Week 3: Management of Patients w Chronic Pulmonary Diseases Flashcards
COPD
- what is it characterized by?
- is it reversible?
- is it a slow or fast progression?
- Characterized by airflow limitation that is not fully reversible
- slowly progressive
what is a COPD patient’s biggest struggle?
Airflow limitation on exhalation
COPD has variable combinations of which 3 conditions?
chronic bronchitis, emphysema, and asthma
describe the pathophysiology of COPD
Airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases
where does the inflammation in COPD occur?
occurs in proximal (close) and peripheral airways, lung parenchyma, and pulmonary vasculature
what are complications of COPD? (list the 3 important ones)
hypoxia, hypoxemia, HF (especially right sided)
list the three primary symptoms of COPD
chronic cough, sputum production, and dyspnea
which type of COPD patients have weight loss? what is recommended for these patients?
emphysema; to have small frequent meals
which type of COPD patients have weight gain & why?
bronchitis patients; loss of muscle
what 3 tests are used to diagnose COPD and what do they measure?
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 do patients look when they have bronchitis?
“Big Blue Bloater”
what is bronchitis?
- what is the main symptom?
- how long must a patient have it to be diagnosed?
Disease of the airways (bronchial tubes are inflamed)
- cough w daily sputum production
- at least 3 months / year for 2 consecutive years
what are s/sx of bronchitis? (4)
- what season does it often occur in?
- 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
name 3 common / important characteristics of bronchitis
- used pursed lip breathing
- go into respiratory acidosis
- core pulmonale (right sided HF)
when are COPD patients given steroids?
ONLY when they have exasterbations!!!
what is emphysema?
- what is destructed?
- progresses fast or slow?
- where is there lots of scar tissue?
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
what happens when the alveolar walls breakdown in emphysema patients? (3)
- 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 do patients look when they have emphysema?
“pink puffer”
how must emphysema patients sleep?
sitting up
what are common characteristics seen in emphysema patients? (6)
- Thin appearance
- Increased respiratory rate to maintain adequate oxygen levels
- Accessory muscle use
- Barrel shaped chest
- Purse lipped breathing
- High CO2 level
how do pulmonary function tests work?
clip on nose & blow out as hard as you can
what type of diet should COPD patients be on?
high protein, low CHO, high fat (their source of energy) adequate hydration!
how do bronchodilators treat COPD?
open up airways
how do corticosteroids treat COPD?
decreases inflammation
