Acute Diseases and Chronic Obstructive and Restrictive Diseases
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| What are the commmom Acute Pulmonary diseases? | Bacterial Pneumonia, Viral Pneumonia, Aspiration Pneumonia, Tuberculosis, Pneumocytis Carinii Pneumonia and SARS( Severe Acute Resp. Synd.)
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| Pneumocytis Carinii pneumonia is most found in : | Patients following transplantation, neonates or patients infected w HIV.
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| Crackles can be heard usually | inspiration
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| Wheezes can be heard usually | expiration, with severe airway constriction, it maybe heard on inspiration as well.
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| Bronchial can be heard usually | a more hollow, echoing sound normally found only over the right superior or anterios thorax. Heard on ALL expiration and most of expiration.
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| What is an Ventilation perfusion scan(V/Q) | it maches the ventilation pattern of the lung to the perfusion pattern to indentify the presence of pulmonary emboli
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| COPD: | Asthma, Cystic fibrosis, Bronchiectasis, Hyaline membrane disease, bronchopulmonary diplasia
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| Chronic Restrictive Diseases due by: | -Due to alterations in lung-Due to alterations in the chest wall-Due to alterations in the neuro musc. apparatus
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| Duration and procedure per postural drainage | up to 20 min
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| Indications for the use postural drainage | Increased pulmonary secretions, aspiration, atalectasis or collapse.
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| Class I 0% ImpairmentsRX | Usually NL, may be evidence of healed or inactive chest
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| Class I 0% ImpairmentsDyspnea | when it occurs it is consistent with the circunstances or activity.
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| Class I- 0% ImpairmentFEV1, FVC, MMV | not >85% of predicted
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| Class II- 20-30% ImpairmentDyspnea | not occur at rest, seldom occurs during ADL's
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| Class II- 20-30% ImpairmentRX | NL or Abnormal
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| Class II- 20-30% ImpairmentFEV1, FCV, MMV | 70-85% of predicted
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| Class III- 40-50% ImpairmentRX | may be NL but usually it is not
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| Class III- 40-50% ImpairmentDyspnea | not occur at rest, occurs during the usual ADL's
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| Class III- 40-50% ImpairmentFEV1, FVC, MMV | 55-70% of predicted
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| Class III- 40-50% ImpairmentART. O2 Sat | 88% or >at rest and after exercise
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| Class IV -60-90% ImpairmentRX | abnormal
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| Class III- 40-50% ImpairmentDyspnea | occurs climbing one flight of stairs or walking 100 yeards on level ground. Even at rest.
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| Class III- 40-50% ImpairmentFEV1, FCV, MMV | <55% of predicted
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| Class III- 40-50% ImpairmentArt. O2 sat | <88% rest and after exercise.
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| Manual secretion removal techniques | Postural drainage,percussion, vibration.
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| Airway clearance techniques | Cough, Huff, assisted cough,tracheal stimulation, endotracheal suction.
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| Independent secretionremoval | Active cycle of breathing, Autogenic drainage, The futter device.
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| Class IV- 60-90% ImpairmentRX | occurs on activ. like climbing one flight of stairs or walking 100 yards on level ground or even at rest.
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| Class IV- 60-90% ImpairmentFEV1, FCV, MMV | <55% of predicted
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| Class IV- 60-90% ImpairmentO2 Sat | <88% at rest and after exercise.
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| Breathing exercises | Diaphragmatic breathing, segmental breathing,Sustained maximal inhaled volume, pursed lip breathing,abs strengthening
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| Beta 2 agonists (sympathomimetics) | Ventolin, Alupent, Maxair and Albuterol
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| Beta 2 agonists (sympathomimetics)Action: | mimics the activity of sympathetic NS which will produce bronchodilatation. Increase HR and BP.
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| Anticholinergics Action: | inhibit the parasympathetic NS, can lead to increase in HR and BP. Drug: ATROVENT
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| Methylxanthines Action | Produce smooth muscle relaxation, limited use due to serious toxicityof Inc. BP, Inc. HR.
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| Anti-inflamatory agents: | used to decrease mucosal edema, decreaseinflamation and reduce air way reactivity.
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| Types of anti- inflammatory | Steroids, Leukotriene receptor Atagonist, Leukotriene receptor antagonist, cromolyn Sodium.
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| Steroids action: | used to maintenance of airway and should be taken regularly.
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| Side effects of systemic administration Steroids: | increase blood pressure, sodium rotation, muscle wasting,osteoporosis, GI irritation
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