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MIDTERMS COVERAGE > COPD > Flashcards

COPD Flashcards

1
Q

is a preventable and treatable slowly progressive respiratory disease of airflow obstruction involving the airways, pulmonary parenchyma, or both.

A

COPD

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2
Q

3rd leading cause of death worldwide accounting for 3.23 million deaths in 2019

A

COPD

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3
Q

Presence of chronic productive cough for 3 months in each of 2 consecutive years in a patient in whom other causes of chronic cough have been excluded

A

Chronic Bronchitis

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4
Q

An abnormal permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis

A

Emphysema

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5
Q

Risk factors of COPD

A

-Cigarette smoking
-Occupational chemicals and dusts
-Air pollution
-Infection
-Genetics
-Aging

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6
Q

An autosomal recessive disorder that may affect the lungs or liver.

A

a-Antitrypsin (AAT) Deficiency

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7
Q

Purpose of AAT (a-Antitrypsin Deficiency)

A

AAT protects normal lung tissue from attack by proteases during inflammation related to smoking and infection

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8
Q

Clinical Manifestations of COPD (Early)

A

-Chronic intermittent cough (Earliest sign)
-Dyspnea on exertion
-Inability to deep breathe
-Heaviness on chest
-Gasping
-Increased effort to breath
-Air hunger
-Rationalization (defense mechanism)

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9
Q

Clinical Manifestations of COPD (Late)

A

-Dyspnea at rest
-Use of accessory muscles
-Wheezing
-Chest Tightness

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10
Q

Clinical Manifestations of COPD (Advanced)

A

-Fatigue
-Weight loss
-Anorexia
-Barrel Chest
-Pursed-lip breathing
-Tripod Positioning
-Cor pulmonale

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11
Q

Classification of GOLD 1 is

A

Mild

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12
Q

Classification of GOLD 2 is

A

Moderate

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13
Q

Classification of GOLD 3 is

A

Severe

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14
Q

Classification of GOLD 4

A

Very severe

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15
Q

Medical Management of COPD

A

-Smoking cessation
-Drug therapy (Bronchodilators, as ordered)

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16
Q

Bronchodilators for Mild COPD

A

Use short-acting bronchodilators

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17
Q

Bronchodilators for Moderate COPD

A

Used long acting bronchodilators

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18
Q

Nusing care of patient taking LABA + ICS Combo

A

-Have the patient to rinse the mouth after using the inhaler because this will help to decrease systemic absorption and decrease GI upset and nausea.
-Monitor the patient for any sign if respiratory infection.

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19
Q

Bronchodilators for severe COPD

A

Rofumilast (Daliresp)

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20
Q

Used to decrease the frequency of exacerbations

A

Rofumilast (Daliresp)

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21
Q

Medical Management for COPD

A

-Oxygen Therapy

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22
Q

Best method of mask for COPD is

A

Venturi Mask

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23
Q

Administers precise, high-flow rates of oxygen

A

Venturi Mask

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24
Q

Tobacco Rregulation Act

A

RA 9211

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25
Q

is a chronic, irreversible dilation of the bronchi and bronchioles that results from destruction of muscles and elastic connective tissue.

A

Bronchiectasis

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26
Q

Bronchiectasis Risk Factors

A

-Recurrent respiratory infections
-Cystic fibrosis
-Rhematic and other systemic diseases
-Tuberculosis
-Immunodeficiency disorders

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27
Q

Clinical Manifestations of Bronchiectasis

A

-Chronic Cough (negative for PTB)
-Sputum Production
-Hemoptysis
-Clubbing of fingers
-History of repeated infections

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28
Q

Surgical removal of a segment of a lobe

A

Segmental resection

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29
Q

Surgical removal of a lobe

A

Lobectomy

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30
Q

Surgical removal of an entire lung

A

Pneumonectomy

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31
Q

Segmental resection and Lobectomy Position

A

Position in semi-fowlers or on UNAFFECTED SIDE

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32
Q

Pneumonectomy Position

A

Position in semi-fowlers or on
AFFECTED SIDE

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33
Q

Is a heterogenous disease, usually characterized by chronic airway inflammation which causes airway hyperresponsiveness, mucosal edema, and mucus production9

A

Asthma

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34
Q

The two distinct disease processes is :

A

-Chronic Bronchitis
-Emphysema

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35
Q

A generalized term in which person is thin, breathing fast and is pink

A

Pink Puffers

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36
Q

A generalized term referring to a person who is blue and overweight

A

Blue boater

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37
Q

Enzyme inhibitor that protects the lung parenchyma from injury.

A

alpha-antitrypsin

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38
Q

Meaning of FEV

A

Forced Expiratory Volume

39
Q

How we classify COPD?

A

Level of Severity

40
Q

Drug of Choice for short-acting bronchodilators in COPD

A

Salbutamol- ipratropium (Pulmodual, Duoneb)

41
Q

Long Acting Bronchodilators drugs:

A

Salmeterol (as monotherapy)
Formoterol (as monotherapy)

42
Q

Drugs for long-acting anticholinergic

A

Tiotropium (Spiriva)

43
Q

Rofumilast classifications

A

Phosphodiesterase inhibitor

44
Q

Nursing care of patients on oxygen therapy

A

-Assess need for adjustments in 02 flow rate
-Evaluate response to 02 therapy
-Monitor patient for signs of adverse effects of 02 therapy
-In many cases, choose the optimal 02 delivery device (nasal cannula, simple face mask)

45
Q

Nursing Management for COPD

A

-Administer medication and oxygen therapy, as ordered
-Instruct patient to eliminate, if not reduce, pulmonary irritants
-Instruct patient to perform “directed coughing” or “huff” coughing
-Facilitate chest physiotherapy
-Encourage increased fluid intake
-Provide bland aerosol mist
-Encouraged pursed-lip breathing
-Encourage patient to pace activities throughout the day or use supportive devices to decrease energy expenditures

46
Q

Coughing that consists of a slow, maximal inspiration followed by breath-holding for several seconds and then two or three coughs.

A

Directed coughing

47
Q

Consists of one or two forced exhalations (huffs) from low to medium lung volumes with the glottis open

A

Huff coughing

48
Q

Steps in chest physiotherapy

A
  1. Positioning
  2. Vibration
  3. Coughing
49
Q

Medical Management of Bronchiectasis

A

-Chest Physiotherapy
-Smoking cessation
-Antibiotic therapy, as ordered
-Bronchodilator, as ordered
-Mucolytic, as ordered

50
Q

Nursing Care of Patients undergoing Lung Surgery

A

-Preoperative preparations
-Obtain an infection free tracheobronchial tree
-Chest physiotherapy
-Antibiotic therapy, as ordered
-Direct suctioning through bronchoscope (collaborative)
-Segmental resection and Lobectomy

51
Q

The purpose of positioning the patient in Semi-Fowlers on Unaffected side

A

To allow expansion of affected lung

52
Q

The purpose of positioning the patient in Semi-Fowles turned on Affected side

A

To promote lung expansion and prevent flooding of the remaining lung expansion and prevent flooding of the remaining lung with blood from the affected part

53
Q

It is a largely reversible, unlike COPD

A

Asthma

54
Q

Risk factors and Triggers of Asthma

A

-Genetics
-Immune response
-Allergens
-Exercise
-Air pollutants
-Occupational factors
-Respiratory tract infection
-Nose and sinus problems
-Drugs (NSAIDS, Beta Blockers and ACE inhibitors)
-GERD
-Psychologic Factors

55
Q

The genetic predisposition to develop an allergic response to common allergens (IgE- mediated

A

Atopy

56
Q

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

A

Hygiene hypothesis

57
Q

Asthma that is induced or exacerbated during physical exertion

A

Exercised-induced asthma

58
Q

Clinical Manifestations of Asthma

A

-Cough
-Tachypnea
-Dyspnea
-Wheezing
-Diaphoresis
-Tachycardia
-Widened pulse pressure
-Central cyanosis (Late)

59
Q

Symptoms occur fewer than 2x per week

A

Mild Intermittent

60
Q

Symptoms occur 3-6 times per week

A

Mild Persistent

61
Q

Symptoms occur daily

A

Moderate Persistent

62
Q

Symptoms occur continuously

A

Severe Persistent

63
Q

Emergency Medical Management

A

O- Oxygen
S-Salbutamol (Nebulize)
H- Hydrocortisone
I- Ipratropium
T- Theophylline

64
Q

Medical Management of Asthma

A

-Management is based on the Global Initiative for Asthma (GINA)

65
Q

Goals of GINA:

A

-Decrease asthma morbidity and mortality
-Improve management of asthma worldwide

66
Q

Goals of Asthma Treatment:

A

Achieve and maintain control of the disease

67
Q

Medication of choice for relief of acute symptoms of EIA

A

Salbutamol (Ventolin)

68
Q

Salbutamol is a

A

Short-acting Beta2-adrenergic Agonist (SABA)

69
Q

Relaxes smooth muscles thereby promoting bronchodilation

A

Salbutamol (Ventolin)

70
Q

Inhibits muscarinic cholinergic receptors and reduce intrinsic vagal tone of the airway

A

Ipratropium (Atrovent)

71
Q

Given if the patient cannot tolerate SABA

A

Ipratropium (Atrovent)

72
Q

Ipratropium is a

A

Anticholinergic

73
Q

Is a plastic container with a mouthpiece or mask at one end, and space to insert an inhaler at the other.

A

Space device

74
Q

Device used for inhaled corticosteroids

A

Spacer

75
Q

Mast cell stabilizer

A

Cromolyn sodium

76
Q

Indications of Cromolyn Sodium

A

-Alternative for corticosteroids
-Prophylaxis for EIA
-Prevents attacks in unavoidable exposure to known triggers

77
Q

Mild to moderate bronchodilator

A

Theophylline

78
Q

Relief of night time symptoms

A

Theophylline

79
Q

Theophylline is a

A

LABA (Long Acting Beta Agonist)

80
Q

Theophylline Toxicity:

A

STARV

S-sweating
T-Tachycardia
A-Anxiety
R-Restlessness
V-Vomiting

81
Q

Acts either by interfering with leukotriene synthesis or by blocking the receptors where leukotrienes exert their action

A

Montelukast (Singulair)

82
Q

Montelukast (Singulair) is a

A

Leukotriene inhibitor

83
Q

May be used as alternative to ICS for mild persistent asthma

A

Montelukast (Singulair)

84
Q

Binds to circulating IgE, preventing it from binding to receptors on mast cells

A

Omalizumab (Xolair)

85
Q

Indication of Omalizumab (Xolair)

A

Used for patients with allergies and severe persistent asthma

86
Q

Nursing Management of Asthma

A

-Monitor respiratory rate, depth, and effort
-Auscultate breath sounds
-Note the declining level of awareness or consciousness
-Note skin color, temperature, and moisture.
-Encourage and assist with deep-breathing exercises, turning, and coughing. Suction as necessary
-Provide airway adjunct as indicated. Place in semi-fowlers position

87
Q

Rapid onset, severe, and persistent asthma that does not respond to conventional therapy and occurs with little or no warning

A

Status Asthmaticus

88
Q

Risk Factors of Status Asthmaticus

A

-Infection
-Anxiety
-Nebulizer abuse
-Dehydration
-Increased adrenergic blockage
-Non-specific irritants
-Hypersensitivity to medications

89
Q

Clinical Manifestations of Status Asthmaticus

A

-Same with asthma but does not respond to conventional treatment
-Disappearance of wheezing- indicates total obstruction of airway and an impending sign of respiratory failure

90
Q

Medical Management of Status Asthmaticus

A

-High-flow supplemental oxygen, as ordered
-Use partial or non-breather mask
-SABA, as ordered
-Systemic corticosteroids, as ordered
-IV fluids, as ordered (for hydration)
-Magnesium sulfate IV infusion, as ordered

91
Q

Nursing Care of Patient on Partial or Non-Rebreather Masks

A

-O2 flows into reservoir bag and mask during inhalation.
-This bag allows patient to rebreathe about first third of exhaled air (rich in O2) in conjunction with flowing O2.
-O2 flow rate must be sufficient keep bag from collapsing during inspiration to avoid CO2 build-up
-If deflation occurs, increase liter flow to keep bag inflated.
-Mask should fit snugly
-With non-rebreather masks, make sure valves are open during expiration and closed during inhalation to prevent drastic decrease in FiO2

92
Q

Which of the following must be ordered for quick relief of bronchospasm in the medical management of Status Asthmaticus?

a. SABA c. Montelukast
B. LABA d. Theophylline

A

SABA

93
Q

Side effects of Magnesium Sulfate IV infusion

A

-Facial warmth
-Flushing
-Tingling
-Nausea
-Central nervous depression
-Respiratory depression
-Hypotension

MIDTERMS COVERAGE (7 decks)

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