Pulmonary_Obstructive vs Restrictive

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  1. Chronic Restrictive Diseases - S/S - 6
    • Dyspnea on exertion
    • Persistent NON-PRODUCTIVE cough
    • Hypoxemia, hypocapnea
    • DEC vital capacity (Amount of air under volitional control)
    • Difficulty expanding lungs --> DEC in lung V
    • CXR changes
  2. Restrictive lung disease - what is normal? - 2
    • Expiratory flow
    • FEV1 - NORMAL
  3. Restrictive lung disease - DEC what? - 5
    • Total lung capacity
    • Vital capacity
    • Functional residual capacity
    • Residual V
    • PaCO2
  4. Restrictive Lung Disease - d/t abnormal lung parenchyma - 5
    • Atelectasis
    • Pneumonia
    • Pulmonary fibrosis
    • Pulmonary edema
    • Acute respiratory distress syndrome
  5. Restrictive Lung Disease - d/t abnormal pleura - 4
    • Pleural effusion
    • Pleural fibrosis
    • Pneumothorax
    • Hemothorax
  6. DEC in chest wall is seen w/what dysfunctions? - 5
    • Ankylosing spondylitis
    • Arthritis
    • Scoliosis
    • Pectus excavatum
    • Scleroderma - chest wall skin burns
  7. Atelectasis - define; obstructive vs restrictive; confirmed how? breath sounds; chest excursion; percussion; + S/S (8)
    • Collapsed or airless part of lung d/t loss of elasticity or airway blockage (infection)
    • Confirmed by CXR - platelike streaks

    • RESTRICTIVE
    • DEC/Absent breath sounds
    • DEC chest excursion
    • Percussion - Dull or flat
    • Dyspnea
    • Cyanosis
    • DEC BP
    • Tachycardia
    • Fever
  8. Atelectasis Tx - what device? Why?
    • (+) end-expiratory P
    • Continuous (+) airway P
    • Keep airways & alveoli open - as this disease is collapsed/airless lung
  9. Acute Respiratory Distress Syndrome - define + d/t what?; obstructive vs restrictive; S/S (2); Tx
    Alveolar collapse in premies resulting from lung inflammation d/t low levels of surfactant

    • RESTRICTIVE
    • Flaring nares
    • Expiratory grunting

    Tx - O2, surfactant admin, assisted ventilation
  10. SARS - define; obstructive vs restrictive; S/S (2); lab test INC/DEC (4)
    An atypical respiratory illness caused by a coronovirus

    RESTRICITVE

    • Fever
    • Dry cough

    • Lab test - DEC WBC, plate­lets, & lymphocytes
    • Lab test - INC liver function tests
  11. Rib fx - Frail chest - define; obstructive vs restrictive; S/S (4); Tx
    2 or more fx in adjacent ribs d/t blunt trauma

    RESTRICITVE

    • Shallow breathing
    • Crepitation during ventilation
    • Inspiration pulled inward
    • Expiration pushed outward

    Tx: Splinting d/t pain
  12. Pneumothorax - define + confirmed how; obstructive vs restrictive; breath sounds; percussion; trachea?
    • Air in pleural space - Confirmed by CXR
    • RESTRICTIVE
    • DEC/absent breath sounds
    • Dry cough
    • Tracheal deviation AWAY from injured side
    • Percussion - Hyperresonant & tympanic
    • Local or referred pain
  13. ACUTE Pulmonary edema - S/S - 6 + Tx
    • Extreme SOB w/profuse sweating
    • Bubbly, wheezing or gasping sound during breathing
    • Pink frothy sputum
    • Cyanotic skin
    • Rapid, IRREGULAR pulse
    • Severe drop in BP

    Tx - EMERGENCY - call 911
  14. Pulmonary emboli - w/ vs. w/o infarction - S/S (5); Tx
    • W/Infarction:
    • Chest pain
    • Hemoptysis
    • Pleural friction rub
    • Fever
    • (+) chest x-ray

    • W/o infarction:
    • Tachypnea
    • Anxiety / Restlessness
    • Rales (crackles)
    • Wheezing
    • DEC breath sounds

    Tx - low dose heparin + analgesics
  15. Name 4 conditions w/COPD
    • A - asthma
    • B - bronchitis
    • C - cystic fibrosis
    • E - emphysema
  16. COPD - General S/S (7); Stage III S/S (3)
    • INC chest size - A-P diameter
    • Dry or productive cough
    • INC resistance to airflow
    • Abnormal breath sounds
    • Use of accessory breathing mms
    • Often a history of smoking

    • Stage III S/S:
    • MM wasting
    • Weight loss
    • INC anteroposterior-to-lateral chest ratio = barrel chest
  17. Asthma - define; obstructive vs restrictive; breath sounds; S/S (3)
    Stimuli - allergens, exercise, cold

    OBSTRUCTIVE


    • Wheezing cough
    • DEC breath sounds
    • Dry or productive mucoid sputum w/plugs
    • Chest wall symmetrically DEC

    • Meds - prednisone, nebulizer or inhaler 
    • Bronchodilators administered PRIOR to exercise
  18. Bronchitis - define; obstructive vs restrictive; breath sounds; S/S (2); Tx
    • Chronic inflammation of tracheobronchial tree w/cough/sputum production
    • @ least 3 months for 2 consecutive years

    • OBSTRUCTIVE
    • Wheezing or rhonchi breath sounds
    • Productive mucoid or purulent sputum w/infection
    • May have fever

    Tx - Paced breathing; relationship to smoking
  19. Bronchiectasis - define; obstructive vs restrictive; breath sounds; S/S (4 major +4 others)
    • Progressive lung disease - permanent dilation of bronchi
    • OBSTRUCTIVE
    • Consistent productive cough
    • Excessive sputum production
    • Hemoptysis
    • Crackles + DEC breath sounds
    • Cyanosis
    • Clubbing
    • Hypoxemia
    • Dyspnea
  20. Cystic fibrosis (CF) - define; obstructive vs restrictive; breath sounds; Early signs (2); S/S (4); test; Tx
    • Thickening of secretions of all exocrine glands, leading to obstruction
    • OBSTRUCTIVE

    • Excessive appetite & weight loss - early sign
    • Infections 
    • Frequent, greasy stools
    • Wheezing
    • Productive mucoid or purulent sputum 

    • Test:
    • (+) sweat electrolyte test - INC chloride

    Tx: Percussion, vibration, shaking & postural drainage - many x/day in acute stage; Suction in severe cases
  21. Emphysema - define; obstructive vs restrictive; breath sounds; S/S (5); Tx
    • Permanent abnormal enlargement & destruction of air spaces distal to terminal bronchioles
    • OBSTRUCTIVE
    • INC lung compliance
    • INC resonance
    • DEC elastic recoil
    • Barreled chest
    • Use of accessory mms of ventilation
    • DEC breath sounds w/or w/o wheezing
    • Dyspnea

    Tx: Pursed lip breathing during expiration
  22. Obstructive lung disease - INC what? - 4
    • Total lung capacity
    • Functional residual capacity
    • Residual V
    • PaCO2
  23. Obstructive lung disease - DEC what? - 4
    • DEC in airflow
    • Breath sounds
    • Vital capacity
    • FEV1 - Sharp DEC
  24. Atelectasis - breath sounds; percussion
    • Breath sounds - absent
    • Percussion - dull
  25. Asthma - breath sounds; percussion
    • Breath sounds - wheezing
    • Percussion - Hyperresonance
  26. Pneumonia - breath sounds; percussion
    • Breath sounds - crackles + bronchial breath sounds
    • Percussion - dull
  27. Bronchitis - breath sounds; percussion
    • Breath sounds - early crackles
    • Percussion - normal
  28. Obstructive vs Restrictive - Flow rates (FEV1/FVC); Volumes
    • Obstructive - Volumes essentially normal; Flow rates low 
    • Restrictive - Volumes DEC; Flow rates normal (Normal FEV1/FVC = 0.8 - 1.0)

Card Set Information

Author:
Tanuisha
ID:
324474
Filename:
Pulmonary_Obstructive vs Restrictive
Updated:
2017-01-18 22:48:52
Tags:
Pulmonary Obstructive vs Restrictive
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Pulm
Description:
Pulmonary_Obstructive vs Restrictive
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