respiratory Flashcards
(37 cards)
What is the pathophysiology of Chronic Bronchitis?
Chronic inflammation; lots of mucus in the bronchi
swelling of the bronchi
What is the pathophysiology of Asthma?
lumen/bronchioles gets smaller (react to something in the air), wheezing will occur
bronchi constricts; narrow; wheezes
can be triggered by cold; activity
childhood; inflammatory response
What is the pathophysiology of Emphysema ?
Emphysema- loss of long elasticity due to hyperinflation of the lung. High protease levels cause alveolar damage and elastin breakdown. Air trapping occurs which causes barrel chest.
Explain the rationale for the VS and assessment data in a patient with COPD:
Temperature
Due to pneumonia the body works harder and is more sceptible to infection
Body is fighting infection. Patient’s with COPD higher risk for respiratory infection
Explain the rationale for the VS and assessment data in a patient with COPD:
Pulse
Heart is working harder at rest and in general to maintain adequate oxygen perfusion
dysrhythmias develop
increased pulse due to strain and body working harder.
Explain the rationale for the VS and assessment data in a patient with COPD:
Respiration
increased respiration rate because you have to work harder to breathe;
Can inhale; but difficulty exhaling
Explain the rationale for the VS and assessment data in a patient with COPD:
Blood Pressure
increased workload on the heart to get the same amount of oxygen and blood to the tissues
increased pressure in lungs and pressure on the heart which makes it harder to work
Explain the rationale for the VS and assessment data in a patient with COPD:
Oxygen Saturation
decrease in the oxygen attached to hemoglobin in the blood which decreases the pulse ox measurement; r/t patient difficulty breathing and attaining enough oxygen
Explain the rationale for the VS and assessment data in a patient with COPD:
Anxiety
Anxiety is a physiological response to the stress of breathing and harder workload to support body systems.
patient is not able to breathe so their anxiety is increased
Explain the rationale for the VS and assessment data in a patient with COPD:
Cachexia
Wasting and weakness of the body
r/t lack of oxygen and nutrients to the body systems
due to a lifelong disease affecting respiratory system
Explain the rationale for the VS and assessment data in a patient with COPD:
Dyspnea
difficulty breathing b/c alveoli are enlarged with trapped air; bronchioles harded and loose elasticity
due to not letting all of air out of lungs and not able to breathe
Explain the rationale for the VS and assessment data in a patient with COPD:
Sputum
Lots of thick, yellow sputum which coats the airways and decreases the elasticity of bronchioles; makes difficult to breathe
also difficult to get air out of the lungs
What are some assessments the nurse may find for a patient that is admitted to the hospital with COPD?
wheezes because of decreased bronchi
diminished lung sounds
enlarged neck muscles - using accessory muscles
tripod position-expand lung capacity
barrel chest
nonproductive cough
pursed lip breathing
thin r/t decreased appetite- too hard because their SOB, and increased work of breathing
clubbing (from long term hypoxia)
delayed cap refill
cyanotic and dark blue/red color because they are overproducing RBC’s (polycythemia) so increased hematocrit
chronic loose productive cough
dyspnea with exertion
lengthened expiratory phase of resp. cycle
What is air-trapping?
What does it do to a patients resp. status?
Air trapping is the retention of air in the lungs;
difficult to exhale all the way
caused by emphysema
Breathing in is normal but you can’t exhale all the way because its so inflamed that you can’t get all the air out. The alveoli has a loss of elasticity from bronchial irritants causing inflammation that restricts the airflow causing the air to become trapped. they can’t get rid of their CO2
In relation to the air trapping- a patient may have a barrel chest, why?
B/c the patient is trying to inhale; your ribs are pushed outwards and the air is trapped inside instead of being exhaled.
What is pursed-lip breathing and how would you explain to the pt how to do this?
Helps to get oxygen out of lungs
breathing in through your nose for 2-3 seconds and exhaling like you’re breathing through a straw for 4-7seconds
focus shifts to diaphragm and abdominal muscles
shortened inspiratory phase and prolonged expiratory phase
Why would bronchodilators be used to treating puts with COPD? What instructions would you give the patient on proper use?
Helps to relax smooth muscle
most common=albuterol
Trigger as you inhale Shake before use, exhale before you inhale, Can use a spacer Clean Mouth piece each use Oral Care after to avoid Thrush Wait 1 minute between puffs Carry with you at all times
common side effects of bronchodilators
Diarrhea, Stomach ache, Headache, Tachycardia, Muscle cramps, N/V
When assessing a patient with respiratory disease, the nurse evaluates a reading from the pulse oximeter.
What does an oximeter measure?
Identify ranges of oxygen saturation
Measures the amount oxygen attached to hemoglobin in the blood.
Normal: 95-100%
Low: <90%
COPD: 88-90% (will be lower as the disease progresses)
What are some important nursing considerations when administering oxygen to a patient with COPD?
Find the patient’s normal oxygen saturation level
Increase oxygen SLOWLY (CAUTION MAY STOP BREATHING)
Watch for skin breakdown
People with COPD normally have a lower oxygen, higher CO2 level
Start off slow: 1.. move to 2.. etc, don’t give them too much-will make them stop breathing
Would a patient with COPD normally have respiratory acidosis or respiratory alkalosis? What is your rationale?
respiratory acidosis
Retaining CO2
Your patient asks you if there are any dietary considerations to consider since they have been recently diagnosed with Emphysema. What are some nutritional restrictions or implications to discuss with your patient?
no carbonated drinks-gas-because it fills them up quick rest periods small frequent meals easily to chew foods high nutrient density high protein foods increase calories high fat low carb - prevent CO2 excess in the body after carb breakdown balance fluids vs nutrients
You notice that the client has a box of dark chocolate at his bedside and he informs you that he eats 4-5 pieces when he wakes up during the night. What is the basis for this craving?
This person is probably craving the caffeine that is in chocolate.
Caffeine is a natural bronchodilator, although it is a weak one, it helps them breath easier.
What assessments would the nurse would expect to find in a patient with acute respiratory distress vs COPD?
ARD-cyanosis, SOB, increased inspiration phase, anxiety, diaphoretic, decreased O2; lethargy; hyperkalemia ; twitchy; inspire=expire
COPD-clubbing, increased access muscle, barrel chest, cyanotic, increased expiration phase, increased CO2 (LESS SEVERE S/S)
