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54/64 Unit 3 > COPD > Flashcards

COPD Flashcards

1
Q

Respiratory symptoms of Cor Pulmonale

A

Hypoxia and hypoxemia, increasing dyspnea, pulmonary hypertension, fatigue

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2
Q

Circulatory symptoms of Cor Pulmonale

A

Warm, cyanosis hands and feet with bounding pulses, cyanotic lips, distended neck veins, visible pulsations below the sternum, dependent edema

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3
Q

Cardiovascular symptoms of Cor Pulmonale

A

Right ventricular enlargement (hypertrophy)

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4
Q

GI symptoms of Cor Pulmonale

A

Enlarged and tender liver, nausea, anorexia

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5
Q

Acid base imbalances related to Cor Pulmonale

A

Metabolic and respiratory acidosis

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6
Q

What is the most common cause of Cor Pulmonale?

A

COPD

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7
Q

The severity of Cor Pulmonale is correlated with what three factors?

A

Magnitude of hypoxemia, hypercapnia, and airflow obstruction

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8
Q

Right-sided heart failure caused by pulmonary disease

A

Cor Pulmonale

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9
Q

What is the initial pathophysiologic event in the production of Cor Pulmonale?

A

An elevation of pulmonary vascular resistance

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10
Q

Low oxygen levels due to COPD that cause a rise in blood pressure in the arteries of the lungs

A

Pulmonary hypertension

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11
Q

Nursing interventions for COPD

A

Maintain airway, breathing techniques, position patient up and forward, ensure effective coughing, supplemental oxygen (if applicable), exercise conditioning, suctioning, hydration, use vibratory positive pressure device, medications, NUTRITION, monitor weight and prealbumin levels, discuss anxiety, assess and treat lung infections

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12
Q

COPD patient education

A

Avoid crowds; get pneumonia vaccine

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13
Q

A _________ test measures how much and how fast you can move air into and out of your lungs

A

Spirometry

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14
Q

Performing a spirometry test

A

Place clips over patient’s nose. Instruct the patient to place the mouthpiece in their mouth and form a tight seal with their lips. Have the patient breathe normally, then slowly blow out until their lungs are empty. Then, have the patient take a deep breath to fill their lungs completely and when their lungs are full, have them blow out as hard and as fast as they can until they are empty.

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15
Q

What helps distinguish airway disease (obstructive diseases) from interstitial lung disease (restrictive diseases)?

A

Airflow rates and lung volume measurements

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16
Q

What is performed before and after administration of bronchodilating agents to see how they work?

A

Pulmonary function tests (PFTs)

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17
Q

Lung volumes measured for COPD

A

Vital capacity, residual volume, forced expiratory volume, and total lung capacity

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18
Q

What lung volume is most affected in COPD with increases reflecting the trapped, stale air remaining in the lungs?

A

Residual volume

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19
Q

A diagnosis of COPD is based mostly on

A

Forced expiratory volume

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20
Q

Lung volume that measures how much air a person can exhale during a forced breath

A

Forced expiratory volume

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21
Q

The amount of air exhaled may be measured during

A

The first FEV1, second FEV2, and/or third seconds FEV3 of the forced breath

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22
Q

The total amount of air exhaled during the FEV (forced expiratory volume) test

A

Forced vital capacity (FVC)

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23
Q

As COPD progresses, the ratio of the forced expiratory volume in the first second compared to the fourth becomes __________

A

Smaller

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24
Q

GOLD 1: mild COPD

A

FEV1 over 80% of predicted

25
Q

GOLD 2: moderate COPD

A

FEV1 50-79% of predicted

26
Q

GOLD 3: severe COPD

A

FEV1 30-49% of predicted

27
Q

GOLD 4: very severe COPD

A

FEV1 less than 30% of predicted

28
Q

8-item test that includes severity indications (0-5 scale) based on symptom scores obtained from patient responses to COPD assessment test

A

CAT assessment

29
Q

Highest score on CAT assessment for COPD

A

40; the lower the score, the more severe the symptoms

30
Q

Assessment of symptoms/risk of COPD exacerbation

A

ABCD assessment tool

31
Q

A on ABCD assessment tool for COPD

A

Indicates low risk for exacerbation

32
Q

T or F: a patient with GOLD 4 COPD is at high risk for exacerbation

A

FALSE; GOLD simply measures severity of COPD, but severity is not correlated with risk for exacerbation (measured through ABCD tool). So a patient can be classified as GOLD 4, but have an A (low-risk for exacerbation) designation

33
Q

D on ABCD assessment tool for COPD

A

Indicated high risk for exacerbation and need for hospitalization

34
Q

Scale used to assess the degree of baseline functional disability due to dyspnea (grade 0-4)

A

Modified MRC dyspnea scale (mMRC)

35
Q

An airway clearance device used to clear airway secretions by which the patient blows air into a vibrating tube (which can be set on different resistance settings) until the they feel the need to cough and clear

A

Acapella; flutter is very similar to acapella

36
Q

What can cause hyperinflated lungs?

A

Blockages in the air passages or air sacs that are less elastic

37
Q

Hyperinflated lungs are seen in patients with

A

COPD, emphysema

38
Q

Normal chest assessment

A

Thorax has an oval shape with an anterioposterior to transverse diameter of 1-1.5 or 5-7

39
Q

Barrel chest assessment

A

Equal anterioposterior transverse diameter; ribs are horizontal to compared to the normal downward slope

40
Q

Barrel chest is associated with what conditions?

A

COPD and severe asthma

41
Q

How many lobes make up the right and left lung?

A

Right has 3, left has 2

42
Q

Branches in the lungs that supply the lobes with independent supplies of air

A

Bronchi

43
Q

Air sacs that are responsible for crucial exchange of air

A

Alveoli

44
Q

The exchange of O2 and CO2 is known as

A

Respiration

45
Q

An umbrella term for a range of progressive lung diseases

A

COPD

46
Q

Chronic bronchitis and emphysema can both result in

A

COPD (a diagnosis of COPD means that you have one of these lung damaging diseases or symptoms of both)

47
Q

Long-term inflammation of the bronchioles that leads to mucus buildup along the lining resulting in narrowing of the tubes; mucus cannot be cleared due to damaged cilia

A

Chronic bronchitis

48
Q

The breakdown of the walls of the alveoli at the end of the bronchial tubes at the bottom of the lungs

A

Emphysema

49
Q

What is the difference between asthma and COPD?

A

COPD is chronic and progressive mainly caused by smoking, while asthma is often set off by an allergy

50
Q

Blue bloater (chronic bronchitis) S/S of COPD

A

Mucous, cyanosis, increased hemoglobin, respiratory acidosis, digital clubbing of fingers

51
Q

Pink puffer (pulmonary emphysema) S/S of COPD

A

Bullae, collapsed alveoli, hyperinflation, pursed lips, barrel chest, speaking in short jerky sentences

52
Q

Noninvasive positive pressure ventilation consisting of two pressures (inspiratory [IPAP] and expiratory [EPAP]) that prevents airway collapsing and helps get rid of CO2 and improve ventilation

A

BiPAP

53
Q

How often should BiPAP be checked/monitored?

A

Every 4 hours

54
Q

The number between IPAP and EPAP values

A

Pressure support (if patient has an IPAP of 10 and EPAP of 5, the pressure support is 5)

55
Q

The amount of time it takes for BiPAP to reach its peak flow

A

Rise time (increase rise time if patient is air hungry)

56
Q

What is the purpose of setting a rate on BiPAP?

A

To give the patient a boost/remind them to breathe. Minimum rate is 4 (meaning the machine will initiate a breath 4 times per minute)

57
Q

BiPAP Inspiratory times can be up to ___ seconds

A

2

58
Q

BiPAP expiratory times should be at least ___ times more than the inspiratory time

A

2

54/64 Unit 3 (8 decks)

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