronchophony, egophony, and whispered pectoriloquy above the effusion one the area of compressed lung.

A

Pleural effusion

119
Q

Name this disorder:
Tactile fremitus: Decreased
Percussion: Hyperresonant
Auscultation: Absent breath sounds

A

Pneumothorax

120
Q

Name this disorder:
Tactile fremitus: Absent
Percussion: Dull (if large)
Auscultation: Decreased to absent breath sounds, fine crackles

A

Atelectasis

NUR 195 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions