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Acute Diseases and Chronic Obstructive and Restrictive Diseases

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