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Obstructive Pulmonary Disease

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Emphysema and Chronic Bronchitis. Etiology. Smoking, Infection, pollution, heredity, aging ... Emphysema vs (chronic) Bronchitis. Dyspnea on exertion. Air is ... – PowerPoint PPT presentation

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Title: Obstructive Pulmonary Disease


1
Obstructive Pulmonary Disease
  • N1228
  • class 7/8
  • 2003

2
Asthma
  • Triggers
  • allergens
  • Respiratory Infection
  • Nose Sinus problems
  • Exercise
  • Drugs food additives
  • GERD
  • Emotional Stress

3
  • Pathophysiology
  • airway inflammation and nonspecific
    hyperirritability or hyperresponsiveness of
    tracheobronchial tree
  • reduction in airway diameter and an increase in
    airway resistance related to mucosal
    inflammation, constriction of bronchial smooth
    muscle, and excess production of mucus

4
  • Management
  • a person with asthma has difficulty with air
    movement in and out of the lungs, which creates a
    feeling of suffocation

5
  • Clinical Manifestations
  • wheezing, chest tightness, dyspnea,
    cough,breathlessness
  • abrupt or gradual onset
  • air trapping d/t contraction of bronchioles
  • sometime no audible wheeze ( r/t air exchange)
  • secretion thick, tenacious,white,gelatinous
  • hypoxemia, restlessness,resp rate increased
  • use of accessory muscles

6
  • Complications
  • rib fractures, pheumothorax, atelectasis,
    pheumonia, status asthmaticus
  • Status Asthmaticus
  • emergent situation

7
Pediatric Considerations
  • Many children lose their symptoms at puberty
  • exacerbation continue AMB airway
    hyperresponsiveness and cough as adults
  • Be alert for
  • refusal to lie down, profuse sweating
  • agitated child that suddenly becomes quiet
  • Use games for compliance or teaching

8
Diagnostic Tests
  • Break into 4 groups
  • Identify and report the diagnostic studies that
    are used to determine
  • 1)if respiratory distress is caused by asthma
  • 2)what the triggering agents are
  • 3)how severe the airway obstruction is
  • 4)evaluation of the severity and response to
    treatment of an attack

9
Collaborative Care
  • Mild Intermittent Persistant Asthma
  • Stepwise approach (table 27-5)
  • Drug therapy (table 27-6)
  • Care Plan ( 27-1)
  • Management Plan (table 27-10)
  • Teaching Plan (table 27-12)

10
Nursing Management of Asthma
  • Assessment (list)(table 27-9)

11
  • Nursing DX
  • Ineffective breathing pattern
  • Ineffective airway clearance
  • Anxiety
  • Risk for infection

12
Emphysema and Chronic Bronchitis
  • Etiology
  • Smoking, Infection, pollution, heredity, aging
  • Pathophysiology
  • enlargement of air spaces distal to the terminal
    bronchioles, destruction of walls, without
    fibrosis
  • centrilobular, panlobular
  • elastin, collagen destroyed

13
Complications
  • Cor Pulmonale
  • Acute exacerbation of chronic Bronchitis
  • Respiratory Failure
  • Peptic Ulcer
  • GE Relfux
  • Pneumonia

14
Emphysema vs (chronic) Bronchitis
  • Dyspnea on exertion
  • Air is trapped
  • chest breather
  • Ribs (inspiratory position)
  • Malnutrition-loss of protein,sq fat
  • secondary bronchitis
  • Cough
  • cilia-disappears
  • Freq infections
  • Normal weight robust appearance
  • emphysema of the centrilobular type

15
  • Diagnostic Studies
  • Chest x-ray
  • Pulmonary function studies
  • ABGs CO2 begins to elevate
  • pulse ox
  • ECG

16
  • Collaborative Care
  • Smoking Cessation
  • assess environmental irritants
  • influenza virus vaccine yearly with pneumococcal
    vaccine

17
Nursing Management Emphysema and Chronic
Bronchitis
  • Assessment
  • Table 27-22

18
  • NDX
  • Self care deficit
  • Sleep pattern disturbance
  • sexual dysfunction
  • disturbance in self-concept
  • risk for infection

19
  • Planning
  • return to baseline resp function
  • perform adls
  • relief of dyspnea
  • No complication r/ t COPD
  • knowledge and ability to implement a long-term
    treatment regimen
  • maintain quality of life

20
  • Implementation
  • Health promotion
  • Acute intervention
  • Ambulatory Home Care
  • Pulmonary Rehab
  • Activity considerations
  • Sexual activity
  • Sleep
  • Psychosocial considerations

21
  • Evaluation
  • What supportive documentation would be seen if
    the patient has met all of their outcomes?
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