Term
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Definition
Characterized by irreversible airflow limitation
*associated with abnormal inflammatory response |
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Term
|
Definition
Emphysema- "pink puffers"
Chronic bronchitis- "blue bloaters" |
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Term
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Definition
Irreversible
*Associated with noxious stimuli |
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Term
| Emphysema Characteristics |
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Definition
Loss of lung elasticity
Hyperinflation of lung
Diaphragm flattens
"Air Hunger" |
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Term
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Definition
| Airtrapping, loss of elastic recoil in alveolar walls, overstretching of alveoli into bullae and collapse of bronchioles |
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Term
| Classification of Emphysema |
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Definition
Panlobular: Destruction of entire alveolus
Centrilobular: Openings in bronchioles
Paraseptal: Alveolar ducts and sacs |
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Term
|
Definition
Inflammation of bronchi & bronchioles
*d/t exposure to irritants |
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Term
| Chronic Bronchitis Physiology |
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Definition
Inflammation, vasodilation, congestion, mucosal edema, and bronchospasms
**Affects ONLY airways, not alveoli |
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Term
| Result of Chronic Bronchitis |
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Definition
| Decreased Pa02; increased PaC02= respiratory acidosis |
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Term
|
Definition
Increased mucus production
Reduces mucociliary clearance
Loss of elastic recoil
Increase smooth muscle tone
Pulmonary hyperinflation
Gas Exchange Abnormalities |
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Term
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Definition
Cigarette smoking
Alpha-1 anti-trypsin deficiency (AAT)
Occupational dust & chemicals
Increasing age
Other: infection and nutrition |
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Term
| Key Indicators for COPD Dx |
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Definition
| Chronic cough, chronic sputum production, dyspnea, acute bronchitis, hx of exposure to risk factors |
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Term
|
Definition
Hypoxemia
Respiratory Acidosis
Respiratory Infections
Cardiac Failure
Cardiac Dysrhythmia |
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Term
| Cardiac Failure Assoc. with COPD |
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Definition
Cor pulmonale
Fatigue, weakness, distended neck veins, dependent edema |
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Term
| Clinical Manifestations of COPD |
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Definition
Barrel chest
Slow moving
Stooped posture
Orthopneic position
Low, flat diaphragm |
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Term
| More Clinical Manifestations of COPD |
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Definition
Shortness of Breath
Unplanned weight loss
Enlarged neck muscles
Loss of muscle mass in extremities |
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Term
|
Definition
Respiratory acidosis
C&S of sputum
Hgb and Hct are increased
Chest X-ray
Pulse Ox- decreased
Serum-AAT- increased
Pulmonary function test- decreased |
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Term
|
Definition
Residual volume
Forced Expiratory Volume (FEV)
FEV1
FVC |
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Term
|
Definition
|
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Term
|
Definition
| indirectly measures the flow resistance of the lung |
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Term
|
Definition
| FEV in the first second of exhalation |
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Term
|
Definition
| Total of volume of air that can be maximal exhalation |
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Term
|
Definition
| Decreased ratio means disease is progressing |
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Term
|
Definition
Assess and monitor disease
Reduce risk factors
Manage stable COPD
Manage exacerbations |
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Term
| Assess and Monitor Disease |
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Definition
Risk factor reduction
Hx of illnesses (Family hx)
Pattern of symptom development
Current tx
Impact on ADLs
Social and family support |
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Term
|
Definition
Respiratory pattern
Shortness of breath, positioning
Clubbing of the fingers
Body weight
Barrel Chest
Cyanosis is a late sign |
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Term
|
Definition
Dyspnea
Exercise Intolerance
Chronic productive Cough
Anorexia or weight gain
Fatigue
Home O2 therapy |
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Term
|
Definition
Rales, rhonchi, wheezes
Prolonged expiratory phase
Hyperresonant breath sounds
Accessory muscle use
Inability to lie flat
Can't speak a complete sentence
Hypoxemia
Tachycardia
Confusion |
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Term
|
Definition
Ask
Advise
Assess
Assist
Arrange |
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Term
|
Definition
stops accelerated decline in FEV1
Phlegm production ends 3-6 mo post-quit
Risk of small cell lung CA reduced by half after 1 yr
5 years-risk of all lung CA halved |
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Term
|
Definition
Impaired gas exchange
Ineffective breathing pattern
ineffective airway clearance
imbalanced nutrition
Anxiety
Activity intolerance |
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Term
|
Definition
Positioning
Suctioning
Humidified breathing tx w/ low O2
ABGs
IV fluids and meds |
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Term
|
Definition
Hydration
Asses weight and skin condition
Morning activities and self-care
increase activity
Supplemental O2
Vaccinations |
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Term
|
Definition
Coughing and pursed lip breathing
Relaxation therapy
Body positioning
Small, frequent meals
Home O2 therapy |
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Term
|
Definition
Beta-adrenergic agents
Anticholinergics
Methylxanthines
Corticosteroids
Leukotriene modifiers
Mucolytics |
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Term
|
Definition
Reverse brocho-swelling
Relaxes smooth muscle
Reduce hyperinflation
Improve breathlessness |
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Term
|
Definition
Produces bronchodilation
Increases mucociliary clearance |
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Term
| Short-acting Beta 2(SABA) |
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Definition
Albuterol
*Monitor HR, increase fluid intake
*Teach correct inhaler use |
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Term
| Long-acting Beta 2 (LABA) |
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Definition
Salmeterol(Serevent), formoterol(Foradil)
*Do not use to relieve acute symptoms |
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Term
|
Definition
| Blocks ACh for bronchodilation |
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Term
| Short-acting anticholinergics |
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Definition
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Term
| Long-acting anticholinergics |
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Definition
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Term
| Nsg actions with Anticholinergics |
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Definition
*Increase fluid intake
S/S of overdose:
Blurred vision, eye pain, H/A, nausea and palpitations |
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Term
|
Definition
| Increased HR, H/A, tremors, restlessness, and palpitations |
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Term
|
Definition
Caution in pts with narrow-angle glaucoma
**Increases IOP |
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Term
|
Definition
Relaxing of bronchial smooth muscle
**Has very small therapeutic range |
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Term
| Nursing considerations with methyxanthines |
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Definition
Monitor drug levels
Avoid caffeine
Observe for s/s of rash or sloughing w/ IV |
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Term
| S/s of methylxanthines toxicity |
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Definition
| N/V, diarrhea, teachycardia, dysrhythmias, restlessness |
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Term
| Methylxanthines: Drug-drug |
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Definition
Increase drug met: smoking, barbiturates, and dilantin
Decrease drug met: H2 blockers, erythromycin, clindomycin, beta-blockers, and zyloprim (gout med) |
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Term
|
Definition
IV- Aminophylline
PO- Theophylline |
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Term
|
Definition
| Anti-inflammatory effects and reduction of mucus production |
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Term
| Corticosteroids: Nsg. considerations |
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Definition
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Term
|
Definition
GI ulcer, poor wound healing, decreased immune function, weight gain, hyperglycemia, fluid retention
**Causes thrush in mouth |
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Term
|
Definition
budesinide(Pulmicort)
fluticasone(Flovent) |
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Term
| Leukotriene Antagonists: Action |
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Definition
| Blocks bronchoconstriction, reduces edema, decreases mucus production |
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Term
|
Definition
| Singulair, Zyflo, Accolace |
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Term
| Leukotriene: Side Effects |
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Definition
| H/A, dry mouth, drowsiness |
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Term
| Leukotriene: nsg. considerations |
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Definition
| Zyflo increases levels of theophylline |
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Term
|
Definition
| Thin secretions, enhances and facilitates mobilization of secretions |
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Term
|
Definition
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Term
|
Definition
| Bronchospasms, nausea, fever, and drowsiness |
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Term
|
Definition
Abx
Controlled O2
Bronchodilators
Steroids
Intubation/ventilation
Tx heart failure if present |
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Term
|
Definition
Lung transplant
Lung reduction |
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