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)