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N3 Ex2 Oxygenation > Asthma > Flashcards

Asthma Flashcards

1
Q

What is Asthma?

A

A chronic inflammatory disease of the lungs characterized by recurrent episodes of wheezing, breathlessness, chest tightness & coughing.

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2
Q

What is a Type 1 Sensitivity Asthma?

A

Airway hyper-responsiveness ( exaggerated bronchodilation response) & airway obstruction from over production of mucus & edema of the airway mucosa.

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3
Q

What happens after Inflammatory Mediators are activated in Asthma?

A
  1. Vascular Congestion
  2. Edema Formation
  3. Increased Mucus Production
  4. Bronchospasm
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4
Q

What is Status Asthmaticus?

A

A severe prolonged form of asthma that is difficult to treat. It is due to the overuse of emergency asthma medication, making the person unresponsive to these meds. This is considered a medical emergency that can result in respiratory failure.

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5
Q

What are some Causes of asthma attacks?

A
  1. Air pollutants: Tobacco, Smoke, Fumes
  2. Allergens: Pollen, Animal Dander, Dust, Mold
  3. Chemicals & Food: Drugs, Nnuts, MSG, Shel-fish & Dairy Products
  4. Respiratory Infections: Bacterial, Fungal, Viral, etc.
  5. Stress: Emotional, Anxiety, Exercise in DRY & COLD climates.
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6
Q

What are Clinical Manifestations of Asthma?

A
  1. Coughing
  2. Wheezing
  3. SOB
  4. Chest Tightness
  5. Tachypnea
  6. Tachycardia
  7. Anxiety
  8. Apprehension
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7
Q

Which airway cell activates 1st in response to an allergen?

A

B-Lymphocyte

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8
Q

What are the cells involved in the early phase response of asthma?

A
  1. B-lymphocyte
  2. Plasma Cells
  3. IgE antibodies
  4. Mast Cells (MVP)
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9
Q

How is Asthma Treated?

A
  1. Attack Prevention
  2. Bronchodilators
  3. Antiinflammatories
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10
Q

What is the Main Difference Between Asthma & COPD?

A

Asthma is reversible

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11
Q

Are men or women more likely to have asthma?

A

Women are 76% at greater probability of having asthma

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12
Q

Which cell is the MVP inflammation in asthma?

A

Mast Cell bc of their granules of histamine that are activated.

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13
Q

What is the Primary Response in Asthma?

A

Chronic Inflammation which leads to…

  1. Airway Bronchoconstriction
  2. Hyperresponsiveness
  3. Edema of Airways.
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14
Q

Early Response Asthma Effects.

A
  1. Vascular Congestion- Bc of Histamin
  2. Edema Formation–Bc of inflammation
  3. Production of Thick, Tenacious Mucus
  4. Bronchial Muscle Spasm
  5. Thickening of Airway Walls.
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15
Q

What cells live within the alveolar wall that is the primary cause of Inflammation?

A
  1. Mast Cells
    - Mast Cells release Histamine
    - -Activated by allergen or chemical mediators through cascade.
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16
Q

Asthma: Primary Response

A
  1. INFLAMMATION
    - From exposure to allergens or irritants
    - -Leading to Airway Bronchoconstriction, Hyperresponsiveness, and Edema of Airways.
    - –RN Dx= Ineffective Airway Clearance
17
Q

What do B cells produce?

A
  1. Antibodies

2. Becoming a factory producing more B cells.

18
Q

Asthma: Late phase Response: What happens when airway inflammation is not treated or resolved?

A

May lead to irreversible lung damage, Such as:

Structural changes in the bronchiol wall known as remodeling

19
Q

How long does the late-phase response take after an initial asthma attack? How long can it last?

A
  1. Late-Phase begins within 4-6 hours

2. Can last 24hours or longer

20
Q

Approximately how many patients with asthma attacks develop into the late-phase response?

A
  1. The late-phase occurs in approximately 50% of pt’s.

2. The late-phase can be more severe than the early-phase

21
Q

When taking a Hx. What is an important question?

A

What was the pt. doing? Feeling?

What was the possible cause?

22
Q

What are the common asthma clinical manifestations?

A
  1. Unpredictable and variable
  2. Recurrent episodes of wheezing (but not very reliable bc there is air movement)
  3. Breathlessness
  4. Cough
  5. Chest Tightness
  6. ABG (most reliable source)
23
Q

Asthma and Wheezing…

A
  1. Wheezing is unreliable to gauge severity
  2. Severe attacks may have no audible wheezing
  3. Usually begins upon exhalation
  4. Silent lung= Medical emergency
  5. ABG is the most reliable diagnostic tool.
24
Q

In asthma, the pt. having difficulty with air movement can create the feeling of suffocation which can lead to what…?

A
  1. Anxiety, which further leads to worsening of the asthma.

Patient may express “I can’t get a breath.”

25
Q

What are some physical manifestations of the asthma pt’s. state of hypoxemia?

A
  1. Using accessory muscles
  2. Anxiety Increases
  3. Tripod position
26
Q

What is the RN’s 1 st action when pt. states they are SOB?

A

Raise HOB to High Fowler Postion

27
Q

Asthma with Hypoxemia Clinical Manifestations

A
  1. Increased BP, HR, RR
  2. Anxiety
  3. Dry mouth
  4. Restlessness
  5. Diaphoretic
  6. Inappropriate behavior
  7. Wheezing
  8. Hyperresonance (Air trapping
    Silent Chest= Impending Intubation.
28
Q

What are the 4 Asthma Classifications?

A
  1. Intermittent
  2. Mild Persistent
  3. Moderate Persistent
  4. Severe persistent
29
Q

Asthma Complications, Severe and Life Threatening Exacerbations

A
  1. RR >30
  2. HR >120
  3. PEFR @ 40%
  4. Too dyspnic to talk
  5. Perspiring profusely
  6. Drowsy and confused
30
Q

What are the 5 Major RN Dx for Asthma?

A
  1. Altered oxygenation R/T bronchial constriction and mucus production
  2. Ineffective Breathing Pattern R/T Bronchospasm
  3. Anxiety R/T fear of sufocation
  4. Fatigue R/T Decreased Oxygen Supply to tissues
31
Q

What are some Outcomes and Goals?

A
  1. Control or eliminate symptoms
  2. Attain normal lung function
  3. Restore normal activities
  4. Reduce of eliminate exacerbation and side effect of medication
32
Q

Diagnostic testing for the asthma pt.

A
  1. Detailed Hx
  2. Peek flow monitoring (PEFR)
  3. Pulmonary Function test
  4. CXR
  5. ABG
  6. Oximetry
  7. Allergy Test
  8. Sputum Culture and A Sensitivity
33
Q

Asthma Collaborative Care: Intermittent & Persistent Asthma

A
  1. Avoid triggers
  2. Drug therapy (depends on severity)
  3. Pre-medicate before exercise.
34
Q

Asthma Collaborative care: Acute Asthma Exacerbations

A
  1. Tx depends on severity & response to therapy
  2. Severity Measured with flow rates
  3. Oxygen therapy may be started & monitored
35
Q

Asthma Treatment: Severe & life threatening exacerbations

A
  1. IV Corticosteroids Q4-6 hours
  2. Arterial Catheter for ABG monitoring
  3. IV magnesium sulfate for bronchoconstriction
  4. Helium and Oxygen Tx given by mask or NC, Keep above 90%.
  5. Epinaphrine used only in life-threateining situations
36
Q

Who is @ most risk for Status asthmaticus?

A
  1. Elderly
  2. Children
    Bc they can decompensate rapidly
37
Q

What are the 2 quick relief medications to Tx Asthma?

A

SABA-Short Acting Beta Agonist

  1. Beta-Agonist= Albuterol
  2. Anticholinergic Agent= Atrovent

N3 Ex2 Oxygenation (8 decks)

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