Pulm Management Flashcards
what is obstructive lung disease
decreased airway lumen thus increasing resistance to expiratory airflow
what is the result of obstructive lung disease
increased dead space and decreased surface area for gas exchange
how does lung function change in obstructive disease (2)
- hyperinflation
2. decreased oxygenation
how do lung volume values change in obstructive disease
- TLC elevated
- FRC elevated
- RV elevated
what are the five obstructive lung pathologies
asthma, chronic bronchitis, emphysema, CF, bronchiectasis
what is the primary symptom of obstructive lung disease
dyspnea on exertion
how does FEV1 change in obstructive lung
> 2 L = little/no obstruction
1-2 L = mild/mod obstruction
< 1 L = severe obstruction
how does FVC change in obstructive lung
reduced
how does FEV1/FVC change in obstructive lung
ratio decreases as severity increases (normal is 75%)
what is the pathophys of COPD
destruction of lung parenchyma due to inflammatory processes leading to loss of alveolar attachments and decreased elasticity
describe a COPD’s patients drive to breathe
normal people are CO2 driven, but chronically elevated CO2 levels in COPD patients create an O2 drive. Therefore if O2 gets too low, pts are stimulated to breathe
what happens if you give long term oxygen to a COPD patient?
since they are O2 driven, when they receive enough O2 their brain will tell them to stop breathing
what is emphysema
abnormal and permanent enlargement of the airspaces distal to the terminal bronchiole accompanied by destruction of the alveolar walls
what is chronic bronchitis
presense of productive cough most days for 3 months during 2 consecutive years when other causes of chronic mucus have been ruled out
what are 6 clinical manifestations of pulmonary disease
- chronic cough
- excess sputum
- dyspnea on exertion
- increased accessory muscle use
- early AM headaches
- postural deficits
how can a cxr determine copd
depressed diaphragm and hyperinflation
what does an ABG say about copd
dec PO2 and inc PCO2
____ is indicative of significant obstruction during auscultation of lungs
> 4s
what are three bronchodilators
anticholinergics, beta2agonists, and methyxanthines
what is a type of anti-inflammatory used for lungs
inhaled corticosteroids
long term admin of O2 (>15 hours per day) to pts with chronic respiratory failure has been shown to increase survival, but only if they fit what criteria?
PO2 < 55 (SaO2 < 88%)
T/F: a patient should use a bronchodilator before initiating PT
true: for patients who need it, it may enhance exercise tolerance
T/F: patients should exercise on less oxygen than they use at rest
false
on a borg 10 dyspnea scale, how should you aerobically exercise your COPD patients?
3 max for inpatient, 6 max for outpatient
