NSB231 Chapter Notes - Chapter 25: Chronic Obstructive Pulmonary Disease, Pulmonary Function Testing, Obstructive Lung Disease

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Week 4: Asthma, Bronchitis & Emphysema (COPD)
ASTHMA
Asthma: chronic inflammatory disorder of the airways that result in recurrent episodes of
airflow obstruction that it is usually reversible
Asthma Triggers:
Allergens
Air Pollutants
Inflammation and Infection
Drugs
Occupational Exposure
Food Additives
Pathophysiology
Persistent but variable inflammation of the airways
Airflow is limited because of inflammation resulting in bronchoconstriction, airway
hyperresponsiveness (hyperreactivity) and oedema of the airways
Exposure to a trigger initiates the inflammatory cascade
Asthma isn't a psychosomatic disease (mind and body cause)
Genetics and immune response can influence asthma development
Exercise-induced Asthma
Most pt with asthma have a history of allergic rhinitis (irritation of nose) and GORD
Signs and Symptoms
Wheezing, cough, dyspnoea and chest tightness
Expiration may be prolonged
When experiencing an asthma attack, usually show signs of hypoxaemia (low blood oxygen)
Can be sudden or abrupt
Wheezing is an unreliable sign to gauge severity off
Asthma Classification
Intermittent
Mild persistent
Moderate persistent
Persistent
Severe persistent
Severe asthma exacerbations (worsening of symptoms) occurs when patient is dyspnoeic
(difficulty in breathing) at rest and speaking in single works
Sit pt forward to maximise diaphragmatic
Severe asthma can result in severe hypoxia (deficiency in oxygen reaching tissue)
Diagnostic
Under-diagnosis of asthma is common
Detailed history is important to determine the trigger
Diagnosis of asthma is made based upon the presences of indicators
Signs and symptoms
Health history
Pulmonary function tests
Peak flow variability
During exacerbation, lung function parameters fall.
Care
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