UNIT 5: ch 24 copd

NM of bronchiectasis

-focus on alleviating symptoms and clearing pulmonary secretions -teach pt about smoking cessation, postural drainage, early s/s of respiratory infections, conserving energy

MM of CF

-Chronic: control of infections; antbiotics -acute: aggressive therapy involves airway clearance and antibiotics based on results of sputum cultures -anti inflammatory agents -corticosteroids: inhaled, oral, IV during exacerbations -inhaled bronchodilators -oral panacreatic enzyme supplementation with meals

Asthma

-chronic inflammatory dz of the airways that causes hyperresponsiveness, mucosal edema, and mucus production -inflammation leads to cough chest tightness, wheezing, and dyspnea -reversible -a;;ergy is the strongest predisposing factor

Bronchiectasis

-chronic, irreversible dilation of the bronchi and bronchioles -caused by airway obstruction, diffuse airway injury, genetic disorders, abnormal host defenses, idiopathic causes

What are four other diagnostics used to diagnosis COPD or used with patients with COPD?

-ABG -CT scan -CXR -Alpha antitrypsin deficiency screening

chronic bronchitis

-a disease of the airway. the presence of cough and sputum production for at least 3 months in each of 2 consecutive years -ciliary function is reduced, bronchial walls thicken, bronchial airways narrow, and mucous may plug airways -alveoli become damaged, fibrosed, and alveolar macrophages function diminishes

Emphysema

-abnormal distention of air spaces beyond the terminal bronchioles with destructioin of the walls of the alveoli -decreased alveolar surface area increases in "dead space" impaired oxygen diffusion -increased pulmonary artery pressure may cause right sided heart failure -increased dead space, progressed slowly for many years.

cystic fibrosis

-most common autosomal recessive disease among the Caucasian population -genetic screening to detect carriers -genetic counseling for couples at risk -genetic mutation changes chloride transport which leads to think, viscous secretions in the lungs, pancreas, liver, intestines, and reproductive tract -respiratory infections are the leading cause of morbidity and mortality

What are the six risk factors for COPD?

-passive smoking -increased age -occupational exposure (dust, chemicals) -indoor outdoor air pollution -genetic abnormalities

NM of CF

-strategies that promote removal of pulmonary secretions (CPT and breathing ezercises) -remind pt to reduce risk factors for resp infection -adequate f&e intake -palliative care -discuss end of life issues and concerns

Complications of COPD

ARDS, pneumonia, chronic ateltasis, pneumothroax, right sided HF

administering to much oxygen can result is retention of _____?

Carbon dioxide

A&D of COPD

H&P, pulmonary function test, spirometry, ABG, CXR

Is the airflow limitation in COPD fully reversible?

No

describe the results of chronic airway inflammation in COPD

When activated, proteinases and other substances are released, damaging the parenchyma of the lung

COPD

a preventable and treatable slowly progressive respiratory disease of airflow obstruction involving the airways, pulmonary parenchyma, or both

bullectomy

a surgical option for select patients with bullous emphysema

S/S of asthma

cough, dyspnea, wheezing

What is included in the parenchyma?

any form of lung tissue, including broncioles, bronchi, blood vessels, interstitium, and alveloli

What does chronic hyperinflation in a patient who has a primary emphysematous component cause?

barrel chest

quick relief medications for asthma

beta2-adrenergic agonists, anticholinergics

Surgical Management of COPD

bullectomy, lung volume reduction, lung transplant

long active meds for asthma

carticosteroids, long active beta2 adrenergic agonists, leukotriene modifiers

S/S and MM of bronchiectasis

chronic cough, purulent sputum in copious amounts, clubbing of the fingers, postural drainage, CPT, smoking cessation, antimicrobial therapy

What are the three primary symptoms of COPD?

chronic cough, sputum production, dyspnea

asthma

classified as a chronic pulmonary disorder. symptoms are more variable than COPD and is an abnormal airway condition characterized primarily by reversible inflammation

what are the three chronic pulmonary disorders?

cystic fibrosis bronchiectasis asthma

What is postural drainage?

drainage used in bronchiectasis and lung abcess. pt body should be positioned so that the trachea is inclined downward and below the affected chest area.

what are the 2 distinct disease processes of COPD?

emphysema and chronic bronchitis

Pt teaching for asthma

how to identify and avoid triggers, proper inhalation techniques, how to preform peak flow monitoring, how to implement an action plan, when and how to seek assistance

What are the three systemic or extrapulmonary manifestations of COPD?

musculoskeletal wasting metabolic syndrome depression

MM of COPD

promote smoking stopping, reduce risk factors, managing exacerbations, providing supplemental oxygen therapy, pneumococcal vaccine, flu vaccine, pulmonary rehabilitation, managin exacerbations

spirometry

used to evaluate airflow obstruction, which is determined by ratio of FEV, to forced vital capacity

What can cause a respiratory infection and produce an acute episode of bronchitis?

viral infection bacterial infection mycoplasma infection