COPD

Question 1

What are common obstructive lung diseases

Answer 1

Asthma
Emphysema also known as COPD
Chronic bronchitis

Question 2

In COPD/Emphysema airflow limitation is not fully what

Answer 2

Reversible

Question 3

COPD is a generally ___ disease

Answer 3

Progressive

Question 4

COPD/Emphysema is an

Answer 4

Abnormal inflammatory response of lungs to noxious particles or gases

Question 5

COPD/emphysema symps occur in the what adult years

Answer 5

Middle adult years

Question 6

COPD/emphysema incidence increase with ___

Answer 6

Age

Question 7

What is COPD often used to describe in the medical field

Answer 7

Emphysema

Question 8

A person with emphysema retain

Answer 8

Co2

Question 9

How will an emphysema pt look (skin, breathing)

Answer 9

Co2 retention causes pink skin
Minimal cyanosis
Purse lip breathing
Dyspnea
Hyper resonance on chest percussion
Orthopneic
Barrel chest
Exertional dyspnea
Prolonged expiratory time
Speaks in short jerky sentences
Anxious
Uses of accessory muscles to breathe
Thin appearance

Question 10

What are s/s of emphysema

Answer 10

Tachypnea
Dyspnea on exertion
Barrel chest
Prolonged expiration and grunting
Decreased breath sounds
Hyper resonance
Clubbing of fingers and toes
Decrease chest expansion
Chronic cough w/ or w/out sputum production
Accessory muscle use
Mental status change

Question 11

Is emphysema damage reversible

Answer 11

No, it’s irreversible

Question 12

What are the risk factors for emphysema

Answer 12

Cigarette smoking
Occupational chemicals and dust
Air pollution
Infection
Heredity
Aging
Genetics

Question 13

How is an Emphysema pt officially diagnosed

Answer 13

Spirometry

Question 14

What does a spirometry test show

Answer 14

Shows how well you breathe in and out

Question 15

What other diagnosing test can diagnose emphysema besides spirometry testing

Answer 15

Chest x-ray
Pulmonary function test
ABG
CBC
EKG

Question 16

What is treatment for emphysema

Answer 16

Avoidance of smoke and air pollution
bronchodilators
Antibiotics
Flu vaccine
Pneumonia vaccine
Adequate hydration
Oxygen therapy for hypoxia
Mucolytics
Corticosteroids
Lung transplant
Diuretics for edema

Question 17

How does pursed lip breathing look

Answer 17

2 count in and 4 count out

Question 18

What should we teach our pts that have Emphysema

Answer 18

Instruct them to stop smoking or being around those that smoke
Importance of early medical treatment at the first signs of illness
May have to sleep semi-Fowler s
Instruct on the importance of oxygen if prescribed

Question 19

What should discharge planning should we consider for a pt with emphysema/COPD

Answer 19

Pulmonary rehab
Psychosocial consideration
Use bronchodilator first before other med
CM for O2, meds, home health
Stress importance of flu & pneumonia vaccine

Question 20

What are s/s of chronic bronchitis

Answer 20

Copious amnts of gray, white, or yellow sputum
Dyspnea & Tachypnea
Cyanosis
Use of accessory muscle
Pedal edema
Jugular vein distention
Wt gain due to edema
Wt loss due to difficulty eating & increased metabolic rate
Wheezing
Prolong expiratory time
Rhonic
Pulmonary hypertension

Question 21

What are risk factors for chronic bronchitis

Answer 21

Cigarette smoking
Exposure to irritants
Exposure to organic or inorganic dust
Exposures to noxious gases
Respiratory tract infection

Question 22

How do we diagnose chronic bronchitis

Answer 22

Presence of cough & sputum production for @ least 3 months for 2 consecutive years

Question 23

What are lab tests we can do to diagnose chronic bronchitis

Answer 23

CXR
PFTS
ABGs
Sputum
EKG
CBC

Question 24

What is the treatment of chronic bronchitis

Answer 24

Cease smoking
Avoidance of air pollutants
Antibiotics
Bronchodilators
Adequate hydration
Chest physiotherapy
Nebulizer treatment
Corticosteroids
diuretics
O2 therapy

Question 25

What should we teach our pts with chronic bronchitis

Answer 25

Instruct benefits of not smoking/being exposed to secondhand smoke Importance of early med treatment @ first sign of illness May have to sleep semi-Fowler s Instruct importance of prescribed o2

Question 26

What should we do with discharge planning for chronic bronchitis

Answer 26

Same as emphysema

Question 27

How do we teach a pt to use inhaler

Answer 27

Shake Exhale Press button and inhale Hold breathe for as long as able Then exhale If taking bronchodilator inhaler or any inhaler first then wait 1 min between taking med to take the next inhaler

Question 28

What is a really well known short actingbronchodilator

Answer 28

Albuterol

Question 29

How often should a pt take a short acting bronchodilator

Answer 29

2 inhalations every 4 hours PRN

Question 30

What are adverse affects of bronchodilators

Answer 30

Tachypnea Palpitations Chest pain Tremors HA Dizziness Nervousness Report s/s of hypokalemia/a fib Call dr if you require more frequent use of med

Question 31

What are anticholinergic names

Answer 31

Iratropium bromide atrovent

Question 32

Are anticholinergic long or short acting bronchodilators

Answer 32

Long

Question 33

What is methylanthie

Answer 33

A bronchodilator

Question 34

What are glucocorticoids

Answer 34

An anti-inflammatory

Question 35

What should we teach a pt taking a glucocorticoid inhaler

Answer 35

Rinse mouth with water after taking inhaler

Question 36

Why do they need to rise mouth out if taking glucocorticoid

Answer 36

To avoid a fungal infection (thrush)

Question 37

What is prednisone

Answer 37

It’s an oral steroid, immunosuppressant and anti inflammatory

Question 38

What should we take prednisone with

Answer 38

Food

Question 39

Why should we take prednisone with food

Answer 39

To avoid gi upset

Question 40

Should a pt stop taking prednisone abruptly

Answer 40

No

Question 41

Do we want to put pts on prednisone for immediate treatment

Answer 41

No, because there’s many side effects to prednisone

Question 42

What are adverse reactions to prednisone

Answer 42

HTN Osteoporosis Mood disturbances Poor wound healing Monitor b/p Monitor bs Avoid live vaccine Avoid contact w/ chickenpox or measles Watch for peptic ulcer disease Anxiety Depression Fluid retention

Question 43

What do leukotriene agonists help with

Answer 43

Respiratory inflammation

Question 44

What do leukotriene agonists prevent

Answer 44

Prevent airway edema

Question 45

What should we monitor when a pt is on leukotriene agonists

Answer 45

Monitor LFTs and blood chemistry

Question 46

What are adverse effects of leukotriene agonists

Answer 46

Mood disorders Cough

Question 47

Why do we need to teach pt to take leukotriene agonists to take the drug at night

Answer 47

Because drug may cause aggressive behavior