fund nursing 51 - asthma

Question 1

asthma is

Answer 1

chronic but reversible. different that COPD. it’s really upper bronchi. intermittent airway obstruction. muscles around bronchioles tighten.

Question 2

mortality for emphaysmia and chronic bronchitis

Answer 2

Mortality is >50% within 10 years of diagnosis. we try to slow progression.

Question 3

chronic airway limiting diseases cause

Answer 3

and increase in CO2 so it causes hypercapnia

Question 4

asthma more common in women or men?

Answer 4

women, but kids it’s boys

Question 5

is alveoli affected with asthma?

Answer 5

nope, just bronchioles. triggered by an irritant. dust mites, smoke, etc. viral infections, nasal polyps. meds, emotional stress.

Question 6

asthma increases

Answer 6

work of breathing to maintain MV (minute volume - this is what gets rid of CO2)

Question 7

asthma and mucus?

Answer 7

Leads to an increased number and size of mucous glands and secretion of thick mucous

Question 8

during asthma attack, where does air get trapped? (A for asthma and alveoli)

Answer 8

the alveoli so we can’t bring down CO2 hypoxic and hypercapnic. also causes tachycardia from stress maybe.

Question 9

cholinergic receptors are what type of cells?

Answer 9

mast cells

Question 10

vitamins associated with asthma (Ce, you have asthma)

Answer 10

Diets low in vitamins C, E and omega-3 fatty acids, obesity

Question 11

asthma diagnosis

Answer 11

Diagnosis
History & Symptoms
PFTs – especially peak flow (spironmetry, pulse ox, use every morning, measuring expiratory volume)
Methacholine challenge test (MCT
Tests airway sensitivity to detect asthma
Increasing amounts methacholine inhaled causes airways to spasm and narrow if asthma present
Measures spirometry before & after and is + if FEV drops by 20% or more
Bronchodilator given at end of test to reverse effects

Question 12

asthma using peak volume flow - measures what?

Answer 12

expiratory volume

Question 13

Peak flow meter - how to use (peaking 3 times a day)

Answer 13

do 3 times take a break in between. do same time every day. sometimes twice a day.

Question 14

asthma meds - in order (SMAL AB - asthma meds are big A little A)

Answer 14

1) steroids
2) mast cell stablizers
3) antihistamines and leukotrienes
4) anticholeringenics and bronchodilators

Question 15

asthma listen to what part of lungs (asthma is everywhere)

Answer 15

brioch, bronchi-vesic, vesic.

Question 16

hydrate or not?

Answer 16

hydrate but don’t overhydrate. usually use a mask not cannula.

Question 17

CPAP expands what? (alvin with a cpap)

Answer 17

alveoli

Question 18

short acting meds - within 5 min (terol is shorty)

Answer 18

ending in terol, terbutaline and epinephrine

Question 19

long acting meds - within 20-30 min (salmon and meta are long)

Answer 19

salmetrol, metaproterononal tablets, and other tablets

Question 20

status ashtmatics in what respiratory state? (status is almost gone)

Answer 20

respiratory distress

Question 21

status asthmatics triggers (latin from fires and cold)

Answer 21

upper respiratory infection, wildfire, or exercising in cold

Question 22

meds to status asthmatics (maticus needs epi pen and maggie)

Answer 22

epinephrine, corticosteroids, magnesium sulfate (relax smooth muscle), terbutaline, leukotriene inhibitors (anti inflammatory)

Question 23

emphysema air gets trapped where?

Answer 23

alveoli, they get flattened out, bronchioles narrow.

Question 24

emphysema cough or not? (emphsymia is out the door too)

Answer 24

can’t cough, sleep with multiple pillows, prolonged expiratory

Question 25

chronic bronchitis definition (chronic addicts are 3 months or longer)

Answer 25

Becomes chronic > 3 months a year for 2 years. mucus trapping. can occur with emphasymia or alone.

Question 26

chronic bronchitis - blue bloater

Answer 26

wheezing, coughing, blue. digital clubbing. edematous.

Question 27

bronchietasis (elongating bronchitis, elongating airways)

Answer 27

can occur with cystic fibrosis. exposed to TB maybe or another pathogen. Resp infections are usually staph.

Question 28

bronchietasis is constriction or dilation?

Answer 28

dilated, filled with thick secretions. many infections. usually on antibotics. usually become resistant.

Question 29

bronchietasis symtoms (think bronchitis)

Answer 29

purulent sputum, hemoptysis, clubbing, SOB, wheezing and rhochi, don’t clear with coughing usually. fevers from infections. loss of appetite. lose cilia.

Question 30

bronchietasis treatment

Answer 30

fluids and nutrition, prevent RTI. bronchodilators, exportants, mucolytics. Pulmonary toilet/hygiene (percussion, postural drainage). oral care.

Question 31

what 3 things increase CO2 in COPD pts? (pink has high co2 from hal, vasoconstriction, and low mv)

Answer 31

Haldane effects
Hypoxic vasoconstriction
Decrease minute ventilation

Question 32

Haldane effects (hal is high in oxygen, so CO2 gets pushed aside to plasma and can’t blow it off)

Answer 32

desaturation of hemoglobin increases CO2 bonding, so it gets higher. High O2 displaces CO2, which makes it higher in plasma. pts can’t blow off the CO2 then. pH decreases and causes respiratory acidosis.

Question 33

in COPD pts, is there vasoconstriction with o2 administration? (O2 is usually a vasoconstrictor)

Answer 33

no, they don’t respond to oxygen administration and the V/Q doesn’t match. it just increases dead space and CO2.

Question 34

COPD O2 administration

Answer 34

Although patients with COPD & acute respiratory failure (ventilation failure)may increase PaCO2 with provision of oxygen:
Maintain O2 saturation at 90-93% with PaO2 of 60-70 mmHg
If PaCO2 rises, assist patient to blow off CO2
NIV or intubation with ventilator

Question 35

asthma med that is a mast cell stablizer (chrome mast)

Answer 35

Cromolyn sodium

Question 36

6 Ps of dyspnea

Answer 36

pulmonary bronchial constriction, foreign body obstruction, pneumonia, heart failure usually right side (left is pulmonary edema), pneumothorax, pump failure, (no breath sounds if lungs collapse)

Question 37

bullae

Answer 37

Bullae are enlarged airspaces that do not contribute to ventilation

Question 38

jugular vein distention - bronchiospasm or not?

Answer 38

nope

Question 39

main goal for COPD pt

Answer 39

provide sufficent O2

Question 40

lower respiratory drugs - Bronchodilators - BAM! you’re dilated

Answer 40

beta 2 agonist, anticholinergics, methylxathines

Question 41

lower respiratory drugs - Anti-inflammatory - SLM anti-inflammatories

Answer 41

steroids, leukotriene inhibitors, mast cell stablizers

Question 42

beta 2 agonists end in (B for beta, B for buterol)

Answer 42

buterol

Question 43

buterol is B for

Answer 43

brutal asthma attacks - 1st drug for severe asthma attacks. use before steroids.

Question 44

acute asthma attack is 3 drugs - AIM (in order)

Answer 44

albuterol, ipratroprium, methypredsidone (steroids act slow)

Question 45

if albuterol not working after how many puffs?

Answer 45

3, then notify provider

Question 46

albuterol ONLY cleaned

Answer 46

1 -2 times a week. STEROIDS (steroids go in sink) are washed after every use

Question 47

anticolinergics (dry you out) - end in what? (anti troops)

Answer 47

tropium - used for moderate asthma and COPD

Question 48

tropeeeem

Answer 48

you can’t pee with them

Question 49

methylxanthines end in (philleen the meth)

Answer 49

phylline - makes heart race

Question 50

phylline has you feelin

Answer 50

caffienated and toxic - take in am

Question 51

SLM - S for steroids = ends in

Answer 51

sone

Question 52

AIM for

Answer 52

acute

Question 53

order of lungs (Us, I, Ole)

Answer 53

trachea, bronchus, bronchi, bronchioles

Question 54

vesicular

Answer 54

soft and low - goes from loud to low

Question 55

what level of PaO2 warrants O2 administration for COPD? (Pa is 20 less than normal)

Answer 55

Give O2 when PaO2 < 55 mmHg & sat < 88%