Asthma

Question 0

Signs of hypoxemia

Answer 0

Inc bp, inc pulse, restlessness,anxiety

Question 1

Wheezing breathless chest tightness cough night and early morning

Answer 1

Asthma

Question 2

As asthma worsen u find..

Answer 2

Hyperresonance, wheezing, thick stringy mucus, diff to speak in complete sentence, rr above 30 with accessory muscles

Question 3

Silent chest

Answer 3

Decreased air movement due to muscle exhaustion diminished breath sounds severe obstruction or respiratory failure

Question 4

Too dyspneic to speak, sweating, peak flow of less than 25% of personal best bradycardia and close the respiratory arrest, drowsy and confused difficult to hear breath sounds

Answer 4

Life threatening asthma

Question 5

Use bronchial dialator to determine bronchoconstriction reversibility which will establish asthma diagnosis.. results are normal in between attacks

Answer 5

Pft

Question 6

Monitor or diagnose asthma, compare with persons previous best

Answer 6

Pefr

Question 7

Drug therapy long-term medication for asthma

Answer 7

Antiimflammatory,
Corticoids
-inhaled fluticasone
-oral ,predisone

Bronchodialtor
Laba, salmeterol, inhaled
Laba, albuterol,oral
Methryxanthines, theophylline

Question 8

Quick relief medications for asthma

Answer 8

Bronchodialators

• Saba ,albuterol
• anticholinergics ipaprotium

Antiimflammatory
-corticosteroids like prednisone

Question 9

Level of control is determined by

Answer 9

FEV1 exacerbations and advese treatment effects

Question 10

What to do in a asthma rescue plan

Answer 10

Any kind of asthma, patient take 2 -4 puffs of albuterol SABA q20 min 3x

Question 11

Difficulty breathing at activity only. “Can’t get enough air”Peak flow greater than 70% of personal best

Answer 11

Mild exacerbation of asthma

Question 12

Dyspnea interfere with usual activities and PeAK flow 40 to 60% personal best give SABA oral steroids

Answer 12

As asthma moderate exacerbation

Question 13

If have severe life-threatening exacerbation of asthma

Answer 13

Give SABA three treatments at 2o to 30 minutes apart

If severe asthma and give SABA and ipraprtium to get partial relief

.

Question 14

If the patient has no response to the asthma treatments

Answer 14

Give intubation or mechanical ventilation and 100% oxygen every hour continued SABA etc.

Question 15

What is bronchial thermoscopy

Answer 15

For severe asthma, add heat through catheter (fiber-optic bronchoscope) parentheses on bronchial walls

Question 16

What anti-inflammatory drug is more effective than any of the long-term drug and also how species hyperresponsiveness

Answer 16

Corticosteroids

Question 17

Only used with ICS never alone added in 3+step

Answer 17

Laba

Question 18

No caffeine the loud report toxicity shown by nausea and vomiting seizures insomnia and is a alternative for step two is job is bronhiole dilation and mild anti-inflammatory. Has issue with drug interaction must be taken with food and anti-acids because it will cause G.I. distress nausea headache take a cardio seizure and narrow therapeutic book range

Answer 18

Methyxanrhjne theopHylline

Question 19

If asthma symptoms persist or the peak flow is below 50%

Answer 19

Get emergency

Question 20

If patients with acute asthma is a health care what do you need to check for

Answer 20

Lung soung, HR, RR,BP, ABG,O2,peak flow

Question 21

Presence of chronic productive cough for three months in each of the two consecutive years in a patient who other causes upon a cough are excluded

Answer 21

Chronic bronchitis

Question 22

Anti trypsin is for what and replace with what

Answer 22

Replace with Prolastin, Att in lung and protects the lungs from breaking down from inflmmation severe ATt deficiency can cause premature bolus emphysema

Question 23

The inflammatory cells of COPD are

Answer 23

Neutrophils macrophages and lymphocytes

Question 24

Asthma the inflammatory cells

Answer 24

mast cells neutrophils macrophages which will attract leukotrienes ans cytokines at the end the lung structure will change

Question 25

what's symptoms of COPD

Answer 25

Barrel chest inability to expire air hyper expanded long overinflated lungs dyspneic probably hypoxemia hypercapnia, CO2 retention excessive mucus bullae destroyed alveolitis due to aIr trapping

Question 26

What happens during the late course of COPD

Answer 26

Pulmonary hypertension due to vasoconstrictive arteries and thick arteries, patients won't have hypoxia atnrest until late stage but can still happen at exercise so do give oxygen . for a hypertension can cause hypertrophy on right ventricular valve of the hearts cor pulmonale right ventricle dilates right side heart failure

Question 27

Pulmonary hypertension can cause

Answer 27

Rv hypertrophy, right heart failure after dialate

Question 28

Systemic diseases of the COPD

Answer 28

Cardiovascular muscle wasting CACHEXIA osteoporosis metabolic syndrome and diabetes

Question 29

Early-stage COPD symptoms

Answer 29

Unproductive chronic cough, decreased airflow secretly, progressive dyspnea on exertion every day ,cannot the deep breathe, heavy chest and air hunger so some difficulties with ADL

Question 30

Copd late stage

Answer 30

Dyspnea of rest, increased trapped, flat diaphragm, accessory muscles - chest breathing, wheezing chest tightness of been following activities

Question 31

Advanced COPD

Answer 31

Fatigue weight-loss and anorexia

Question 32

Prolonged expiration, wheezing, decreased breath sounds, barrel chest, sitting upright with pursed lip breathing and assessory muscle. Increase hemoglobin

Answer 32

Copd

Question 33

Edema on ankle is

Answer 33

Right heart cor pulmonale

Question 34

Mild stage of COPD is what FEV

Answer 34

More than or equal to 80

Question 35

Moderate COPD is what FDV

Answer 35

50 to 80%

Question 36

Severe COPD is How many FEV

Answer 36

30-50

Question 37

If the FEV is less than30 for COPD

Answer 37

Very severe COPD

Question 38

Most common chronic sympt of cor pulmonale

Answer 38

Dyspnea

Question 39

Distended neck , right upper quadrant tender hepatomegaly peripheral edema and weight gain

Answer 39

Right heart manisfestation

Question 40

Three things to treat cor pulmonales

Answer 40

Bronchial dilatiooxygen 15 or more hours today | Diuretic

Question 41

HCO3 level late COPD stage

Answer 41

Normal to hi

Question 42

If late COPD patient is breathless

Answer 42

Give SABA

Question 43

Late COPD stage need to be treated something

Answer 43

CPAP

Question 44

Three symptoms of COPD exacerbation

Answer 44

Dyspnea , Sputum vol , nd purulence

Question 45

If patient has acute respiratory failure because it way too long to report or the discontinued the med you give now

Answer 45

Cardio selective b adrenergic blockers and chronic beta blocker prophylactic

Question 46

4 things that reduce COPD exacerbation

Answer 46

LA BA, long anti-cholinergic, ICS, rofluminast

Question 47

Two test to check the symptoms of COPD

Answer 47

MMRC dyspnea | CAT impact the life

Question 48

Test copd death

Answer 48

Bode

Question 49

ABGs of late COPD

Answer 49

Low O2 low pH high CO2 hi HCO3

Question 50

Early COPD ABGs

Answer 50

Normal to low oxygen .normal CO2

Question 51

Vaccines for COPD smokers

Answer 51

Flu shot and pneumococcal vaccine

Question 52

Moderate COPD which is FEV of greater than 60% use what drug

Answer 52

L ABA Longbronchodilator but for rescue can use short SABA | Can also add ICS to bronchodilator

Question 53

A drug that is anti phosdiesterase anti-inflammatory and a block the production of reactive oxygen radicals to decrease of COPD exacerbation

Answer 53

ROFLUMILAST

Question 54

The drive to breath depends on the carbon dioxide then the sensitivity drive to breath is lost

Answer 54

CO2 narcosis

Question 55

RARE, from too much oxygen ,PUL EDEM, CAUSE ARDS

Answer 55

Oxygen toxicity More than 50% of oxygen given for 24 hours is potentially toxic less than 40% for short time is non-toxic

Question 56

When nitrogen is not absorbed, nitrogen supposed to prevent collapse when is too much oxygen given the nitrogen is filtered out

Answer 56

Absorption atelectasis

Question 57

Infection the highest risk for wat nd by what organism and prevent is what

Answer 57

Heated nebulizers by Pseudomonas Aeruginosa prevented with Ballard closed suction system

Question 58

Wash nasal cannula is needed | Wen when, replace when

Answer 58

Wash 1-2x a week. Replace q.2-4wk

Question 59

If rbc hematocrit and hemoglobin goes down

Answer 59

Dyspnea

Question 60

If acute respiratory failure

Answer 60

So someone to help make sure patient have IV access device ready For. Stat give more than 94% maintainoxygen, High fowler

Question 61

Dyspnea, dec chest movement ,decreased breath sounds hyperresonance the solution is insert tube or a flutter valve

Answer 61

Pneumothorax

Question 62

Considered in medical emergency showing signs of cyanosis and air hunger ,agitate, sub q emphysema, hyperrresonance. Needle compression and chest to chest drainage

Answer 62

Tension pneumothorax