MS chapter 32
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Emphysema and chronic bronchitis result in irreversible and increasingly sever tissue damage. What are they termed?
COPD. Its is classified from mild to severe.
Type of COPD that involves the loss of lung elasticity and hyperinflation, causing dyspnea, increased respiratory rate, and eventually, cardiac failure
an inflammation of the bronchi and bronchioles caused by chronic exposure to irritants, especially tobacco smoke, triggering inflammation with vasodilation, congestion, mucosal edema, and bronchiospasm
COPD is characterized by what two manifestations?
Bronchospasm and dyspnea
What does a nurse need to know about Tissue damage regarding COPD?
Tissue damage is not reversible and increases in severity, eventually leading to respiratory failure (must know for test)
What do arterial blood gases identify ?
oxygenation, ventilation, and acid-base status
For a person with COPD, what may help with airway clearance?
careful use of drugs combined with controlled coughing, hydration, postural drainage, and flutter valve (mucous clearing device)
Intermittent and reversible airflow obstruction affecting only the airways, not the alveoli
Asthma. Can be reversed.
Asthma is classified into different two types based on triggering events, what are these types?
Infllammation and hyperresponsiveness.
this type of class of asthma occurs in response to specific allergens, general irritants (cold air), microorganisms or air born particles. These cause the lumen to become smaller
this type class of asthma is caused by excercise, URI, or small amounts of polluntants stimulatig nerve fibers causing obstucion of the airways by constricting bronchial smooth muscle causing a narrowing of the airway from the outside.
These can cause asthma by causing an increase production of leukotriene when they suppress othe inflammatory pathways.
Aspirin and other NSAIDs.
Inflammation in Asthma can be caused by an allergin binding to espcially this innunoglobulin?
immunoglobulin E (IgE)
a manifistation that can occur in asthma that involves the narrowing of the bronchial tubes through constriction of the smooth muscle around and within the bronchiole walls.
genetic variations in the gene that controls the synthesis and activity of beta adrenergic receptors impact what regarding asthma?
Who is more at risk for asthma, men or women?
Women have 35% more incidence than men
What happens to older adults regarding asthma that makes therapy harder to achieve.
Change in sensitivity of beta-adrenergic receptors. With sensitivity decreased, they no longer respond as quickly to therapy. Nurses role is to teach older pt how to prevent asthma attacks
what would the nurse expect to find in the history assessment for a pt with asthma?
difficulty breathing, chest tightness, coughing, wheezing
What are some clinical manifestations for a pt with asthma?
- audible wheeze and increased resp rate
- increased coiugh
- use of accessory muscles
- "Barrel chest"(long term side effect from air trapping)
- long breathing cycle
- increased resp rate
what should a normal Pao2 level lie between?
What should a normal Paco2 level lie between?
Arterial o2 level may _____ in an acute asthma attack?
Arterial carbon dioxide level may ______ early in the attack and _______ later, indicating poor gas exchange.
this kind of asthma often occurs with an elevated serum eosinophil count and immunoglobulin E levels
the sputum of an asthma pt may contain what?
esosinophils and mucous plugs with shed epithelial cells.
What are the most accurate tests for asthma?
pulmonary function tests. These are measured using spirometry.
this type of pulmonary function test measures (volume of air exhaled from full inhalation to full exhalation)
Forced vital capacity
this type of pulmonary function test measures (volume of air blown out as hard and fast as possible during the first second of the most forceful exhalation after the greatest full inhalation).
Forced Expiratory volume in the first second (FEV 1)
this type of pulmonary function test measures ( the fastest airflow rate reached at any time during exhalation.)
Peak expirator flow rate (PEFR)
this type of assessment is done for pts with asthma for ruling out other causes or to track changes in chest structure over time.
Chest x ray
A decrease in either the FEV 1 or the PEF of __% to __% below the expected value for age, gender, and size is common for the pt with asthma
15% to 20%
An increase of __% in a pts FEV1 or PEF after use of broncho dilators is diagnostic for asthma
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