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Med Surg 1 > ATI: Chapter 21 - Asthma > Flashcards

ATI: Chapter 21 - Asthma Flashcards

1
Q

Asthma is a chronic inflammatory disorder of the airways that results in intermittent and reversible airflow obstruction occurs either by inflammation or __________.

A

airway hyper-responsiveness

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2
Q

Asthma can occur at any ____. The cause is unknown.

A

age

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3
Q

Manifestations of asthma include mucosal edema, bronchoconstriction, and _________.

A

excessive mucus production

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4
Q

Advise the client to use _______ and ensure proper ventilation while working in environments that contain carcinogens or particles in the air.

A

protective equipment (mask)

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5
Q

Encourage influenza and pneumonia vaccinations for older adults and all clients who have _____.

A

asthma

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6
Q

Instruct the client how to recognize and avoid _____.

A

triggers

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7
Q

_____ factors, such as changes in temperature (especially warm to cold) and humidity.

A

environmental

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8
Q

Air ______ are asthma triggers.

A

pollutants

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9
Q

Strong _____ (perfume) are triggers for asthma.

A

odors

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10
Q

______ allergens (grass, tree, and weed pollens) and perennial allergens (mold, feathers, dust, roaches, animal dander, foods treated with sulfites) are asthma triggers.

A

seasonal

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11
Q

Stress and ______ distress are asthma triggers.

A

emotional

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12
Q

_______ such as (aspirin, NSAIDs, beta-blockers, cholinergics) can be asthma triggers.

A

medications

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13
Q

_____, including those in laundry detergents can be asthma triggers.

A

enzymes

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14
Q

____ (household cleaners) can be asthma triggers.

A

chemicals

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15
Q

______ with postnasal drip can be an asthma trigger.

A

sinusitis

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16
Q

Viral respiratory tract infection can be an asthma ____.

A

trigger

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17
Q

Teach the client how to self-administer ______ (nebulizers and inhalers) for asthma.

A

medications

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18
Q

Educate the client regarding infection ________ techniques to asthma pts.

A

prevention

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19
Q

Encourage regular ______ as part of asthma therapy.

A

exercise

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20
Q

Regular exercise promotes ventilation and perfusion. It also maintains cardiac health. It enhances skeletal muscle strength. Clients can require _______.

A

pre-medication

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21
Q

Instruct the client to use hot water to eliminate dust mites in ______.

A

bed linens

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22
Q

Diagnosis of asthma is based on symptoms and classified into one of the following four categories: mild intermittent, mild persistent, moderate persistent, and _______.

A

severe persistent

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23
Q

______ asthma includes symptoms that occur less than twice a week.

A

mild intermittent

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24
Q

______ asthma includes symptoms that arise more than twice a week but not daily.

A

mild persistent

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25
Q

______ asthma is daily symptoms occur in conjunction with exacerbations twice a week.

A

moderate persistent

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26
Q

______ asthma is symptoms occur continually, along with frequent exacerbations that limit physical activity and quality of life.

A

severe persistent

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27
Q

Older adult clients have decreased pulmonary reserves due to physiologic _______ that occur with the aging process.

A

lung changes

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28
Q

Older adult clients are more ______ to infections.

A

susceptible

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29
Q

The sensitivity of beta-adrenergic receptors decreases with age. As the beta receptors age and lose ______, they are less able to respond to agonists, which relax smooth muscle and can result in bronchospasms.

A

sensitivity

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30
Q

A family _______ of asthma is a risk factor.

A

history

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31
Q

Smoking is a risk factor for _____.

A

asthma

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32
Q

Secondhand _______ is a risk factor for asthma.

A

smoke exposure

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33
Q

Environmental ______ is a risk factor for asthma.

A

allergies

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34
Q

Exposure to chemical _______ or dust is a risk factor asthma.

A

irritants

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35
Q

_________ reflux disease (GERD) is a risk factor for asthma.

A

gastroesophageal

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36
Q

Expected findings of asthma include dyspnea, chest tightness, and _____ or stress.

A

anxiety

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37
Q

Physical assessment findings of asthma include:

A 
coughing
wheezing
mucus production
use of accessory muscles
prolonged exhalation
poor oxygen saturation (low SaO2)
barrel chest or increased chest diameter
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38
Q

Obtain a history regarding current and previous asthma exacerbations: (6)

A

onset and duration
precipitating factors (exercise, stress, exposure to irritant)
changes in mes regimen
meds that relieve symptoms
other meds taken
self-care methods used to relieve symptoms

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39
Q

Lab Tests for Asthma

A

ABG and Sputum Cultures

40
Q

ABGs test for ______ which is when PaO2 less than 80 mm Hg.

A

hypoxemia

41
Q

ABGs test for _______ which is when PaCO2 is less than 35 mm Hg: early in attack)

A

hypocarbia

42
Q

ABGs test for _______ which is when PaCO2 is increased greater than 45 mm Hg: later in the attack.

A

hypercarbia

43
Q

Sputum cultures for asthma look at bacteria which can indicate _______.

A

infection

44
Q

________ are the most accurate tests for diagnosing asthma and its severity.

A

pulmonary function tests (PFTs)

45
Q

________ is the volume of air exhaled from full inhalation to full exhalation.

A

forced vital capacity (FVC)

46
Q

_______ in the first second is the volume of air blown out as hard and fast as possible during the first second of the most forceful exhalation after the greatest full inhalation.

A

Forced expiratory volume (FEV1)

47
Q

Peak expiratory flow is the fastest airflow rate reached during ________.

A

exhalation

48
Q

A decrease in FEV1 (forced expiratory volume) by ____ to _____% below the expected value is common in clients who have asthma. An increase in these values by 12% following the administration of bronchodilators is diagnostic for asthma.

A

15 to 20%

49
Q

A _____ is used to diagnose changes in chest structure over time.

A

chest x-ray

50
Q

An asthma patient should be positioned in _______ to maximize ventilation.

A

high-Fowlers

51
Q

With asthma patients you should administer ________ therapy as prescribed.

A

oxygen therapy

52
Q

With asthma patients you should monitor _______ and rhythm for changes during an acute attack (can be irregular, tachycardia, or with PVCs).

A

cardiac rate

53
Q

Asthma patients should have IV access and _______ it.

A

maintain

54
Q

Maintain a clam and _______ demeanor with asthma patients.

A

reassurance

55
Q

Provide rest periods for older adult clients who have _________. Design room and walkways with opportunities for rest. Incorporate rest with ADLs.

A

dyspnea

56
Q

Encourage prompt medical attention for ________ and appropriate vaccinations for asthma patients.

A

infections

57
Q

The four types of bronchodilators (inhalers)

A

short-actign beta2 agonists
anticholinergic medications
Methylxanthines
Long acting beta2 agonists

58
Q

________ such as albuterol, provide rapid relief of acute symptoms and prevent exercise-induced asthma.

A

short-acting beta2 agonists

59
Q

________, such as ipratropium, blocks the parasympathetic nervous system. This allows for the sympathetic nervous system effects of increased bronchodilation and decreased pulmonary secretions. These medications are long-acting and used to prevent bronchospasms.

A

anticholinergic medications

60
Q

_______, such as theophylline, require close monitoring of serum medication levels due to a narrow therapeutic range. Use only when other treatments are ineffective.

A

Methylxanthines

61
Q

__________, such as salmeterol, primarily are used for asthma attack prevention.

A

Long-acting beta2 agonists

62
Q

With albuterol watch for tremors and _______.

A

tachycardia

63
Q

With Ipratropium observe for ______.

A

dry mouth

64
Q

Wtih theophylline monitor serum levels for toxicity. Side effects include tachycardia, nausea, and ______.

A

diarrhea

65
Q

With ______: advise the client to suck on hard candies to help relieve dry mouth;; increase fluid intake, and report headache, blurred vision, or palpitations, which can indicate toxicity of ________. Monitor _______.

A

Ipratropium (anticholinergic meds)
Ipratropium
HR

66
Q

_________: advise the client to use to prevent an asthma attack and not at the onset of an attack.

A

Salmeterol (long-acting beta2 agonists)

67
Q

_______ agents are used for prophylaxis and are used to decrease airway inflammation.

A

anti-inflammatory agents

68
Q

Anti-inflammatory agents (4)

A

corticosteroids = fluticasone and prednisone
leukotriene antagonists = montelukast
mast cell stabilizers = cromolyn
monoclonal antiboides = omalizumab

69
Q

With the use of anti-inflammatory agents watch for decreased ________ function.

A

immunity

70
Q

With the use of anti-inflammatory agents monitor for ________.

A

hyperglycemia

71
Q

With the use of anti-inflammatory agents advise the client to report _______ stool.

A

black, tarry

72
Q

With the use of anti-inflammatory agents observe for fluid retention and _______. This can be common.

A

weight gain

73
Q

With the use of anti-inflammatory agents monitor the throat and mouth for ______.

A

aphthous lesions (canker sores)

74
Q

With the use of anti-inflammatory agents with _________ be careful it can cause anaphylaxis.

A

omalizumab (monoclonal antibodies)

75
Q

When taking anti-inflammatory agents encourage the client to ______ of fluids to promote hydration.

A

drink plenty

76
Q

Encourage the client to take _____ with food.

A

predinsone

77
Q

When taking anti-inflammatory agents encourage the client to use this medication to prevent _______, not for the onset of an attack.

A

asthma

78
Q

When taking anti-inflammatory agents encourage the client to avoid people who have ______.

A

respiratory infections

79
Q

When taking anti-inflammatory agents encourage the client to use good _____ care.

A

mouth

80
Q

When taking anti-inflammatory agents warn the client _____ to discontinue this type of medicine suddenly.

A

not

81
Q

If prescribed separately for inhalation administration at the same time, administer the _______ first in order to increase the absorption of the anti-inflammatory agent.

A

bronchodilator

82
Q

Combination agents (bronchodialtor and anti-inflammatory)

A

Ipratropium and albuterol

Fluticasone and salmeterol

83
Q

______ services should be consulted for inhalers and breathing treatments for airway management.

A

Respiratory

84
Q

Nutritional services can be contacted for weight loss or gain related to ________ or ______.

A

medication or diagnosis

85
Q

_______ can be consulted if the client has prolonged weakness and needs assistance with increasing levels of activities.

A

rehabilitation

86
Q

Complications of asthma include respiratory failure and _________.

A

status asthmaticus

87
Q

Peristent hypoxemia related to asthma can lead to _______.

A

respiratory failutr.

88
Q

When dealing with the complication of respiratory failure, monitor _______ levels and acid-base balance.

A

oxygenation

89
Q

When dealing with the complication of respiratory failure, prepare for intubation and ________.

A

mechanical ventilation

90
Q

_______ is a life-threatening episode of airway obstruction that is often unresponsive to common treatment. It involves extreme wheezing, labored breathing, use of accessory muscles, distended neck veins, and creates a risk for cardiac and/or respiratory arrest.

A

status asthmaticus

91
Q

With status asthmaticus prepare for emergency ______.

A

intubation

92
Q

With status asthmaticus administer IV fluids, oxygen, bronchodilators, and epinephrine. Initiate systemic ________.

A

steroid therapy

93
Q

A nurse in the emergency department is caring for a client who is having an acute asthma attack. Which of the following assessments indicates that the respiratory status is declining? (select all that apply)

A. SaO2 95%
B. Wheezing
C. Retraction of sternal muscles
D. Pink mucous membranes
E. Premature ventricular complexes (PVCs)
A

B. Wheezing is a manifestation indicating that the client’s respiratory status is declining

C. Retraction of sternal muscles is a manifestation that the client’s respiratory status is declining

E. PVCs are a manifestation that the client’s respiratory status is declining.

95% is an expected finding w/in the respiratory system and exhibits no signs of distress

Pink mucous membranes is an expected findings

94
Q

A nurse is caring for a client 2 hr after admission. The client has an SaO2 of 91%, exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medications should the nurse expect to administer?

A. Antibiotic
B. Beta-blocker
C. Antiviral
D. Beta2 agonist

A

D. The nurse should administer a beta2 agonist, which causes dilation of the bronchioles to relieve symptoms.

95
Q

A nurse is providing discharge teaching to a client who has a new prescription for prednisone for asthma. Which of the following client statements indicates an understanding of the teaching?

A. “ i will decrease my fluid intake while taking this med”

B. “I will expect to have black, tarry stools.”

C. “ I will take my meds with meals.”

D. “ I will monitor for weight loss while on this med.”

A

C. Take meds with food. Taking prednisone on an empty stomach can cause GI distress.

96
Q

A nurse is assessing a client who has a history of asthma. Which of the following factors should the nurse identify as a risk for asthma?

A. Gender
B. Environmental allergies
C. Alcohol use
D. Race

A

B. Environmental allergies are a risk factor associated with asthma. A client who has environmental allergies typically has other allergic problems, such as rhinitis or a skin rash.

97
Q

A nurse is reinforcing teaching with a client on the purpose of taking a bronchodilator. Which of the following client statements indicates an understanding of the teaching?

A. “ This medication can decrease my immune response.”
B. “I take this medication to prevent asthma attacks.”
C. “I need to take this med with food.”
D. This med has a slow onset to treat my symptoms.”

A

B. A bronchodilator can prevent asthma attacks from occurring.

A bronchodilator has a fast onset to relief asthma attack symptoms.

Med Surg 1 (15 decks)

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