Care of Patients With Noninfectious lower respiratory problems Flashcards Preview

Nursing 202 > Care of Patients With Noninfectious lower respiratory problems > Flashcards

Flashcards in Care of Patients With Noninfectious lower respiratory problems Deck (23)
1

Asthma Risk Factors:

-Inherited Disorder
-Environmental Factors: Viral infection, Allergens, pollutants
-Excitatory States: Stress, Laughing, Crying
-Aspirin & NSAIDS
-GERD
-Exercise, changes in temperature, strong odors

2

Asthma Pathophysiology: Early Phase

Shortness of breath, chest tightness, wheezing

3

Asthma Pathophysiology: Immune Activation

IgE, Mast cells, chemical mediators

4

Asthma Pathophysiology: Vasodilation

Edema in airway, attempt to dilute the allergen

5

Asthma Pathophysiology: Bronchospasm

narrowing of bronchial tubes by constriction of the smooth muscle around and within the bronchial walls

6

Asthma Pathophysiology also includes Late Phase

Bronchial Hyperresponsiveness, cyanosis (late sign)

7

Asthma Clinical Manifestations

Cough
Wheezing
Chest tightness
Dyspnea
Nasal flaring
Use of accessory muscles
Cyanosis

8

Nursing Interventions

Auscultate breath sounds
Monitor respiratory pattern
Monitor oxygen saturation
Elevate head of bed
Deep breathe
Activity
Encourage fluid intake

9

Asthma Treatment

Inhaled Beta2 agonists
Corticosteroids
Anticholinergics
Mast cell stabilizers
Leukotriene modifiers
Oxygen

10

Chronic Obstructive Bronchitis Risk Factors

Chronic productive cough
Smoking
Exposure to air pollution
Older adults
Repeated infections

11

Chronic Bronchitis Pathophysiology:

Irritant triggers:
-Inflammation of airway
-Infiltration of inflammatory cells
-Continuous irritation and inflammation
-Bronchial edema
-Hypersecretion of mucus
-Bacterial colonization
-Airway obstruction: not alveoli
-Air trapping

12

Chronic Bronchitis Clinical Manifestations:

Acute versus Chronic
Productive cough “smoker’s cough”
Decrease exercise tolerance
Wheezing
Shortness of breath
Prolonged expiration

13

Emphysema Risk Factors

Cigarette smoking
Alpha1-antitrypsin deficiency
Air pollution
Occupational chemicals or dust

14

Emphysema Pathophysiology:

Irritant or Alpha 1 antitrypsin deficiency triggers:
-Inflammation of airway
-Infiltration of inflammatory cells: Inhibition of normal endogenous antiproteases
-Increased protease activity
-Destruction of alveolar septa: Loss of elastic recoil
-Blebs
-Bullae
-Air trapping

15

Emphysema Clinical Manifestations:

-Dyspnea on exertion
-Dyspnea at rest
-Anteroposterior diameter of chest enlarges
-Chest hyperresonant sound with percussion
-Cyanosis lips
-Neck vein distention
-Pitting peripheral edema

16

Chronic Obstruction Pulmonary Disease(COPD) Risk factors:

-Primary risk factor = SMOKING
-Air pollution
-Second-hand smoke
-History of childhood respiratory tract infections
-Hereditary

17

COPD stimulates

excessive mucus production

18

COPD causes

-Cough
-Destroy ciliary function
-Inflammation
-Damage to bronchiolar and alveolar walls
-Increased airway resistance secondary to bronchial mucosal edema
-Decreased elastic recoil

19

COPD manifestations:

Easily fatigued
Frequent Respiratory Infections
Use of Accessory to Breathe
Orthopneic
Cor Pulmonale (late in disease)
Thin in appearance
Wheezing
Pursed lip breathing
Chronic cough
Dyspnea
Prolonged expiratory time
Bronchitis - increased sputum
Digital clubbing

20

Laboratory assessments for all these diseases:

-Arterial Blood Gas (ABG):
Identify abnormal gas exchange, oxygenation, ventilation & acid-base status
-Sputum & WBC:
Acute respiratory infection
-Hemoglobin & hematocrit:
polycythemia
-Electrolytes:
acidosis

21

Diagnostics:

-Chest x-ray:
Rule out lung disease
Check progress of infection or chronic disease
Emphysema – hyperinflation & flattened diaphragm
-Pulmonary Function Test:
Determines lung flow volumes

22

Medications For Treatment of COPD:

-Bronchodilator:
Beta2-agonists (albuterol/ Proventil)
Adrenergic (salmeterol/ Serevent)
Leukotriene antagonist (montelukast/ Singulair)
-Anticholinergic:
Ipratropium bromide (Atrovent)
-Methylxanthines:
Theophylline, Aminophylline
-Corticosteroid:
(fluticasone/ Flovent)
-Glucocorticosteroids:
Prednisone (prednisone/ Deltasone)

23

Other Therapies for COPD

Long term oxygen therapy
Pulmonary hygiene
Deep venous thrombosis
Influenza vaccine
Pneumococcal vaccine
Exercise
Smoking Cessation
Nutrition