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Pediatrics > ATI 18 - Asthma > Flashcards

ATI 18 - Asthma Flashcards

1
Q

EARLY indications of RESPIRATORY DISTRESS

A

restless
tachypnea
tachycardia
diaphoresis

nasal flaring
retraction
drunting
wheezing

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2
Q

ADVANCED HYPOXIA aka RESPIRATORY FAILURE

A 
bradypnea
bradycardia
cyanosis
stupor
coma
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3
Q

Asthma

A

persistent inflammation leads to overreaction of normal protective mechanism of

  • mucus production
  • swelling of airway mucosa
  • bronchospasm
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4
Q

Asthma triggers

A
  • exercise
  • allergens
  • weather change
  • smoke
  • stress, emo
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5
Q

Asthma

symptoms

A

sudden onset of cough, wheeze, SOB

  • freq coughing at night
  • resp distress
  • prolonged expiratory phase
  • chest tightness
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6
Q

Asthma

diagnosis

A
  • hx
  • assessment
  • pulmo function test (most accurate)
  • peak exp flow rate w establishment of personal best
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7
Q

Intermittent Severity

A

symptoms of 2 or fewer days a week

  • no nightime awakening
  • oral corticosteroid no more than 1/yr
  • SABA use 2 or less/wk
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8
Q

Intermittent Severity is only triggered by…

A

viral resp infection

-asthma maintenance does not prevent trigger

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9
Q

Mild persistent Severity

A

symptoms >2days/wk, but not daily

-nighttime awakening 1-2x/month (younger than 5yo) or 3-4x/month (older than 5)

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10
Q

Moderate persistent Severity

A

daily symptoms

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11
Q

Severe persistent

A

symptoms throughout the day

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12
Q

SABA

meds + route + action

A

albuterol + levalbuterol

  • nebulizer metered dose inhaler
  • relac=xed bronchiole smooth muscle
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13
Q

albuterol + levalbuterol [SABA]

education

A

dont use more than 2dy/wk

  • can cause tachycard, n/v, nervousness
  • use spacer
  • wait 1-2min bw puff
  • 15min to give steroid
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14
Q

corticosteroid

med + route + action

A

prednisone

  • oral or IV
  • decr airway inflammatn
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15
Q

corticosteroid - prednisone

education

A

gastric irrtatn

long term: gluc instability + immunosuppression

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16
Q

long acting beta agonIst [LABA]

meds + route + action

A

salmeterol + formeterol

  • dry powder inhaler
  • relax smth muscle + incr ciliary motility
17
Q

LABA - salmeterol + formeterol

education

A

take 30-60 min before exercise

SE: tachycard, insomnia, tremor may last 8hr

18
Q

theophylline - methylxanthine

moa + education

A

relax muscle bundles that constricts airway

-limit caffeine - tachycard + insomnia (meth)

19
Q

montelukast -leukotriene receptor agonist

A

reduce inflammtn cascade

  • take in evening or before exercise
  • dont stop abruptly
  • may cause depression
20
Q

Asthma Med Action Plan

A

GREEN/GO: use preventative med
YELLOW/CAUTION: add quick relief med
RED/DANGER: get Dr

21
Q

green/go asthma criteria

A

must have all:

  • good breathing
  • no cough/wheeze
  • sleep thru night
  • can work + play
22
Q

yellow/caution criteria

A

must have atleast 1 of these:

  • first sign of a cold
  • exposure to known trigger
  • cough
  • mild wheeze
  • tight chest
  • cough at night
23
Q

red/danger criteria

A

asthma is getting worse fast

  • med not helping
  • breathing is hard + fast
  • ribs show
  • nose flaring
  • cant talk well
24
Q

Inhaler use

A 
1 remove cap + shake 5-6x
2 attach spacer
3 deep breath + exhale prior
4 tilt head back, press inhaler, slow deep breath for 3-5 sec
5 hold breath 5-10 sec
6 inhale slowly thru nose

wait 1 min bw puffs + resume norm breathing

25
Q

when using an inhaler, if you head ____, then you are inhaling too fast

A

whistling

26
Q

signs of worsening

A

after albuterol + corticosteroids, if pt continues to worsen:

  • hypoxemia
  • recr expiration fr air trapping
  • resp acidosis
27
Q

additional meds for severe asthma [STATUS ASTHMATICUS]

A
  • IV mag sulfate
  • theophylline
  • IV corticosteroid (methylprednisone)
28
Q

nursing interventions for asthma in school

A
  • long peak flow meter readings
  • coordinate support group
  • 1/10 kids have asthma - leading cause of absenteeism
  • admin quick relief med

Pediatrics (51 decks)

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