Transcript Respiratory Issues

Chronic Obstructive Pulmonary
Diseases (COPD)
COPD
•Definition: Chronic Obstructive Pulmonary
Disease (COPD) is not one single disease
but an umbrella term used to describe
chronic lung diseases that cause limitations
in lung airflow (World Health Organization)
•Types of COPD:
–Asthma
–Emphysema
–Chronic Bronchitis
Symptoms of COPD
• Dyspnea
–Difficulty breathing
• Shortness of Breath
(SOB)
• Fatigue
• Coughing
• Sputum (phlegm)
Production
COPD Diagnosis
• The main test for
COPD is
Spirometry
• During the test, a
technician will ask
you to take a deep
breath and then
blow as hard as you
can into a tube
connected to a
small machine
Facts About COPD
• According to the American Lung Association,
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COPD is the 4th leading cause of death in the
United States
– Behind heart disease, cancer, and strokes
Cigarette smoking is the primary cause of
COPD
Long-term exposure to secondhand smoke can
also increase a person's risk for COPD
Industrial exposures, such as toxic fumes or
dust, can increase a person's risk of COPD as
well
What Is Asthma
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A chronic disease that causes:
– Bronchial constriction and spasm (tightening
of the muscles around the airways)
– Inflammation of the bronchioles
– Airways that are overly sensitive to allergen
and irritant triggers
– Excessive mucus production in the
bronchioles
• There may be periods when there are no
symptoms but the airways are swollen and
sensitive to some degree all of the time
Symptoms of Asthma
• Breathlessness
• Nighttime or early morning coughing
• Coughing or wheezing after physical
activity
• Breathing problems during particular
seasons
• Coughing, wheezing, or chest tightness
after allergen exposure
• Colds that last more than 10 days
• Relief when medication is used
What Is Asthma Video
• http://www.youtube.com/watch?v=qQEjzM
TSzAY
Risk Factors for Developing Asthma
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Smoking
Environmental Pollutants
Allergies
Family History
African Americans are more likely than
Caucasians to be hospitalized for asthma
attacks and to die from asthma
• It often starts in childhood. More boys
have asthma than girls, but in adulthood,
more women have asthma than men.
Asthma Triggers
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Exercise
Viral Illness
Weather Changes
Exposures to
Airborne
Chemicals
Dust
Tobacco Smoke
Animal Dander
(cats more of a
problem)
Cockroaches
• Dust Mites (tiny insects
that eat dead skin)
• Grass, Mold, and
Pollens
• Stuffed Animals
Additional Asthma Triggers
• Wood Fires
• Charcoal Grills
• Perfume and
Scented Soaps
• Household
Sprays
• Paint
• Gasoline
• Expressing strong
emotions like anger, fear,
or excitement
• When a person with
asthma laughs, yells, or
cries hard, natural airway
changes may cause
wheezing or other asthma
symptoms
Exercise Induced Asthma (EIA)
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Tightening of the muscles around the
airways
Distinct from other types of asthma
because it only happens with exercise
Can be prevented by taking pre-exercise
medication and by warming up/cooling
down
About 10% of the general population
without asthma, have EIA when they
exercise
Symptoms of Exercise Induced Asthma
• Coughing, wheezing,
chest tightness and
shortness of breath
• Coughing is the most
common symptom of
EIA and may be the only
symptom
• The symptoms of EIA
may begin during
exercise and will usually
be worse 5 to 10
minutes after stopping
exercise
Symptoms of Exercise Induced Asthma
• Symptoms range from mild to severe
and often resolve in 20-30 min
• Occasionally some individuals will
experience "late phase" symptoms
four to twelve hours after stopping
exercise
• Late-phase symptoms are frequently
less severe and can take up to 24
hours to do away
Causes of Exercise Induced Asthma
• When you exercise you breathe faster due to the
increased oxygen demands of your body.
• Usually during exercise you inhale through your
mouth, causing the air to be dryer and cooler than
when you breathe through your nasal passages.
This decrease in warmth and humidity are both
causes of bronchospasm
• Exercise that exposes you to cold air such as
skiing or ice hockey is therefore more likely to
cause symptoms than exercise involving warm and
humid air such as swimming
Preventing Exercise Induced Asthma
• Proper warm up for 6 to 10 minutes before
exercise
• Proper cool down
• Carefully monitor respiratory status
before, during and after exercise
• Use medication (Albuterol) 15-30 minutes
before exercise begins
• Check outdoor ozone/air quality levels
• If your client is complaining of breathing
difficulty- BELIEVE IT and take action
• Never encourage your client “tough it out”
when having asthma symptoms
Training Considerations
• Clients with asthma can participate in
exercise/sports without restrictions
• If your client is having trouble
exercising, their asthma may not be in
good control
• If clients are having symptoms with
activity, encourage them to use their
rescue inhalers
Training Considerations
• Aerobic exercise should be guided by the
client’s shortness of breath
• Intermittent exercise with frequent rest breaks
at a ratio of two parts exercise to one part
recovery
• A circuit training format is recommended
emphasizing breathing control and rest as
needed between sets
• If a client is experiencing unusual dyspnea
during exercise, stop exercise
• Upper extremity exercises cause increased
dyspnea and must be monitored
Training Considerations
• Good
– Activities that involve only short bursts of
exercise or intermittent periods of activity are
usually better tolerated
– Walking, volleyball, gymnastics or baseball
– Swimming that involves breathing warm and
moist air, is often well tolerated
• Bad
– Aerobic sports are more likely to cause
symptoms
– Distance running, soccer or basketball
– Cold air sports such as ice hockey or iceskating may not be tolerated as well
Exercise Guidelines
• Mode:
– Treadmill walking, cycling, elliptical trainers
• Frequency:
– 3-5 days per week
• Intensity: 40-60%
• Duration: 20-45 minutes
• Resistance Training:
– 1 set of 8-15 repetitions
– 2-3 days per week
– Allow for sufficient rest between exercise
Asthma Medications
• Two categories of medications:
– Controller Medications
• Taken every day to prevent swelling in the
lungs
• Examples may be Inhaled Corticosteroids such
as Azmacort, Pulmicort, Flovent, Advair
• These medications must be taken every day,
regardless if there are symptoms or not
– Reliever or Rescue Medications
• Taken only when needed to relieve symptoms
• Taken before strenuous exercise to prevent
exercise induced asthma (EIA) from developing
Reliever or Rescue Medications
• Examples: Albuterol, Proventil, Ventolin, Maxair
• Should be taken 10-15 minutes before
strenuous or aerobic activity begins
• Taken when needed to relieve symptoms
• Should be immediately and easily accessible
• You should be aware that your client is using
this medication
What is an Asthma Attack?
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Occurs when a person is exposed to
a trigger and their asthma symptoms
start to appear
• This can occur suddenly without
warning, or develop for days before
the symptoms begin
• Attacks are preventable by avoiding
exposure to triggers and taking
medications
Handling an Asthma Attack
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Remain calm and reassure the person
If the person has an inhaler with them, they
should take it
Have the person sit up and breathe slowly- in
through the nose, out through pursed lips
slowly
Have the person sip room temperature water/
fluids
If the person is a minor, contact the parent or
guardian as necessary
Do not leave the person unattended
Call 911 If…
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Lips or nail beds are bluish
Person has difficulty talking, walking or drinking
Quick relief or “rescue” meds (albuterol) is
ineffective or not available
Neck, throat, or chest muscles are pulling in
(retracting).
Nostrils flare out when trying to breathe
Obvious distress
Altered level of consciousness/confusion
Rapidly deteriorating condition.
What is Emphysema?
• Damage to the lungs that is Permanent and
Irreversible
• Destruction of the alveoli
• The lungs become less efficient at gas
exchange
• The lungs also lose their elasticity and the
person experiences difficulty exhaling
• Loss of elasticity results in lung enlargement.
The enlarged areas are ineffective in
eliminating CO2 and in transferring O2 from the
air into the blood stream
What is Emphysema
• Damage to the
alveoli not only
results in difficulty
breathing, but the
heart also has to
work harder to
circulate blood
through the lungs.
• All these changes
make less O2
available to the body
Symptoms of Emphysema
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Shortness of Breath (SOB)
Cough with Phlegm
Dyspnea-difficulty breathing
Coughing
Wheezing
Excess Mucus
Cyanosis-bluish color of the skin
Causes of Emphysema
• Cigarette smoking is the most
common cause of emphysema
–Smoking is responsible for
approximately 80-90% of deaths
due to COPD
• Environmental Conditions
–Pollution
–Work Environment (miners)
Complications of Emphysema
• People with emphysema eventually die
from it, or from complications resulting
from:
–Recurring chest infections, pneumonia,
the flu, colds
–Pulmonary Hypertension: Abnormally
high blood pressure in the arteries of the
lungs
–Cor Pulmonale: Enlargement and strain
on the right side of the heart
Emphysema Treatment
• Two surgical procedures can be done to
help people with emphysema:
–Lung-Volume Reduction Surgery:
The most severely diseased parts of
the lung are removed allowing the
remaining lung tissue and muscles to
work better
–Lung Transplantation: Last resort for
people with emphysema
Emphysema Treatment
• Quit smoking
–The single most
important factor
for maintaining
healthy lungs
• Bronchodilator
• Antibiotics/Steroids
• Exercise
What’s In a Cigarette Video
• http://www.youtube.com/watch?v=rHVW8
wojWgA&feature=related
What is Chronic Bronchitis?
• Inflammation of the trachea, bronchi, and
bronchioles causing excessive mucous
production and inflammation of the bronchial
walls
Symptoms of Chronic Bronchitis
• Persistent cough that produces mucus,
which may be blood streaked
• Shortness of breath aggravated by
exertion or mild activity
• Frequent respiratory infections that
worsen symptoms
• Wheezing
• Fatigue
• Ankle/foot and leg swelling
• Headaches
Causes of Chronic Bronchitis
• Cigarette Smoking
–The longer and heavier a person
smokes, the more likely it becomes that
the person will get chronic bronchitis
• Secondhand Smoke
• Viruses
• Air Pollution
• Infection
• Allergies
Chronic Bronchitis Treatment
• Quit Smoking!
• Drinking Water-lung secretions will be
thinner and easier to clear when the
person is well hydrated
• Bronchodilator Medications
• Vaccines-annual flu shot
• Humidifier
• Corticosteroids
• Exercise