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chap 29
Med surg obstructive pulmo disease
| Term | Definition |
|---|---|
| a1 antitrypsin deficiency (ATT) | a genetic risk factor that leads to COPD. It is an autosomal recessive disorder that may affect the lungs or liver, severe ATT deficiency leads to emphysema. Mutation in SERPINA 1 (chromo 14). s/s: lung/liver disease, onset btw 20-40yrs old, tx: prolastin |
| asthma | chronic inflammatory disorder of the airways, leads to recurrent episodes of wheezing, breathlessness, chest tightness, cough in early morning and night time. risk triggers: allergen inhalation, animal dander, pollens, air pollutants, fumes, cigarette |
| asthma s/s | wheezing, breathlessness, chest tightness, cough |
| bronchiectasis | characterized by permanent abnormal dilation of medium sized bronchi in either a localized or diffuse pattern. ability to clear mucus from the lungs is decreased and airflow is reduced. it is an obstructive lung disease. |
| bronchiectasis; cause, s/s, dx, tx | cause: bacterial infections of lung, tumor, s/s: recurrent cough with purulent sputum, hemoptysis, Dx: CXR, high resolution computed tomography (HRCT), tx: aimed at treating the flare-ups, abx, bronchodilators, mucolytics, hydration |
| chest physiotherapy (CPT) | primarily used for pts with excessive bronchial secretions who have difficulty clearing them (cystic fibrosis, bronchiectasis), position is determined by CXR and chest ausculatation |
| chronic obstructive pulmonary disease(COPD) | preventable & treatable disease characterized by chronic airflow limitation that is not fully reversible. airflow limitation is progressive 2 types chronic bronchitis & emphysema main cause is smoking |
| COPD s/s | develop slowly, by age 50 with cigarette smoking, cough, sputum production, dyspnea, in late stages; dyspnea @ rest, chest breathing wheezing, wt loss, anorexia, fatigue, decrease breath sounds, cyanosis, hypoxemia, |
| COPD dx | PFT, CXR, serum a1 antitrypsin level, 6 min walk test, |
| COPD tx | bronchodilators, B2 adrenergic agonists, anticholinergic agents and methylxanthines, breathing training (pursed lip breathing), CPT, postural drainage |
| COPD, nsg assmnt | s: med hx (smoking, exposure to pollutants) O: debilation, restlessness, assumption of upright position, cyanosis, poor skin turgor, shallow breathing, pursed lip breathing, rhonchi, crackles, decrease breath sounds, edema of lower ext, barrel chest |
| cor pulmonale | n complication of COPD occurs when pulmonary HTN progresses & leads to hypertrophy of right ventricle of the heart with or without right sided heart failure |
| cystic fibrosis | autosomal recessive multisystem disease characterized by altered function of the exocrine glands, (pancreas, sweat glands), abnormally thick abundant secretions, end stage lung disease is main cause of death |
| cystic fibrosis s/s | finding of meconium ileus in newborn, failure to grow, clubbing, persistent cough with mucus production, tachypnea, large frequent stools, salty skin, |
| cystic fibrosis dx | labs, genetic tests, Gold standard dx test is the sweat chloride test, value of 60mmol/L is indicative of CF, ABG, PFT |
| cystic fibrosis nsg assmt | S: hx (recurrent resp infections, cough, meds, nutrition, activity, elimination), O: restlessness, failure to thrive, cyanosis, clubbing, salty skin, scleral icterus, sinu |
| emphysema (complication of COPD) | abnormal permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls & without obvios fibrosis |
| O2 toxicity | due 2 prolonged exposure to high level of O2 (PaO2). development is rare, it's determined by pt tolerance, exposure time & effective dose. High concentrations of O2 can lead to severe inflammatory response, O2 should only be enough to maintain PaO2 WNL |
| postural drainage | use of positioning technique that drain secretions from specific segments of the lungs & bronchi into the trachea. position depends on area of lung involved, this is determined by CXR and chest auscultation |
| Pursed lip breathing | used for clients with a history of COPD, asthma & tx of asthma. used to slow expiration and decrease dyspnea, 2:4, inhale for 2 secs & exhale for 4 secs |
Created by:
cheychey26
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