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N233 > Module 3 Part 2: Asthma, bronchiolitis, RSV > Flashcards

Module 3 Part 2: Asthma, bronchiolitis, RSV Flashcards

1
Q

what is bronchiolitis?

A

inflammation of the fine bronchioles and small bronchi - lower respiratory tract infection

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2
Q

what is bronchiolitis usually caused by?

A

viruses, particularly respiratory syncytial virus (RSV)

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3
Q

who is at a higher risk of bronchiolitis? (theres a looot)

A
  • those who are immunocompromised
  • those who live in colder areas of the world (inc. risk in the winter seasons)
  • born in winter months (Nov, Dec, Jan)
  • children with siblings in daycare
  • low birth weight
  • males
  • formula fed
  • eczema family history
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4
Q

what is the most frequent cause of hospitalization in children under 2 years?

A

RSV

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5
Q

which group is RSV more prominent in in Canada?

A

Indigenous populations in Northern Canada

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6
Q

what other respiratory disease is RSV linked to?

A

asthma

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7
Q

how long can RSV live on the surface? what about the hands?

A

surface: several hours
hands: 30 mins

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8
Q

what are the initial mnfts of RSV?

A
  • rhinorrhea (nasal cavity filled with lots of mucus)
  • phayngitis
  • coughing
  • wheezing
  • eye/ear drainage
  • intermittent fever
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9
Q

what are the progressive mnfts of RSV?

A
  • increased coughing and wheezing
  • tachypnea and retractions
  • cyanosis
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10
Q

what are the severe mnfts of RSV? what should you do if these occur?

A
  • tachypnea (over 70bpm)
  • listlessness (inactivity)
  • apnea
  • poor air exchange
  • decrease breath sounds
  • **YOU MUST TAKE THEM TO EMERGENCY **
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11
Q

what do you assess for with RSV?

A
  • colour
  • movement
  • work of breathing
  • auscultations
  • secretions
  • hydration
  • caregivers??
  • intake/output
  • weight
  • resps greater than 55/min?
  • nutritional status
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12
Q

what movement would you assess for RSV?

A

head bob

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13
Q

what would you assess for work of breathing for RSV?

A
  • resp rate
  • nasal flare
  • tracheal tug
  • in drawing/retractions
  • seesaw breathing
  • sounds - grunting, coughing, crying
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14
Q

what would you auscultate for during you RSV assessment?

A
  • stridor

- wheeze

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15
Q

what vital signs would you do for RSV?

A
  • HR
  • RR
  • temp
  • BP
  • O2
  • *weight
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16
Q

how is the diagnosis done for RSV?

A
  • nasopharyngeal swab - RSV antigen
  • chest x-ray hyperinflation
  • arterial blood gases
  • CBC, electrolytes
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17
Q

what are non-pham treatment for RSV?

A
  • treat sympt
  • adequate fluids
  • a/w management
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18
Q

what are pharm management for RSV?

A
  • cool humidified O2
  • antipyretics
  • supplemental humidified oxygen
  • bronchodilator epinephrine nebs
  • 3% NS nebs
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19
Q

what are some nursing interventions for RSV?

A
  • droplet precautions
  • grouping other RSV patients together
  • nurses with RSV patients, limit contact with non-RSV pts
  • frequent monitoring
  • health promotion
  • meds
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20
Q

what is a good health promotion topic for parents with children with RSV?

A

limit smoking in the home

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21
Q

what is the pharmacological goal for RSV?

A
  • prevent and control symptoms -reduce freq and severity of exacerbations
  • improve health status
  • improve exercise tolerance
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22
Q

what are nursing considerations for the pharmacology of RSV?

A
  • pre/post resp assessment
  • adverse effects
  • patient teaching
  • lifespan considerations
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23
Q

what is a pulmonary function test (PFT)?

A

a test done to assess respiratory function

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24
Q

what are PFTs used?

A
  • to stage COPD (1-4)
  • to determine whether obstruction or restrictive condition
  • to determine if treatment is effective
  • may be used with patient history, ABGs, and chest x-ray for diagnoses
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25
Q

what is forced expiratory volume (FEV1)?

A

volume of air forcibly blown out in one second after a full inspiration

26
Q

what is forced vital capacity (FVC)?

A

volume of air that can be forcefully blown out after a full inspiration

27
Q

what is one example of when you would use FVC?

A

discharging a patient with asthma

28
Q

what is FEV1/FVC? (divide the two)

A

percentage of your forced vital capacity that is expelled in 1 sec?

29
Q

what do restrictive lung conditions cause?

A

-difficulty in lung expansion

30
Q

what are examples of intrinsic restrictive lung conditions?

A
  • pneumonia
  • fibrosis
  • lobectomy
31
Q

what are examples of extrinsic restrictive lung conditions?

A
  • pregnancy
  • obesity
  • ascites
32
Q

what do obstructive lung conditions cause?

A
  • difficulty exhaling

- narrowing of a/w

33
Q

what conditions are an example of obstructive lung conditions?

A
  • COPD

- asthma

34
Q

is FEV1 and FEV1/FVC low or high in COPD? what is this used for?

A

low - this is used to stage the progression

35
Q

is FEV1/FVC low or high in asthma?

A

low - but improves significantly after receiving a bronchodilator

36
Q

what are predisposing factors of asthma?

A
  • female

- atopy

37
Q

what are causal factors of asthma?

A
  • exposure to indoor and outdoor allergens

- occupational sensitizers

38
Q

what are contributing factors of asthma?

A
  • resp infections
  • air pollution
  • active/passive smoking
  • other (diet, small size @ birth)
39
Q

describe BRIEFLY the patho of asthma

A

hyper-responsiveness to airways which leads to airway limitation

40
Q

what are the symptoms of asthma?

A
  • wheezing
  • cough
  • dyspnea
  • chest tightness
41
Q

what are the risk factors for asthma exacerbations?

A
  • allergens
  • resp infect
  • exercise and hyperventilation
  • weather changes
  • exposure to sulphur dioxide
  • exposure to food, additives, medications
  • stress
  • gastroesophageal reflux
42
Q

what are the S&S of asthma exacerbations?

A
  • may begin abruptly
  • often proceeded by increasing symptoms over the previous few days
  • inc. effort with expiration
  • diaphoresis
  • tachycardia
  • severe hypoxia is rare, but lit threatening
43
Q

what are possible complx of asthma?

A
  • status asthmaticus
  • resp failure
  • pneumonia
  • atelectasis
  • a/w obstruction, especially in acute episodes
44
Q

what are the short-term meds for asthma?

Aziz mentioned to MAKE SURE you know these

A

-short-acting beta adrenergic agonists

45
Q

wha are the long-acting meds for asthma?

Aziz mentioned to MAKE SURE you know these

A
  • inhaled corticosteroids
  • long-acting beta1-adrenergic agonist
  • anticholinergics
  • xanthins
  • leukotriene modifiers
46
Q

what are the goals for care with patients with asthma?

A
  • participate in ADLs, including exercise and other physical activity
  • normal to near-normal pulmonary function
  • asthma under control
  • as few SE from meds as possible and take the lowest dose required
  • possess knowledge and skills to manage their asthma
47
Q

what is the nursing management for patients with asthma?

A
  • asthma education
  • environmental control
  • self-monitoring and action plans
  • monitor resp status: severity of sympt, breath sounds, peak flow, O2 sats, VS
48
Q

how does asthma differ from other resp diseases?

A
  • largely reversible

- spontaneous

49
Q

what age is asthma most common at?

A

can occur at any age - most common in childhood

50
Q

what are the most common allergens that cause asthma?

A
  • seasonal

- perennial (eg. mold, dust)

51
Q

when are asthma attacks most common? why do we think this is?

A

late at night or early in the morning. possibly d/t circadian rhythm

52
Q

does wheezing happen during inspiration or expiration with asthma?

A

at first it’s with expiration, then with inspiration as well

53
Q

what are the S&S of exercise induced asthma?

A
  • worse during exercise
  • no nocturnal symptoms
  • a choking feeling during exercise
54
Q

what histories are important for diagnosing asthma?

A
  • family
  • environmental
  • occupational
55
Q

what skin conditions may also present with asthma?

A
  • rashes
  • eczema
  • temporary edema
56
Q

what type of WBC may be elevated in asthma?

A

eosinophils

57
Q

what antibody may be elevated with asthma?

A

IgE (if caused by allergies)

58
Q

what prevention techniques can be used for asthma?

A

-identification of substances that precipitate the sympts and avoid them

59
Q

why is immediate intervention during an exacerbation required?

A

because the continuing and progressive dyspnea leads to increased anxiety, aggravating the situation

60
Q

what is status asthmaticus?

A
  • complx of asthma
  • severe and persistent asthma that does not respond to conventional therapy
  • can happen with little to no warning and progresses fast

N233 (6 decks)

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