General
What is the number one cause of respiratory diseases?
SMOKING
How do we diagnose someone with chronic bronchitis?
They must have a chronic productive cough for 3 months over 2 years
What can cause COPD?
Smoking, secondhand smoke, alpha-anti trypsin defeiciency (lysis of lung tissue), air pollution, aging
What is a barrel chest?
Expansion of the chest due to the over use of accessory muscles to breathe
What is pneumonia?
excess fluid in the lungs with inflammation in the interstitial spaces, alveoli, and bronchioles (WBCs will go to area)
What are examples of respiratory dysfunction?
airway obstruction, poor chest expansion, respiratory depression, interference with oxygen/carbon dioxide exchange
What is a nickname for chronic bronchitis patients, and why?
Blue bloaters because they have a high amount of CO2 and a low amount of O2 (cyanotic and hypoxic).
What is some nursing care for COPD patients?
body positioning, monitor resp status, teach coughing and purse lip breathing, and monitor need for O2 teaching
Pink puffer because they cannot expel the CO2 and will be easily exerted due to lack of O2
What is asthma?
intermitternt and reversible airflow obstruction that involves the inflammation of the mucus membrane lining
What is polycytemia?
Excess RBC production for more O2 transpot through the body in response to lack of O2
What vaccines do we want to make sure bronchitis patients have?
covid, flu, pnemonia
What are the hallmark signs of COPD?
dyspnea, chronic cough, sputum production
What can emphysema lead to?
thin appearance, use of accessory muscles to breathe, right-sided heart failure
How do we diagnose and treat asthma?
Diagnose: PFT (drop in FEV or PEF that increases after inhaler use), WBC, ABGs (may be normal), chest x-ray, sputum
Treat: need for IV fluids, lifestyle management, avoiding triggers such as animals, pollen, smoke, foods, feathers, and molds
What 3 things do we need for normal respiratory function?
-integrity of the airway system to transport air to and from the lungs
-proper function of the alveolar system
-proper function of the cardiovascular system
What can bronchitis lead to?
clubbing, respiratory acidosis, cardiac enlargement, use of accessory muscles to breathe, right-sided heart failure
ABGs, sputum sample, WBC, H/H, serum AAT, chest x-ray, pulse ox, pulmonary function tests
Why do emphysema patients sit orthopneic?
It makes it easier for the lungs to open up and expand
How do we diagnose and treat pneumonia?
Diagnose: hx of recent resp infection, sputum culture, CBC/blood cultures, electrolytes, ABGs, chest x-ray, pulse oc
Treat: broad spectrum abx until culture is identified, small freq meals, oral hygiene, oral fluids (3L a day), supplemental O2, and inhalers
ALSO: encourage vaccine if 65 or older/have underlying conditions (PVC 13 and PPSV 23 given one year apart)
Describe the breath sounds (3 of them and where we would hear them at)
-Bronchial (heard in the upper region of the lungs where inspiratory < expiratory)
-Bronchiovesicular (heard in the middle region of the lungs where inspiratory = expiratory)
-Vesicular (heard in the lower region of the lungs where inspiratoy > expiratory)
What is the patho for bronchitis?
Too much mucus tha traps bacteria so the bronchial wall thickens
What is hypoxic drive?
What tells us to breathe in response to low O2 levels due to the retention of CO2 in COPD patients
What is the patho for emphysema?
Abnormal, permanent enlargement of the air spaces accompanied by destruction of air space walls. elasticity is lost and hyperinflaton of the lungs occurs
What bronchodilator is used for rescue vs preventative?
Rescue: albuterol (short-acting beta 2 agonist that will have no effect on inflammation)
Preventative: formoterol (change airway responsiveness to prevent attacks)