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What are the functions of the pulmonary system?
- 1. gas exchange
- 2. acid-base balance of the body
- 3. prevention of infection
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______________ and ____________ are interdependent
nutritional status and pulmonary function
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Explain the cycle between malnutrition and pulmonary disease.
impaire nutritional status can lead to a decline in pulmonary function (because of fewer functioning cells) which increases the energy need becuase the remaining cells are working harder to exchange oxygen, which further impairs nutritional status and so on.
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The impact of malnutrition on pulmonary status
-vitmain C
-vitamin A
-Protein
-Zinc
-Vitamin B6
- -collagen formation to support connective tissue
- -mucus production
- -antibody production
- -immunity
- -protein & antibody production
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Explain the findings of the Keys study (1959)
- stravation = impaired pulmonary function
- -impairs lung structure, function, muscle strength, endurance, immune defense, and breathing control
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ABGs
arterial blood gases
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clinical symptoms of pulonary disease.
- -early satiety
- -anorexia
- -weight loss
- -cough
- -dyspnea during eating
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COPD
- chronic obstructive pulmonary disease
- -presence of chronic bronchitis or emphysema leading to airway obstruction
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what is the primary risk factor for the development of COPD?
smoking
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emphysema
a condition of the lung characterized by abnormal permanent enlargement of alveoli accompanied by destruction of their walls with out obvious fibrosis
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bronchitis
inflammation and eventual scarring of the lining of the bronchial tubes, restricted airflow, excessive mucous production, presistent cough
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bronchitis-clinical manifestations
- -decreased airflow rate
- -dyspnea
- -hypoxemia
- -cyanosis
- -clubbing
- -quality of life diminishes
- -require supplemental oxygen
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clubbing
discoloration/blueness at the end of the fingers or toes due to lack of oxygen
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cor pulmonale
a heart condition that may develop in patients with COPD. It is an enlargement of the right ventricle and right ventricular structure due to increased pressure in the pulmonary arteries
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emphysema-pathophysiology
- -destruction of lung tissue, loss of surface area
- -decreased surfactant
- -bronchioles collapse during exhalation
- -traps air in the lungs
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COPD treatment
- -lifestyle changes: smoking cessation, and avoidance of other pollutants
- -exercise as tolerated
- -good nutrition
- -pharmacologic treatment: bronchodilators, steroids
- -pulmonary rehabilitation
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respiratory quotient
-CHO
-Protein
-Fat
- the rate of exchange between CO2 and O2. For every macronutrient consumed how much CO2 is produced per O2 produced.
- -CHO RQ = 1
- -Protein RQ = 0.8
- -Fat Rq = 0.7
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respiratory quotient for fat synthesis from excess CHO
13.71
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a complex multisystem disorder that is inherited by an autosomal recessive fashion that creates abnormally thick mucous secretions
cystic fibrosis
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cystic fibrosis- treatment
- -goal is to control malabsorption and provide adequate nutrients
- -pancreatic enzyme repalcement
- -nutritional assessments should focus on growth with CDC charts
- -adequate kcal from normal growth based on weight gain patterns
- -protein 15-20% kcals
- -higher fat intake (35-45% kcals)
- -MCT oil
- -glucose intolerance common
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cystic fibrosis- diagnosis
-sweat test, levels of sodium greater than 60 mEq/L or 3-5 times the normal concentration of sodium and chloride
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bronchopulmonary dysplasia
- a chronic lung diesase of infancy which occurs most frequently in premature infants following respiratory distress syndrome in the neonatal period
- -symptoms: slow growth, chronic hypoxia, GERD, feeding difficulties
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BPD treatment
- -energy needs 15-20% higher
- -120-130 kcals/kg/day
- -protein 3-4 g/kg/day
- -closely monitor electrolyte balance
- -need sufficient minerals for bone growth
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