exam 2 study guides Flashcards
List the anatomical structures of the respiratory system and identify the function
of each structure.
Conducting Zone
Nasal Cavity
Pharynx
Trachea
Bronchi
Most Bronchioles
Purpose is to provide a route for air, remove
debris, warm and humidify a
Bronchioles
Alveolar Ducts
Alveolar Sacs
Purpose is to perform gas exchang
What are the three types of inhalation drug devices?
nebulizers, pressurized metered-dose inhaler (pMDI), and dry powder inhalers (DPIs)
List the patient education needed for using inhalers.
Prime inhaler prior to INITIAL use
2) Activate the canister at the beginning of a slow deep breath
3) Press down on the inhaler quickly to release the
medicine as you start to breathe in slowly for 3 to 5
seconds
4) Then hold your breath for 10 seconds to allow medicine to go deeply into your lungs
5) Breathe out slowly
6) Wait 2 minutes between inhalation
What are some of the common causes of asthma?
inflammation, edema, and bronchospasm of the airways, which inhibits air from entering the lungs.
- Excessive mucus secretion can occur, contributing to airway blockage.
- Immune system cells can infiltrate the walls of the bronchi and bronchiole
What are the differences between asthma and COPD?
COPD-Chronic inflammatory lung disease that causes obstructed airflow out of the lungs
asthma is diifucitly breathing
COPD is more serious and is a lot harder ti breath in
asthma prevents it from coming in,copd prevents it from going out
What is the difference between a preventer and reliever? Describe how each
would be used.
Preventers – that slowly make the airways less sensitive to triggers by reducing swelling and mucus inside the airways. This medication is taken daily.
Relievers – that act quickly to relax the tight muscles around the airways and are used when symptoms breakthrough, despite good asthma management.
What is the difference between first- and second-generation antihistamines?
First-generation antihistamines block both histaminic and muscarinic receptors as well as passing the blood-brain barrier.
Second-generation antihistamines mainly block histaminic receptors and do not pass the blood-brain barrier.
Why are drugs for asthma and COPD given by inhalation?
the medicine quickly reaches the airways and less is absorbed into the bloodstream.
Allergic Rhinitis
What is it
Causes/ Triggers
Assessment findings
Interventions-
Pharmacological & Non-
pharm
Patient Teaching
What is it –Immune reaction to foreign substance. Creates antibodies, causing inflammatory response
Causes/ Triggers-hay fever, food allergy, insect bite, drug allergy, aczcems
Antihistamines
* Diphenhydramine
* Cetirizine
Corticosteroid
* Fluticasone
* Prednisone
* Severe
Asthma
What is it
Causes/ Triggers
Assessment findings
Interventions-
Pharmacological & Non-
pharm
Patient Teaching
What is it
Inflammation, edema, and bronchospasm of the airways, which inhibits air from entering
the lungs.
- Excessive mucus secretion can occur, contributing to airway blockage.
- Immune system cells can infiltrate the walls of the bronchi and bronchioles
triggers
Dust
* Pollen
* Pet hair or dander
* Changes in the weather
* Mold
* Tobacco smoke
* Respiratory infections
* Exercise
* Stress
treatment-albuterol
COPD
What is it
Causes/ Triggers
Assessment findings
Interventions-
Pharmacological & Non-
pharm
Patient Teaching
hronic inflammatory lung disease that causes obstructed airflow out of the lungs
Two types: Emphysema and Chronic Bronchitis
Chronic – treatable but not curable
Triggers:
Irritating gases or dust
Smoking
Symptoms:
Shortness of breath
Chest tightness
Cough
Mucus (sputum) production (clear, white, yellow or green)
Cyanosis
Frequency respiratory infections
Lack of energy
Unintended weight loss (later stages)
Wheezing
Treatment:
Expectorant (guaifenesin)
Anticholinergic (tiotropium)
Corticosteroids (prednisone)
Xanthine derivative (theophylline)
Common cold
What is it
Causes/ Triggers
Assessment findings
Interventions-
Pharmacological & Non-
pharm
Patient Teaching
iral infection of the upper respiratory tract
Symptoms appear 1 – 3 days after exposure
Children <6 are at greatest risk
Recover in a week or 10 days
Symptoms:
Runny or stuffy nose
Sore throat
Cough
Congestion
Slight body aches or a mild headache
Sneezing
Low-grade fever
Generally feeling unwell (malaise)
Treatment:
Expectorant (guaifenesin)
Decongestant (pseudoephedrine)
Antitussives (dextromethorphan)
albuterol
MOA
Patient teaching
side effects
Mechanism of Action:
- Stimulate beta-2 adrenergic receptors of bronchi
and bronchioles producing bronchodilation. Beta-1
receptors can inadvertently cause tachycardia.
Adverse/Side Effects:
- Muscle tremors
- Excessive cardiac stimulation
- CNS stimulation
Patient Teaching/Education:
- SABA is for use in acute asthma attack
- LABA is NOT for acute asthma attack
- Take as directed
- Prime inhaler prior to first use
- Rinse mouth d/t unusual taste
theophylline
MOA
Patient teaching
side effects
Mechanism of Action:
- Relaxes bronchial smooth muscle by inhibition of the
enzyme phosphodiesterase and suppresses airway
responsiveness to stimuli that cause bronchoconstriction.
Adverse/Side Effects:
- Nausea / vomiting
- CNS stimulation
- Nervousness
- Insomnia
Patient Teaching / Education:
- Avoid caffeine
- Requires evaluation of therapeutic blood levels to
prevent toxicity
- Drink fluids to thin secretions, avoid irritant
guaifenesin
MOA
Patient teaching
side effects
Mechanism of Action:
- Reduces viscosity of thick secretions by irritating the gastric vagal receptors that stimulate the respiratory tract fluids (thin secretions)
Nursing Considerations:
- Safe for all ages
- Only recommended in pregnancy when benefit outweighs risk
Adverse/Side Effects:
- Skin rash
- Headache
- Nausea
- Vomiting
Patient Teaching/Education:
- Increase hydration (thins secretions)
- Avoid irritants that stimulate coughing
- Can cause drowsiness
- Avoid alcohol and other CNS depressan
Ipratropium
MOA
Patient teaching
side effects
Mechanism of Action:
- Blocks the action of acetylcholine in bronchial smooth muscle, reducing bronchoconstrictive substance release.
Adverse/Side Effects:
- Use caution with the elderly
- May cause cough, drying of the nasal mucosa,
nervousness, nausea, GI upset, headaches, and
dizziness.
- Long-acting may cause angioedema
Patient Teaching/Education:
- Short-acting is for rapid bronchodilation
- Long-acting is for prevention of bronchospasms and
reduces exacerbation of COPD
- Take as directed, do not exceed max dose
diphenhydramine
MOA
Patient teaching
side effects
Mechanism of Action:
- Blocks histamine at H1 receptors; inhibits smooth muscle constriction in the blood vessels, respiratory and GI tracts; decreases capillary permeability, salivation and tear formation
Nursing Considerations:
- Do not use in children < 2 years old
Adverse/Side Effects:
- Can cause anticholinergic effects (dry mouth, UA retention, constipation, and blurred vision)
- Use caution in elderly patients (CNS depression or stimulation)
- May cause headache, N/V, dysmenorrhea, and fatigue
Patient Teaching/Education:
- May cause drowsiness
- Caution with positional changes
- Do not drive or operate heavy equipment
- Avoid alcohol and other CNS depressants
- Take only recommended amount / do not exceed max dose
fluticasone
MOA
Patient teaching
side effects
Mechanism of Action:
- Locally acting anti-inflammatory and immune modifier.
Nursing Considerations:
- Fluticasone safe over 4yo, others safe for all ages
Adverse/Side Effects:
- May cause hoarseness, dry mouth, cough, sore throat, and oropharyngeal candidiasis (thrush)
- CV: Fluid retention, edema, and hypertension
- Can cause an increased blood glucose with associated weight gain
- CNS: Mood swings and euphoria
- GI: Nausea, vomiting, and GI bleed
- Increased risk for fractures, bruising, thin skin, delayed wound healing, masked infections, and risk for infection in long-term use
- Never stop abruptly because adrenal insufficiency may occur
- Oral/IV: Prevents inflammation = Immunosuppresion
- Decreased WBC – should avoid large crowds
Patient Teaching/Education:
- Rinse and spit after inhaler use d/t risk of thrush
cetirizine
MOA
Patient teaching
side effects
Mechanism of Action:
- Blocks histamine at H1 receptors; inhibits smooth muscle constriction in the blood vessels, respiratory and GI tracts; decreases capillary permeability, salivation and tear formation
Nursing Considerations:
- Do not use in children < 2 years old
Adverse/Side Effects:
- Can cause anticholinergic effects (dry mouth, UA retention, constipation, and blurred vision)
- Use caution in elderly patients (CNS depression or stimulation)
- May cause headache, N/V, dysmenorrhea, and fatigue
Patient Teaching/Education:
- May cause drowsiness
- Caution with positional changes
- Do not drive or operate heavy equipment
- Avoid alcohol and other CNS depressants
- Take only recommended amount / do not exceed max dose
montelukast
MOA
Patient teaching
side effects
Blocks leukotriene receptors and decreases inflammation
teaching
Take at the same time each day, at least two hours prior to exercise – NOT A RESCUE MED!
- Do not discontinue without notifying PCP
- Takes 3 – 7 days for desired effect
Side effects
Headache
- Cough
- Nasal congestion
- Nausea
- Hepatotoxicity
Beta-adrenergic agonists
Used prevent and treat
bronchospasms (asthma,
airway disease, E-I asthma
Stimulate beta-2 adrenergic receptors of bronchi
and bronchioles producing bronchodilation. Beta-1
receptors can inadvertently cause tachycardia
Methylxanthines
a purine-derived group of pharmacologic agents that have clinical use because of their bronchodilatory and stimulatory effects.
Anticholinergics
Used for maintenance therapy
of bronchoconstriction
(asthma, chronic bronchitis,
and emphysema
Blocks the action of acetylcholine in bronchial smooth muscle, reducing bronchoconstrictive substance release.
Glucocorticoids
anti-inflammatory in all tissues, and control metabolism in muscle, fat, liver and bone. Glucocorticoids also affect vascular tone, and in the brain influence mood, behaviour and sleep‒wakefulness cycles
Leukotriene modifiers
Used for the long-termccontrol of asthma, decreasing
the frequency of asthmacattacks. Also, for exercise-induced bronchospasm and allergic rhinitis
Blocks leukotriene receptors and decreases inflammation
Mucolytics
drugs belonging to the class of mucoactive agents. They exert their effect on the mucus layer lining the respiratory tract with the motive of enhancing its clearance.
Expectorants
Used for productive cough
and loosening mucus from
the respiratory tract
Reduces viscosity of thick secretions by irritating the gastric vagal receptors that stimulate the respiratory tract fluids (thin secretions
Antihistamines
Used for relief of allergy or cold symptoms
Blocks histamine at H1 receptors; inhibits smooth muscle constriction in the blood vessels, respiratory and GI tracts; decreases capillary permeability, salivation and tear formation
Mast cell stabilizers
thought to prevent calcium influx across mast-cell membranes, thereby preventing mast-cell degranulation and mediator release.
- Intranasal sympathomimetics
used as nasal decongestants for the treatment of allergic rhinitis and conjunctivitis.
Antitussives
Used for dry, hacking, non-productive cough that
interferes with rest andsleep
Depresses the cough center in the medulla oblongata or thecough receptors in the throat, trachea, or lungs – elevating the threshold for coughing
- Nasal decongestants
Used to relieve nasal obstruction due to
inflammation/congestion in mucus membranes
Acts directly on adrenergic receptors and indirectly by
releasing epinephrine. Produces vasoconstriction, shrinking nasal mucosa
ALLERGIES
causes
treatments
worst case scenario
Hay Fever, Food Allergy, Insect Bite, Drug Allergy, Atopic Dermatitis (eczema
ANTIHISTAMINES
* Diphenhydramine
* Cetirizine
CORTICOSTEROIDS
* Fluticasone
* Prednisone (severe only
ANAPHYLAXIS
* Life-threatening
* Emergency
* Can lead to shock
Cough/cold
symptoms/types
treatment
greatest risk
Runny nose/stuffy nose
Sore throat
Cough/congestion
Body aches/headache
Low-grade fever
Maiaise (feeling unwell
Non-pharmacological
Expectorant (guaifenesin)
Decongestant (pseudoephedrine)
Antitussive (dextromethorphan
children under 6
asthma
symptoms/types
triggers
treatment
Mild
* Coughing, SOB, wheezing, chest tightness
Severe
* Trouble breathing, cyanosis, confusion, drowsiness, anxiety
Dust, pollen, pet hair/dander, temp changes, mold, smoke
Respiratory infxn, exercise, stres
Short-acting Beta-2 Agonist (abluterol)
Anticholinergic (ipratropium)
Long-acting Beta-2 Agonist (salmeterol)
Corticosteroid (fluticasone)
Leukotriene Receptor Antagonist (montelukast)
Xanthine Derivatives (theophylline)
bronchitis
symptoms/types
triggers
treatment
Acute- Virus, resolves in 10 days – cough, mucus, fatigue, SOB
Chronic-Never goes away – cough, mucus, fatigue, SOB
Virus/exposure to cold, irritating substances, smoke/ Smoking
Expectorant (guaifenesin)
Anticholinergics (tiotroprium) – COPD exacerbation
Corticosteroids (prednisone) – SEVERE
Xanthine Derivatives (theophylline) - COPD
CopD
Types????
Emphysema
Chronic Bronichitis
Triggers????
Irritating gases
Dust
Smoke
Symptoms????
SOB Lack of Energy
Chest tightness Unintended Weight Loss
Cough Wheezing
Mucus production Frequent Resp. Infections
Cyanosis
Treatment????
Non-pharmacological
Expectorant (guaifenesin)
Anticholinergic (tiotropium)
Corticosteroids (prednisone)
Xanthine Derivative
(theophylline)
