NUR 245 - Exam 3 Study Guide
COPD modifiable risk factors - ANS - Smoking
- Passive (secondhand) smoke
- Recurrent childhood infections
- Air pollution
- Work toxins
COPD non-modifiable risk factor - ANS - Alpha 1 antitrypsin deficiency (genetic)
- Aging
- Asthma
COPD - ANS - Progressive disease
- Chronic inflammatory response to smoke
- Increased mucus production
- Mucus reduces diameter of airways
S/S of COPD - ANS - Dyspnea
- SOB w/ activity (early)
- SOB at rest (late)
- Increased sputum (early)
- Accessory muscles (late)
- Clubbing of fingernails
- Tripod position
- Barrel chest (late)
,- Chest breathing instead of ABD breathing (late)
- Chronic intermittent cough (early)
- Crackles and wheezing
- Low O2 sat
- Shallow respirations
- Orthopnea
- Pale ashen skin color
- Malnutrition
Complications of COPD - ANS - Pulmonary HTN
- Cor Pulmonale
- Exacerbations
- RF
Pulmonary HTN - ANS Leads to cor pulmonale
Cor pulmonale - ANS Right-sided HF
COPD exacerbation - ANS - Worsening of respiratory S/S that often result in hospitalization
- Increased dyspnea
- Increased cough
- Increased sputum volume
- Activity intolerance
- Wheezing
- Change in color of sputum (yellow, green, bloody)
, Tx of COPD exacerbation - ANS - Short acting beta agonist (SABA)
- Albuterol
- Ipratropium
- Duoneb (Albuterol + Ipratropium)
- Oral steroids
- Prednisone, Methylprednisolone
- ATBs
- O2 (BiPAP/CPAP)
- Venturi mask
Primary cause of COPD exacerbations - ANS Bacterial & viral infections
COPD pt teaching - ANS - Get vaccines (pneumonia, COVID, flu)
- Avoid sick people
- Smoking cessation
- Teach pursed lip (diaphragmatic breathing techniques)
- Safe use of O2
- Hand washing
COPD RF - ANS Prefer not to vent because are very difficult to wean off
COPD O2 - ANS - Low flow (mixed w/ room air: NC, SFM, NRB)
- Long term use should include humidification D/T drying mucosa and secretions
- 2 - 3 L or lose drive to breathe D/T baroreceptor destruction (CO2 narcosis)
COPD modifiable risk factors - ANS - Smoking
- Passive (secondhand) smoke
- Recurrent childhood infections
- Air pollution
- Work toxins
COPD non-modifiable risk factor - ANS - Alpha 1 antitrypsin deficiency (genetic)
- Aging
- Asthma
COPD - ANS - Progressive disease
- Chronic inflammatory response to smoke
- Increased mucus production
- Mucus reduces diameter of airways
S/S of COPD - ANS - Dyspnea
- SOB w/ activity (early)
- SOB at rest (late)
- Increased sputum (early)
- Accessory muscles (late)
- Clubbing of fingernails
- Tripod position
- Barrel chest (late)
,- Chest breathing instead of ABD breathing (late)
- Chronic intermittent cough (early)
- Crackles and wheezing
- Low O2 sat
- Shallow respirations
- Orthopnea
- Pale ashen skin color
- Malnutrition
Complications of COPD - ANS - Pulmonary HTN
- Cor Pulmonale
- Exacerbations
- RF
Pulmonary HTN - ANS Leads to cor pulmonale
Cor pulmonale - ANS Right-sided HF
COPD exacerbation - ANS - Worsening of respiratory S/S that often result in hospitalization
- Increased dyspnea
- Increased cough
- Increased sputum volume
- Activity intolerance
- Wheezing
- Change in color of sputum (yellow, green, bloody)
, Tx of COPD exacerbation - ANS - Short acting beta agonist (SABA)
- Albuterol
- Ipratropium
- Duoneb (Albuterol + Ipratropium)
- Oral steroids
- Prednisone, Methylprednisolone
- ATBs
- O2 (BiPAP/CPAP)
- Venturi mask
Primary cause of COPD exacerbations - ANS Bacterial & viral infections
COPD pt teaching - ANS - Get vaccines (pneumonia, COVID, flu)
- Avoid sick people
- Smoking cessation
- Teach pursed lip (diaphragmatic breathing techniques)
- Safe use of O2
- Hand washing
COPD RF - ANS Prefer not to vent because are very difficult to wean off
COPD O2 - ANS - Low flow (mixed w/ room air: NC, SFM, NRB)
- Long term use should include humidification D/T drying mucosa and secretions
- 2 - 3 L or lose drive to breathe D/T baroreceptor destruction (CO2 narcosis)
