22 - Adult - Asthma/COPD

Question 1

Oxygen in the adult Asthma/COPD patient should be titrated to reach an SpO2 between ____.

Answer 1

94-99%

Question 2

For the adult asthma/COPD patient, what is the first line treatment to relieve respiratory distress?

Answer 2

Aerosolized 2.5 mg albuterol and 0.5 mg ipratropium with 4L/min oxygen

Question 3

For the asthma/COPD patient, CPAP may be utilized if the patient’s blood pressure is above ____ systolic.

A. 80 mmHg
B. 90 mmHg
C. 100 mmHg
D. 110 mmHg

Answer 3

C. 100 mmHg*

80-100 mmHg systolic requires medical control authorization

Question 4

If the adult asthma/COPD patient does NOT improve with duo-new treatments, _____ may be administered before Solu-Medrol.

Answer 4

0.3 mg IM/SQ 1:1,000 epinephrine

Question 5

If the adult asthma/COPD patient improves with Duo-Neb treatments, what is the next treatment?

Answer 5

125 mg of IV Solu-Medrol slow IVP

Question 6

An adult asthma/COPD patient is not improving after Duo-Neb, epinephrine, and Solu-Medrol. What is your next step in treating this patient?

Answer 6

Contact medical control for orders for:

• 2 g IV Mg2+ over 2 minutes
• 0.1 mg/kg IV ketamine

Question 7

What are the relative contraindications (requiring medical control contact) for epinephrine administration in the adult COPD/asthma patient?

Answer 7

• HR over 130
• patient over 40 YO
• irregular heart rate
• Prev. Hx of heart disease or HTN