Exam 2 pulmonary part 2

Question 1

Pathophysiology of Asthma

Answer 1

Intermittent and reversible airflow obstruction affecting airways only, not alveoli

Question 2

Etiology of Asthma

Answer 2

• Inflammation:
  Caused by cold air, dry air, specific allergens, general irritants, microorganisms, aspirin
• Hyper-responsiveness:
  caused by exercise, URI, GERD, unknown reasons

Question 3

Asthma severity: Mild Intermittent- Class I

Answer 3

• Sx less than twice a week

Question 4

Asthma severity: Mild Persistent- Class II

Answer 4

Sx more than twice a week, but not daily

Question 5

Asthma severity: Moderate Persistent- Class III

Answer 5

Daily sx, with exacerbations twice a week

Question 6

Asthma severity: Severe Persistent- Class IV

Answer 6

Sx occur continually with frequent exacerbations

Question 7

Drug therapy for Asthma (Not the specific names): Preventive therapy (controller drugs)

Answer 7

• Change airway responsiveness to prevent asthma attacks

- Used every day, regardless of symptoms

Question 8

Drug therapy for Asthma (Not the specific names): Rescue Drugs

Answer 8

Actually stop attack once it has started

Question 9

Albuterol; Salmetrol

Answer 9

• Short- and long-acting beta2 agonists
• Bronchodilator
• Main rescue inhaler (Albuterol)

Question 10

Ipratroprium bromide

Answer 10

• Cholinergic antagonists

- Bronchodilator

Question 11

theophylline

Answer 11

• Methylxanthines

- Bronchodilator

Question 12

Fluticasone, prednisone

Answer 12

• Corticosteroids

- Anti-inflammatory agents

Question 13

nedocromil

Answer 13

• Cromones

- Anti-inflammatory agents

Question 14

montelukast

Answer 14

• Leukotriene modifiers

- Anti-inflammatory agents

Question 15

Status Asthmaticus

Answer 15

Severe, life-threatening, acute episode of airway obstruction

Intensifies once it begins, often does not respond to common therapy

Patient can develop pneumothorax and cardiac/respiratory arrest

Question 16

Chronic Obstructive Pulmonary Disease (COPD)

Answer 16

• Characterized by bronchospasm and dyspnea

- Tissue damage not reversible; increases in severity, eventually leads to respiratory failure

Question 17

Emphysema

Answer 17

• Loss of lung elasticity and hyperinflation of lung
• Dyspnea
  need for increased respiratory rate
• Air trapping
  caused by loss of elastic recoil in alveolar walls, overstretching and enlargement of alveoli into bullae, collapse of small airways (bronchioles)

Question 18

Chronic Bronchitis

Answer 18

Inflammation of bronchi and bronchioles caused by chronic exposure to irritants, especially cigarette smoke

Question 19

Chronic Bronchitis symptoms

Answer 19

• Inflammation, vasodilation, congestion, mucosal edema, bronchospasm
• Affects only airways, not alveoli
• Production of large amounts of thick mucus

Question 20

Chronic Obstructive Pulmonary Disease (COPD) etiology

Answer 20

• Cigarette Smoke
  First, second & third hand smoke
• Advanced Age
• Alpha1-antitrypsin (AAT) deficiency (important)
• Exposure to air pollution

Question 21

Chronic Obstructive Pulmonary Disease (COPD) complications

Answer 21

• Hypoxemia/tissue anoxia
• Acidosis
• Respiratory infections
• Cardiac failure, especially cor pulmonale
• Cardiac dysrhythmias

Question 22

Laboratory Assessment of COPD

Answer 22

• ABG values for abnormal oxygenation, ventilation, acid-base status
• Sputum samples
• CBC
• Hemoglobin and hematocrit (up)
• Serum electrolytes
• Serum AAT
• Chest x-ray
• Pulmonary function test

Question 23

COPD interventions

Answer 23

• Improve oxygenation and reduce carbon dioxide retention
• Prevent weight loss
• Minimize anxiety
• Improve activity tolerance
• Prevent respiratory infection

Question 24

COPD drug therapy

Answer 24

• Beta-adenergic agents
• Cholinergic antagonists
• Methylxanthines
• Corticosteroids
• NSAIDs
• Mucolytics

Question 25

Chest tube Chambers: Chamber 1

Answer 25

collects fluid draining from patient

Question 26

Chest tube Chambers: Chamber 2

Answer 26

water seal prevents air from re-entering patient’s pleural space

Question 27

Chest tube Chambers: Chamber 3

Answer 27

suction control of system