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NURS 347 EXAM 2 > Asthma > Flashcards

Asthma Flashcards

1
Q

Asthma is 38% higher in who than whites?

A

Black people

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2
Q

Who has the highest mortality rates from asthma ?

A

Black women

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3
Q

Asthma effects about how many adult Americans?

A

20.4 million

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4
Q

Asthma gender differences
Men vs women? (2)

A

Men are more effected
But women die more too it

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5
Q

We tend not to diganosis asthma in child until 5 years old. Why?

A

Because children have small airways
Their airways can be obstructed by the smallest things

Reactive airway, they have reactive to a stimuli
After 4-5 years old, they have a pattern. Then we can say that have asthma

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6
Q

How much percentage of people are not using their inhalers correct?

A

72%

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7
Q

Asthma is the number one reason why kids ?

A

Miss school
13.8 million miss school

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8
Q

Asthma definition? (2) textbook definition

A

Combination of bronchial hyper responsive with
reversible expiratory airflow limitation

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9
Q

Asthma definition shorter version or how she says it (2)

A

Combination of
Bronchial construction ( narrowing )
&
Inflammation

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10
Q

The important part of reversible expiratory airflow limitation, the difference between asthma and COPD is?

A

Once the construction releases, the airway goes back to normal

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11
Q

Parents think when their kids get asthma they can’t do a lot of things, but you want them to get up and moving ( excerise ) why?

A

In order to gain resilience

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12
Q

In an adult airway they can handle more ____compared to an infant?

A

Inflammation

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13
Q

Asthma sign and symptoms may __?
Clinical course can be ___?

A

Vary
Unpredictable

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14
Q

Clinical course can be unpredictable because everyone Varys but it’s important to make sure the patient has what and why?

A

Making sure they have medication
In order to prevent an asthma attack

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15
Q

What are the 2 main consequences Of asthma?

A

Exposure to allergens or irritants triggers the inflammatory cascade involving a variety of inflammatory cells

Inflammation leads to bronchoconstirction, hyperresponsiveness and edema of airways lead to limited airflow

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16
Q

What does a person look like without asthma (3)?

A

Normal lining
Normal amount of mucus
Muscle relaxes

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17
Q

What does asthma look like in a person? (3)

A

Swollen lining
Excess amount of mucus
Muscle tightened

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18
Q

When we say more mucus on the asthma it’s usually what color?

A

Clear

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19
Q

What are some risk factors for asthma and triggers of asthma attacks? (12)

A

Cockroaches
Second hand smoke
Environmental allergies
Nasals polys
URI
Excersise enduced asthma
Animal dander
Mold
Fire pollution
Occupation
Cold air
Medications

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20
Q

Asthma can also come from where? (5)

A

GERD - gastroesophacal reflux disease
Asthma triad
Genetics
Immune system
Emotions

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21
Q

Can you just treat the constriction of the asthma? Why?

A

No because we also need to treat the inflammation if we’re going to reduce risk of death

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22
Q

What is the pathophysiology map for asthma? (10)

A

Triggers
- infection, allergens, exercise, irritants

Immune activation
- IL-4 & IGE production

Mast cell degranulation

Inflammatory mediators

Vasodilation
- increased capillary permeability

Cellular infiltration
- neutrophils, lymphocytes, eosinophils

Neuropeptides released with autonomic nervous system effects

Bronchospams
Vascular congestion
Etc

Airway remodeling

Bronchial hyperresponsiveness
Airway obstruction

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23
Q

Asthma & ___ & ___?

A

Allergens
Eczema

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24
Q

IL-4 is a what and functions how?

A

Cytokine
Functions as a potent regulator of immunity secreted primarily by mast cells

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25
IGE and mast cells are known to drive what and cause what? (3)
Immediate hypersensitivity Cause acute reactions such as Hives, wheezing, anaphylaxis
26
Mast cells serve as immune sentinel cells that respond to pathogens and sends signals to ?
Other tissues to modulate both innate and adaptive immune responses
27
When having asthma, our airway is remodeling, what does that mean?
We are changing to tolerate the change due to the bronchial construction/ hyperreactive
28
Early phase response is what after exposure to allergen or irritant?
30-60mins
29
In the early phase response of asthma what is being released? (2)
Mast cells release inflammatory mediators Mediators includes leukotrienes, histamines, cytokines,
30
Medications are made to help with the problems of asthma, like for the release of histamine we made medication for like?
Anti histamine Anti leurkotrienes
31
When you think of medication, you can’t treat something that isn’t the body. The medication goes into the body and works to attack the ?
Specific things Like the anti histamines Cause asthma is releasing histamine, so we give ANTI histamines to reverse the wrong
32
You can’t treat something new, instead you give medication to??
Reverse it!!
33
Late phase response what is it & time ? We see what symptoms & time? Occurs in % of patients(3)
Airway inflammation occurs within 4-6 hours Severe symptoms (24 hours+) Occurs in 50% of patients
34
Inflammation takes a what?
A little while to active Which is why we see it more in the late phase
35
What are used to treat inflammation?
Corticosteroids
36
What is remodeling for asthma? Proper definition
Structural changes in bronchi wall from chronic inflammation
37
What are changes that are in remodeling in asthma? (4)
Fibrosis Smooth muscle hypertrophy Mucus hypersecretion Angiogenesis
38
progressive loss of lung function not fully reversible results in persistent asthma? True or false? Why?
True We can treat it, however since it’s persistent, it’s constantly gonna cause damage to the lung function
39
What will a patient with asthma look like?
Distress Anxious Panic
40
What does respiratory distress look like? (5)
Hyperventilating Color change - cyanosis Blood pressure Respiratory rate increase Pulse ox
41
What are the diagnostic studies ? (5)
Peak flow meter Spirometer Fraction of exhaled nitric oxide (FENO) Serum eosinophils & IGE Allergy testing
42
What is peak flow meter? And predict what? What’s the rate called ?
- how feel your expiring ( getting air out ) Predict attack or monitor severity Peak expiratory flow rate
43
What is spirometry? Want to stop what/time?
Lung volumes & capacities -stop bronchiodilators 6-12 hours prior
44
Green means Yellow means Red means For peak flow meters?
Good Got to get more meds Danger !
45
What does EIA/EIB stand for? And means what?
Exercise induced asthma Exercise induced bronchospasm During physical exertion
46
EIA is during what?
Activity
47
EIB occurs after?
Vigorous exercise
48
If someone has a recent asthma attack they are more likely to what?
Have another attack
49
What is asthma triad mean?
Food triggers/ drug triggers Nasal polyps, asthma and sensitivity to aspirin and & NSAIDS OTC drugs, foods, beverages and flavorings
50
Clinical manifestations of asthma (8)
Wheezing Cough Dyspnea Chest tightness Silent chest - ominous sign Decreased/absent breath sound Hyperventilation Abnormal alveolar perfusion & ventilation
51
Clinical manifestations Hyperinflation & prolonged expiration are due to what?
Air trapping in narrowed airways
52
In an acute asthma attack, the most common clinical manifestation is what?
Wheezing
53
When do you normally hear wheezing?
initially expiration ( then progression in both inspiration & expiration )
54
How is wheezing described?
Whimsical, musical breath sound heard mainly on expiration
55
Wheezing is unreliable to gauge severity of attack why?
Because it can happened in both chronic and acute attacks and it could become chronic too
56
What is silent chest mean for clinical manifestations of asthma?
Severe airway obstruction or impending respiratory failure Life threatening
57
What does hyperventilation of asthma clinical manifestations?
Increased lung volume from trapped air and limited airflow
58
What is abnormal alveolar perfusion & ventilation?
Hypoxemic - decreased oxygen in blood Decreased paCO2 Increased pH Respiratory alkalosis results in respiratory acidosis as patient tires Respiratory failure
59
If the patient is hypoxemic what do they look like? And where? Why these locations?
Cyanotic Blue In the lips & finger tips & toes Capillaries & because oxygen first goes to brain/core Lips, tips, and toes are last
60
How do we test for capillary refill? How many seconds to come back to normal color?
Pinch/press finger to see how fast blood come back 3 or less
61
When pressing down on the hand or just testing for capillary refill, what is that called? And when you release what happens?
Gland change It refilled back to pretty pink
62
Slow Capillary refill means there’s a what?
Lack of perfusion in that body part where we tested the capillary refill
63
Asthma isn’t always wheezing or respiratory issues, it can be a what?? And typically wakes them up at?
Cough (dry) Night time cough
64
If the person is waking up more than twice a night to cough, we need to what?
Amplified medication
65
What are the 4 asthma classifications ? ( like how do we measure )
Intermittent - less than 2 times a week Mild persistent - more than 2 times a week Moderate persistent - daily Severe persistent - continual
66
What are the impairment criteria for asthma classifications? (7) ( think of like what needs to happen for us to classify it, like what happens with night time??)
Frequency of symptoms Night time awakenings SABA use for symptoms Interferences with normal activity Lung function : FEV1, FVC risk for exacerbation Severity
67
What are the complications of asthma? (7) What can it cause, think of the P in complications
Mild to life Last few mins to hours Asymptomatic Pneumonia Tension pneumothorax Status asthmatics !!! Acute respiratory failure
68
What is status asthmaticus in asthma?
Extreme acute asthma attack Hypoxia, hypercapnia, acute respiratory failure
69
What else would you see in status asthamticus? (3)
Can’t speak Chest tightness Shortness of breathe
70
Without treatment of status asthmaticus what happened? (3)
Hypotension Bradycardia Respiratory/cardiac arrest
71
Are bronchodilator’s and corticosteroids effective on status asthmaticus?
No
72
Status asthmaticus, patients are hard to intubated why?
Because it’s hard to even put it And it’s hard to get out of them cause they need oxygen
73
Asthma treatment ( mild to moderate ) (4)
Inhalers bronchodilator’s - albuterol ( topical medication ) Oral corticosteroids - inflammation Monitor vital signs Monitor as outpatient unless not responding to treatment or another contributing factor Follow up with HCP
74
What is the asthma rescue treatment and does what?
Albuterol Bronchodilator Helps with the bronchoconstriction
75
What does ICS stand for? And does what?
Inhaled corticosteroids Helps for inflammation of asthma
76
Since inflammation takes a while to start, so inhaled corticosteroids takes what?
It always takes a while to start being effective
77
Do we give inhaled corticosteroids to respiratory distress patients?
NO!!! They will die
78
What do you give for bronchoconstriction!?? And it’s a what?
Albuterol!! Bronchodilator
79
What do you give for inflammation?
Inhaled Corticosteroids
80
Should you being inhaled corticosteroids everyday? Why?
Yes because we can prevent or at least help get air in when an asthma attack is coming in Vitamins !! Apple a day keeps the doctor away
81
What is treatment for asthma? Measurements (2) (6)
Hospital admission for oxygen PaO2 > 60mmHG sa02 > 93% Monitor PERF, ABGS, VS Bronchodilators & oral corticosteroids Silent chest - call HCP stat
82
A patient is admitted to the emergency department with a severe exacerbation of asthma. Which finding is of most concern to the nurse? - unable to speak and sweating profusely - paO2 of 80mm ahh and PaCO2 of 50mm Hg - presence of inspiration and expiratory wheezing - peak expiratory flow rate at 60% of personal best
Unable to speak and sweating profusely
83
Drug therapy - rescue What are they called?
Short acting B adrenergic agonists ( SABAs )
84
What is an example of SABA?
Albuterol
85
What is the function of SABA?
Stimulate b2 receptors in bronchioles to produce bronchodilaton
86
When is SABA most effective ?
Relieving acute bronchospams with acute attack
87
What’s the onset and duration of Saba? (2)
Minutes - onset 4-8 hours - duration
88
What is drug therapy long term ??
Long acting b2 - andrenergic agnosit drugs ( LABA )
89
What are two examples of LABA?
Salmeterol ( serevent ) Formoterol ( foradil )
90
Do you use LABA for acute attacks?
NO!!
91
How often do you use LABA and decreased the need for what?
Once every 12 hours Decreased need of Saba
92
You can you add ICS ( inhaled corticosteroids) to LABA?
Yes
93
What’s another example of long term ? (2) And it has a what index? Meaning?
Meyhylaxnthines Theophylline ( it’s not used often & narrow therapeutic index ) - just right otherwise you get to toxic
94
Drug therapy Anti-inflammatory Corticosteroids It’s the most effective what?
Long term control drug
95
What are two examples of cortiscoertioids?
Beclomethasone Budesonide
96
When you inhale a corticosteroid is it actually touching the airway?
Yes because it’s like a topical
97
Why is it important to administer the medication proplery. Can you breathe through liquid? No though when you spray the liquid come out. It needs time to become vapor, so instead we use a what to help it become vapor?
A spacer
98
People get worried taking steroids for the inflammation but we tell patient that there is a little what?
Systemic absorption
99
What is LTMA stand for? Singular
Leukotriene modifying agents
100
What are examples of of LTMAS? (3) And how do we administer?
Zarirlukast Montelukast Zileuton Oral
101
How does LTMA work?
Interfere with synthesis or block the action of leukotrienes Produce both bronchodilator, antiiflmmatory
102
When do we give LTMAS? (3)
Asthma Allergic rhinitis EIB/EIA
103
LTMA isn’t for what?
An acute asthma attack
104
LTMA treats what?
Allergy & asthma
105
What’s a nebulizer mean?
Machine converts drug solution into a fine mist for inhalation via face mask or mouthpiece ; easy to use
106
If you have congestions, do you use a nebulizer or even albuterol?
No it won’t work
107
Patient teaching related to drug therapy Example?
Identify factors that affect correct use to medications Correct administration Important of following plan Side effects How to clean
108
What is an MDI? Inhaler?
Small hand held pressurized devices
109
A spacer helps what? (3)
Reduce oropharyngeao medication deposition Increase delivery to kings Reduce problems with hand breath coordinating
110
What are some subjective data we want to collect from a patient for nursing assessment for asthma?
Past health history Medications
111
We want to health promote/implementation of what in asthma?
Avoid triggers Prompt diagnosis Weight loss Increase fluids Exercise
112
What’s an oral corticosteroid example?
Prednisolone
113
What’s an ICS example?
Fluticasone/flovent
114
Inhaled corticosteroids can easily what?
Easy bruise Reduce bone density

NURS 347 EXAM 2 (7 decks)

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