Weakening and permanent enlargement of the air spaces distal to the
terminal bronchioles, often accompanied by hypertrophy of the goblet
cells and mucus glands. Characterized by dyspnea on exertion with
significant hypercapnea - ANSWER-Emphysema/ Chronic Bronchitis
What are 5 terms/phrases that are used to describe a patient with
COPD - ANSWER-1. Chronic Ventilatory Failure
2. Chronic Hypercapnea
3. Increased lung compliance
4. Loss of elastic recoil
5. Chronic CO2 retention
What would the general appearance of someone with COPD/ Chronic
bronchiectasis look like - ANSWER-Barrel chested, Clubbing and
cyanosis
What would the respiratory pattern of someone with COPD/ Chronic
bronchiectasis be - ANSWER-Dyspnea, accessory muscle use,
pursed-lip breathing
What would the breath sounds of someone with COPD/ Chronic
bronchiectasis sound like - ANSWER-Diminished aeration with
bilateral expiratory wheeze
,During patient assessment what would be a fast easy diagnostic test
for someone with COPD/ Chronic bronchiectasis - ANSWER-
Diagnostic chest percussion - tympanic or hyper resonant
What would the cough of someone with COPD/ Chronic
bronchiectasis consist of - ANSWER-Congested, Productive of thick
sputum
What would be 3 diagnostic tests used to diagnose COPD/ Chronic
bronchiectasis - ANSWER-1. Chest X-ray
2. ABG
3. PFT
What would the X-ray of someone with COPD/ Chronic bronchiectasis
look like - ANSWER-Hyperlucency, hyperinflation, increased A-P
diameter, flattened diaphragm
What would be effected in a PFT for a patient with COPD/ Chronic
bronchiectasis - ANSWER-Decreased flows
What SpO2 do you want for a patient with COPD/ Chronic
bronchiectasis - ANSWER-88-92% (Treat with Low O2)
What kind of aerosolized bronchodilators can be used for patients
with COPD/ Chronic bronchiectasis - ANSWER-SABA- Albuterol or
Levalbuterol
,LABA- Salmeterol, formoterol (Must be given with corticosteroid-
budesonide, Fluticasone)
Anticholinergic- Ipratropium, Tiotropium
For an acute exacerbation of ventilatory failure in a patient with
COPD/ Chronic bronchiectasis what should be done to support them -
ANSWER-NPPV
A chronic inflammatory, obstructive, non-contagious airway disease
with varying levels of severity, characterized by exacerbations of
wheezing and coughing - ANSWER-Asthma
What would the general appearance of someone with an asthma
exacerbation look like - ANSWER-Pursed-lip breathing, chest
tightness, increased A-P diameter during episode, Diaphoresis
What would the breathing pattern of someone with an asthma
exacerbation look like - ANSWER-Accessory muscle usage,
Retractions (especially in children)
What would diagnostic Chest percussion sound like in someone with
an asthma exacerbation - ANSWER-Hyperresonant/tympanic note
What would breath sounds be in someone with an asthma
exacerbation - ANSWER-Diffuse wheeze, diminished breath sounds,
prolonged expiration
, What would the vital signs be in someone with an asthma
exacerbation - ANSWER-Tachycardia, Tachypnea, pulsus paradoxus
during severe episode (Drop in BP when breathing in)
What 3 diagnostic tests would help diagnosis someone with asthma -
ANSWER-1. X-ray
2. ABG
3. PFT
What would the x-ray of someone with asthma look like – ANSWER-
During acute episode increased A-P diameter, translucent (dark) lung
fields, depressed or flattened diaphragms
What would the PFT of someone with asthma look like - ANSWER-1.
Spirometry shows reduced flow rates
2. Post bronchodilator spirometry increases FEV1 at least 12% and
200 ml
3. Bronchial provocation test: FEV1 decreases significantly when
provocation agent, such as methacholine is inhaled
What would the treatment be for someone with an acute asthma
exacerbation - ANSWER--O2
-Aerosol Therapy with SABA and anticholinergic agents (Albuterol or
Levalbuterol, Ipratropium or Tiotropium) consider continuous aerosol
Therapy
-Corticosteroids (Oral or IV)
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