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chap 29

Med surg obstructive pulmo disease

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