Chronic Respiratory

Question 1

what does asthma consist of

Answer 1

airway obstruction, bronchial irritability, edema of mucous membranes, congestions, and spasms of smooth muscles of the bronchi and bronchioles

Question 2

what type hypersensitivity immune response does asthma have

Answer 2

1

Question 3

what immunoglobulin releases histamine and leukotrienes

Answer 3

IgE mediated mast cells

Question 4

what are the common triggers for asthma

Answer 4

pets, exercise, polls, bugs, chemical fumes, cold air, fungus spores, dust, smoke, strong odors, pollution, anger, stress

Question 5

what are the host factors / risk factors of asthma

Answer 5

age (usually show symptoms 4-5Y), heredity, gender, obesity, ethnicity (african american)

Question 6

what are the environmental risk factors of asthma

Answer 6

allergens, infections, tobacco smoke (prenatal or postnatal), indoor or outdoor air pollution, diet (allergic to foods or specific formula)

Question 7

what are the 10 clinical manifestations of asthma

Answer 7

dyspnea
expiratory wheezing
cough
diaphoresis
hacking, non productive cough
prolonged expiratory phase

Question 8

what are the 9 clinical manifestations of asthma

Answer 8

dyspnea
expiratory wheezing
cough
diaphoresis
hacking, non productive cough
prolonged expiratory phase
anxious or restless
coarse rhonchi
signs of respiratory distress

Question 9

what is helpful in diagnosing asthma

Answer 9

pulmonary function tests - specifically peak expiratory flow

Question 10

what are 6 specific things a nurse can educate on about controlling the environment around a patient that has asthma

Answer 10

house dust mite control
pillows/mattress in allergen impermeable covers
cockroach control
dust/wash linens in hot water twice weekly
vacuum weekly
avoid kerosene or wood heat

Question 11

what type of sensitization is allergy shots

Answer 11

hyposensitization

Question 12

what is the typical medications that are preventer medications for asthma

Answer 12

corticosteroids (QVAR, pulmicort, flovent), long acting beta 2 adrenergic agonists (advair, serevent), mast cell stabilizers (cromolyn), leukotriene inhibitors (singulair)

Question 13

what are the rescue medication that are typical for asthma

Answer 13

short acting beta 2 adrenergic agonists / brochodilators (proventil, xopenex, albuterol), methylxanthines

Question 14

what are the rescue medication that are typical for asthma

Answer 14

short acting beta 2 adrenergic agonists / brochodilators (proventil, xopenex, albuterol), methylxanthines

Question 15

pulmicort is a

Answer 15

corticosteroid

Question 16

QVAR is a

Answer 16

corticosteroid

Question 17

flovent is a

Answer 17

corticosteroid

Question 18

advair is a

Answer 18

long acting beta 2 adrenergic agonist

Question 19

serevent is a

Answer 19

long acting beta 2 adrenergic agonist

Question 20

cromolyn is a

Answer 20

mast cell stabilizer

Question 21

singulair is a

Answer 21

leukotriene inhibitor

Question 22

proventil is a

Answer 22

short acting beta 2 adrenergic agonist

Question 23

xopenex is a

Answer 23

short acting beta 2 adrenergic agonist

Question 24

albuterol is a

Answer 24

short acting beta 2 adrenergic agonist

Question 25

green zone of a peak expiratory flow rate is what % of best, and what are the symptoms

Answer 25

80-100% of best no symptoms, minimal coughing, feeling good overall

Question 26

yellow zone of a peak expiratory flow rate is what % of best

Answer 26

50-79% of personal best

Question 27

red zone of a peak expiratory flow rate is what % of best

Answer 27

below 50% of the personal best

Question 28

what are the 3 things an asthma action plan show you how to recognize

Answer 28

1. recognize well controlled asthma 2. recognize which symptoms indicate you should pay extra attention and add/increase medication according to the plan 3. recognize the symptoms of an asthma emergency in which you should provide rescue medication and call 911

Question 29

what are the 4 key nursing interventions for asthma ***

Answer 29

1. high fowlers position 2. teach child how to use diaphragm to pull in and push out air 3. control the panic 4. administer rescue drugs

Question 30

is exercise induced brochospasms considered asthma

Answer 30

yes

Question 31

what is exercise induced brochospasms

Answer 31

self-terminating airway obstruction that develops during or after vigorous exercise

Question 32

when do exercise induced brochospasms peak

Answer 32

5-10 minutes during exercise

Question 33

what is the genetic component of cystic fibrosis

Answer 33

it is an autosomal recessive disorder

Question 34

every child born to parents that both have the recessive gene for cystic fibrosis have a what percentage of developing the disorder

Answer 34

25%

Question 35

what is the patho behind cystic fibrosis

Answer 35

it disrupts the normal functionings of the exocrine glands related to Na+ and CL- transport via the cystic fibrosis transmembrane regulator protein this results in impaired fluid secretion and abnormally thick exocrine secretions

Question 36

what are 4 multi-organ effects of cystic fibrosis

Answer 36

respiratory, gastrointestinal, reproductive, and hepatic

Question 37

what are the s/s of the pulmonary effects of cystic fibrosis

Answer 37

Wheezy cough, increasing dyspnea, thick rattling extremely productive cough, cyanosis, pneumonia, polyps in the nose, clubbed digits, chronic sinusitis

Question 38

what are the GI effects of cystic fibrosis

Answer 38

small intestines - intestinal obstructions pancreatic ducts - degeneration of the pancreas, decreased secretion of digestive enzymes - which can lead to malabsorption syndrome and diabetes

Question 39

in cystic fibrosis what vitamins have a decreased absorption

Answer 39

fat soluble, A, D, E, K

Question 40

what are the s/s of the GI effects of cystic fibrosis

Answer 40

Appetite changes, steatorrhea (fatty stools), azotorrhea (foul smelling stools), weight loss, tissue wasting, distended abdomen, sallow skin, anemia

Question 41

what are the hepatic effects of cystic fibrosis

Answer 41

the bile ducts become clogged which leads to biliary fibrosis and biliary cirrhosis and lead to eventual portal hypertension

Question 42

what are the s/s of the hepatic effects of cystic fibrosis

Answer 42

ascites, GI bleeding, jaundice

Question 43

what are the reproductive effects of cystic fibrosis

Answer 43

delayed puberty, infertility

Question 44

what value would a sweat chloride test be indicative of cystic fibrosis

Answer 44

> 60 mEq / L

Question 45

what does a prenatal diagnosis of cystic fibrous consist of

Answer 45

DNA analysis of chorionic villi or amniotic fluid samples

Question 46

what are the 3 specific things nurses can focus on to maximize health potential for those with cystic fibrosis

Answer 46

pulmonary hygiene, nutrition, and prevention/early treatment of infection

Question 47

why is it beneficial to do aggressive airway clearance before eating for a patient with cystic fibrosis

Answer 47

it increases appetite and decrease vomiting

Question 48

what are the 4 components of aggressive airway clearance for a cystic fibrosis patient

Answer 48

percussion, postural drainage, breathing exercise, and physical exercise

Question 49

what are the drugs a patient with cystic fibrosis may be prescribed

Answer 49

bronchodilators, mucolytics, chloride channel activators and sodium channel blockers, antibiotic therapy (both therapeutically and prophylactically), pancreatic enzymes, fat soluble enzymes, stool softeners (prn), NaCl during hot weather, iron supplements

Question 50

what are the nutrition needs of a patient with cystic fibrosis

Answer 50

high protein, high calorie, unrestricted fat