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