Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
375 Exam 1
COPD, Pulmonary Hypertension
| Term | Definition |
|---|---|
| high CO2 | hypercapnic, give a bipap |
| copd exacerbation | avoid opioids (lead to less ventilation), no benzodiazepines |
| copd diet teaching | diet, oral hygiene before meals, small frequent meals, high calories and protein, avoid exercise 1 hour before and after meals, avoid gassy foods and carbonation, avoid high fiber (causing bloating and more pressure0 |
| fluid copd teaching | increase fluid intake to thin mucus, avoid drinking fluids while eating |
| infection copd teaching | report increase in sputum, fever and worsened dyspnea |
| meds copd teaching | albuterol used for shortness of breath |
| pursed lip breathing | inhale for 2 seconds, exhale 4 seconds with pursed lips; helps decrease shortness of breath, prevents air way collapse and airway trapping |
| huff coughing | cough out thick mucus; sit upright in chair, feet shoulder width, lean forward, deep slow inhalation through mouth and diaphragm muscle, hold breath 2 -3 seconds and forcefully exhale, repeat once or twice to clear |
| chronic bronchitis | daily productive cough for three months or more in at least two consecutive years, damaging to the airways |
| bronchitis manifestations | overweight and cyanotic, elevated hemoglobin, peripheral edema, rhonchi and wheezing |
| emphysema | permanent enlargement and destruction of airspaces distal to the terminal bronchiole |
| emphysema manifestations | older and thin, severe dyspnea, quiet chest |
| copd manifestations | underweight, dyspnea on exertion, SOB, progressive cough and sputum, air hunger, tripod position and barrel chest |
| diagnosis copd | pulmonary function's test, chest xray, test cat, echo |
| forced vital capacity (FVC) | maximum volume of air that can be forcibly expired (3 seconds) |
| forced expiratory volume in 1 second (FEV1) | volume of air that can be expired in the first second of a forced expiration, 70% or above |
| increased residual volume copd | air left in the lungs after forced exhalation |
| spirometry | confirms presence of airflow obstruction |
| copd alterations in ABG | decreased O2, increased CO2, decreased pH, increased HCO3 |
| 6 minute walk test | measures distance an individual is able to walk over a total of 6 minutes, self paced, exercise is a predictor of risk for mortality, can determine functional status and response to treatment |
| risk modification copd | smoking cessation, hand washing, avoid irritants, vaccines, Tdap vaccination |
| bronchodilators | preferred to improve ventilation, decrease dyspnea and increase FEV |
| SABA | short acting bronchodilator agonist - rescue inhaler; albuterol, makes you anxious |
| LABA | long acting bronchodilator agonist, maintenance inhaler; salmeterol |
| anticholinergic, muscarinic | block acetylcholine, decrease mucus production (end in ium) |
| SAMA | short acting muscarinic antagonist; ipratropium |
| LAMA | long acting muscarinic antagonist; tiotripium |
| corticosteroids | decrease inflammation, inhalers are used in a stepwise approach; SABA, LABA, SAMA, LAMA, corticosteroid then combination inhaler |
| phosphodiesterase inhibitor | for severe copd and chronic bronchitis; roflumilast |
| long term o2 therapy improves | survival, exercise capacity, cognitive performance, sleep |
| nasal cannula | patient's can eat, talk and cough; most common and comfortable |
| simple face mask | low flow system, delivers 5 - 8L/min = 40 - 60% fiO2 depending on fit and oxygen flow; never run at less than 5LPM or CO2 may buildup in mask; must remove to eat and oral care |
| non rebreather | valves going to the reservoir bag prevent CO2 being re inhaled, highest FiO2 without becoming invasive (intubation) |
| venturi mask | delivers precise amount of oxygen by use of adapters or dial selector making it most accurate non invasive method; liter flow as indicated on the dial or adapter, no humidification necessary |
| goal of pursed breathing | prolong exhalation and increase airway pressure during expiration; improves oxygen transport; do not puff cheeks |
| airway clearance technique | loosen mucus and secretions to be cleared by coughing, huff coughing |
| chest physiotherapy | postural drainage (2-4 x/day), percussion, vibration |
| copd malnutrition | increased metabolic rate, lack of appetite, altered taste, weight loss |
| goals for copd | reduce symptoms, reduce risk, prevent progression |
| lung volume reduction surgery (LVRS) | reduce size of hyper inflated lungs, decrease airway obstruction and increase room for normal alveoli |
| bronchoscopy lung volume reduction surgery | valves used for endoscopic lung volume reduction; removable one way flow devices placed by flexible bronchoscopy into selected airways supplying emphysematous lung |
| pulmonary hypertension | elevated pulmonary arterial pressure from a increase in resistance to blood flow through the pulmonary circulation |
| normal pulmonary pressure | 12 - 16 mmHg |
| risk factors for pulmonary hypertension | 30 - 60 years of age, higher among women, history of blood clots, diseases that change the chest wall, hepatitis b or c, liver disease and thyroid disease |
| idiopathic PAH | cause unknown, injury to endothelium leads to vascular scarring, smooth muscle proliferation and endothelial dysfunction |
| manifestations of idiopathic | dyspnea on exertion, fatigue, exertional chest pain, dizziness; with progression abnormal s3 heart sound or ventricular gallop |
| secondary pulmonary hypertension | chronic increase in artery pressures from another disease |
| assessment findings secondary PAH | RV hypertrophy, s4 or atrial gallop, peripheral edema, increased peripheral venous pressure, hepatomegaly because the portal vein is unable to circulate |
| chest x ray PAH | visualize pulmonary system, hypertrophy of heart; reveals no vasculature, this is to rule out other disease process and see enlargement of the heart |
| BNP | hormone, an increase reflects heart failure |
| transthoracic echocardiogram (TTE) | ultrasound looks at blood flow and measures pressures in the heart; mean pulmonary artery pressure; will report ejection fraction - normal 55 - 70% |
| pulmonary functions test | look for other underlying conditions, COPD, pulmonary fibrosis |
| right heart catheterization | accurate measurement of right atrial pulmonary artery pressure, cardiac output and pulmonary vascular resistance |
| cath procedure | catheter is placed in the femoral, internal jugular or subclavian veins and advances into the vena cava into the right atrium; balloon is inflated on the tip of the catheter and wedges in the pulmonary artery |
| calcium channel blockers for PAH | cause blood vessels to relax and widen, lowers artery pressure - dilitazem or amlodipine |
| CCB teach | count HR and check BP, change position slowly, bad headaches because blood vessels in the brain vasodilate |
| endothelin receptor antagonists PAH | block the constriction of pulmonary arteries, relaxing and decreasing the pressure; need to monitor LFT; bosentan |
| phosphodiesterase inhibitors PAH | promote smooth muscle relaxation in lung vasculature; side effects of hypotension and bradycardia; sildenafil |
| inhaled vasodilators PAH | dilates systemic and pulmonary arterial vasculature; nebulizer 6 - 9 days; need to check BP; iloprost |
| parenteral vasodilators PAH | reduces pulmonary vascular resistance, continuous IV or subcutaneous, short half life; education is essential; epoprostenol |
| diuretics PAH | used to manage peripheral edema |
| anticoagulants PAH | prevent thrombus formation; patients are at risk for blood clots in the small arteries in the lungs |
| pulmonary thromboendarterectomy | removes clots from the pulmonary arteries |
Created by:
ahommel
Popular Nursing sets