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NCM118 > Asthma Book > Flashcards

Asthma Book Flashcards

1
Q

is a heterogeneous disease, usually characterized by chronic airway inflammation

A

Asthma

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2
Q

This chronic inflammatory disease of the airways causes

A

airway hyperresponsiveness
mucosal edema
mucus production

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3
Q

This inflammation ultimately leads to recurrent episodes of asthma symptoms

A

cough, chest tightness, wheezing, and dyspnea

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4
Q

is the most common chronic disease of childhood, it can occur at any age.

A

Asthma

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5
Q

disruptive disease, affecting school and work attendance, occupational choices, physical activity, and general quality of life.

A

Asthma

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6
Q

Predisposing factors

A

Atopy
Female gender

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7
Q

Casual factors

A

Exposure to indoor and outdoor allergens
Occupational sensitizer

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8
Q

Contributing factors

A

Respi infection
Air pollution
Active/passive smoking
Diet
Microsomia

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9
Q

Factors causes

A

Inflammation

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10
Q

Inflammation causes

A

Hyper responsiveness of airways
Airflow limitations
Symptoms

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11
Q

Risk factors for exacerbations

A

Allergens
Respiratory infections
Exercise and hyperventilation
Weather changes
Exposure to sulfur dioxide
Exposure to food, additives, meds

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12
Q

percent of patients with asthma smoke, even though cigarette smoke is known to trigger an attack

A

21 percent

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13
Q

Percent of people without asthma smoke

A

17%

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14
Q

refers to patients who have clinical presentations of both conditions

A

Asthma-COPD

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15
Q

are at higher risk for having asthma–COPD overlap

A

Smokers

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16
Q

Contributing to these disparities are epidemiologic considerations and risk factors that include

A

genetic and molecular aspects;
inner-city environments;
limited community assets;
health care access/delivery/and quality;
and insufficient health insurance
coverage

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17
Q

Unlike other obstructive lung diseases, asthma is

A

Largely reversible, spontaneous or tx

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18
Q

is the strongest predisposing factor for asthma

A

Allergy

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19
Q

Common allergens

A

Seasonal or Perennial

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20
Q

Seasonal allergens

A

grass, tree, weed pollens

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21
Q

Perennial allergens

A

mold, dust, roaches, animal dander

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22
Q

Common triggers for asthma symptoms and exacerbations

A

Airway irritants
Foods
exercise, stress, hormonal factors, medications, viral respiratory tract infections, and gastroesophageal refl

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23
Q

is reversible diffuse airway inflammation that leads to long-term airway narrowing.

A

Asthma

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24
Q

This narrowing, which is exacerbated by various changes in the airway, includes

A

bronchoconstriction, airway edema, airway hyperresponsiveness, and airway remodeling

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25
Q

all play a key role in the inflammation of asthma

A

Mast cells, macrophages, T lymphocytes, neutrophils, and eosinophils

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26
Q

When activated, mast cells release several chemicals called

A

Mediators

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27
Q

chemicals and other mediators, perpetuate the inflammatory response

A

histamine, bradykinin, prostanoids, cytokines, leukotrienes,

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28
Q

Chemicals and mediators causes

A

increased blood flow, vasoconstriction, fluid leak from the vasculature, attraction of white blood cells to the area, mucus secretion, and bronchoconstriction

29
Q

bronchial smooth muscle contraction
or bronchoconstriction occurs quickly to narrow the airway in response to an exposure.

A

Acute exacerbation of asthma

30
Q

Acute bronchoconstriction due to allergens results from an

A

immunoglobulin E (IgE)-dependent release of mediators from mast cells

31
Q

IgE mediators that contract the airway

A

histamine, tryptase, leukotrienes, and prostaglandins

32
Q

are stimulated, bronchoconstriction occurs

A

alpha-adrenergic receptors

33
Q

The balance between alpha- and beta-2–adrenergic receptors is controlled primarily

A

cyclic 3′,5′-adenosine monophosphate (cyclic AMP

34
Q

results in increased levels of cyclic AMP, which inhibits the release of chemical mediators and causes bronchodilation

A

Beta-2–adrenergic stimulation

35
Q

The three most common symptoms of asthma are

A

Cough, dyspnea, and wheezing

36
Q

Asthma attack occurs

A

At night or early in the morning

37
Q

As the exacerbation progresses these occur

A

diaphoresis, tachycardia, and a widened pulse pressure c hypoxemia and central cyanosis (late sign of poor oxygen)

38
Q

is secondary to a ventilation–perfusion mismatch and readily responds to supplemental oxygenation.

A

Hypoxemia

39
Q

Symptoms of exercise-induced asthma include

A

Maximal symptoms during exercise
Absence of nocturnal symptoms
Choking sensation during exercise

40
Q

Assessment and dx findings

A

Family hx
Sputum and bld tests (eosinophilia)
Serum levels of IgE increase
ABG and pulse oximetry (Hypoxemia)
FEV1 and FVC
Pulmonary fx

41
Q

Initially these are prsent, then if condition worsen… May increase

A

Hypocapnia and respi alka… Increase PaCO2

42
Q

Prevention

A

Undergo testing to identify what precipitate sx

43
Q

refers to asthma induced by exposure in the work environment to dusts, vapors, or fumes, with or without a preexisting diagnosis of asthma.

A

Occupational asthma

44
Q

should be part of the differential diagnosis of every case of adult-onset asthma

A

Work-related asthma

45
Q

Complications

A

status asthmaticus, respiratory failure, pneumonia, and atelectasis

46
Q

particularly during acute asthmatic episodes, often results in hypoxemia, requiring the administration of oxygen and the monitoring of pulse oximetry and arterial blood gases

A

Airway obstruction

47
Q

Medical mgt

A

Pharmacologic Therapy
Mgt of exacerbations
Peak flow monitoring

48
Q

Primary tx

A

Primary tx: preventing impairment of lung function, minimizing symptoms, and preventing exacerbations

immediate interventioncto diminish bronchoconstriction

49
Q

Pharmacologic Therapy

A

Two general classes of asthma meds: quick-relief medications & longacting medications

50
Q

for immediate treatment of asthma symptoms and exacerbations.

A

quick-relief medications

51
Q

to achieve and maintain control of persistent asthma

A

longacting medications

52
Q

Because the underlying pathology of asthma is inflammation, control of persistent asthma is accomplished primarily with regular use of

A

anti-inflammatory medications

53
Q

The route of choice for administration of these medications which allows for localized administration within the lungs

A

pMDI

54
Q

Quick-Relief Medications

A

Short-acting beta-2–adrenergic
agonists (SABAs)
Anticholinergics

55
Q

relief of acute symptoms and prevention of exercise-induced asthma. They are used to relax smooth muscle.

A

Short-acting beta-2–adrenergic
agonists (SABAs)

56
Q

inhibit muscarinic cholinergic receptors
and reduce intrinsic vagal tone of the airway

A

Anticholinergics

57
Q

Long-Acting Control Medications

A

Corticosteroids
Long-acting beta-2 adrenergic agonists (LABAs)
Leukotriene modifiers (inhibitors), or antileukotrienes

58
Q

are the most potent and effective anti-inflammatory medications currently available.

A

Corticosteroids

59
Q

are used with antiinflammatory medications to control asthma symptoms, particularly those that occur during the night.

A

Long-acting beta-2 adrenergic agonists (LABAs)

59
Q

are a class of medications that include montelukast, zafirlukast, and zileuton. Dilate BV

A

Antileukotrienes

60
Q

Mgt of exacerbations

A

early treatment and education
ICS tx
Short-acting beta-2–adrenergic agonist medications
Systemic corticosteroids
oxygen supplementation
ICS-LABA

61
Q

measure the highest airflow during a forced expiration

A

Peak flow meters

62
Q

Daily peak flow monitoring is recommended for patients who meet one or more of the following criteria

A

have moderate or severe persistent asthma, have poor perception of changes in airflow or worsening symptoms, have unexplained response to environmental or occupational exposures, or at the discretion of the clinician and patient

63
Q

helps measure asthma severity and, when added to symptom monitoring, indicates the current degree of asthma control.

A

Peak flow monitoring

64
Q

peak flows are monitored for..after receipt of optimal asthma therapy.

A

2-3 weeks

65
Q

Green

A

80% to 100% of personal best

66
Q

yellow

A

60% to 80%

67
Q

Nsg mgt

A

assesses the patient’s respiratory status by monitoring the severity of symptoms, breath sounds, peak flow, pulse oximetry, and vital signs.

68
Q

The nurse generally performs the following interventions:

A

Obtains a history of allergic reactions to medications before administering medications.

Identifies medications the patient is taking.

Administers medications as prescribed and monitors the patient’s responses to those medications.

These medications may include an antibiotic if the patient has an underlying respiratory infection.

Administers fluids if the patient is dehydrated

NCM118 (23 decks)

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