109: U4: Noninfectious Resp Disorders Flashcards Preview

109: U4: Chronic Resp Disorders > 109: U4: Noninfectious Resp Disorders > Flashcards

Flashcards in 109: U4: Noninfectious Resp Disorders Deck (16):
1

Cystic Fibrosis Definition

A disorder of blocked chloride transport in cell membranes causing thick mucus that plugs up the lungs, pancreas, liver, salivary glands, and testes.

2

Cystic Fibrosis Etiology

Genetic - autosomal recessive

3

Cystic Fibrosis Pathophysiology

THICK MUCUS PLUGS UP GLANDS and causes glandular atrophy and organ dysfunction.

4

Cystic Fibrosis S/S (early)

Failure to grow
Clubbing
Cough
Large, bulky BMs
Large abdomen

5

Cystic Fibrosis S/S (late)

Increase sweat chloride test (Na excretion through skin)
Chest congestion, cough, sputum
Frequent URT infections
Decreased PFTs
Abdominal distention, GERD, rectal prolapse, foul stools, steatorrhea
Malnourished with vitamin deficiencies
DM (over time): pancreas becomes fibrotic.

6

Cystic Fibrosis Collaborative Treatment

Chest PT, Vest, PEP device (positive expiratory pressure)
Huff coughing
Meds: Abx (if pneumonia), Bronchodilators, Mucolytics, Hypertonic saline (helps get mucus out).
Fat soluble vitamins (A, D, E, K)
Pancreatic enzymes (give with meals)
Diet: low fat, high sodium, high calorie, high protein.
Pulmozyme: decreases viscosity of sputum (to increase airflow)
Exercise: aerobic helps with airway clearance
Goals of therapy: *promote airway clearance*, increase oxygenation, promote good nutrition.

7

Lung Cancer Definition

Tumor in the lungs. 28% of all cancer deaths. The 5yr survival rate is 15%. Lung cancer is the leading cause of death in men.

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Lung Cancer Etiology

Smoking 80-90%
Exposure to other carcinogens (espestos)

9

Lung Cancer Pathophysiology

90% arise from bronchial epithelium.
Classified according to histologic cell type: small cell (more aggressive & spreads faster) and non-small cell.
Metastasize by direct extension, through blood or by lymph. Can move right through tissue, lymph, or blood (or to spine)..

10

Lung Cancer S/S

Hard to detect! Often late & nonspecific sx.
Hoarseness, cough, sputum, blood tinged sputum, hemoptysis (rare), wheezing, anorexia, fatigue, weight loss.
Pain: chest, arm, shoulder.
Pneumonis, bronchitis, pleural effusion (2ndary to lung CA).
Weight loss, clubbing.
Sx r/t mets - vomiting, anorexia, hoarseness (if spread to laryngeal nerve), paralysis of diaphragm. Confusion (=mets to the brain).

11

Lung Cancer Collaborative Treatment

Radiation, Chemo, Surgery
Treatment depends on metastasis (liver and brain are the main places it spreads).
Prophylactic cranial radiation.
Bronchoscopic laser therapy.
Cryotherapy
Airway stent.
Photodynamic therapy.
Focus on risk factors and recognizing s/s.
Prevention is key! 80% of the time, it has already spread by the time it is caught.

12

Sleep Apnea Definition

A breathing disruption during sleep that lasts at least 20 seconds and occurs a minimum of 10x/hour with O2 sats <90%.

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Sleep Apnea Etiology

Increased airway obstruction by soft palate or tongue (most common).
Neurologic or Central origin.
Obesity, large uvula, large neck circumference, enlarged tonsils, edema, smoking, craniofacial abnormalities.

14

Sleep Apnea Pathothysiology

Skeletal muscles relax -> tongue and soft palate displaced -> increased airway obstruction -> increased CO2 and decreased pH & paO2 -> sleeper aroused and corrects obstruction (startle, snort, gasp) -> respiration resumes -> cycle repeats.

15

Sleep Apnea S/S

Daytime sleepiness (fatigued all the time)
Irritability, mood and personality changes
Snoring (partner will complain)
Driving accidents
Morning headache (d/t increased CO2 level)
HTN
Frequent awakening (unaware of it)
Witnessed apnea
Muscle pain
Diagnosed with a sleep study at a center

16

Sleep Apnea Collaborative Treatment

Change sleeping position (side is better)
No sedatives or ETOH before bed
CPAP/BiPAP (increases pressure with inspiration to keep airway open)
Surgery: tonsillectomy/adenoidectomy/uvulectomy.
Oral appliances (similar to jaw thrust maneuver)
Weight loss