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z_MEDSURGE: FINAL REVIEW > Asthma > Flashcards

Asthma Flashcards

1
Q

Describe Asthma.

A
  • A chronic inflammatory disorder of the Bronchi & Bronchioles that obstructs airways
  • Asthma comes & goes with flare-ups in the form of asthma attacks
  • Attacks ARE REVERSIBLE!
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2
Q

What are the s/s of Asthma?

A
  • A – accessory muscle use
  • S – SOB/dyspnea
  • T – Tight chest/tachypnea
  • H – High pitched wheezing
  • M – Minimal/diminished breath sounds
  • A – 3 A’s
    • Absent breath sounds (silent chest) PRIORITY
    • Acidosis (CO2 retention)
    • Air trapping (prolonged exhalation)
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3
Q

How does air trapping during an asthmatic attack manifest?

A

Barrel chest

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4
Q

True or False

Asthma can lead to hypercapnic respiratory failure.

A

True

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5
Q

What is hypercapnia?

A

High CO2

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6
Q

A pH of < 7.35 and a PaCO2 > 45 indicates…

A

Acidosis

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7
Q

A PaO2 < 80 indicates…

A

Hypoxia

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8
Q

What are the s/s of Hypoxia?

A
  • Mental status change (FIRST SIGN OF HYPOXIA!)
  • Agitation
  • Restlessness
  • Drowsiness
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9
Q
A
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10
Q

What is Status Asthmaticus?

A
  • EMERGENT!
  • Severe, life-threatening, acute episode of airway obstruction
  • Intensifies once it begins, often does not respond to common therapy
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11
Q

What can Status Asthmaticus lead to?

A

Patient can develop pneumothorax and cardiac/respiratory arrest

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12
Q

What is the treatment of Status Asthmaticus?

A
  • IV fluids – to promote sputum
  • Potent systemic bronchodilator, steroids, epinephrine – to open airways
  • Oxygen – to promote gas exchange/perfusion
    • May need intubation to keep the airway open
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13
Q

What is the purpose of the peak flow meter?

A

Allows us to evaluate lung performance to anticipate a severe asthma attack before it happens

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14
Q

What is the procedure to use a Peak Flow Meter?

A
  1. Stand or sit in upright position
  2. Put the flow meter scale to 0 or lowest value
  3. Inhale deeply
  4. Put the mouthpiece in mouth & create a seal with the lips
  5. Exhale as quickly & forcibly as possible & record reading
  6. Repeat 2 more times, with a break of 5 -10 seconds between
  7. Record 1 score = the HIGHEST of the 3 attempts
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15
Q

What are some triggers for asthma attacks?

A
  • Allergens (indicated by elevated eosinophils)
  • Smoking
  • Stress (emotional/physical)
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16
Q

True or False

Strenuous activity must be avoided to prevent an asthma attack.

A

False – take meds before exercise to avoid attack

17
Q

True or False

Iced water can produce bronchospasms

A

True

18
Q

What diagnostic procedures are used for Asthma?

A

Pulmonary Function Test (PFT)

19
Q

What does a PFT measure?

A
  • Forced vital capacity (FVC)
  • Forced expiratory volume (FEV)
  • Peak expiratory flow rate (PEFR)
20
Q

What do “controller” drugs do for Asthma?

A
  • Change airway responsiveness to prevent asthma attacks
  • Used every day, regardless of symptoms
21
Q

What do “rescue” drugs do for Asthma?

A

Actually stop attack once it has started

22
Q

What are the two TYPES of drugs used for both controller and rescue therapy for Asthma and why?

A
  • Bronchodilators – to open the airways
  • Anti-inflammatories – to reduce inflammation of the airways
23
Q

What type of bronchodilators may be used to treat Asthma, what does each do and name the drug used for each?

A
  • B – Beta 2 agonist
    • Relaxes smooth muscles of the airways
    • albuterol
  • A – anticholinergic
    • dries out the body, decreasing secretions & dilating the airways
    • Ipratropium
  • M – Methylxanthines
    • Prevents histamine/allergic reactions – opens airways
    • Theophylline
24
Q

What do we need to keep in mind regarding Theophylline use?

A
  • Toxic and will cause tachycardia
  • Therapeutic range is 10-20 mg/dL
25
Q

A drug ending in “phylline” is a …

A

Bronchodilator

26
Q

A drug ending in “sone” is a _____ and helps with asthma by _____.

A
  • Steroid
  • Reducing inflammation
27
Q

What are the top 3 side effects of steroid use w/ asthma treatment?

A

S – Sores – in mouth (oral thrush)

S – Sepsis/Sickness (increased risk for infection – elevated WBC)

S – Sugars increased (watch for hyperglycemia issues)

28
Q

An asthma attack is being treated with Albuterol, Ipratropium and methylprednisolone. What is this doing to the body?

A
  • Albuterol is relaxing smooth muscle, opening airways
  • Ipratropium is drying out the system and decreasing secretions
  • Methylprednisolone is reducing inflammation
29
Q

True or False

A client should hold their breath for 10 seconds after inhaling so that the medication gets deep into the airways.

A

True

30
Q

True or False

I client is in need for further teaching if he states “I will shake the canister before I use it”.

A

False, he should shake the canister before use so you get the right amount of each drug within.

31
Q

A pt is having a severe asthma attack. Give the numbers to expect for the following:

HR, RR, O2sat, Peak Exp Flow

A
  • HR = >120bpm
  • RR = >30bpm
  • O2sat = <90% on RA
  • PEF = <40%
32
Q

When a pt presents to the ED with an acute asthma attack and cant catch his breath, when is the Peak Flow Meter test performed?

A

AFTER respirations are under control

33
Q

Which medication would you give for an acute asthma attack? Select All that apply

  1. Inhaled salmeterol
  2. Albuterol inhale
  3. Nebulizer Ipratropium
  4. IV methamphetamines
  5. IV Methylprednisolone
A

2, 3, 5

34
Q

Why should a pt rinse their mouth out after using an inhaler with corticosteroids?

A

To prevent candida albicans (thrush) from developing in the mouth

35
Q

What should you avoid if taking theophylline and why?

A
  • Caffeine
  • It has the same properties as Theophylline, which can increase the toxic effects of the medication
36
Q

When taking bronchodilators and corticosteroids separately, how long do you wait to take the steroid after the bronchodilator?

A

5 mins

z_MEDSURGE: FINAL REVIEW (15 decks)

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