Obstructive Pulmonary 2 Flashcards Preview

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Flashcards in Obstructive Pulmonary 2 Deck (40)
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1
Q

What are some causes of COPD

A

cigs
recurrent resp infecitons
urban air pollution
genetic deficiency in a1-antitrypsin

2
Q

Is it common to have both emphysema and chronic bronchitis

A

yes but one will dominate the other

3
Q

What is needed to diagnose chronic bronchitis

A

Excess bronchial mucus with cough for at least 3 months during two successive years.

4
Q

What are the manifestations of Cor pulmonalee

A

JVD
hepatomegaly with URQ tenderness
ascites, peripheral edema and weight gain
epigastric distress

5
Q

What are some management strategies with cor pumonale

A

low flow O2
salt restriction and diuretics
digitalis if they have CHF

6
Q

What are some complications of COPD

A

Resp tract infection
Peptic Ulcer Dis
GERD
Pneumonia

7
Q

Why is peptic ulcer dis a possible complication of COPD

A

bec of long term steroid use

8
Q

Why is GERD a possible comp for COPD

A

it may be associated with hiatal hernia

9
Q

What is a special consideratioin with pneumonia infections with COPD

A

its symptoms (fever, chills, and leukocytosis) may not appear

10
Q

What interventions are part of the collaborative care for COPD

A
annual pneumococcal and flu vaccines 
quit smoking 
treating resp infections quickly 
bronchodilator therapy
O2 therapy 
postural drainage
11
Q

What are some considerations for safe O2 therapy for COPD pts

A

bec their drive is on O2 now, limit flow to 2-3L, aim for O2 >90%, if O2 keeps falling risk it and increase the O2 flow `

12
Q

What position do drains the anterior upper lungs

A

supine with knees bent

13
Q

What position drains the posterior upper position

A

slightly leaned foward sitting in a chair so maybe have them sit in a chair with the back rest on their front side

14
Q

What position drains the apical upper

A

supine fowlers

15
Q

What position drains the lingula and right m (right on the nipple)

A

SIMs trendelenburg

16
Q

What position drains the superior lower

A

prone, arms above head, pillow under stomahc

17
Q

What positioni drains the lateral basal lower

A

lateral trendelenburg

18
Q

What position drains the anterior basal

A

lateral trendelenburg with top arm resting above the head

19
Q

What positioin drains the posterior basal lower

A

prone trendelenburg, arms above head

20
Q

What is a big goal for COPD pats

A

ability to do ADL’s

21
Q

What are some teaching points for optimising ADL’s for COPD

A

get physical therapy like strengthening arms bec eventually chair bound
keep nutrition up
poss use bronchodi’s before meals and have small meals
build up activity tolerance with consistent activity for 15-20 mins 3 times weekly (make sure its not strenuous)

22
Q

What are some secual activity recommendations for COPD

A

dont right after eating or strenuous activity
dont assure top position
dont prolong foreplay

23
Q

In order to get an accurate reading for PFT’s what is a guideline for meds

A

no bronchodilators for 6hrs before

24
Q

What are some psychological problems COPD might be suseptable to

A
guilt 
depression 
aniety 
social isolation 
denial 
dependence
25
Q

What are some interventions for psycho probs with COPD

A

relaxation techniques

social groups

26
Q

What goals for COPD

A

effective coughing
normal breath sounds
return of PaO2 to normal range for patient
improved mental status

27
Q

What are some COPD meds

A

Advair diskus
nebulisers
bronchodilators

28
Q

What are some considerations for advair diskus

A

inhale rapidly so it doesnt stick onto tongue
dont shake bc its dry powder
no spacers
dont cough or huff after inhaling-let it settle

29
Q

When doing chest physiotherapy what are some considerations

A

use bronchodi’s before
cough after done
remain in positions for min 5 min
dont perform 1hr bef or 3hrs after

30
Q

What is never a good solution for stress for COPD

A

sedation

31
Q

What is the procedure for pursed lip breathing

A

Inhale slowly through nose. Do not puff cheeks. Relax cheeks. Practice by blowing through a straw

32
Q

What is the goal of pursed lip breathing

A

3:1 ratio of inspiration to expiration

33
Q

How does a flutter airway clearance device work

A

breathing through it causes the ball to vibrate and causes a back up of pressure that keeps the bronchi open for longer and the vibrations help to loosen mucus

34
Q

What is cystic fibrosis and how to get it

A

Autosomal recessive disease 1 in 4 both parents have to have it

35
Q

What are manifestations of cystic fib in newborns

A
Meconium ileus (obstruction)
failure to grow 
clubbing of fingers 
persistent cough with mucous production 
Tachypnea 
Large frequent BM
36
Q

What are the manifestations of cystic fib for adults

A

Cough (first sign) becomes productive with purulent green mucous.
Increasingly recurring lung infections with periods of stabilization
can have distal bowel obstructions (RLQ pain N/V. Anorexia)

37
Q

What is the definitive diagnoostic test for cystic fib

A

sweat chloride test

38
Q

What are some unique considerations for cystic fib

A

hot weather, ecercise and fevers can cause sweating and fluid loss so intake more fluids and salt so that secretions stay thinner

39
Q

What is bronchiectasis

A

bronchial tubes are permenantly damaged, widdened and thickened

40
Q

What are the manifestations of bronchiectasis

A

chronic daily cough
bloody cough
coughing up larger amounts of mucus