ch 28 OPD - book/1

Question 1

CF produces airway obstruction because of changes in

Answer 1

exocrine glandular secretions, resulting in increased mucus production

Question 2

asthma s/s

4

Answer 2

1. wheezing
2. breathlessness
3. chest tightness
4. cough (higher at night and in early morning)

Question 3

what genetic predisposition is to developing asthma from common allergens

Answer 3

atopy

Question 4

asthma - hygiene hypothesis suggest that

Answer 4

a newborn baby’s immune system must be conditioned so that it will function properly during infancy and the rest of life

Question 5

GERD may worsen asthma symptoms because reflux may do what

Answer 5

trigger bronchoconstriction and cause aspiration

Question 6

asthma meds may worsen GERD s/s how

Answer 6

beta2-agonists that treat asthma relax the lower esophageal sphincter, thus allowing stomach contents to reflux into the esophagus

Question 7

primary patho of asthma

Answer 7

persistent but variable inflammation of the airways

Question 8

asthma - airflow is limited because the inflammation results in
3

Answer 8

1. bronchoconstriction
2. airway hyperresponsiveness (hyperreactivity)
3. edema of the airways

Question 9

remodeling

Answer 9

chronic inflammation may result in structural changes in the bronchial wall

Question 10

PEFR

Answer 10

measured by the peak flow meter is an aid to dx and monitor asthma

Question 11

FEV1 stands for

Answer 11

forced expiratory volume in 1 second

Question 12

when spirometry is schedules, ask the pt to stop what

Answer 12

taking any bronchodilator meds for 6-12 hrs before the tests

Question 13

what serum values are highly suggestive of atopy

Answer 13

elevated serum eosinophil count and elevated serum IgE levels

Question 14

atopy

Answer 14

genetic predisposition to develop an allergic response

Question 15

asthma - the level of control is determined by the patient’s current what

Answer 15

peak flow/FEV1

Question 16

pts in all classifications of asthma require what

Answer 16

short term (rescue or reliever) meds

Question 17

most effective class of drugs used as rescue or reliever meds

Answer 17

SABA

Question 18

asthma - best drugs to treat inflammation

Answer 18

ICSs

Question 19

ICS name

Answer 19

fluticasone

Question 20

oral steroids

Answer 20

prednisone

Question 21

inhaled anticholinergic name

Answer 21

ipratropium

Question 22

acute asthma attack clinical manifestations

4

Answer 22

1. sits forward to maximize diaphragmatic movement
2. wheezing
3. RR > 30
4. PR > 120

Question 23

mild asthma PEF

Answer 23

> 70% of personal best

Question 24

PEF

Answer 24

peak expiratory flow - the amount of air that you expel after taking a full breath

Question 25

FEV1

Answer 25

forced expiratory volume in one sec - the amount of air you expel in one second

Question 26

mod asthma PEF

Answer 26

40-60%

Question 27

severe asthma PEF

Answer 27

<40%

Question 28

life threatening asthma PEF

Answer 28

<25%

Question 29

management of pt with acute exacerbation focuses on | 2

Answer 29

1. correcting hypoxemia | 2. improving ventilation

Question 30

asthma attack - give oxygen by NC to achieve a PaO2 of what

Answer 30

at least 60 mm Hg or oxygen saturation greater than 90%

Question 31

hyperventilation occurs during an asthma attack as lung receptors respond to

Answer 31

increased lung volume from trapped air and airflow limitation

Question 32

severe exacerbations - what is used with SABA

Answer 32

inhaled ipratropium (Atrovent)

Question 33

what levels are increased in the breath of people with asthma associated with eosinophilic-induced airway inflammation

Answer 33

nitric oxide

Question 34

asthma attack - IV mag sulfate may be administered to pts with 2

Answer 34

very low FEV1 or peak flow (<40%) or those who fail to respond to initial treatment

Question 35

IV mag has what type of effect

Answer 35

bronchodilator effect