Whittney Shared "BreathingProblems" - 22 Picmonics
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BreathingProblems
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
- Causes
- Inhaled Toxins
- Smoking
- AAT Deficiency
- Assessment
- Emphysema
- Chronic Bronchitis
- Asthma
- Considerations
- Spirometry
- Slow Progression
2 mins
COPD gradation and treatment
- Mild - short acting bronchodilator PRN
- Moderate - long acting bronchodilator + short acting PRN
- Severe - INHALED corticosteroid + long acting + short acting
- very severe - O2 therapy, lung TP
CHRONIC COPD Treatment
- Treatment for Prevention of Exacerbations
- Vaccines
- Influenza
- Pneumococcal
- Quit smoking
- Bronchodilators
- Beta-2 agonists
- Anti-cholinergics (e.g. ipratropium)
- LONG-acting bronchodilators
- anti-cholinergics (tiotropium)
- Beta-2 agonists (salmeterol)
- Inhaled corticosteroids
- Oxygen
- PaO2 < 55
- SpO2 < 88
- COPD Exacerbation
- SYSTEMIC steroids
- Antibiotics
Chronic Bronchitis Assessment
- Clinical Findings
- Chronic Productive Cough
- > 3 Months for 2 Years
- Increased Mucus Production
- Dyspnea
- Cyanosis
- Wheezes
- Complications
- Right Side Heart Failure
- Jugular Venous Distention (JVD)
- Peripheral Edema
2 mins
Emphysema
- Mechanism
- Hyperinflation and Loss of Elasticity
- Assessment
- Pursed Lip Breathing
- Barrel Chest
- Dyspnea on Exertion
- Clubbing
- Depression and Anxiety
- Thin Appearance
- Nursing Considerations
- CO2 Retention
- Low Concentration of O2
- High Fowler's Position
- High Calorie, High Protein Diet
2 mins
Chronic Bronchitis Interventions
- Tripod Position
- Humidified Oxygen
- Pursed Lip Breathing
- Increase Fluid Intake
- ABGs
- Early Detection of Exacerbation
- Considerations
- Lowest O2 Therapy
- Assisted Ventilation
- Increased Infection Risk
2 mins
Respiratory Acidosis Interventions
- Improve Respiration
- Pharmacologic Interventions
- Bronchodilators
- Respiratory Stimulants
- Drug Antagonists
- Nonpharmacologic Interventions
- Oxygen
- Assisted Ventilation
- Prevent Complications
1 min
Respiratory Acidosis
- Hypoventilation
- Increased PaCO2 > 45
- Barbiturates Depress Central Respiratory Center of Brain
- Opioids Depress Central Respiratory Center of the Brain
- Airway Obstruction
- Respiratory Muscle Weakness/Paralysis
3 mins
Beta-2 Agonists
- Short-term Treatment
- Terbutaline
- Asthma
- Tocolysis
- Albuterol
- Asthma
- Long-term Treatment
- Salmeterol
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
3 mins
Acute Respiratory Distress Syndrome (ARDS) Assessment
- Cause
- Damaged Alveolar-Capillary Membrane
- Assessment
- Restlessness
- Dyspnea
- Refractory Hypoxemia
- Decreased PaO2
- Diffuse Pulmonary Infiltrates
- Atelectasis
- Pulmonary Hypertension
2 mins
Restrictive vs. Obstructive Lung Diseases
- Restrictive Lung Disease
- Decreased Lung Volume
- FEV1/FVC Ratio Normal to Increased
- Obstructive Lung Disease
- Increased Lung Volume
- Decreased FEV1/FVC Ratio
2 mins
Acute Bronchitis
- Cough and Sputum Production
- Viral upper respiratory infection
- Hemoptysis
- Fever is NOT typical
- Antibiotics not beneficial
- Self limiting- just treat symptoms
- procalcitonin to distinguish between bacterial and viral
Lung Sounds - Wheezes
- Location
- Throughout Lung
- Description
- High Pitched
- Sounds Like
- Musical
- Cause
- Air Moving through Narrowed Airways
38 secs
Lung Sounds - Crackles
- Location
- Lower Lobes
- Description
- Fine/Coarse
- Sounds Like
- Fine: Twisting Hair through Fingers
- Coarse: Velcro
- Cause
- Collapsed Small Airways and Alveoli "Popping Open"
1 min
Lung Sounds - Rhonchi
- Location
- Trachea and Bronchi
- Description
- Low Pitched Rumbling
- Sounds Like
- Gurgling
- Cause
- Narrowed Airway
- Secretions or Bronchospasm
49 secs
Inhaled Corticosteroids
- Inhaled Corticosteroid
- Budesonide
- Budesonide
- Ages 12 +
- Beclomethasone
- Fluticasone
- MOA: Anti-Inflammatory through Gluc. Response Elements
- Side Effects
- Fx: Candidiasis
- Fx: Bone Resorption
- Fx: Osteonecrosis
- Fx: Psychosis
- Candida albicans (Oral Thrush)
- Fx: Cushing Syndrome Characteristics
Inhaled corticosteroids for asthma
- Fluticasone
- Budesonide
- Ciclesonide
- Beclomethasone
- Prodrug activates by airway esterase
- Less SEs than other corticosteriods
- Chronic asthma 1st Line Therapy (I)
- Inhibits synthesis of virtually all cytokines (MOA)
- Inactivates NF-Kappa-B the TF responsible for making TNF-Alpha (MOA)
- Oral thrush (SE)
- Limited role in COPD (I)
- Beneficial combination with beta-2-agonists
Corticosteroids
- Inhibit NF-κB. Suppress both B- and T-cell function by transcription of many cytokines. Induce apoptosis of T lymphocytes.
- Transplant rejection prophylaxis, many autoimmune and inflammatory disorders
- Hyperglycemia, osteoporosis, central obesity, muscle breakdown, psychosis, acne, hypertension, cataracts, avascular necrosis (femoral head).Cushing syndrome
Anticholinergics
- B.O.AT.S Acronym
- Benztropine
- Parkinson's Disease
- Oxybutynin
- Decrease bladder spasms
- Atropine
- Mydriasis and Cycloplegia
- Scopolamine
- Motion Sickness
1 min
Anticholinergics Continued
- Drugs
- Glycopyrrolate
- Reduces Airway Secretions
- Ulcer Treatment
- Ipratropium
- Asthma and C.O.P.D
- Dicyclomine
- Hyoscyamine
- Irritable Bowel Syndrome
1 min
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