Ch 28 Obstructive Pulmonary Disease
A hallmark of cystic fibrosis (CF) in children is
poor weight gain and growth
High resolution CT is the
preferred method for diagnosis of bronchiectasis
Pneumothorax occurs due to
formation of bullae and blebs in the lungs
Patients with CF secrete
four times the normal amounts of sodium in their sweat
Steatorrhea occurs due to
pancreatic insufficiency in the patient with cystic fibrosis
Patient with broncchiectasis experiences
pleuritic chest pain, dyspnea, wheezing, and clubbing of digits
The nurse expects which treatment therapy will be prescribed for a patient with massive hemoptysis?
Bronchial artery embolization
The nurse expects which diagnosis for a patient who has permanent, abnormal dilation of medium-sized bronchi, inflammation, and elastic and muscular structural destruction of the bronchial wall?
Bronchiectasis
Which condition may develop if severe pneumonia is left untreated?
Bronchiectasis
Which clinical manifestations of bronchiectasis should be reported to the health care provider?
Chest pain Fever and chills Blood clots in the sputum Increased sputum production
Which conditions are late complications of cystic fibrosis (CF) caused by pulmonary hypertension?
Cor pulmonale & Respiratory failure
Which action will the nurse take for a male patient with cystic fibrosis (CF) who states, "I hope that this condition allows me to have biologic children"?
Educate the patient about assisted reproductive technology
Which treatment helps to degrade deoxyribonucleic acid of neutrophils in the sputum of a patient with cystic fibrosis (CF)?
Dornase alfa
Postural drainage is the use of positioning techniques to accomplish which clinical action?
Drain secretions from specific segments of the lungs and bronchi into the trachea
Which finding helps to diagnose cystic fibrosis (CF) in a newborn?
Meconium ileus
Which technique is the most beneficial for airway clearance for a patient with cystic fibrosis (CF)?
No single technique has been shown superiority to the others
Chest tube drainage helps the patient with
Pneumothorax
Which condition may develop if cystic fibrosis of liver is left untreated?
Portal hypertension
Pancreatic insufficiency is associated with which complications?
Stetorrhea & Low body mass index (BMI) A patient with pancreatic insufficiency may have protein and fat malabsorption.
Gold standard for diagnostic cystic fibrosis (CF)
Sweat chloride test
A crackle is
a short, low-pitched sound consisting of discontinuous bubbling caused by air passing through the airway intermittently occluded by mucus, an unstable bronchial wall, or a fold of mucosa.
Respiratory failure occurs due to the
accumulation of effects of lung damage
Pneumothorax is a condition where
air accumulates in the plural space
Cystic Fibrosis (CF)
an autossomal recessive, multisystem disease that alters transport of sodium and chloride ions in and out of epithelial cells.
Cor pulmonale occurs due to
an increase in vascular resistance or pulmonary hypertension
Cystic fibrosis leads to gastrointestinal problems that
cause severe abdominal pain. If the patient is left untreated, he or she may develop gallstones, pancreatitis, and portal hypertension
Inhaled hypertonic saline (7%)
clears mucus, promotes bronchodilation, and decreases the frequency of exacerbations.
Airway clearance techniques are
critical because the normal ciliary motion in CF airways is impaired
The buccal smear test and pilocarpine iontophoresis help
determine the presence of cystic fibrosis
Stridor is a
high-pitched, wheezing sound caused by disrupted airflow in the larynx or trachea
Atelectasis is a complication of ashtma due to
hyperinflation of the lungs and increased dead space
Cystic fibrosis (CF) affects both the upper and lower respiratory tracts. It affects the small airway first and progresses to the larger airways, finally passing into the lungs, causing
hyperinflation of the lungs due to obstruction of the bronchioles by thick mucus that traps the air
Chest physical therapy (CPT) and high-frequency chest wall oscillation
loosen mucus
Ciprofloxacin helps to treat
mild exacerbations
A wheeze is a form of
rhonchus characterized by a continuous, high-pitched squeaking sound caused by rapid vibration of bronchial walls.
A patient with pleuritic chest pain and dyspnea has bronchiectasis. Upon auscultation of the lungs, a variety of
sounds such as crackles, rhonchi, and wheezes are heard.
Cor pulmonale, or right-sided heart failure occurs due
the increased pressure in the lungs
Clearance is achieved by
the specialized expiratory techniques aimed at using airflow to remove the loosened secretions. Examples of clearance techniques and devices are PEP devices (e.g., flutter device), acapella, breathing exercises (autogenic drainage), pursed-lip breathing, and huff coughing.
The sweat glands of a cystic fibrosis patient secrete normal volumes of sweat, but sodium chloride cannot be absorbed from sweat as it moves through the sweat duct. Therefore four times the normal amount of sodium and chloride is excreted in sweat. This abnormality is detected by
the sweat chloride test, which is the main diagnostic test for cystic fibrosis (CF)