Adult 1 Exam 2 Outline - Exam 2 Outline Main Topics PVS Problems Done by Jodi Respiratory Problems Upper Respiratory Infection(URI Bacterial infections

Adult 1 Exam 2 Outline - Exam 2 Outline Main Topics PVS...

This preview shows page 1 - 4 out of 8 pages.

Exam 2 Outline: Main Topics PVS Problems : Done by Jodi Respiratory Problems Upper Respiratory Infection (URI) Bacterial infections: 25% Influenza Common cold Acute laryngitis Acute epiglottitis Respiratory syncytial virus (RSV) URI: Management Discussion of antibiotics, oseltamivir, zanamivir Cough suppressants Rest Fluids Antipyretics Asthma Three principle triggers 1. Allergens and environmental factors Inhaled substances Food additives Medications 2. Infections Upper respiratory infection 3. Psychological factors Stress Asthma: Management Identification of exacerbating factors Daily monitoring of peak expiratory flow See online resource on asthma attack trigger diary Written instructions to manage an acute attack Education and follow-up Asthma: Medications Relievers SABA Controllers Oral systemic corticosteroids Low, medium, or high-dose ICS LTRA, cromolyn, nedocromil, or theophylline, zileutin LABA Step-up and step-down therapy Six steps
Image of page 1
Chronic Obstructive Pulmonary Disease (COPD) Obstructive (impaired expiratory flow rate) Reversible Asthma Irreversible Chronic bronchitis and emphysema Restrictive (reduced lung volumes) Musculoskeletal disorders Tumors Lung resection, ILD Chronic Obstructive Pulmonary Disease (COPD) (cont’d) “Blue bloaters” Chronic bronchitis and pulmonary hypertension Edema, cyanosis, polycythemia “Pink puffers” Emphysema, severe dyspnea Relatively normal ABGs “Barrel chest” COPD: Objective Findings AP/lateral chest diameter 1:1 Distant breath sounds End-expiratory wheezes Prolonged exhalation Neck vein distension Pedal and ankle edema Clubbing Fatigue COPD: Diagnostic Tests PFTs FEV 1 /FVC ratio <70% diagnostic for COPD Chest x-ray (although normal in early COPD) Chest CT CBC with diff, blood chemistry, alpha 1 -antitrypsin Sputum with Gram stain ECG COPD: Pharmacological Therapy Inhaled beta-2 agonist bronchodilators Inhaled anticholinergic bronchodilators Corticosteroids Xanthines Antibiotics Diuretics Mucolytics and expectorants COPD: Requirements for Home Oxygen PaO 2 of 55 mm Hg or less Oxygen saturation below 85%
Image of page 2
A PaO 2 of 55 to 59 mm Hg if erythrocytosis (HCT of 56% or more), cor pulmonale (P wave more than 3 mm in leads II, III, and aVF), edema, or CHF Goal on 1-2 L/min for 15 hours day is O 2 sat. of 90% or PaO 2 of 60 mm Hg COPD: Patient Education Smoking cessation Yearly influenza shot and every 5 year pneumovax Physical rehabilitation Support groups Teach pursed-lip breathing and O 2 therapy Assess for depression and treat if present Discuss advance directives Community-Acquired Pneumonia (CAP) Streptococcus pneumoniae, Haemophilus influenzae, Legionella pneumophila, Staphylococcus aureus Viral pneumonia Mycoplasma
Image of page 3
Image of page 4

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture