exam 2 learning objectives

Question 1

Explain how the autonomic nervous system controls airflow in the bronchial tree and how this can be modified with drugs.

Answer 1

Sympathetic innervation causes relaxation of bronchial smooth muscle via beta-2 receptors, which causes an increase in airway diameter to allow more airflow.

Question 2

Describe the anatomy and physiology of the upper and lower respiratory system.

Answer 2

The upper respiratory tract (upper airway) consists of the nose, mouth, sinuses, pharynx (upper section of the throat), and larynx (voice box).

The lower respiratory tract consists of the trachea (windpipe), bronchial tubes, and lungs.

Question 3

List non-drug measures which can be used to ease breathing and promote comfort in a patient with respiratory disease.

Answer 3

fluids

tea

humidifier

head up

positional changes

Question 4

Use the Nursing Process to care for patients who are receiving pharmacotherapy for respiratory disorders.

Answer 4

Assessment
 Is it appropriate to give this medication?
 Assess respiratory status

 Diagnosis
 Activity intolerance r/t bronchoconstriction,
increased mucus and ineffective cough

 Planning
 Patient will demonstrate methods of controlled
breathing technique to conserve energy daily
or when short of breath.

 Implementation
 Administer appropriate medications,
demonstrate breathing exercises, etc.

 Evaluation
 Are the medications and interventions
working?

Question 5

6.1. cite the classifications and actions of antimicrobial drugs

Answer 5

Narrow-spectrum antimicrobial
 Will treat either gram-positive or negative bacteria
 Targets only specific subsets of bacterial pathogens

 Broad-spectrum antimicrobial
 Will treat both gram-positive and negative bacteria
 Often used to cover infections while waiting on lab
analysis
 Increased risk for SUPERINFECTION
 A secondary infection caused by the primary treatment,
killing protective bacteria along with infectious bacteria
 Yeast infections
 Clostridium difficile (C-diff)
 Encouraged probiotics while taking antibiotics

 Bacteriostatic
 Supresses bacterial growth– may not eliminate bacteria

 Bactericidal
 Targets and kills the bacteri

Question 6

6.2. give examples of when, how and to whom antimicrobial drugs may be administered

Answer 6

oral - tablets, capsules or liquids that treat most mild to moderate infections. topical – creams, lotions, sprays or drops that treat skin infections. injections – given directly into the blood or muscle for more serious infections.

Question 7

6.3. identify the side effects and special considerations associated with antimicrobial therapy

Answer 7

Half-Life
 Timing of administration ensures therapeutic levels remain in the bloodstream
 May require interval or repeated dosing
 A longer half-life can also be a concern for serious side effects for a longer period-
of-time

 Labs
 Liver Function
 Kidney Function
 Peak / Trough

 Dose Dependency
 More significant killing of the bacterial with increasing levels of the antibiotic

 Time Dependency
 Exert the greatest effect at a lower dose by binding to the microorganism for an extensive length of time

 Route
 Allergies
 Drug Interactions
 Synergistic interaction
 Improved effect when two drugs are combined
 Antagonistic interaction
 Decreased drug activity, therapeutic levels, and potential for toxicity when two drugs are
combined

Question 8

6.4. identify considerations and implications of using antimicrobial medications across the life span

Answer 8

dosage and route of administration

Other considerations include the patient’s age, mass, ability to take oral medications, liver and kidney function, and possible interactions with other drugs the patient may be taking

Question 9

6.5. apply evidence-based concepts when using the nursing process

Answer 9

Nursing Process
 Assessment
 Assess for signs and symptoms of infection
 Focused assessment depending on infection
 Vitals, labs, allergies/interactions, signs of
sepsis?
 Diagnosis
 Impaired urinary elimination r/t urinary tract
infection AEB painful voiding
 Planning
 Patient will maintain balanced I&O with clear,
odorless urine by completion of antibiotics.
 Implementation
 Administer appropriate medications, teach s/s
of UTI, prevention measures, s/e of med, etc.
 Evaluation
 Are the medications and interventions working?
Labs improving? Complications?

Question 10

6.6. identify indications, side effects and potential drug interactions associated with the use of herbal supplements

Answer 10

allergic reactions, rashes, asthma, headaches, dizziness, agitation, dry mouth, seizures, fatigue, tachycardia, nausea, vomiting, and diarrhea.

Question 11

labs

Answer 11

Liver Function
 Kidney Function
 Peak / Trough