Term
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Definition
| A general term for pulmonary disorders characterized by chronic airflow limitation from the lungs that is not fully reversible |
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Term
| What are the two diseases with COPD? |
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Definition
| chronic bronchitis and emphysema |
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Term
| What is chronic bronchitis? |
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Definition
-excessive mucous in the lungs producing cough
-lasts at least 3 months in 2 consecutive years |
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Term
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Definition
| permanent enlargement of the air spaces distal to to the terminal bronchials, destruction of the alveolar walls |
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Term
| Why are these two diseases grouped together as COPD? |
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Definition
| because the symptoms can over lap making it hard to distinguish if someone has one or the other |
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Term
| What is the third leading cause of death is the US? |
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Definition
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Term
| What is the number one risk for COPD? What are some other causes? |
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Definition
-tobacco smoking
-, long-term exposure to occupational and environmental pollutants and the absence or deficiency of α1-antitrypsin |
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Term
| What happens in large compared to small airways in chronic bronchitis? |
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Definition
Large- tobacco smoke and irritants induce thickened bronchial walls with inflammatory cell infiltrate, increased size of the mucous glands, and goblet cell hyperplasia
Small-obstruction is exacerbated by narrowing, scarring, increased sputum production, mucous plugging, and collapse of peripheral airways resulting from the loss of surfactant |
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Term
| When is obstruction present with chronic bronchitis? |
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Definition
| on inspiration and expiration |
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Term
| How does smoking cause emphysema?(timeline) |
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Definition
-alveolar epilthelium is damaged
-inflammatory mediators released
-release elastase that destroys alveolar wall, resulting in enlarged air spaces
-obstruction is then caused by the collapse of these on expiration NOT inspiration |
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Term
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Definition
| yes, and usually causes deterioration unless intervention is provided early |
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Term
| What can develop from the progression of COPD? |
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Definition
| Pulmonary hypertension(cor pulmonale) |
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Term
| Is the onset of COPD sudden? |
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Definition
| no, usually takes years. Seen after age 40 |
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Term
| What are some key indicators of developing COPD? |
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Definition
-a chronic cough with sputum production that may be intermittent, unproductive or productive
-scanty or copious
-dyspnea that is persistent and progressive or that worsens with exercise
-As the disease progresses, weight loss and decreased exercise capacity also are seen |
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Term
| People with chronic bronchitis are known as? |
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Definition
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Term
| People with emphysema are known as? |
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Definition
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Term
| Can people with COPD exhibit both of these symptoms? |
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Definition
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Term
| What are the key diagnostic features for COPD? |
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Definition
| Measures of expiratory airflow (Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) |
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Term
| What are these determind by? |
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Definition
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Term
| What is the partial pressure of carbon dioxide and oxygen like in patients with COPD? |
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Definition
Bronchitis- elevated PCO2 and decreased PO2
Emphy- normal PCO2, decreased PO2 |
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Term
| What does this mean for chronic bronchitis patients? |
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Definition
| Leads to secondary erythrocytosis, an elevated hematocrit value, and compensated respiratory acidosis |
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Term
| What does this mean for emphysema patients? |
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Definition
| Maintains normal hemoglobin saturation, avoiding erythrocytosis |
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Term
| What are some radiographic abnormalities seen in chronic bronchitis patients? |
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Definition
| increased bronchovascular markings at the base of the lungs |
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Term
| What are some radiographic signs of emphysema? |
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Definition
| persistent and marked overdistention of the lungs, flattening of the diaphragm, and emphysematous bullae |
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Term
| What does management of COPD include? |
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Definition
-smoking cessation
-influenza and pneumococcal vaccinations
-use of short- and long-acting bronchodilators
-lifestyle changes |
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Term
| What is the cornerstone of management in COPD? |
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Definition
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Term
| Who are inhaled cortocosteriods added to? |
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Definition
| the regimen for symptomatic patients at stage III or above who have repeated exacerbations |
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Term
| What are alternative agents to bronchodilators? |
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Definition
| Phosphodiesterase inhibitors |
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Term
| When is supplemental O2 recommended? |
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Definition
| when the patient’s PO2 is 88% or less |
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Term
| Who is considered unstable and needs an med con? |
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Definition
| displays shortness of breath at rest, a productive cough, an upper respiratory infection, or an oxygen saturation level less than 91% |
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Term
| How should the chair be in treatment of COPD patients? |
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Definition
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Term
| What may be used for sedative medication? |
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Definition
| low-dose oral diazepam (Valium) |
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Term
| Who can nitrous oxide be used with? |
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Definition
| used with caution in patients with mild to moderate chronic bronchitis |
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Term
| Who should nitrous oxide NOT be used in? |
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Definition
| patients with severe COPD and emphysema |
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Term
| What medications should NOT be used in patients with COPD? |
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Definition
-Narcotics and barbiturates should not be used
-Anticholinergics and antihistamines used with caution |
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Term
| What do patients with COPD often have? |
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Definition
| hypertension and coronary heart disease |
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Term
| What is contradicted for most patients with COPD? |
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Definition
| outpatient general anesthesia |
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Term
| What do systemic cortocosteriods cause? |
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Definition
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Term
| Macrolide antibiotics and ciprofloxacin hydrochloride should be avoided in who? |
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Definition
| in patients taking theophylline |
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Term
| What are the oral manifestations of COPD? |
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Definition
-halitosis, extrinsic tooth stains, nicotine stomatitis, periodontal disease, and oral cancer(all because of smoking)
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