exam 2 study guides Flashcards by Logan Kaiser

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

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What are the three types of inhalation drug devices?

nebulizers, pressurized metered-dose inhaler (pMDI), and dry powder inhalers (DPIs)

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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

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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

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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

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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.

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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.

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Why are drugs for asthma and COPD given by inhalation?

the medicine quickly reaches the airways and less is absorbed into the bloodstream.

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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

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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

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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)

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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)

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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

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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

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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

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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

 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

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.

10. 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

12. 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)