Brainscape's Knowledge GenomeTM

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


See full index

Adults Exam 1 > Week 3: Management of Patients w Chronic Pulmonary Diseases > Flashcards

Week 3: Management of Patients w Chronic Pulmonary Diseases Flashcards

1
Q

COPD
- what is it characterized by?
- is it reversible?
- is it a slow or fast progression?

A
  • Characterized by airflow limitation that is not fully reversible
  • slowly progressive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is a COPD patient’s biggest struggle?

A

Airflow limitation on exhalation

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

COPD has variable combinations of which 3 conditions?

A

chronic bronchitis, emphysema, and asthma

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

describe the pathophysiology of COPD

A

Airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases

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

where does the inflammation in COPD occur?

A

occurs in proximal (close) and peripheral airways, lung parenchyma, and pulmonary vasculature

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

what are complications of COPD? (list the 3 important ones)

A

hypoxia, hypoxemia, HF (especially right sided)

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

list the three primary symptoms of COPD

A

chronic cough, sputum production, and dyspnea

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

which type of COPD patients have weight loss? what is recommended for these patients?

A

emphysema; to have small frequent meals

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

which type of COPD patients have weight gain & why?

A

bronchitis patients; loss of muscle

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

what 3 tests are used to diagnose COPD and what do they measure?

A

Spirometry (pulmonary function tests): measures volume in lungs
ABGs: gas levels in blood (PaO2, PaCO2)
chest x-ray / CT scan: shows fluid in lungs; reveals HF

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

how do patients look when they have bronchitis?

A

“Big Blue Bloater”

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

what is bronchitis?
- what is the main symptom?
- how long must a patient have it to be diagnosed?

A

Disease of the airways (bronchial tubes are inflamed)
- cough w daily sputum production
- at least 3 months / year for 2 consecutive years

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

what are s/sx of bronchitis? (4)
- what season does it often occur in?

A
  • hypertrophy (enlargement) & hypersecretion of mucus glands
  • chronic inflammation & edema (going into right sided HF)
  • cough
  • gradual structural changes (belly breathing & retaining fluid)
  • most often occurs in winter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

name 3 common / important characteristics of bronchitis

A
  • used pursed lip breathing
  • go into respiratory acidosis
  • core pulmonale (right sided HF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when are COPD patients given steroids?

A

ONLY when they have exasterbations!!!

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

what is emphysema?
- what is destructed?
- progresses fast or slow?
- where is there lots of scar tissue?

A

Impaired oxygen and carbon dioxide exchange
- Destruction of the walls of over distended alveoli
- Progresses slowly for years
- Lots of scar tissue in the alveoli

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

what happens when the alveolar walls breakdown in emphysema patients? (3)

A
  • Increase in dead space in the lungs (more dead space = less air to get in the lungs)
  • CO2 elimination is impaired (retaining CO2) resulting in a red flushed face
  • PaCO2 gets too high, going to shut down breathing (respiratory acidosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how do patients look when they have emphysema?

A

“pink puffer”

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

how must emphysema patients sleep?

A

sitting up

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

what are common characteristics seen in emphysema patients? (6)

A
  • Thin appearance
  • Increased respiratory rate to maintain adequate oxygen levels
  • Accessory muscle use
  • Barrel shaped chest
  • Purse lipped breathing
  • High CO2 level
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how do pulmonary function tests work?

A

clip on nose & blow out as hard as you can

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

what type of diet should COPD patients be on?

A

high protein, low CHO, high fat (their source of energy) adequate hydration!

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

how do bronchodilators treat COPD?

A

open up airways

24
Q

how do corticosteroids treat COPD?

A

decreases inflammation

25
Q

what is asthma? what specifically happens?

A

Chronic inflammatory disease of the airways→ airway hyper-responsiveness

26
Q

are bronchospasms in asthma reversible?

A

usually but not always

27
Q

what are mast cells?

A

type of WBC

28
Q

function of macrophages

A

clean up after attack

29
Q

function of neutrophils

A

first attackers / responders

30
Q

function of eosinophils

A

released / increased in times of allergies

31
Q

function of T lymphocytes

A

part of immune system; survalance crew

32
Q

what do mast cells do w asthma?

A

key role in the inflammation

33
Q

what is the physiology when asthma attacks occur initially?

A

Hypoxia (oxygen level drops), hyperventilation (CO2 decreases), respiratory alkalosis

34
Q

what is the physiology later on in asthma attacks?

A

increased CO2, respiratory acidosis, respiratory failure

35
Q

list some triggers of asthma? (8) what is the strongest predisposing factor?

A
  • Allergens - Strongest predisposing factor
  • Medications
  • Upper respiratory infection
  • GERD
  • Strong odors, fumes, smoke
  • Hormone levels (during periods)
  • Especially in females
  • Exercise, Stress, Laughing
  • Cold air
36
Q

what are the 3 most common symptoms of asthma?

A

cough, dyspnea, and wheezing

37
Q

list other s/sx of asthma (7)

A
  • Accessory muscle use
  • Anxiety / Chest tightness
  • Prolonged expiration
  • Diaphoresis
  • Hypoxemia (<80 in blood)
  • Tachypnea / Tachycardia
  • Widened pulse pressure
    EX: 130/70, 150/60, 220/60
38
Q

how do you assess an asthma patient? (2)

A
  • Determine symptoms of airflow (pulmonary function test)
  • Identify triggers
39
Q

how is asthma diagnosed? which tests are used? (2) what do they measure?

A

Forced Expiratory Volume (FEV1)
- Blowing into a tube & tells us how much air is coming out
Forced Vital Capacity
- Breathing treatments w pulmonary function tests
PFTs

40
Q

how is the treatment of asthma evaluated?

A

FEV (forced expiratory volume): amount of air expired after 1, 2, 3 seconds of forced vital capacity (amount of air forced out of the lungs after the greatest inhalation)
Measures lung capacities, lung volume, rates of flow, gas exchange

41
Q

how should O2 levels be after asthma treatment?

A

expect an increase

42
Q

how should breath sounds be after asthma treatment?

A

wheezing to clear or diminished

43
Q

what is important to educate an asthma patient about? (3)

A
  • medication usage: how to use their inhalers (shake it, use spacer (helps get all medication down), place 1-2 inches away from mouth, breathe in slowly
  • Self monitoring of PEF (peak expiratory flow): measures peak rate individually
  • Exercise: use inhaler 15 min before exercising
44
Q

list some asthma complications (5)

A
  • Status asthmaticus: asthma attack that does not respond to the normal treatment; lasts longer than a normal asthma attack
  • Respiratory failure
  • Pneumonia
  • Atelectasis
  • Hypoxemia
45
Q

nonpharmacological dyspnea management (6)

A
  • Cool air on face, use fan (turn heat down in room)
  • Strengthen respiratory muscles thru exercise training (diaphragmatic breathing)
  • Improve nutrition to improve muscle mass
  • Positioning (HOB up)
  • Pursed lip & diaphragmatic breathing
  • Oxygen therapy
46
Q

pharmacological dyspnea management (3)

A
  • Bronchodilators
  • Opioids – Morphine Sulfate (decreases CNS & respiratory rate) – not only for pain!
  • Anxiolytics
47
Q

which medication is most effective for asthma & COPD? what is an intervention for this med?

A

Inhaled corticosteroids most effective (rinse mouth after) - can cause thrush!
- Fluticasone
- Budesonide
- Flunisolide

48
Q

how do anticholinergics treat asthma & COPD? list the med; what is an intervention?

A

dries everything up!!
- Ipratropium
- Make sure pt. pees before you administer this med!

49
Q

how do short acting bronchodilators treat asthma & COPD? list the meds (2)

A

rescue!!!
- Beta 2 adrenergic agonists
- Albuterol
- Levalbuterol (also known as zopenex)

50
Q

how do long-acting adrenergic agonists treat asthma & COPD? which meds? (2)

A
  • maintenance or prevention!
    Salmeterol
    Formoterol
51
Q

a beta agonist is commonly combined w which med?

A

an inhaled steroid

52
Q

how do combo drugs treat asthma & COPD? name them (2)

A

used for maintenance only!!
Fluticasone-salmeterol
Budesonide-formoterol

53
Q

what is the leukotriene modifier that treats asthma & COPD?
when is it given?
list the BBW

A
  • Montelukast: prevents bronchial tubes from constricting
  • BBW: hallucinations
  • Given at night
54
Q

how do immunomodulators treat asthma & COPD? what do they decrease & what could this be a risk of? name the med

A

biological modifiers; work on specific targeted organs; decrease immune system (at higher risk for developing infections & cancers)
- IgE-Inhibiting IgG monoclonal antibody
omalizumab

55
Q

list nursing interventions for O2 / oxygen therapy (4)

A
  • not around anything flammable (signs posted at home)
  • oxygen carrier
  • change oxygen tubing if dirty
    – do not use more than what’s ordered
56
Q

dyspnea assessment & management (3)

A
  • pursed lip breathing
  • leaning over table
  • sleeping w multiple pillows
57
Q

which med helps w cough enhancement?

A

expectorant

Adults Exam 1 (4 decks)

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