chronic obstructive pulmonary disease

Question 1

what is COPD?

Answer 1

• narrowed bronchioles blocked with mucus
• causes disruptions to the airway and breathing difficulties

Question 2

what does COPD result in?

Answer 2

• emphysema

Question 3

what are the 4 problems of breathing in COPD?

Answer 3

• hypoxia
• increased WOB
• ineffective airway clearance
• increased sputum production

Question 4

what are the 3 main symptoms of COPD?

Answer 4

• dyspnoea
• wheeze, recurrent cough and LRTI
• history of risk factors

Question 5

what is dyspnoea?

Answer 5

• shortness of breath

Question 6

what is the time frame of dyspnoea? when it is worse?

Answer 6

• progressive over time
• persistent
• worse on exercise

Question 7

what does LRTI stand for?

Answer 7

• lower respiratory tract infection

Question 8

what is the wheeze and recurrent cough described as?

Answer 8

• intermittent
• unproductive

Question 9

what are the risk factors of COPD?

Answer 9

• smoke (tobacco or home cooking/ heated fuels)
• occupational dusts/ fumes
• host factors e.g., genetic, developmental abnormalities, low birthweight, prematurity, childhood RI

Question 10

what is exacerbation?

Answer 10

• event characterised by dyspnoea and/ or cough and sputum that worsens over 14 days

Question 11

what may the dyspnoea and/ or cough and sputum be accompanied by in exacerbation?

Answer 11

• tachypnoea and/ or tachycardia

Question 12

what is tachypnoea?

Answer 12

• abnormally rapid breathing

Question 13

what is tachycardia?

Answer 13

• increased heart rate

Question 14

what is exacerbation associated with regarding inflammation?

Answer 14

• increased local and systemic inflammation
• caused by airway infection, pollution or other insult to the airways

Question 15

how do you measure exacerbation?

Answer 15

• VAS scale used
  0-10

Question 16

how is exacerbation categorised?

Answer 16

• mild
• moderate
• severe

Question 17

what are the key signs of COPD?

Answer 17

• sputum volume and colour
• respiratory distress (accessory muscle use)

Question 18

how do you evaluate severity of COPD symptoms?

Answer 18

• use appropriate additional investigations e.g., pulse oximetry, laboratory assessment, and CRP and/ or arterial blood gases

Question 19

what should you establish lastly in the diagnostic approach of COPD?

Answer 19

• establish cause of event

Question 20

what are the main three cause of events of COPD?

Answer 20

• viral
• bacterial
• environmental

Question 21

what should you give a hypoxic patient?

Answer 21

• immediately give them oxygen
• as they can die from lack of oxygen

Question 22

what is a humidified circuit?

Answer 22

• delivers water so the regulatory system isn’t dry and hence mucus is less likely to get stuck

Question 23

what is the purpose of the nebuliser attachment?

Answer 23

• can deliver liquid form of drugs

Question 24

what do different adaptors on the oxygen machine represent? what group of people is this especially important for?

Answer 24

• represent different percentages of oxygen
• ensures we can control the flow
• important specific flow rate for stroke patients

Question 25

how much oxygen does a normal breath bag deliver?

Answer 25

- delivers 15litres of oxygen per minute

Question 26

what percentage of oxygen does a normal oxygen bag give patients?

Answer 26

- 98% of oxygen

Question 27

what is the problem with the normal breath bag? what does this mean?

Answer 27

- dry circuit - important to move acute patients on

Question 28

what are COPD patients more prone to obtaining? what does this cause the body to do?

Answer 28

- high carbon dioxide - prolonged period of high C02 concentration means the body adapts

Question 29

what happens if a COPD patient is given too much oxygen?

Answer 29

- might knock off respiratory drive

Question 30

what type of oxygen is given to COPD patients?

Answer 30

- dry air

Question 31

what is the respiratory management for increased secretion load/ ineffective airway clearance? what does it do?

Answer 31

- active cycle of breathing technique - moves the secretions from the lower airway to the higher airway

Question 32

what are the active cycle of breathing steps?

Answer 32

- breathing control for 20-30 seconds - 3/4 deep breaths - breathing control - 3/4 deep breaths - breathing control - huffing followed by cough if needed

Question 33

what are the four types of respiratory managements?

Answer 33

- suction - airobika - acapella - nasopharyngeal suction

Question 34

what type of devices are acapella and airobika?

Answer 34

- oscillatory devices

Question 35

what do acapella and airobika help split?

Answer 35

- help split the airways open - send vibrations into the airways to help move secretions up

Question 36

what is an example of a suction machine?

Answer 36

- endotracheal tube

Question 37

what are the two different ways a nasopharyngeal suction can be used?

Answer 37

- orally - nasally

Question 38

what is a barrel chest?

Answer 38

- ribs up and stiff - flattened diaphragm (hasn't got far to go to increase volume so want to make more dome shape)

Question 39

what is the respiratory management of increased work of breathing?

Answer 39

- forward lean position - abdominal contents push up on diaphragm to aid dome shape - more movement produced and bigger change in volume

Question 40

what should you fixate in the forward lean position? what does this prevent?

Answer 40

- fixate the arms to help the accessory muscles - prevents the muscles becoming fatigued