COPD: Asthma Flashcards
(44 cards)
What are the signs and symptoms of Samter’s triad?
Asthma, Aspirin and NSAID sensitivity, causing the growth of Nasal polyps.
What does Retraction mean?
Retraction occurs when the intercostal muscles surrounding the lungs retract/constrict showing the outline of the patient’s ribs.
Psychological issues can cause an asthma exacerbation. True or False?
True. Strong psychological emotions such as (crying, laughing, anger, fear)
What is a secondary effect of Beta Blockers on a patient with asthma?
Beta Blockers ( aka Beta 2 Antagonist) also decrease the patient’s response to inhaled or oral Beta 2 Receptor Agonists.
Study Tip: These meds have opposite effects so they cancel each other out.
People with emphysema have very collapsible airways. If you teach them to breathe in normally but breathe out through a narrow orifice of their lips, they keep the pressure up in their airways and it tends to prevent the large airways from collapsing. In COPD patients with advanced emphysema, this type of breathing can also open up airways enough to release more air. That may allow some air that’s trapped in the lungs to exhale out, so it decreases the amount of gas trapped in your chest.
What type of breathing technique does this define?
Pursed Lip Breathing
Study Tip: To do pursed lip breathing:
Relax your neck and shoulder muscles.
Breathe in for two seconds through your nose, keeping your mouth closed.
Breathe out for four seconds through pursed lips. If this is too long for you, simply breathe out twice as long as you breathe in.
What is the #1 most polluted U.S. city?
Los Angeles is the most polluted.
What Is important for Nurses to obtain from the patient for Long Term Management of Asthma before educating the patient?
Obtain health & medication history
Things that trigger lifestyle, environment, and work.
Study Tip: Teaching self-care Education is Key
Why does the medication Beta Blockers cause an Asthma exacerbation?
Beta-blockers causes bronchoconstriction which may increase risk for airway reactivity which causes bronchospasm,
Asthma Pathophysiology: Irritants causes a cascade effect which stimulates the inflammatory response. The Immune system is then activated. IgE is produced. ______degranulate. The granules are made up of cellular mediators. Cellular Mediators cause Inflammation which leads to Vasodilation and increased capillary permeability which leads to cellular infiltration which causes ___________, ___________, Mucus Secretion (which further clogs airways), _____________(causes patient not to be able to clear the airways). Thickening of airway walls (also called remodeling the lungs). Leads to bronchiole hyper responsiveness and airway obstruction.
Mast cells
Bronchospasm
Impaired mucocilliary function
Vascular congestion
People with asthma do not have changes in pulmonary tissue unless the asthma is not treated. This only occurs in untreated asthma patients. This also makes lungs less effective. What is this abnormal reaction to asthma called?
Airway Remodeling
Study Tip: Thickening of the walls of the bronchioles which decreases the size of the lumen.
Can someone die from asthma?
Patients can die from an asthma attack if the ineffective airway clearance is not resolved.
Why does the medication Aspirin cause an Asthma exacerbation?
Some people with asthma cannot take aspirin because of what’s known as Samter’s triad which is a combination of asthma, aspirin sensitivity, and nasal polyps. Nasal polyps are small growths that form inside the nasal cavity.
Name the 7 medications that you would administer to a patient with Asthma?
- Beta 2 Agonists Bronchodilators
- Anti-Cholinergic Bronchodilators
- Mast Cell Inhibitors
- Mast cell stabilizers
- Corticosteroids
- Theophylline Bronchodilators
- Singulair Leukotriene Receptor Blockers
Study Tip: Mast Cell Inhibitors and Mast cell Stabilizers: Both Prevent Inflammation
What are the 4 most common signs and symptoms of asthma?
S/Sx: Wheezing, Breathlessness, Tightness in their chest, Cough especially at Night (caused by PNS bronchoconstriction).
What are 3 priority Independent Interventions that a nurse is required to implement for Acute Management of Asthma?
- Re-Positioning? High-fowlers allows for more effective lung expansion ALLOWS FOR MORE EFFECTIVE LUNG EXPANSION
- Breathing techniques. Educate the patient to use Pursed Lip Breathing and Diaphragmatic Breathing
- Do NOT leave the patient.
Study Tip: Always Stay calm. DO NOT PANIC! If you panic your patient will panic if you feel yourself panicking get assistance from another nurse.
Asthma attacks can be abrupt or gradual and they can also last from a few minutes to a few hours. Asthma normally has an onset of before the age of ______. Usually is also usually seen in ______ gender patients. Between asthma attacks the patients lungs may seem fine and have normal or near normal functioning.
12
Males
Name the 5 Collaborative Interventions required to treat a patient with asthma?
- IV fluids (Hydration to Decrease Secretions)
- Medication (Beta 2 Agonists & Ect.)
- Intubation if airway closes (If Necessary)
- Oxygen Therapy (O2 via NC to Hyperoxygenate)
- Respiratory Therapy (Can Administer SVN Treatment)
What 4 pharmacological medications can cause an Asthma exacerbation?
NSAIDS, Beta Blockers, GERD, ACE inhibitors (causes a cough),
An increase in secretions can cause a patient to cough due to increased mucus. If your patient can’t cough or experiences diminished or absent breath sounds (if they stop wheezing) during an asthma exacerbation that is a sign that your patient is going into __________ because they are not even moving enough air to wheeze. If this happens to your patient you need to do something fast.
Respiratory Failure
Why do the medication NSAIDS cause an Asthma exacerbation?
Some people with asthma cannot take NSAIDs because of what’s known as Samter’s triad which is a combination of asthma, aspirin sensitivity, and nasal polyps. Nasal polyps are small growths that form inside the nasal cavity.
What is Asthma?
Chronic intermittent inflammatory disorder of the airways. Inflammation causes a vicious cycle. Chronic inflammation causes the airways to be very sensitive causing them to hyper-respond to triggers. Asthma patients will have an exaggerated response to stimulus.
Study Tip: A normal person can walk through a cloud of dust and sneeze and the irritant will go away. When this happens to someone in asthma they will have bronchoconstriction and wheezing.
______ is prolonged in asthma patients.
Expiration
Normally Inspiration and Expiration has a 1:2 ratio. Asthma has a 1:4 ratio. Air trapping causes hyper-inflation of the lungs which will cause the patient’s lungs to retain Co2 because they cannot blow it off. This can cause what fluid and electrolyte imbalance?
Respiratory Acidosis
The diaphragm is the main muscle of breathing. It’s supposed to do most of the work. When you have COPD, the diaphragm doesn’t work as well and muscles in the neck, shoulders and back are used. These muscles don’t do much to move your air. Training your diaphragm to take over more “work of breathing” can help.
What type of breathing technique does this define?
Diaphragmatic Breathing
Study Tip: How to do a diaphragmatic breath:
- Sit or stand in a comfortable position with your back straight and your feet flat on the floor.
- Slowly inhale through your nose, counting slowly to 4.
- Slowly exhale through the mouth, counting slowly to 6.
- That’s it! Repeat several times.
Not Common Practice because once patients stop doing the exercise, they revert back to their usual way of breathing. Trying to teach someone to diaphragmatic-breathe or breathe with their belly probably doesn’t work because your mind will take you back to a way that’s less taxing for your abdominal muscles.
