NURS372

Card Set Information

Author:
asquared85
ID:
9300
Filename:
NURS372
Updated:
2010-03-06 10:35:38
Tags:
COPD
Folders:

Description:
Schell Med Surg
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user asquared85 on FreezingBlue Flashcards. What would you like to do?


  1. Diagnostics for COPD
    H&P, Pulmonary Function Test, ABGs, CBC, CXR, EKG & Echocardiogram, AAT deficiency
  2. Pulmonary Function Tests
    • Decreased: Forced Expiatory Volume, Vital Capacity, FEV1/FVC ratio
    • Increased: Residual Volume, Total Lung Capacity, Functional Residual Capacity
  3. Normal FEV1/FVC Ratio
    • >/= .8
    • .7 or < is COPD
  4. Normal ABG Values
    • pH: 7.35-7.45
    • pCO2: 35-45 mm Hg
    • HCO3: 22-26 mmol/liter
    • pO2: 80-100 mm Hg
    • SaO2: 95-100%
  5. Collaborative Care for COPD
    Control/Avoid environment/occupational irritants; smoking cessation; avoid exposure to large crowds in peak cold/flu season; yearly flu vaccines, once/every 5 years pnuemococcal vaccines; treat resp infections
  6. Medications for COPD
    • Bronchodilators: Beta adrenergic agonists & anticholinergics
    • Steroids (exacerbation & infection control)
    • Non-prescription drugs
  7. Oxygen Therapy in COPD
    • Short Term: <30 Days, following exacerbation & hospitalization
    • Long Term: >30 Days, disease stable w/ paO2 60 mg or less, may need only during sleep/excersize

    • Goal: paO2 >/= 60 mm Hg
    • O2 Sat >/= 90%
  8. Oxygen Therapy Complications
    Combustion, CO2 Narcosis, Oxygen Toxicity, Infection
  9. Oxygen Toxicity
    • Risk when O2 supplied at levels above 50% over 24 hrs
    • Inactive pulmonary surfactant, reduce VC = pulmonary fibrosis

    S/S = cough, chest pain, N/V, paresthesia, nasal stuffiness, sore throat, malaise, copious secretions
  10. Pulmonary Rehabilitation
    • Physical Therapy: Bronchial hygiene, exercise conditioning, breathing retraining, energy conservation
    • Nutrition, Smoking cessation, control of environmental factors, psychological counseling, vocational rehabilitation
  11. Respiratory/Physical Therapy
    • Breathing Retraining - Most Important
    • -Pursed Lip breathing (8-10x; 3-4x/day) - to prevent bronchial collapse/air trapping
    • Effective Coughing = "huffing" - to get secretions out
    • Chest physiotherapy
    • -percussion
    • -vibration
    • -postural drainage (using gravity)
    • Aerosol-Nebulization Therapy & Flutter mucus clearance device
  12. When should respiratory rate return to normal after exercise in COPD?
    5 minutes. Longer than that indicated over excretion.
  13. Other Considerations
    • Sleep - can't due to medications/inability to breath
    • Psychosocial - variety of emotions, avoid higher elevations
    • Sexual activity - not after meals/exercise, don't prolong foreplay
  14. Nursing Diagnoses
    Impaired Gas Exchange; Ineffective Airway Clearance; Ineffective Breathing Patterns; Activity Intolerance, Imbalanced Nutrition (Less than Needed); Disturbed Sleep Patterns
  15. Surgery Therapy for COPD
    • Lung Volume Reduction Surgery - Decreased airway obstruction = better gas exchange, reduce size of hyper-inflated lung
    • Lung Transplant - single or bilateral

What would you like to do?

Home > Flashcards > Print Preview