Misc.
For many years health care has focused on reactive, episodic care of acute illness and trauma. What has this focus shifted more towards now in healthcare?
The focus has moved to proactive health promotion, disease prevention, and chronic disease management.
Is COPD more likely to lead to respiratory or metabolic acidosis or alkalosis?
Respiratory acidosis
Bonus Q: why?
T/F: Having COPD increases your risk of developing osteoporosis.
True.
What has been shown to improve fatigue symptoms seen in cancer survivors?
Physical activity
What type of pain can radiation and chemotherapy often cause because they damage nerves?
Neuropathic pain
T/F: A majority of leading causes of death are related to chronic disease.
True!
Bonus Q: What chronic disease caused the most deaths from 2020-2022?
Why is pulmonary hypertension often seen in COPD?
In healthy lungs, when an area of the lungs doesn’t get proper ventilation, the arteries in that area will vasoconstrict and shunt the blood elsewhere in the lungs to get more gas exchange.
In COPD there is poor ventilation everywhere in the lungs, which causes vasoconstriction everywhere in the lungs, which causes pulmonary hypertension.
Why would someone with COPD be more at risk of developing a respiratory infection?
The chronic mucus production and inability to properly clear secretions creates a warm, wet environment more likely to allow for a respiratory infection
T/F: Both chemotherapy and radiation therapy to the chest can cause heart problems.
True!
Bonus Q: Who is at highest risk of developing heart problems? (When it comes to post-cancer treatment)
What are some potential cognitive changes/mild impairment that can occur after cancer treatment? (AKA: chemo brain)
-Memory issues
-Brain fog
-Inability to concentrate
-Disruption of executive function
List at least 1 example of a program that supports chronic disease prevention and chronic disease management. (+50 pts for each additional answer)
-transitional care
-self-management education (SME)
-nutritional consults
List at least 2 reasons patients with COPD are more likely to have osteoporosis.
-smoking reduces bone blood flow and reabsorption of calcium
-their decreased activity level/tolerance (due to SOB) reduces bone health
-steroid use (especially long-term) causes bone loss
T/F: A spontaneous pneumothorax is not a potential complication of COPD.
False! COPD damages the lung tissue, which can result in the leakage of air into the pleural space, causing a spontaneous pneumothorax.
What are 3 things that might be included in the follow-up care plan for a cancer survivor?
-timing for medical visits and routine screenings
-Watching for signs of cancer recurrence or a second cancer
-Managing long-term side effects
List at least 3 emotional difficulties a cancer survivor is more at risk of developing.
-Post-traumatic stress disorder
-Anger
-Guilt
-Depression
-Anxiety
-Fear of recurrence
What are the 4 spheres of care?
-wellness/disease prevention
-regenerative/restorative care
-chronic disease care
-hospice/palliative care
What are at least 2 characteristic physiologic abnormalities of COPD? (+50 for each additional answer)
-Mucus hypersecretion
-Ciliary dysfunction
- Airflow obstruction and hyperinflation (air trapping)
- Gas exchange abnormalities (ex: hypercapnia)
- Pulmonary hypertension
Why is atrial fibrillation and other dysrhythmias common in COPD?
-chronic hypoxia and poor oxygenation trigger ectopic areas
Bonus Q: What are 2 possible surgical interventions to treat COPD when symptoms cannot be managed pharmacologically?
What are at least two common heart issues that can be caused by chemo or radiation therapy to the chest?
-heart failure
-CAD (especially with high doses of radiation therapy)
-dysrhythmia
-hypertension (risk lowers onset pt stops taking chemo drugs)
What does chemotherapy and radiation damage that increase the risk of acute leukemia and/or myelodysplasia?
Bone marrow stem cells
What is self-management education (SME)?
SMEs are. Self-empowerment programs that provide information for patients about chronic conditions and how to maintain the highest quality of life while managing the disease.
Bonus Q: What are some proven benefits of SME programs?
What are at least 2 drug classes that can be used to help treat stable COPD?
-beta-2 agonists
-antimuscarinics
-methylxanthines
-inhaled corticosteroids
-systemic glucocorticoids
-phosphodiesterase inhibitors
Why can COPD lead to right-sided heart failure?
-ongoing vasoconstriction leads to pulmonary hypertension
-severe pulmonary hypertension increases right ventricular afterload, eventually leading to right-sided heart failure (cor pulmonale)
Cancer survivors who are older adults and/or have pre-existing lung disease are more likely to develop what type of respiratory issues after cancer treatment?
-Decreased tidal volume
-Thickening of the lining of the lung, decreasing gas exchange
-Inflammation of the lung
-Shortness of breath/dyspnea
Chemotherapy, steroid medications or hormonal therapy can cause bone loss, as well as problems with the brain, spinal cord or nerves. List 3 of the 5 potential problems these can include mentioned in the lecture.
-Osteoporosis
-Hearing loss from drugs like cisplatin
-Increased risk of stroke from radiation to the head
-Peripheral neuropathy
-Dental or oral health problems
What are 2 of the 3 requirements for delivery of care?
-follow-up visits (as a part of standard procedure)
-determination of needs (based on condition)
-centralized, current information about the patient’s status
What are the 4 diagnostic criteria/ways to measure COPD severity and treatment from the Global Initiative for Chronic Obstructive Lung Disease initiated by WHO?
-measures symptoms
-number of exacerbations
-severity of exacerbations
-spirometry results
Bonus Q: What two things do the spirometry results include?
List at least 3 potential treatment options for an acute exacerbation of COPD.
-controlled oxygen therapy
-increased dose/frequency of bronchodilators
-IV glucocorticoids
-antibiotics if indicated
-nutritional status
-monitoring fluid balance
List at least 5 potential late effects or consequences of cancer treatment. (+50 pts for each additional answer)
-fatigue
-post-surgical issues
-cardiac involvement
-respiratory issues
-endocrine issues
-digestive issues
-bowel and bladder issues
-sexual dysfunction
-nerve and muscle issues
-pain
-cognitive changes (cognitive changes (chemo brain)
-emotional difficulties
-secondary cancers
-growth & development
What are 3 common endocrine issues post-cancer treatment?
-Premature menopausal symptoms
-Infertility
-Thyroid changes