Asthma

Question 1

Asthma Patho

Answer 1

chronic inflammation from exposure to allergen or irritants

• early phase: within 30-60 minutes
• late: 4-10 hrs

Question 2

During an asthma attack

Answer 2

1. respiratory alkalosis

2. respiratory acidosis (sign of respiratory failure)

Question 3

The nurse caring for a client with asthma understands the pulmonary system most affected by asthma is the:

Answer 3

airways

Question 4

Meds that can trigger asthma

Answer 4

• aspirin
• ACE inhibitors
• beta blockers

Question 5

What should you teach the client who has asthma that is triggered by exercise?

Answer 5

“Use a short-acting beta2 agonist before engaging in exercise.”

Question 6

Asthma Manifestations

Answer 6

• prolonged expiration
• wheezing
• cough
• hypoxemia

Question 7

Hypoxemia signs

Answer 7

• restlessness and anxiety
• wheezing
• hyperresonance
• silent chest= failure
• confusion: most worried

Question 8

Severe Acute Attack

Answer 8

• dyspenic at rest
• talk in words
• RR> 30
• P>120
• PEFR: 40%
• in ED or hospitalized

Question 9

Life-threatening Asthma

Answer 9

• too dyspenic to speak
• sweating
• drowsy/confused
• PEFR < 20%

Question 10

Status asthmaticus

Answer 10

Life-Treatening Asthma Exacerbation

• hypercapnia and hypoxemia
• can lead to pnemothorax

Question 11

Asthma Diagnostics

Answer 11

• detailed history and physical exam

- pulmonary finction tests

Question 12

Asthma Management

Answer 12

Adrenergics (beta-agonists)
Steroids
Theophylline
Hydration
Mask O2
Anticholinergics

Question 13

Acute treatment of Asthma Attacks

Answer 13

Short acting bronchodilators
Epinephrine
Oxygen

Question 14

Prophylactic (preventative) therapy to reduce number of asthma flares

Answer 14

Inhaled corticosteroids
Long acting bronchodilators
Inhaled Anticholinergic
Management of triggers (treatment of seasonal allergies)

Question 15

3 Types of Bronchodilators

Answer 15

β2-adrenergic agonists (long and short acting)
Methylxanthines
Anticholinergics

Question 16

Short-acting β2-adrenergic agonists

Answer 16

• albuteril and pirbuterol
• for acute bronchospasm
• onset in minutes

Question 17

Quick-relief bronchodilators (rescue inhalers)

Answer 17

Treat symptoms of acute exacerbations
Short-acting inhaled β2-adrenergic agonists (e.g., albuterol [Proventil HFA])
Anticholinergics

Question 18

Inhaled Corticosteriods

Answer 18

• Pulmicort
• don’t use with corticosteroids
• for persistent asthma
• 1-2 wks before effective
• women: take calcium & vit D

Question 19

Leukotriene modifiers

Answer 19

• bronchodilator and anti-inflammatory
• prophylactic and maintenance
• allergy & exercised induced

Question 20

Monoclonal Antibodies

Answer 20

• prevents IgE from attaching to mast cells

- high risk of anaphylaxis

Question 21

Bronchodilators (long-acting/long-term control)

Answer 21

• beta agonists
• effective for 12 hrs
• added to ICS
• not monotherapy

Question 22

Methylxanthines

Answer 22

• theophylline (therapeutic: 10-20 mcg)
• step 2 care in mild persistent asthma
• bronchodilator with mild antiinflammatory
• high interaction

Question 23

Anticholinergic drugs

Answer 23

• Short-acting (e.g., ipratropium [Atrovent])
• Long-acting (e.g., tiotropium [Spiriva])
• in combo with SABA
• SE: dry mouth

Question 24

Peak Flow results

Answer 24

Green zone
-80-100%
-remain on meds
Yellow
-50-80%
-trigger
Red
->50%
-definitive action taken

Question 25

What is the major difference in pathophysiology between asthma and COPD?

Answer 25

COPD results in permanent airflow obstruction and asthma is a condition of reversible airflow obstruction.