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CNUR 203 midterm > Unit 4 Resp > Flashcards

Unit 4 Resp Flashcards

1
Q

COPD is

A

Progressive, Preventable, Chronic inflammation or airway and lungs, persistent airflow limitations

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2
Q

When someone has COPD and inhale chemicals what happens

A

Chronic inflammation response

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3
Q

Carbon monoxide attaches to what in COPD

A

hgb limiting gas exchange (gas tripping)

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4
Q

What does nicotine do

A

vasoconstriction and hypertension

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5
Q

Cellular hyperplasia causes

A

excess mucous production

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6
Q

Muscous blocks airway causing

A

obstruction

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7
Q

Obstructions lead to

A

Alveolar dilation

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8
Q

Long term hyperinflation of the alveoli causes

A

Thoracic remodelling

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9
Q

Parenchymal destruction

A

Imbalance between proteinase and antiprotenase.

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10
Q

Pulmonary Vascular changes COPD

A

Thick vessels, inflammatory cells infiltrate Collagen deposit, destruction of capillary bed

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11
Q

Emphysema

A

Emphysema is a lung disease that results from damage to the walls of the alveoli in your lungs. A blockage (obstruction) may develop, which traps air inside your lungs. If you have too much air trapped in your lungs, your chest may appear fuller or have a barrel-chested appearance.

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12
Q

What happens to the Alveoli with COPD

A

Abnormal permanent enlargment of air spaces distal to the terminal bronchioles accompanied by the destruction of alveoli

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13
Q

Impaired gas exchange

A

-Progresses for years
-Alveoli walls become over-distended, increase in dead space, CO2 retention, increased CO2, resp acidosis, decreased O2. (hypoxia

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14
Q

Diagonising COPD

A

Chronic productive cough lasting at least 3 months in 2 consecutive years

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15
Q

what does AAT do

A

Protein in the blood that protects the lungs from damage caused by activated enzymes. Labratory tests measure the level of AAT in blood or identify abbnormal forms of AAT that a person has inherited to help diagnose alpha 1 antitrypsin

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16
Q

Subjective questions to ask patients with COPD

A

Current reason for seeking care, related illness, other health history, medications, pain, risk factors, family history

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17
Q

Signs and Symptoms

A

Cough (esp morning), Characteristic of sputum, smoking history, recurrent resp infections, SOB/SOBOE/ADL limit, nutritional deficiency, disabling dyspnea

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17
Q
A
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18
Q

How to calculate packs per year

A

Multiply number of cigarette packs smoked daily by number years smoked (Pack-year history)

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19
Q

Vitals for COPD

A

Increased Pulse
Increased resp
Increased BP
lower O2
Higher pain

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20
Q

Inspection for COPD

A

SOB/SOBOE, Cynosis, tripod positioning, purse lip breathing, accessory muscle use, barrel chest, malnutrition

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21
Q

Palpate

A

loss of muscle mass, lower limb deem, Tachycardia, tactile fremits

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22
Q

Why would lungs sound dull

A

Air or fluid in or around the lungs (such as pneumonia, heart failure, and pleural effusion) Increased thickness of the chest wall. Over-inflation of a part of the lungs

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23
Q

Why would someone have hyper resonance

A

air has filled the space around your lungs and is prohibiting them from expanding fully

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24
Q

What will you hear when auscultating the lungs of someone with COPD

A

-Prolonged expiration, wheeze, crackles, decreased breath sounds

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25
Q

Lab tests for people with COPD

A

Inflammatory cascade, ABG;s, RBC’s, Alpha 1-Antitrypsin

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26
Q

Diagnostic test

A

CXR, Sputum C and S, Spirometry/PFT’s, Exercise tolerance test, ECG, Cardio ECHO

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27
Q

With infection what are blood results going to look like

A

-High WBC
-High RBC
-Low hemoglobin
-high hemotocrit
-High Neurtrrophils
-High lymphocytes

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28
Q

Arterial blood gases

A

Measures, acidity, level of oxygen, level of carbon dioxide, check how well lungs move oxygen into the blood and remove carbon dioxide from the blood

29
Q

What to expect for people with COPD when getting Arterial blood gases

A

-low pH
-low PaO2
-High PaCO2
-High HCO3
-Low O2

30
Q

Mild spirometry

A

SOB on mild exertion

31
Q

Moderate Spirometry

A

SOB after 100 meters

32
Q

Severe spirometry

A

SOB housebound, Resp failure, Right heart failure

33
Q

Complications with COPD

A

-Pulmonary hypertension
-Hypercapnia
-Cor pulmonale
-Malnourishment
-Reccurent infections
-Osteoporosis
-anemia
-depression
-cardiovascular disease
-oxygen toxicity

34
Q

Bronchodilators

A

decrease broncho spasm

35
Q

Corticosteroids

A

decreased inflammation

36
Q

Referrals for COPD

A

pharmacy, social work, cardiac rehab, live well with chronic disease, respology, Resp therapy, Dietician, Home O2 program

37
Q

Teach

A

smoking cessation, med use scheduled, rescue, O2 therapy, exercise, nutrition/fluids, ADL

38
Q

SOS for SOB

A

-Stop and rest
-head down
-Shoulders down
-Breath in through mouth
-Blow out through mouth
-Breathe in and blow out as fast as necessary
-Blow out longer not forcefully
-Begin to slow your breathing
-Diaphragm breathing
-Stay in position for 5 mins

39
Q

Pursed lips

A

-Breath in slowly for 1 count
-purse your lips as if you were going to whistle
-Breath out gently through pursed lips for 2 slow counts
-Let the air escape naturally don’t force the air out of your lung.

40
Q

Diet for COPD

A

-Nutritent dense
-small volume
-multiple small meals
-Increased fluids
-daily weights

41
Q

Difference between asthma and COPD

A

Asthma: Airways (Reversible)
-Airway hyper responsiveness
-airway obstruction
COPD: Airways and Lung (Non reversible)
-Airway obstruction
-Emphysema

42
Q

What can affect sleep quality

A

-Sleep disorder
-abN resp problems with sleep
-Snoring
-Apnea
-Retained CO2
-Frequent waking
-Daytime fatigue

43
Q

Lack of sleep effects

A

-cognitive impairment
-behaviour changes
-Impaired function
-Heart disease
-Increased BP
-Stroke
-Increased obesity
-GERD

44
Q

Obstructed sleep Apnea (OSA)

A

Partial or complete upper airway obstruction during sleep creating periods of apnea
(Muscles in the back of your throat relax, Airway narrows or closes lowers the oxygen levels, brain senses the inability to breath -Briefly roused from sleep to reopen airway. Snort, choke, gasp, Impaired ability to reach REM Sleep

45
Q

STOP BANG

A

Snoring (do you snore), Tired (during day) , Obstruction (stop breathing while sleeping), Pressure (high?)
BMI (Greater then 28), Age (greater then 50, Neck greater then 43, Greater then 41cm, Gender male

46
Q

Diagnosis factors for Sleep apnea

A

More then 5 apnea/hypopnea per hour, at least 10 seconds, corresponding decrease in O2 sats by minimum 3%

47
Q

Sleep apnea effect on health

A

-sleep deprivation
-increased risk for cardiovascular event
-MI
-Dysrhythmia
-CVA
-HTN
-Increase injury risk

48
Q

Oral appliance used for sleep apnea

A

-Mandibular advancement device
-It forces lower jaw forward and down slightly, bringing tongue and tissue down as well, keep airway open

49
Q

CPAP

A

-Delivers air pressure through a mask
-The air pressure splints the airway open

50
Q

Uvulopalatopharyngoplasty

A

-Tonsillectomy
-Trimming tonsillar pillars
-Excision of the uvula and posterior palate

51
Q

Teaching for Sleep Apnea

A

-Weight loss, sleep on side not back, wide or more pillow

52
Q

Asthma path

A

-increased airway resistance
-smooth muscle bronchospasm
-destruction of lung tissue
-Combination of any/all
(hear weases)
-recurrent/chronic
-sudden
-inflammatory
-triggers
-Inflammatory response

53
Q

Bronchospasm

A

Smooth muscle contraction

54
Q

Early Asthma

A

Exposure = permeability
-IgE, Mast Cells, Histamine
-Mucous/Thick sputum
-Wheeze/SOB/Tightness

55
Q

Late asthma

A

Inflammation: limits airway diameter and increases airflow resistance
(Eosinophil, basophils neutrophil, more mast cells, histamine, inflammation)

56
Q

Cough variant asthma

A

usually exercise induced, limited bronchospasm/edema, irritation not outgrow

57
Q

Assesss triad

A
  1. known diagnosis of asthma
  2. presence of nasal polyps
  3. NSAID sensitivity (Increase bronchospasm)
58
Q

NSAID

A

Non-steroidal anti-inflammatory drugs

59
Q

Examples of NSAIDS

A

ibuprofen.
naproxen.
diclofenac.
celecoxib.
mefenamic acid.
etoricoxib.
indomethacin.
aspirin for pain relief (low-dose aspirin is not normally considered to be an NSAID)

60
Q

Warning signs of an asthma attack

A

-Headache, stuffy nose, sore throat coughing or wheeze after exercise, difficulty sleeping, feeling moody irritable, tiredness or weakness during activity

61
Q

Symptoms of asthma attack

A

chest tightness, coughing (at night or when laughing), difficulty breathing, SOB, Sleep problems resulting from issues, a wheezing sound in chest when exhaling

62
Q

If someone who is having an asthma attack stops wheezing what is happening

A

airway blockage

63
Q

Lab tests to do for someone with asthma

A

WBC, differential, Arterial blood gas, CO2 will be high because they are getting enough oxygen but cannot get rid of O2

64
Q

Diagnostic tests

A

-Pulmonary function tests
-CXR
-allergy testing
-symptom tracking

65
Q

What lab values will be abnormal

A

Eosinophils, basophils because Sometimes your body produces these immune cells in higher amounts. They overreact and can cause inflammation in the body, including in the lungs. And swelling in the airway

66
Q

Medications for Asthma attack

A

Rescue inhaler (Ventolin), Bronchodilators, inhaled steroids

67
Q

Goal of medications

A

-reduce inflammation, reduce mucous production, reduce bronchospasm

68
Q
A
69
Q
A

CNUR 203 midterm (10 decks)

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