HPA - Emphysema

Beschreibung

Karteikarten am HPA - Emphysema, erstellt von Em J am 08/06/2018.
Em J
Karteikarten von Em J, aktualisiert more than 1 year ago
Em J
Erstellt von Em J vor etwa 6 Jahre
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What is it? A form of COPD where the walls of alveoli are destroyed due to inflammation and become enlarged, and decrease in elasticity, leading to airflow impairment.
Prevalence of COPD 2011 - 2012 530,000 Australians
What are the risk factors Age: > 50 Smoking Occupational exposure to fumes Genetic: severe ATT deficiency associated with a single gene
Causes Main cause is long term exposure to airborne irritants, especially through smoking. Genetic: severe ATT deficiency which can be inherited (rare)
Pathophysiology behind the disease Inflammatory cells collect in distal airway tissues These lead to the destruction of elastic fibres in the respiratory bronchioles & alveolar ducts. Alveolar wall destruction causes the alveoli to combine and create larger air spaces - causing a loss of pulmonary capillary bed. This reduces the surface area for alveolar-capillary diffusion - affecting gas exchange. The loss elastic recoil reduces passive expiration of air.
What are the symptoms? Absent/ mild cough with scant clear/no sputum Person appears thin and cachectic* (waisted) Barrel chest Commonly uses accessory muscles to assist breathing "Pink puffer"
What might a nurse notice on examination? Resp: Distant/diminished breath sounds on auscultation Hyper-resonant on percussion Nurse may note pink skin, barrel chest, anxious expression and assumption of tripod position. ^ WOB and prominent use of accessory muscles.
Vitals? SpO2 may be < 95% RR: may be above normal HR: can be normal or increased BP: may be above normal Temp: can often be increased
Other relevant tests ABGs can be normal or indicative of mild hypoxaemia RFTs increased total lung capacity (due to increased lung fields) and markedly increased residual volume FBC may show ^ haematocrit and ^ RBCs due to chronic hypoxia Chest xray may show enlongated lung fields
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