Chapter 24: noninfectious respiratory disorder Flashcards
Agonist and beta-adrenergic drugs are ineffective in treating asthma in older adults because of
decreased sensitivity of receptors
how does montelukast help asthma?
it blocks leukotriene receptors, preventing the inflammatory mediator from stimulating inflammation.
cromolyn sodium
medication for asthma with elevated serum immunoglobulin IgE levels.
Late phase of asthma attack
is seen in patient who has low partial pressure of arterial oxygen and elevated c02.
which pain medication is safe for asthma patient?
Tylenol is safe.
But Ibuprofen can trigger asthma symptoms.
for a patient with asthma attack, what would be the expect ABG?
partial pressure of carbon dioxide (Paco2) 50
Pac02 increases during asthma attack, normal is 35-45
signs of overdose from ipratropium
blurred vision, HA and palpitations.
worsening of status asthmaticus
patients with status asthmaticus who suddenly have absence of wheezing may have a complete airway obstruction.
which diseases experience COPD?
chronic bronchitis
how does cystic fibrosis (CF) cause airway obstruction?
by secretion of thick and sticky mucus
what test can diagnose cystic fibrosis?
sweat chloride analysis
which two assessment findings are changes secondary to chronic COPD?
barrel chest and finger clubbing
what is cystic fibrosis caused by?
CF is a genetic disorder with the presence of B. cepacia bacterial infection
oxygen level acceptable for patients with COPD
90%
acute emphysema
causes air hunger due to weakening of the diaphragm muscle.
heart failure can cause pelural effusion due to:
increased venous pressure
SABA (short acting)
ex: Albuterol and Salbutamol
are given for rescue/reliver drug for an acute or sudden respiratory or asthma attacks.
LABA (long acting)
ex: Salmeterol & folmoterol.
are given for maintenance drugs.
Ipratropium
an Anticholinergic Bronchodilator, decreases mucus production and dries it out. Often times used with Albuterol for treatment of acute attacks.
Corticosteroid Inhalers
fluticasone, prednisone, beclomethasone given for maintenance. Can be taken orally or inhaled.
**RINSE MOUTH after each use of inhaler.
Mucolytics
ex: Acetylcysteine (liver protector)
breaks and thins down mucus.
Expectorants
ex: Guaifenesin
thins out mucus, SAFE FOR HTN
Antitussives
ex: Dextromethorphan
suppresses cough.
also SAFE for HTN.
cough medicines to avoid with HTN
Pseudoephedrine.
Phenylephrine,
Ephedrine.
cough medicines SAFE for HTN
Guaifenesin (mucinex)
Dextromethorphan (robitussin)
Atelectasis
collapse of alveoli due to deflation or filling of fluid.
s/sx: diminished breath sounds, fine crackles and hypoxia.
intervention: lung expansion by use of incentive spirometer.
what can diagnose Asthma or COPD?
a pulmonary function tests
COPD: Emphysema
A chronic lung disease where the alveoli are damaged, causing difficulty of breathing and impaired ventilation.
what is a late stage sign of Emphysema?
barrell chest
COPD: Chronic Bronchitis
long term condition caused by smoking or prolong exposure to lung irritatnts. Causes overproduction of mucus and impairs gas exchange.
S/SX of COPD
productive cough
dyspnea on exertion.
labored breathing.
tachypnea.
wheezes & crackles
diminished lung sounds.
Nursing intervention to improve oxygenation in respiratory distress
Tripod positioning.
pursed lip breathing.
effective coughing and hydration.
Pleural Effusion
FLUID COLLECTION between the lungs and cavity space.
Medical intervention: thoracentesis or chest tube placement.
what confirms pleural effusion?
chest Xray ( fluid collection will look like white space)
Crepitus
abnormal air collection under the skin.
Pneumothorax
(closed, open, and tension)
(collapsed lung). When AIR leaks into the space between lung and chest wall.
Tension Pneumothorax
AN EMERGENCY.
AIR leaks into the pleural space causing PRESSURE and compressing the lungs, heart and blood vessels.
Chest Tube
(important key notes)
- Constant bubbling in the collection chamber: indicates that air is leaked in. Occasional bubble is fine.
- ## if chest tube gets pulled out, apply vaseline type gauze onto the chest with clear tape until it can be properly reinserted.
Pneumonia
acute inflammation of the lungs caused by infection (bacterial, viral or fungal).
nursing teaching for bone scan
teach patient that radioactive is injected to vein.
Compartment Syndrome
increased pressure in a muscle compartment, leading to reduced blood flow (ischemia +hypoxia) and can cause tissue damage. (necrosis).
Medical intervention: surgical decompression.
Biphosphonate
Treatment for osteoporsis. Take in the morning 30 min before food with FULL glass of water and remain upright for +30 min to prevent esophagitis.
Estrogen/ Raloxifene
other options for treatment of osteoporosis. LFTs should be monitored.
6 P’s of Neurovascular Assessment
Pain
Paresthesia
Pulselessness
Pallor
Poikilothermia (feeling of cold).
Paralysis (rarely).
Rheumatoid Arthritis (RA)
an autoimmune and progressive disease. The pain is always bilateral and systemic.
Treatments: Methotrexate (DMARDS), Nsaids, glucocorticoids.
Antacids
offer immediate but short lasting relief. It neutralizes acid.
Sucralfate
A mucosal barrier that coats stomach and heals ulcer.
watch out for : salicylate toxicity ringing of ears.
Famotidine
Ranitidine
Cimetidine
Histamine (H2) Antagonist that blocks acid secretion
Omeprazole
Pantoprazole
PPI that suppress acid secretion.
MOST EFFECTIVE for acid problems. Long term use can cause electrolyte imbalance (hypomagnesemia).
Zofran
when given IV push, PUSH SLOWY !! push 4mg over 2 minutes.
important s/e: can cause dysrhythmias.
Promethazine (phenergan)
an antihistamine that treats allergies and nausea/ motion sickness. Can be very sedating.
IBS
most common digestive disorder.
s/sx: frequent diarrhea or constipation, gas, abdominal pain
cause - unknown. Foods can trigger an episode.
NGT or OGT
short term feeding tube manually inserted into
NOSE —> Mouth —> Stomach
Enterostomal Tube
long term feeding tube (+30 days), surgically inserted to GI via gastrostomy or jejunostomy.
ex of enterostomal tubes: PEG, PEG/J, DPEJ
Gastric Residual volume (GRV)
amount of liquid drained from stomach following administration of feed. Tests fir gastric emptying.
Parental Nutrition
Last choice. This is for patients who have major dysfunction of GI tract.
complications: infection, air embolism, pneumothorax, phlebitis, hyper/hypovolemia.
Refeeding Syndrome
SERIOUS CONDITION of dangerous shifts in electrolytes (hypophosphatemia, hypokalemia, and hypomagnesemia) due to increased insulin secretion triggered by high carb intake.
Gastric Ulcer
sharp pain occurs 1-2 hours after a meal.
causes hematemesis.
Duodenal Ulcer
burning pain occurs 2-5 hours after a meal. Pain is reduced when eating.
may see melena (dark tarry stool).
Peptic Ulcer Disease
either Gastric or Duodenal ulcer.
caused by H. Pylori and long term NSAID use.
