W2: Chronic Pulmonary Disease

chronic obstructive pulmonary disease

preventable, treatable and slowly progressive respiratory disease that involves airflow obstruction in airways and pulmonary parenchyma; includes emphysema and chronic bronchitis

COPD clinical manifestations

chronic cough, sputum production, dyspnea, weight loss, barrel chest

COPD treatment

smoking cessation, bronchodilators, inhaled corticosteroids

COPD nursing management

improve airway clearance, breathing patterns, monitor complications, directed coughing, chest physiotherapy

bronchiectasis

chronic, irreversible dilation of bronchi and bronchioles resulting from destruction of muscles and elastic connective tissue

bronchiectasis clinical manifestations

chronic cough with copious purulent sputum production, hemoptysis, clubbing of fingers, repeated pulmonary infections

bronchiectasis nursing management

clear pulmonary secretions, smoking cessation, postural drainage

asthma

heterogenous disease characterized by chronic airway inflammation causing airway hyperresponsiveness, mucosal edema, and mucus production

asthma clinical manifestations

cough, chest tightness, dyspnea, wheezing

asthma treatment

short and long acting medications; SABA and anticholinergics or LABAs and corticosteroids, leukotrine modifiers

status asthmaticus

emergent episode of asthma exacerbation that does not respond to conventional therapy

status asthmaticus clinical manifestations

labored breathing, prolonged exhalation, distended neck veins, wheezing
wheezing may disappear as the obstruction worsens which indicates respiratory failure

status asthmaticus treatment

inhaled SABA, supplemental O2, IV fluids

status asthmaticus nursing management

assess airway, monitor vigilantly, fluid intake, BP and cardiac monitoring

cystic fibrosis

autosomal recessive disease caused by mutations in CFTR protein that lead to thick, viscous secretions in various organs

cystic fibrosis clinical manifestations

productive cough, wheezing, hyperinflation on CXR, sinusitis, nasal polyps

cystic fibrosis treatment

abx, airway clearance measures, bronchodilators, CFTR modulators

cystic fibrosis nursing management

pulmonary secretion removal, postural drainage, chest percussion, breathing exercises, reduce infection, avoid crowds