Gas Exchange

Question 1

What is the maintenance medication for asthma?

Answer 1

Fluticasone
Rescue: albuterol
Severe: ipatropium

Question 2

A patient admitted to the ICU 72 hours ago (breathing on their own, and alert) developed a productive cough and 103.2 fever 12 hours ago. What type of pneumonia would you suspect?

Answer 2

HAP
-immunocompromised = OP
-LOC/intubation/stroke/etc = AP
-earlier onset = CAP

Question 3

A client w/ a history of asthma presents to the clinic, A provider wants to assess the client’s asthma progression. What will be ordered?

Answer 3

-pulmonary function test

Question 4

A client w/ a S/S of CAP presents to the clinic. What will be ordered?

Answer 4

CBC and chest X-ray

Question 5

The two organs most affected in CF are:

Answer 5

-lungs, pancreas

Question 6

A female sex patient w/ CF is expected to have which of the following symptoms?
a. hyperglycemia
b. infertility
c. meconium ileus
d. weight loss

Answer 6

a) hyperglycemia (pancreatic/insulin production function impaired),

d) weight loss (malabsorption)

-infertility only affects male sex CF patients (Vas deferens clogged/missing)
-meconium ileus is present in fetus–possible diagnostic tool

Question 7

In people w/ CF, BMR (define this term) is typically ________.

Answer 7

-higher
-BMR = basal metabolic rate

Question 8

COPD:
-progresses _________
-leads to weight ________.
-smoking cessation _______ disease progression
-the ________-_____ breathing technique helps prolong exhalation
-________ is a common symptom because it takes for work to breathe.

Answer 8

-progresses slowly
-weight loss
-smoking cessation slows disease
-pursed-lip breathing
-fatigue

Question 9

Name three obstructive diseases that affect the respiratory system

Answer 9

-asthma
-COPD
-CF

Question 10

Is COPD preventable? Curable? Reversible?

Answer 10

-preventable yes, but not curable/reversible (progression CAN be slowed/stopped)
-primary risk factor: smoking (not causal, correlative)
-other risk factors: occupational, air pollution, asthma

Question 11

Pathophysiology of COPD

Answer 11

Irritation leads to:
-mucus overproduction –> airways narrow –> cilia function is affected

-destruction of alveoli –> scar tissue/rebuilding

-Chronic air flow limitation (air is stuck in lungs)

Question 12

Describe alveoli remodeling that happens w/ COPD

Answer 12

-alveoli slowly destroyed by air trapping
-bullae, blebs (large air spaces) formed instead–these are not effective in gas exchange

Question 13

Clinical manifestations of COPD

Answer 13

-cough/sputum/dyspnea
-wheezing/chest tightness
-anorexia/weight loss
-AP diameter: “barrel chested” (rib cage is partially expanded at all times, basically)
-fatigue
-tripod, pursed lip breathing
-hypoxemia, hypercapnia
-clubbing, polycythemia, cyanosis

Question 14

Describe the classifications of COPD

Answer 14

GOLD-
1. FEV > 80% (mild)
2. FEV 50-80% (moderate)
3. FEV 30-50% (severe)
4. FEV <30% (very severe)

Question 15

COPD Treatment

Answer 15

-vaccinations–flu, pneumonia
-smoking cessation
-bronchodilator medications (maybe before eating?)
-nutrition therapy
-exercise therapy

Question 16

COPD medications

Answer 16

-ipatropium, samuterol