class 4 COPD

Question 1

what is COPD

Answer 1

preventable, treatable, slowly progressive respiratory disease characterized by airflow limitations that are not fully reversible
-may include chronic obstructive bronchitis and emphysema

Question 2

step 1 of COPD development

Answer 2

exposure to irritating inhaled substance (smoking, workplace, resp infection)
-changes cellular makeup

Question 3

step 2 of COPD development

Answer 3

the inflammatory response in airways and lungs

Question 4

step 3 of COPD development

Answer 4

increased mucus production and narrowing of bronchioles, chronic hypoxia
-inc WBC and dec air exchange

Question 5

step 4 of COPD development

Answer 5

hyperinflation of the alveoli
inspiration more difficult to reduce gas exchange
-diaphragm wont be able to fully contract

Question 6

COPD risk factors

Answer 6

-smoking
-indoor or outdoor pollution
-occupational exposure
-second hand smoke
-genetics (alpha-1 antitrypsin deficiency (AAT))
-COPD develops over time, dx usally 40+

Question 7

diagnosis criteria for chronic bronchitis

Answer 7

presence of a cough and sputum production for at least 3 months in each of 2 consecutive years

Question 8

what is chronic bronchitis

Answer 8

inflammation of the bronchi
-vasodilaion, congestion, edema of mucosa
-bronchospasm
-inc mucus production and mucus plugging
-thickening of bronchial walls
-alveoli become damaged/fibrosed

Question 9

what is emphysema

Answer 9

impaired gas exchange resulting from destruction of the walls of overdistended alveoli
-permanent overdistension of air spaces
-air passages are obstructed
-increased ventilatory “dead space”
-less function of lung tissue & inc work of breathing

Question 10

clinical manifestations of COPD

Answer 10

-a progressive disease characterized by 1.chronic cough 2.sputum production 3.dyspnea
-weight loss
-use of accessory muscles (barrel chest)
-poor sleep, dec ADL’s

Question 11

how may a patient present with empysema

Answer 11

in tripod pose + use of accessory muscles
-may exhale w pursed lips

Question 12

how is COPD diagnosed

Answer 12

-health hx and physical assessment
-pulmonary function test
-spirometry
-ABGs
-chest xray
-ATT screening
-vitals w o2 sats
-skin assess
-phx,fhx, s&s

Question 13

medication to improve COPD

Answer 13

1. bronchodilators
2. steroids
3. oxygen
4. smoking cessation aids
   -alpha-1 antitrypsin augmentation therapy, antibiotic, mucolytic, antitussive, vasodilators, narcotics(codeine), vaccines

Question 14

surgical management of COPD

Answer 14

bullectomy (remove air pockets in lungs before they pop)
lung transplant (not usually for COPD)
lung volume reduction (remove dead lung/space)
-pulmonary rehabilitation

Question 15

nutrition for people with COPD

Answer 15

increased protein, calories, and carb diet d/t energy loss
offer boost

Question 16

nursing care for COPD

Answer 16

-manage exacerbations (meds)
-airway maintenance
-monitor for complications (o2 sats)
-improving activity tolerance
-drug therapy
-o2 therapy
-patient teaching

Question 17

complications for COPD

Answer 17

-respiratory infections
-hypoxemia & acidosis
-cor pulmonale
-heart failure
-pulmonary hypertension
-acute respiratory failure
-anxiety and depression