resp.txt

COPD; COLD(CHRONIC OBSTRUCTIVE LUNG DISEASE); CAL(CHRONIC AIRWAY LIMITATION)

"CHRONIC BRONCHITIS, EMPHYSEMA, ASTHMA"

"INFLAMMATION OF BRONCHI, MAYBE ACUTE OR CHRONIC"

"INFLAMMATION OF BRONCHI, PRESENCE OF A PRODUCTIVE COUGH THAT LASTS 3MO. PER YEAR FOR 2 CONSECUTIVE YEARS"

THICKENING AND RIGIDITY OF BRONCHIAL MUCOSA; EXCESS SECRETIONS DEVELOP WITH NARROWING OF AIRWAYS; LEADS TO OBSTRUCTION OF EXPIRATION -LATER TO INSPIRATION; MORE SUSCEPTIBLE TO LOWER RESP. INFECTIONS

AVOIDANCE OF SMOKING AND OTHER IRRITANTS (ALLERGENS); IMMUNIZATION FOR INFLUENZA and PNEUMONIA; Air quality control – inside and outside

Alveolar wall destruction; Over distention of air spaces distal to the terminal bronchioles

PERSISTENT COUGH; COPIOUS SPUTUM ; DYSPNEA ON EXERTION; WHEEZING ON EXPIRATION; FREQUENT INFECTIONS; GEN. APPEARANCE -BLUE BLOATER --DUE TO PRESENCE OF CYANOSIS AND EDEMA

centriacinar – most common; panacinar and paraseptal

BRONCHITIS

EMPHYSEMA

"Progressive dyspnea on exertion & eventually at rest; AP enlarged; Hyper resonant; Over inflation; Flattened diaphragm; ABG normal till late; Enlarged heart, right ventricular lift and axis deviation"

"SMOKING (PRIMARY); HEREDITY; AGING; Also air pollution, second-hand smoke, childhood resp infections"

DECREASED O2 IN TISSUES DUE TO INADEQUATE DELIVERY OF O2 TO SATISFY METABOLIC REQUIREMENTS OF CELLS OF BODY

"CYANOSIS (CENTRAL CYANOSIS-DOES NOT OCCUR UNTIL THERE IS 5Gm. or less of OXYGENATED HGB); CLUBBING OF FINGERS-BULBOUS,SPONGY NAILBEDS GREATER THAN 160 DEGREES; POLYCYTHEMIA-INCREASE IN TOTAL RBC. MASS"

RETENTION OF CO2 IN THE BLOOD -PaCO2>45 mm. Hg.; COPD PATIENTS EXPERIENCE CHRONIC HYPERCAPNIA (DUE TO TRAPPING OF CO2 IN THE AIRWAYS; UNEVEN MATCH UP OF VENTILATION AND PERFUSION IN THE LUNGS); COPD PTS. INSENSITIVE TO HIGH CO2

"NARROWING OF AIRWAYS WITH DYSPNEA,COUGH, wHEEZING; REVERSIBLE, IN ACUTE FORM; ACUTE ATTACKS- LAST MIN.-HRS.; ATTACKS MAY BE INTERSPERSED WITH SYMPTOM FREE PERIODS"

"EXTRINSIC (ALLERGIC), INTRINSIC (IDIOPATHIC), MIXED"

"COUGH, DYSPNEA , WHEEZING, LATER-SWEATING,TACHYCARDIA,DIMINISHED BREATH SOUNDS"

IgE & ABG’S-INITIAL vs. LATE FINDINGS

Prevention of chronic asthma and asthma exacerbations; Maintenance of normal activity levels; Maintenance of nomral or near-normal lung function; Minimal or no side effects while receiving optimal medications; Client satisfaction with program of care

"Inability to ausculate wheezing in an asthmatic patient can indicate lack of air movement and acute respiratory distress (Airways too constricted & Immediate, aggressive treatment); Continuous coughing can occur with bronchospasm in attempt to exhale and clear airway"

CONTROLLER vs. RELIEVER DRUGS - BRONCHODIALATORS-Reliever Drugs (METAPROTERENOL(ALUPENT) & TERBUTALINE(BRETHINE)); LOW FLOW HUMIFIED O2 (1-3 LITERS ); MAST CELL INHIBITORS-CROMOLYN SODIUM- Controller Drugs (Inhibit release of histamines & Only used to prevent attacks); LEUKOTRIENE MODIFIERS-SINGULAIR-block inflammatory process; I.V. FLUIDS-QUIET ENVIRONMENT; SKIN TESTING FOR ALLERGENS