respiratory - patho Flashcards
cellular respiration
- what do respirations have to do with it
gas exchange that occurs at the alveoli
- respirations: where gas exchange is occurring
ventilation
- what system is this controlled by?
movement of air in and out of the lungs
- controlled by the CNS
what does the diaphragm look like at rest
upside down U, inc pressure to blow air out
what does the diaphragm look like while breathing in
flattened, dec pressure so that air can come in
what are the 3 phases of respiration and explain each
- ventilation: ability to move air in and out of the lungs
- perfusion: ability to oxygenate tissue thru blood flow
- diffusion: movement of molecules; gas exchange (high to low concentration)
explain lung compliance and what 2 factors influence it
how “stiff” are the lungs; how good is the ability for the lungs to expand
influenced by:
1. connective tissue (bronchioles)
2. surface tensions (surfactant)
why should we not give an asthmatic pt a cholinergic drug
it will constrict the bronchioles and make it harder for the pt to breathe
what are some diseases of the lower airways
acute bronchitis, asthma, COPD, PNA, cystic fibrosis
what are the 3 parts of COPD
chronic bronchitis, emphysema, repeated severe asthma attacks
what is cystic fibrosis
- what population is this prevalent in
scarring of lung tissue = extensive damage prevents the lung from expanding
- pediatric disease
explain the patho of asthma
response to a trigger –> airway hyper-responsiveness –> inflammation and constriction –> mast cell rupture = release inflammatory cells = severe b.constriction = airway obstruction and b.spasms
chronic inflammation can lead to ___
COPD
how to treat intermittent asthma
- daytime symptoms
- night time symptoms
day: 2x/week or less
night: 1-2x/month or less
how to treat mild persistent asthma
- daytime symptoms
- night time symptoms
day: 3-4x/week
night: 2-4x/month
how to treat moderate persistent asthma
- day symptoms
- night symptoms
AT THIS POINT, SEND TO ER
day: >4x/week or daily
night: 4x/month or more
how to treat severe persistent asthma
- day symptoms
- night symptoms
day: continuous
night: frequent
factors that can exacerbate asthma
tobacco smoke, wood smoke, household sprays, exercise
nursing int for acute severe asthma exacerbation
- O2 = promote flow
- systemic glucocorticoid
- high dose IV push SABA
- nebulized ipratropium
what drugs are recommended for prophylaxis of exercise induced asthma
SABA + cromolyn sodium
which factor of COPD predominates
chronic bronchitis
a pt must have _____ and _____ to be considered having COPD
chronic bronchitis and emphysema
cause of COPD and S/S
smoking
S/S: chronic cough, excessive sputum, wheeze, dyspnea, poor exercise tolerance
explain the patho of COPD
inflammation + edema + fibrosis = irreversible damage
hypertrophy of submucosal glands = paralysis of cilia
loss of lung fiber elasticity = destruction of alveolar tissue
what will the chest of a pt with COPD look like
barrel chest
should a pt take an anti-inflammatory or bronchodilator first and why
bronchodilator first = open up bronchioles is priority –> then give anti-inflammatory (now more open = better reach for anti-inflammatory_
how many min to wait between bronchodilator and anti-inflammatory
3-4 min
pt education for any inhaled corticosteroids
good oral hygiene = prevent thrush / rinse mouth after each admin
cannot abruptly discontinue
advantages of inhalation drug therapy
- enhanced therapeutic effects
- minimized systemic effects
- relief of acute attacks
explain each type of inhalation device
- metered dose inhalers (MDI)
- respimats
- dry powder inhalers (DPI)
- nebulizer
MDI: think albuterol inhaler; PSI can be irritating to throat
- shake before use, hard for ppl with dexterity issues
respimats: similar to nebulizer mist, not as irritating to throat (mini neb lmao)
DPI: think advair
nebulizer: misted, heated, gets medication in deeper
time between:
- puffs with same inhaler
- puffs for different inhalers
same inhaler: 30sec-1min
diff inhalers: 2-5min
what are spacers
make it easier for med to reach lungs; helps inc distribution to lungs rather than mouth or throat
